Carecore At Mary Scott
Inspection Findings
F-Tag F0610
F 0610
represents non-compliance investigated under Complaint Number 1313950 (OH00167084).
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
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
08/12/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Carecore at Mary Scott
3109 Campus Dr Dayton, OH 45406
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 F0695
F 0695
Provide safe and appropriate respiratory care for a resident when needed.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, observations, staff interviews and policy review, the facility failed to ensure tracheostomy (trach) supplies were available in accordance with the care plan and facility policy. This affected one (#77) out of three residents reviewed for trach care and services. The facility census was 77.
Finding include: Review of the medical record for Resident #77 revealed an admission date of 03/06/23 with diagnoses of anoxic brain damage, epilepsy, unspecified, intractable, without status epilepticus, chronic obstructive pulmonary disease, and acute on chronic systolic (congestive) heart failure. Review of the Quarterly Minimum Data Set (MDS) dated [DATE REDACTED] revealed the resident was cognitively impaired, was dependent on staff for all activities of daily living, and resident had a trach. Review of the care plan dated 03/07/23 revealed a care plan for trach related to impaired breathing mechanics injury with interventions of keep extra trach tube and obturator at bedside. If tube is coughed out attempt to reinsert tube. Review of
the physician orders revealed an order dated 01/02/25 for trach care daily. Change inner cannula number four (#4) Shiley every day shift related to anoxic brain damage. On 08/11/25 an order was noted for trach size 4UN85H with inner canula size Shiley #4- 41C85 every shift. Observation and interview on 08/12/25 at 7:20 A.M. with Licensed Practical Nurse (LPN) #234 confirmed there was not an extra trach available if Resident #77's current trach became dislodged. Interview with LPN #234 also confirmed the facility does not always have the trach supplies that are needed for Resident #77. Interview on 08/12/25 at 8:37 A.M. with LPN Unit Manager #294 brought a trach size #4 with a cuff stating it was the trach Resident #77 used and was placing the trach at the residents beside. Interview with LPN Unit Manager #294 confirmed Resident #77 did not have a cuffed trach and did not have a physician's order for a cuffed trach. Review of
the Tracheostomy Care policy dated 01/10/25 revealed a replacement trach tube must be available at the bedside at all times. This deficiency represents non-compliance investigated under Complaint Number 1313951 (OH00166239).
Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Event ID:
Facility ID:
If continuation sheet
CARECORE AT MARY SCOTT in DAYTON, 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 DAYTON, 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 CARECORE AT MARY SCOTT or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.