Scioto Rehabilitation & Care Center

F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

had grabbed Resident #39 on the shoulders prior to LPN #166 intervening and removing Resident #79 from the area. She confirmed the only pain that Resident #39 expressed was a stressed induced headache

after the incident, which she addressed with pain reliever.Interview with Resident #39 on 12/30/25 at 10:10 A.M. confirmed that Resident #79 grabbed her shoulders. She felt like he was doing this to intimidate her.

She did state she did not feel intimidated, but she did not want him grabbing her.Interview with the DON on 12/30/25 at 11:10 A.M. revealed she completed the investigation for this incident and there were no reports to her of any physical interaction between Resident #39 and Resident #79. She stated she interviewed LPN #166 and Resident #39 and neither of them had told her Resident #39 was grabbed by Resident #79. Also,

she stated that she spoke with Resident #39's daughter a couple days after the incident and she did not mention that Resident #79 had grabbed Resident #39. She confirmed she did not document the interview

she had with Resident #39. She stated she was not aware of any documentation (progress note written by LPN #166 on 12/02/25) or any interview statements in which Resident #39 was grabbed.Review of facility Abuse, Mistreatment, Neglect, Exploitation, and Misappropriation of Resident Property policy, dated March 2024, revealed the facility will report and investigated any allegation of abuse. Abuse was defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. All new employees will have criminal and professional background checks completed prior to starting employment. When an allegation is made, the facility will ensure the resident is safe. All allegations will be reported in a timely manner, in accordance with local, state, and federal guidelines. A thorough investigation will be completed, which includes observations, interviews, medical

record reviews, and any other information collecting to identify concerns. This deficiency represents non-compliance investigated regarding complaint number 2685201.

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

12/31/2025

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 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review, interview and facility policy review, the facility failed to implement physician orders to care for

an indwelling urinary catheter. This affected one resident, (Resident #72) of three residents reviewed for urinary catheters. The facility census was 111.Findings Include:Record review for Resident #72 revealed

this resident was admitted to the facility on [DATE REDACTED] with diagnoses including: chronic obstructive pulmonary disorder, tracheostomy, obstructive sleep apnea, muscle wasting and atrophy. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE REDACTED] revealed this resident had intact cognition evidenced by a Brief Interview for Mental Status (BIMS) score of 15. This resident was assessed to require assistance with self-care activities.Review of the care plan dated 12/09/26 revealed Resident# 72 was at risk for a urinary tract infection.Review of the physician's order for Resident #72 as of 12/29/25 revealed no catheter care, catheter cleansing or catheter flush orders.During an interview with Licensed Practical Nurse (LPN) #162 on 12/30/25 at 2:15 P.M. she stated catheter care is conducted per the physician orders appearing in

the system of record.During an interview with Director of Nursing, (DON) on 12/30/25 at 2:48 P.M. she confirmed Resident #72 did have an indwelling urinary catheter and no physician orders had been entered pertaining to catheter care for Resident #72. Later that afternoon she confirmed that she added the orders

in Resident #72's electronic medical record for his catheter care. Review of policy titled Urinary Catheter Care dated February 2024 revealed the purpose of this procedure is to prevent catheter-associated urinary tract infections. Routine hygiene (e.g. cleansing of the meatal surface during daily bathing or showering) is appropriate. Empty the drainage bag regularly, at least every shift and as needed. Changing indwelling catheters or drainage bags at routine, fixed intervals is not recommended. Rather, it is suggested to change catheters and drainage bags based on clinical indications such as infection, obstruction, or when the closed system is compromised. Catheter irrigation may be ordered to prevent obstruction in residents at risk for obstruction. Observe residents for complications associated with urinary catheters. This deficiency represented non-compliance investigated regarding complaint numbers 2676997.

Event ID:

Facility ID:

If continuation sheet