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Complaint Investigation

Otterbein Lebanon Retirement Community

Inspection Date: September 12, 2025
Total Violations 3
Facility ID 365346
Location LEBANON, OH
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Inspection Findings

F-Tag F0584

Resident Rights Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0584 Level of Harm - Minimal harm or potential for actual harm

shelves, tables, windowsill, remove cobwebs, sweep under furniture and in closet, and mop floors (use wet floor sign).This deficiency represents non-compliance investigated under Master Complaint Number 2592669 and Complaint Number 2566253.

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

09/12/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Otterbein Lebanon Retirement Community

585 North State Route 741 Lebanon, OH 45036

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)

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F-Tag F0656

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

should have developed a care plan for COPD for Resident #151.During an interview on 09/11/25 at 4:07 P.M., the Director of Nursing (DON) stated MDS Coordinator #4 and Assistant Director of Nursing (ADON) #2 oversaw developing care plans. She stated care plans were reviewed and updated interventions were added to align with physician orders and diagnoses. She stated a care plan should have been developed for Resident #151's diagnosis of COPD and the care plan interventions should be updated as needed.

During an interview on 09/11/25 at 4:10 P.M., the Administrator stated he expected the resident's care plan to outline the care that was needed based on the resident's diagnoses and interventions were to be updated as needed. Review of a facility policy titled, Comprehensive Care Planning Policy, effective 11/13/17, indicated it is the policy of the facility for the interdisciplinary team to develop, implement and evaluate the comprehensive, person-centered plan of care, which includes measurable objectives and timeframes to meet a resident's medical, nursing and mental/psychosocial needs that are identified in the comprehensive assessment. The facility encourages the resident and/or resident representative to participate in the care planning process.

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

09/12/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Otterbein Lebanon Retirement Community

585 North State Route 741 Lebanon, OH 45036

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)

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F-Tag F0880

Infection Control Deficiencies
Harm Level: Potential for More Than Minimal Harm

Federal health inspectors cited OTTERBEIN LEBANON RETIREMENT COMMUNITY in LEBANON, OH for a deficiency under regulatory tag F-F0880 during a complaint investigation conducted on 2025-09-12.

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 D: isolated, 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 3 deficiencies cited during this inspection of OTTERBEIN LEBANON RETIREMENT COMMUNITY.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-14.

📋 Inspection Summary

OTTERBEIN LEBANON RETIREMENT COMMUNITY in LEBANON, OH inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 LEBANON, 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 OTTERBEIN LEBANON RETIREMENT COMMUNITY or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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