Astoria Place Of Waterville
Inspection Findings
F-Tag F0561
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0561 during a standard health inspection conducted on 2025-08-27.
Category: Resident Rights Deficiencies
The facility was found deficient in the following area: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0569
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0569 during a standard health inspection conducted on 2025-08-27.
Category: Resident Rights Deficiencies
The facility was found deficient in the following area: Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0580
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0580 during a standard health inspection conducted on 2025-08-27.
Category: Resident Rights Deficiencies
The facility was found deficient in the following area: Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0605
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0605 during a standard health inspection conducted on 2025-08-27.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
The facility was found deficient in the following area: Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0655
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0655 during a standard health inspection conducted on 2025-08-27.
Category: Resident Assessment and Care Planning Deficiencies
The facility was found deficient in the following area: Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0656
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0656 during a standard health inspection conducted on 2025-08-27.
Category: Resident Assessment and Care Planning Deficiencies
The facility was found deficient in the following area: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0677
F 0677 Level of Harm - Minimal harm or potential for actual harm
wanted them trimmed. CNA #305 stated it was unknown who normally trimmed Resident #45's nails.
Review of the policy titled, Activities of Daily Living, revised January 2022, verified staff will carryout the ADL care tasks following the resident's ADL care plan. This deficiency represents non-compliance investigated under Complaint Number 2562969.
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
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Astoria Place of Waterville
555 Anthony Wayne Trail Waterville, OH 43566
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 F0688
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0688 during a standard health inspection conducted on 2025-08-27.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0689
F 0689
This deficiency represents non-compliance investigated under Complaint Number OH00166789 (1260025).
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
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Astoria Place of Waterville
555 Anthony Wayne Trail Waterville, OH 43566
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 F0690
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0690 during a standard health inspection conducted on 2025-08-27.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0773
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0773 during a standard health inspection conducted on 2025-08-27.
Category: Administration Deficiencies
The facility was found deficient in the following area: Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0805
F 0805 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
position was stuck. LPN #381 further stated with repositioning that the food was able to be dislodged and Resident #07 spit the food into a towel. Interview on 08/06/25 at 10:28 A.M. with ADON #370 revealed Resident #07 coughed up his food and spit it in a towel. ADON #307 confirmed that the most recent nutritional assessment on 07/17/25 stated Resident #07 was to be supervised while eating. Furthermore,
the ADON confirmed the MDS indicates Resident #07 requires substantial assistance for feeding. Interview with CNA #323 on 08/06/25 at 10:45 A.M. revealed Resident #07 had choked on his oatmeal on 08/04/25 and was able to clear it himself. Furthermore, CNA #323 stated typically Resident #07 is left unsupervised when eating in his room. Interview on 08/06/25 at 11:18 A.M. with Dietetic Technician #415 stated there are varying levels of set up and supervision that Resident #07 may need; however, if Resident #07 had a choking episode on 08/04/25, then the episode should have been reported, and Resident #07 should have been evaluated by speech therapy. Review of the Facility Assessment, dated 06/17/25, indicated the facility will meet individualized dietary requirements, including specialized diets to ensure the resident's nutritional requirements are met. The staff training and education provided annually and as needed to ensure the level of support and care needed for the resident population included nutritional promotion in older adults, diets
in long term care, and feeding and eating assistance. Review of the undated facility policy titled Therapeutic Diets, identified therapeutic diets shall be prescribed by the attending physician. Mechanically altered diets are identified as therapeutic. The Dietician and Dietary Manager are responsible to record in the resident's medical record significant information related to the resident's therapeutic diet. A tray identification system is utilized to ensure each resident receives the correct diet. Review of the undated facility policy titled Reading Meal Tickets/Cards, revealed all staff will read and review the meal ticket/card, including any meal alteration for consistency, to ensure residents are served the correct meal or snack. Review of the facility policy titled Activities of Daily Living, revised January 2022, stated ADL services are directed toward the goal of promoting the highest practicable physical, mental and psychological functioning of the resident.
ADL care plans are developed by a nurse and may be delivered by the designated staff members as part of routine care with a facility goal that a resident's abilities do not diminish. ADL care areas include bathing, dressing/grooming, toileting, mobility, transfers and eating. Staff are to follow the resident's care plan when carrying out the ADL task and inform the nurse when there is a refusal or significant decline in the resident's abilities. This deficiency represents non-compliance investigated under Complaint Number OH00166789 (1260025).
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
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Astoria Place of Waterville
555 Anthony Wayne Trail Waterville, OH 43566
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 F0810
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0810 during a standard health inspection conducted on 2025-08-27.
Category: Nutrition and Dietary Deficiencies
The facility was found deficient in the following area: Provide special eating equipment and utensils for residents who need them and appropriate assistance.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0835
F 0835 Level of Harm - Minimal harm or potential for actual harm
Chairpersons who are considered subject matter experts; Executive Director, Director of Nursing, Medical Director, and Infection Preventionist. Further, the policy revealed the object of the QAPI Governing was to develop a continuous pro-active approach to self-discovery to decrease the likelihood of issues/concerns and test new approaches to correct underlying potential causes of those issues/concerns.This deficiency represents non-compliance investigated under Complaint Number 2562969.
Residents Affected - Many
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
08/27/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Astoria Place of Waterville
555 Anthony Wayne Trail Waterville, OH 43566
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 F0842
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0842 during a standard health inspection conducted on 2025-08-27.
Category: Resident Assessment and Care Planning Deficiencies
The facility was found deficient in the following area: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0880
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-08-27.
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 F: widespread, 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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0881
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0881 during a standard health inspection conducted on 2025-08-27.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: Implement a program that monitors antibiotic use.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0883
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0883 during a standard health inspection conducted on 2025-08-27.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: Develop and implement policies and procedures for flu and pneumonia vaccinations.
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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
F-Tag F0921
F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and
the public.
Based on observation and staff interview, the facility failed to ensure the facility maintained a homelike environment. This affected eight (#35, #82, #22, #36, #12, #81, #7, and #29) of eight residents reviewed for environment. The facility census was 74.Findings include:1. Observation on 08/05/25 at 1:43 P.M. behind Resident #12's bedroom door revealed a large hole in the drywall at the door handle height. Also noted in
the coinciding area behind the door right below the ceiling was a small hole in the drywall. In Resident #12's shared bathroom there was a waste basket under the sink, approximately one-quarter full of water.2.
Observation on 08/05/25 at 1:43 P.M. of Resident #81's bedroom revealed a light above his bed with no cord to turn the light on. Resident #81 shared a bathroom with Resident #12 which had a waste basket under the sink, approximately one-quarter full of water.3. Observation on 08/05/25 at 1:49 P.M. of Resident #7 and Resident #35's room revealed large brown-colored areas of a substance throughout the entire ceiling.4. Observation on 08/05/25 at 1:51 P.M. of Resident #29's bedroom revealed a light above the bed with no pull cord.5. Observation on 08/05/25 at 1:52 P.M. of Resident #36 and Resident #22's room revealed large brown-colored areas of a substance throughout the entire ceiling.6. Observation on 08/05/25 at 1:53 P.M. of Resident #82's bedroom revealed a light above the bed with a broken cover that was hanging from the light.Interview and observation on 08/06/25 at 8:07 A.M. with Regional Director of Maintenance (RDM) #403 confirmed Resident #12 had two holes behind the door and a waste basket under the bathroom sink shared by Resident #12 and Resident #81 that was approximately one-quarter full of water. RDM #403 stated he was going to get a part to fix the sink. RDM #403 also confirmed Resident #81 and Resident #29 did not have pull cords for their lights over their bed. RDM #403 confirmed the ceilings in the room shared by Resident #7 and Resident #35 and the room shared by Resident #36 and Resident #22 had water pipes that burst and were fixed; however, the brown-colored spots on the ceiling were not. Additionally, RDM #403 confirmed Resident #82's light was broken.This deficiency represents non-compliance investigated under Complaint Number 2562969 and Complaint Number OH00166789 (1260025).
Event ID:
Facility ID:
If continuation sheet
F-Tag F0944
Federal health inspectors cited ASTORIA PLACE OF WATERVILLE in WATERVILLE, OH for a deficiency under regulatory tag F-F0944 during a standard health inspection conducted on 2025-08-27.
Category: Administration Deficiencies
The facility was found deficient in the following area: Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Scope/Severity Level F: widespread, 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 20 deficiencies cited during this inspection of ASTORIA PLACE OF WATERVILLE.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-30.
ASTORIA PLACE OF WATERVILLE in WATERVILLE, 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 WATERVILLE, 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 ASTORIA PLACE OF WATERVILLE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.