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Complaint Investigation

Monarch Meadows Nursing And Rehabilitation

Inspection Date: September 18, 2025
Total Violations 1
Facility ID 365906
Location SEAMAN, OH
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Inspection Findings

F-Tag F0578

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

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review and staff interviews, the facility failed to ensure signed Do Not Resuscitate (DNR) paperwork was present in the chart for a resident who requested DNR code status. This affected one (#52) of 19 residents reviewed for advance directives. The facility census was 47. Findings include:Closed record

review for Resident #51 revealed the resident was admitted to the facility on [DATE REDACTED]. Diagnoses included metabolic encephalopathy, diabetes mellitus, Alzheimer's disease, and seizures. Review of the physician's order, dated [DATE REDACTED], revealed an order for the resident to be Do Not Resuscitate - Comfort Care Arrest (DNRCCA) code status. There was no DNR paperwork found in Resident #51's medical record. The nursing progress note, dated [DATE REDACTED], revealed Resident #51 became unresponsive. Writer unable to find a pulse and began chest compressions. Certified Nursing Assistant (CNA) bagged resident until Registered Nurse (RN) took over. Emergency Medical Services (EMS) arrived. Telephone interview on [DATE REDACTED] at 12:30 P.M. with Licensed Practical Nurse (LPN) #150 confirmed the nurse was passing morning medications when she was notified Resident #52 was on the floor in the bathroom. LPN #150 responded immediately and while providing care to Resident #52 the resident ceased breathing and was without a pulse. LPN #150 confirmed Cardiopulmonary Resuscitation (CPR) which included chest compressions and providing oxygen by bagging the resident was initiated until EMS personnel arrived. LPN #150 confirmed a pulse check was performed and the resident had regained a pulse and was transported to the hospital. LPN #150 confirmed CPR was initiated due to the resident not having signed DNR paperwork in the medical record. Interview on [DATE REDACTED] at 1:50 P.M. with the Director of Nursing (DON) confirmed Resident #52 had a physician's order for DNRCCA code status but the facility had not ensured signed DNR paperwork was present in the medical

record to prevent CPR from being initiated. This deficiency represents non-compliance investigated under Complaint Number 2602027.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date

these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

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

Facility ID:

If continuation sheet

Event ID:

📋 Inspection Summary

MONARCH MEADOWS NURSING AND REHABILITATION in SEAMAN, 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 SEAMAN, 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 MONARCH MEADOWS NURSING AND REHABILITATION or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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