Scioto Rehabilitation & Care Center

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, record review and policy review, the facility failed to notify the transfer of Resident #10 to their Power of Attorney (POA). This affected one (Resident #10) of three residents reviewed for transfers and notification to their POAs. The facility census was 91.Findings include : Review of the medical record for Resident #10, revealed an admission date of 08/16/25 and a transfer to the hospital date of 08/27/25.

Diagnoses included but were not limited to chronic kidney disease, stage 4, chronic obstructive pulmonary disease, chronic diastolic heart failure, and iron deficiency anemia. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed a Brief Interview for Mental Status (BIMS) of 13 out of 15 that suggested cognitive intactness. The resident was assessed to be independent with bed mobility, to require setup or clean-up assistance with toilet hygiene, supervision or touching assistance with transfers, and total dependence on shower/bathe self. This resident was also assessed to have heart failure.Review of the closed record for Resident #10 revealed an emergency contact to be the POA.Review of the progress note dated 08/27/25 at 6:37 A.M. revealed Resident #10 to be transferred to the hospital and the emergency contact/POA was not notified. Interview on 09/16/25 at 10:57 A.M. with the Director of Nursing verified when Resident #10 was transferred to the hospital on [DATE REDACTED] at 6:37 A.M. and the emergency contact/POA was not notified and should have been. Review of the facility policy titled Change

in a Resident's Condition or Status revised on May 2017 revealed a nurse will notify the resident's representative when it is necessary to transfer the resident to a hospital.This deficiency represents non-compliance investigated under Complaint Number 2611549 and Complaint Number 2609966.

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:

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

discontinue date of 09/09/25 for Resident #20 revealed for the right lower extremity: cleans with soap and water. Apply non-adherent contact layer and wrap with gauze and ace Monday, Wednesday, and Friday.Further review of the physician order dated 08/21/25, with a discontinuation date of 09/09/25 for this resident revealed for the left lower extremity: cleanse with soap and water. Apply foam dressing, wrap with kerlix and ace every Monday, Wednesday and Friday.Review of the Wound Consultant Wound Practitioner (WCNP) #777 visit dated 08/26/25 for Resident #20 revealed bilateral lower legs were stasis dermatitis and recommended bilateral lower legs have ammonia lactate applied and to be wrapped in an ace wrap daily.

Review of the physician's orders dated 08/26/25 through 09/01/25 for Resident #20 revealed no order for bilateral lower legs have ammonia lactate applied and to be wrapped in an ace wrap daily. Review of the WCNP #777's visit dated 09/02/25 for Resident #20 revealed to continue bilateral lower legs have ammonia lactate applied and to be wrapped in an ace wrap daily. Review of the physician's orders dated 09/02/25 through 09/08/25 for Resident #20 revealed no order for bilateral lower legs have ammonia lactate applied and to be wrapped in an ace wrap daily. Review of the WCNP #777's visit dated 09/09/25 for Resident #20 revealed to continue bilateral lower legs have ammonia lactate applied and to be wrapped in an ace wrap daily. Interview on 09/18/25 at 11:09 A.M. with the Assistant Director of Nursing verified Resident #20 did not receive the correct treatment for the bilateral lower leg extremities non pressure skin condition as recommended by WCNP #777. 3. Review of the medical record for Resident #300, revealed an admission date of 09/10/25. Diagnoses included but were not limited to acute kidney failure, anxiety disorder, type 2 diabetes, and muscle weakness. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed a Brief Interview for Mental Status (BIMS) of 15 out of 15 which suggested cognitive intactness. The resident was assessed to require supervision or touching assistance with bed mobility, transfers and total dependence on toilet hygiene. Review of the plan of care dated 09/18/25 for Resident #300 revealed an actual skin impairment related to surgical incisions to the midabdominal, right chest, left chest, and sternum with interventions included but not limited to initiate wound treatment and continue treatment as ordered by the physician/nurse practitioner. Review of the physician order dated 09/16/25 for Resident #300 revealed non-pressure skin condition treatment orders: cleanse midabdominal with normal saline, pat dry, apply silver alginate and cover daily and cleanse the right chest, left chest and sternum with normal saline, pat dry, apply silver alginate and cover with a dressing daily. Observation on 09/22/25 at 10:15 A.M. with the Assistant Director of Nursing of Resident #300's dressings to the non pressure skin alterations to the midabdominal, right chest, left chest and sternum area revealed all of them to have the date of 09/19/25. Verified the current date is 09/22/25 and verified the facility nursing staff are expected to date the dressings when they are changed, so the dressings have not been changed since 09/19/25.Interview on 09/22/25 at 10:21 A.M. with Resident #300 verified his dressings to the midabdominal, right chest, left chest and sternum have not been changed since last Friday (09/19/25) and only refused to have them changed once on Sunday (09/21/25), but no one came in to change them Saturday or even asked him. Review of the facility policy titled Skin and Wound Management revised January 2025 revealed nurses will ensure orders and treatment for skin and wounds are implemented as ordered. This deficiency represents non-compliance investigated under Master Complaint Number 2624710 and Complaint Number 2608381.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

be admitted to this facility with one surgical wound, one stage one pressure ulcer and one deep tissue injury.

Review of the progress note dated 07/01/25 at 9:19 P.M. created by the Wound Nurse #325 revealed Wound Nurse in to see resident, new admit, deep tissue injury to the right heel start skin prep, stage 2 coccyx wound start zinc, skin tear the left 2nd toe dorsal start skin prep, skin tear left 2nd toe medial start skin prep, surgical wound to the left upper hip pad and protect, surgical left lower hip pad and protect, skin tear right elbow start skin prep, resident has no complaints of pain or discomfort, no signs of infection noted, primary physician aware, resident aware, resident self.

Interview on 09/16/2025 at 1:30 P.M. with the Director of Nursing confirmed Resident #70 was noted to be admitted to the facility with multiple wounds that was not captured on the nursing admission assessment and treatment orders were not put in place for these orders.

This deficiency represents non compliance investigated under Master Complaint Number 2624710 and Complaint Number 2618524,2616238, and 2604216.

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

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 Level of Harm - Minimal harm or potential for actual harm

his wheelchair with the use of the Hoyer lift. CNA #97 claimed this resident was becoming agitated and started to yell at her because he didn't want to wait for assistance, so she went ahead and got him up on her own. She thinks the other aide forgot to come to help or got busy with someone else. While transferring him with the Hoyer lift the strap was not on the hook properly and slipped off. Claimed that this resident is usually a two staff assist with a pivot, and this method has been used since then.

Residents Affected - Few

Interview on 09/22/2025 at 12:00 P.M. with LN #333 confirmed this resident had a care plan for his bed to be in the lowest position while occupied and currently it was not in the lowest position.

Review of the facility policy titled. Mechanical Lift Education, no date noted revealed that at least two staff members are used during a lift transfer.

Review of the facility policy titled Fall Prevention and Management dated November 2024 revealed based

on assessment results, the nurse will meet with the direct care staff to establish and implement approaches to minimize the risk.

These deficiencies represents non-compliance investigated under Complaint Number 2624117, Complain Number 2618524, and Complaint Number 2609966.

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

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Licensed Practical Nurse (LPN) #333 revealed, Resident noted to be non-responsive to commands this shift. Certified Nurse Practitioner (CNP) in to assess with new orders for fluids, stat labs, and med changes noted. Stat labs obtained and orders updated. Unable to insert IV and all stat lab services notified to start IV. CNP reassessed Resident #60 and determined resident ‘s condition declined and gave new orders to send to emergency room for evaluation. Family in room with resident and notified of transfer. Review of the hospital paperwork dated 07/11/2025 revealed Patient is quite drowsy yet easily arousable and does answer many questions appropriately, although falls back asleep. Per his family, he was awake earlier at the nursing facility and was given his pain medication in the morning. Later on, his wife arrived to visit him and found him very drowsy. He has a known right sided weakness from a prior stroke, but there is no mention of any new deficits. He was given Narcan with some improvements here. Interview on 09/17/2025 with the Director of Nursing (DON) confirmed Resident #60's medication, Acetaminophen, Gabapentin, and Oxycodone was not transcribed in the medication administration record or orders as prescribed by the hospital. Continued interview with the DON revealed there was some confusion about Resident #60's Gabapentin orders and after clarification was received, he was only supposed to receive Gabapentin 300 mg, three times a day. No other orders for Gabapentin should have been active. The Acetaminophen order was written and being administered sooner than every 8 hours as prescribed on the hospital discharge orders. Review of the facility policy titled, Administering Medications, dated 12/2012 revealed 3. Medications must be administered in accordance with the orders, including any required time frames. 5.If a dosage is believed to be inappropriate or excessive for a resident, or a medication has been identified as having potential adverse consequences for the resident of being associated with adverse consequences, the person preparing or administering the medication shall contact the resident's Attending Physician or the facility's Medical Director to discuss the concern. This deficiency represents non compliance investigated under Master Complaint Number 2624710 and Complaint Number 2581952.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Continued review of progress notes for Resident #70 indicated this resident was out of the facility at the hospital. Resident #70 was noted to be officially discharged from the facility on [DATE REDACTED].

Review of nursing progress notes for Resident #70 dated [DATE REDACTED] at 2:57 P.M. created by Registered Nurse (RN) revealed Temperature, 97.6 degrees, route: Forehead (non-contact), pulse at 66 beats per minute, respiration at 18 breaths per minute. [DATE REDACTED]. Resident is alert and easily aroused. Resident is alert and oriented to person/ Not oriented to place. Not oriented to time. Oriented to situation. Resident is able to make own decisions. Resident is free of signs or symptoms of delusions. Resident weight bearing as tolerated. Steady gait noted. Weakness not noted. Able to move all extremities has full sensation. No changes in ADL capability noted. Does not require assistance with bed mobility. Does not require assistance with transfers. Changes to mood and behavior noted. Bladder function unchanged. Resident is continent of urine. Denies Nausea Denies emesis.

Interview on [DATE REDACTED] at 10:30 A.M. with the DON confirmed Resident #70 had not returned to the facility

after an physician appointment on [DATE REDACTED] and had officially discharged from the facility on [DATE REDACTED]. The DON confirmed there was a nursing progress note entered on [DATE REDACTED] indicating Resident #70's vitals had been obtained that day as well as the residents current health status. The DON verified this was not accurate since Resident #70 had not been at the facility since [DATE REDACTED].

1. 3. Review of the medical record for Resident #50 revealed an admission date of [DATE REDACTED] with a transfer to

the hospital date from a doctor's appointment offsite of [DATE REDACTED]. Diagnoses included but were not limited to type 2 diabetes mellitus, retention of urine, personal history of transient ischemic attack, anxiety disorder, depression, unspecified dementia, and muscle weakness.

Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE REDACTED] revealed a Brief

Interview for Mental Status (BIMS) of 8 out of 15 which indicated moderate cognitive impairment. The resident was assessed to require partial/moderate assistance with bed mobility, substantial/maximal assistance with transfers, and total dependence on toilet hygiene, shower/bathe self. This resident was also assessed to have an unstageable pressure ulcer and a stage 3 pressure ulcer on admission as well as a venous/arterial ulcer.

Review of the progress note dated [DATE REDACTED] at 3:06 P.M. for Resident #50 revealed this resident's pressure ulcers were assessed by a Wound Nurse Practitioner.

Review of the medical record for Resident #50 revealed no note from the Wound Nurse Practitioner for [DATE REDACTED].

Interview on [DATE REDACTED] at 11:32 A.M. with the Assistant Director of Nursing verified Resident #50 was seen by

an outside wound consultant from a previous company on [DATE REDACTED] that included assessment and treatment recommendations, and the visit was never received from them to upload into this resident's chart. Verified it should have been received and uploaded to make Resident #50's medical record complete and accurate.

This deficiency represents noncompliance investigated under Complaint Number 2609966.

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

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scioto Rehabilitation & Care Center

433 Obetz Road Columbus, OH 43207

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

Federal health inspectors cited SCIOTO REHABILITATION & CARE CENTER in COLUMBUS, OH for a deficiency under regulatory tag F-F0880 during a complaint investigation conducted on 2025-10-09.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 7 deficiencies cited during this inspection of SCIOTO REHABILITATION & CARE CENTER.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2025-10-17.