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Complaint Investigation

Aventura At Humility House

Inspection Date: August 15, 2025
Total Violations 1
Facility ID 366186
Location AUSTINTOWN, OH
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Inspection Findings

F-Tag F0803

Nutrition and Dietary Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observation, record review, interview, review of the food committee meeting minutes and review of the facility policy, the facility failed to ensure dietary menus were followed. This affected one (Resident #13) of three reviewed for dietary concerns and had the potential to affect all residents receiving meals from the kitchen. The facility identified one (Resident #45) who did not consume anything by mouth. The facility census was 66. Findings include:Review of the medical record for Resident #13 revealed an admission date of 09/08/23 with diagnoses including diabetes, high cholesterol, arthritis and chronic pain. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE REDACTED] revealed Resident #13 was cognitively intact.

She was independent in eating, required supervision for oral hygiene and showers, partial assistance for personal hygiene and substantial assistance for toileting. Review of the food committee meeting minutes dated 07/03/25 revealed the residents were concerned the menu did not always match the meal being served. Review of the posted menu for breakfast dated 08/15/25 revealed breakfast would consist of hot or cold cereal, breakfast quiche and milk or juice. Observation of tray line on 08/15/25 at 7:37 A.M. revealed breakfast was being served which consisted of hot or cold cereal, scrambled eggs, yogurt and donuts.

Interview at the time of the observation with Dietary Manager #200 revealed he had to make some changes to the breakfast menu at the last minute. He revealed the changes had not been corrected on the master menu. Interview on 08/15/25 at 8:12 A.M. with Resident #13 revealed she did not get to choose what she wanted for breakfast, she was given whatever the kitchen served. She revealed she would prefer to know ahead of time what was being served, and she confirmed today's breakfast consisted of scrambled eggs and a doughnut. Interview 08/15/25 and 8:21 A.M. with the Administrator confirmed there were issues with

the facility following menus as posted. She verified this morning's breakfast menu should have been corrected and provided to residents when changes were made. Review of the facility policy titled Displaying

the Menu, dated 2023, revealed planned menus would be posted each week in an area where residents could view them and the food and nutrition services staff were responsible for posting revisions to the plan

the menu in a timely manner. This deficiency represents noncompliance investigated under Master Complaint Number 1344519 (OH00167046).

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date

these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

📋 Inspection Summary

AVENTURA AT HUMILITY HOUSE in AUSTINTOWN, OH inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in AUSTINTOWN, OH, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from AVENTURA AT HUMILITY HOUSE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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