Walnut Creek Nursing Center
Inspection Findings
F-Tag F0550
F 0550
non-compliance investigated under Complaint Number 2643951.
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
10/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Walnut Creek Nursing Center
5070 Lamme Road Kettering, OH 45439
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
Administrator or supervisor as per facility policy. 2. Review of the medical record for Resident #105 revealed
an admission date of 09/23/25 with diagnoses including anemia, heart failure, chronic kidney disease stage III, atrial fibrillation, and myelodysplastic syndrome. Resident #105 was discharged on 10/10/25. The admission Minimum Data Set (MDS) assessment dated [DATE REDACTED] revealed Resident #105 was cognitively intact and required partial/moderate staff assistance with bathing, toilet hygiene, bed mobility, and transfers.
Review of the facility's SRI number 265724 dated 09/26/25 at 4:34 P.M. stated on 09/25/25 at 9:00 P.M., Resident #105 was being assisted by CNA #211 and Licensed Practical Nurse (LPN) #220 and Resident #105 felt he was rushed with the mechanical lift transfer process and neither staff members were polite.
Review of the SRI investigation revealed an Employee Reporting form, that was not dated, did not indicate who obtained Resident #105's statement, was not signed, and did not have any questions on the form answered. The form did contain documentation of a statement but did not indicate whose statement it was that said I was going to bed, I called and asked for help. I asked her to raise the bed, they tossed me in the bed and left me on the side of the bed, laying she didn't give me my call button, so I called out to see if anyone was in the hall. She came in and yelled. (It was unspecified which staff member and what exactly was yelled at to Resident #105), The facility's investigation did not include CNA #211 and LPN #220's witness statements. The investigation did not include any staff statements who worked the shift on 09/25/25. The facility's investigation did not include Resident #105's roommate statement and/or other residents to see if they witnessed the incident and/or have concerns with CNA #211 and/or LPN #220.
Interview on 10/27/25 at 10:18 A.M. with the Director of Nursing (DON) confirmed SRI number 265724's investigation did not contain documentation to support witness statements were obtained. The DON also confirmed the allegation of abuse was not reported immediately to Administrator or supervisor as per facility policy. The DON also confirmed that the Employee Reporting form for SRI number 265724 did not contain the date/time, the name of the person who completed the form, the name of the person who provided the statement, or had any of the questions answered that were on the form. Review of the facility policy titled Abuse, Mistreatment, Neglect, Exploitation and Misappropriation of Resident Property revealed
the staff were to report all incidents/allegations of abuse immediately to the Administrator or designee.
Once the Administrator and State Agency are notified, an investigation of the allegation violation will be conducted and completed within five working days. The investigation protocol included interviewing the resident, the accused, and all witnesses. The witnesses generally, including anyone who witnessed or heard of the incident, came in close contact with the resident the day of the incident (including other residents, family members) and employees who worked closely with the accused employee(s) and/or alleged victim the day of the incident. This deficiency represents non-compliance investigated under Complaint Number 2643951.
Event ID:
Facility ID:
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WALNUT CREEK NURSING CENTER in KETTERING, 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 KETTERING, 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 WALNUT CREEK NURSING CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.