Centerville Post Acute
Inspection Findings
F-Tag F0921
F 0921 Level of Harm - Potential for minimal harm Residents Affected - Many
FORM CMS-2567 (02/99) Previous Versions Obsolete
dark stain measuring approximately nine feet by four feet, leading toward the nurses' station. Five additional stains of varying sizes were present, ranging from small splatters to larger patches covering some of the tiles. A dark trail extended from the elevator along the right-hand side, with scattered blotches and heavy discoloration that suggested frequent foot traffic and liquid spills. Observation on 09/19/25 at 10:42 A.M. revealed the area outside the downstairs' main dining room had 10 carpet tiles with visible water damage and six with signs of wear and tear. A particularly egregious stain, dark and irregular in shape, stretched approximately eight feet by two feet, appearing as if liquid had been repeatedly spilled and left to soak into
the fibers. Observation on 09/19/25 at 10:45 A.M. revealed severe staining outside the nurses' station. The carpet was heavily discolored with dirt, shadowing and water stains in various shades of brown and gray. A four by one-foot dark stain was located near the nurses' cart, with ripple-like water stains extending beyond its edges. Near the water fountain, a dark blotch measuring approximately three by two feet was observed.
The flooring in front of the nurses' station was deeply worn and appeared saturated with soil. The area measured eight tiles in length and four tiles in depth. Observation on 09/19/25 at 10:44 A.M. revealed hallway 338, measuring 74 tiles in length by five in width, totaling approximately 370 tiles. A total of 43 tiles were soiled with shadowing, dark patches and embedded grime. The carpet showed signs of adhesive buildup and fiber breakdown, contributing to a dull and dirty appearance. Observation on 09/19/25 at 10:47 A.M. revealed hallway 332, measuring 65 tiles in length by five in width, totaling approximately 325 tiles. A total of 115 tiles were soiled. The carpet was scattered by widespread staining, adhesive residue and worn fibers. Observation on 09/19/25 at 10:49 A.M. revealed hallway 333, measuring 67 tiles in length by five in width, totaling approximately 335 tiles. A total of 69 tiles were soiled. The stains were varied in size and shape, with many appearing as dark blotches or sticky patches. The carpet was visibly worn and discolored. Observation on 09/19/25 at 10:50 A.M. revealed the front lobby area had a high-traffic zone around the desk with shadowing on the carpet measuring approximately two feet by eight feet. The discoloration was consistent with prolonged wear and heavy foot traffic. Interview on 09/19/25 at 10:58 A.M. revealed Maintenance Director #189 confirmed the facility was working on replacing the carpets. He could not specify when quotes were first requested but stated bids were currently being collected. He acknowledged the carpets were covered in numerous stains scattered throughout the facility. Interview on 09/19/25 at 10:59 A.M. revealed the Director of Nursing confirmed that all carpeted areas in the facility, including the main entrance, hallways 332, 333, 325, 338, 431 and a currently closed hallway, were stained throughout. The DON confirmed the facility had been working on getting new carpets throughout the facility since acquisition in February of 2025. Interview on 09/19/25 at 11:26 A.M. revealed HSM #661 confirmed
the carpets were soiled. Interview on 09/19/25 at 11:42 A.M. revealed Certified Nursing Assistant (CNA) #184, who stated she has worked at the facility for three months, stated that many items were dropped on
the carpets during meal service and other tasks. She noted that housekeepers try to clean the carpets, but
they were in such poor condition they cannot be salvaged. Interview conducted 09/19/25 at 1:38 PM with Resident #64 confirmed carpets in the hallway were very soiled, they have may stains and look very dirty.
Resident #64 voiced significant soiling outside the elevator stating the floor looks black. Review of the facilities homelike policy dated 02/2021 revealed residents are provided with a safe, clean, comfortable and homelike environment. The facility staff and management maximize, to the extent possible, the characteristics of the facility that reflect a personalized homelike setting. These characteristics include: a clean, sanitary and orderly environment. This deficiency represents non-compliance investigated under Complaint Number 2609903.
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CENTERVILLE POST ACUTE in CENTERVILLE, OH inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 CENTERVILLE, 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 CENTERVILLE POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.