Willow Brook Christian Home
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
revealed she observed some blood on Resident #44's arm after a Hoyer transfer and revealed she informed
the other CNA also participating in the Hoyer transfer. They lifted the resident's sleeve and found a large skin tear and they informed the nurse. CNA #99 reported no issues during the transfer and no reason to believe it occurred during the Hoyer transfer. She reported she was unsure how the skin tear occurred.
Interview on 12/23/25 at 10:34 A.M. with the Director of Nursing (DON) verified RN #200 was given a written disciplinary action due to a delay in reporting an injury of unknown origin. The DON first revealed
she was informed of the injury of unknown origin the next day at the care conference with Residents daughter (09/04/25). The DON verified after review of the self reported incident documentation and staff statements Resident #44's family reported concerns to facility during the care conference on 09/11/25. The DON stated it was believed the resident was cut by a buckle on the Broda chair and after doing the investigation that was the cause determined by the facility. The DON also acknowledged if the injury was not known and observed to occur it should be reported timely and then the investigation would be initiated.
A follow-up interview on 12/23/25 at 10:56 A.M. with RN #200 verified she filled out the incident report related to the Resident #44's skin tear but reported she had not completed the section asking what happened. She reported that was filled out by another staff after the investigation was completed. Interview
on 12/23/25 at 10:56 A.M. with the Assistance Director of Nursing (ADON) #315 verified she updated the incident report reasoning after facility completed the investigation as they did not know how the injury occurred. Interview on 12/23/25 at 11:20 A.M. with the Regional Administrator #250 and the DON revealed
the facility felt they could determine the cause of the injury based on the information obtained in the investigation and that Resident #44 had just been transferred by using the Hoyer. She stated it most likely occurred from a buckle from the Broda chair. They acknowledged it was not reported to the state agency until 09/11/25 after family had reported concerns. Interview on 12/23/25 at 1:10 P.M. with CNA #210 reported Resident #44's injury was found after a Hoyer transfer, but reported their was no incident that occurred that would have caused the large skin tear injury during that transfer. CNA #210 reported she was unsure what would have caused the injury. Interviews on 12/23/25 with Hospice staff #360 and #370 reported Resident #44 did not have a skin tear, it was a deep laceration through the subcutaneous tissue.
They reported they were not witnessed to care the morning of the transfer prior to the injury being found by staff. They stated Hospice spoke with Resident #44's family as well as the DON and the ADON #315 on 09/04/25 and at that time a cause of the injury was under investigation and had not been determined.
Review of the facility policy titled Abuse, Neglect and Exploitation dated 07/2025, revealed facility shall report allegation to the administrator and the state agency within required timeframes. The Administrator shall follow up with state agencies with updates and to report final findings within five days. This deficiency represents non-compliance investigated under Complaint Number 2627023.
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
12/23/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Willow Brook Christian Home
55 Lazelle Rd Columbus, OH 43235
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-Tag F0610
F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
the investigation was completed. Interview on 12/23/25 at 10:56 A.M. the Assistance Director of Nursing (ADON) #315 verified she updated the incident report reasoning after the facility completed the investigation as they did not know how the injury occurred. Interview on 12/23/25 at 11:20 A.M. the Regional Administrator #250 and the DON revealed the facility felt they could determine the cause of the injury based on the information obtained in the investigation and Resident #44 had just been transferred by using the Hoyer. She stated it most likely occurred from a buckle from the Broda chair. They acknowledged
the Self reported incident (SRI) investigation was not started until after 09/11/25 and verified staff and resident interviews were done after 09/11/25. Interview on 12/23/25 at 1:10 P.M. the CNA #210 reported Resident #44's injury was found after a Hoyer transfer, but reported their was no incident that occurred that would have caused the large skin tear injury during that transfer. CNA #210 reported she was unsure what would have caused the injury. Interviews on 12/23/25 with the Hospice staff #360 and #370 reported Resident #44 did not have a skin tear it was a deep laceration through the subcutaneous tissue. They reported they were not witness to care the morning of the transfer prior to the injury being found by staff.
They stated Hospice spoke with Resident #44's family as well as the DON and the ADON #315 on 09/04/25 and at that time a cause of the injury was under investigation and had not been determined. Review of the Self Reported incident investigation revealed staff statements were obtained after 09/11/25 with a final summary report dated 09/17/25. The incident had not defined a cause of the injury, but determined the evidence supported abuse and neglect did not occur. Review of the facility policy titled Abuse, Neglect and Exploitation dated 07/2025, revealed the facility shall begin an immediate investigation after a suspicion of abuse and neglect. This should include identifying staff responsible for the investigation, interviews with any witnesses or anyone with knowledge of the allegations and provide documented evidence of a thorough investigation. The Administrator shall follow up with state agencies with updates and to report final findings within five days. This deficiency represents non-compliance investigated under Complaint Number
- 2627023. Event ID:
Facility ID:
If continuation sheet
WILLOW BROOK CHRISTIAN HOME in COLUMBUS, 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 COLUMBUS, 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 WILLOW BROOK CHRISTIAN HOME or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.