Inspection visit
Health inspection
9 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 9 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0580
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room,
etc.) that affect the resident.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
medical record review, policy review, and interview, the facility failed to ensure the nurse practitioner or
physician were notified of a resident's low blood pressure reading prior to administering a medication with
anti-hypertensive properties. This affected one (Resident #103) of three residents reviewed for medication
administration.
Findings include:
Review of Resident #103's medical record revealed diagnoses including hypertensive heart disease,
paroxysmal atrial fibrillation (irregular heart rhythm), atherosclerotic heart disease, malignant neoplasm of
the scrotum and prepuce (a movable sheath of skin that covers the head of the penis), and pleural effusion.
On 05/29/25 orders were started for midodrine HCL (a medication that belongs to the class of medications
called alpha-adrenergic agonists. It works by causing blood vessels to tighten, which increases blood
pressure.) 5 milligrams (mg) three times a day with instructions to hold the medication for a systolic blood
pressure (top number of the blood pressure) was greater than 120 millimeters of Mercury (mm Hg) and
metoprolol tartrate (a medication used to treat angina, high blood pressure and a number of conditions
involving an abnormally fast heart rate) 12.5 mg twice a day.
Review of Resident #103's June Medication Administration Record (MAR) revealed the blood pressure the
morning of 06/11/25 was 70/50 mm Hg (normal blood pressure is 120/60 mm Hg) and the pulse was 59
beats per minute (bpm) (average [NAME] rate is 60-90 bpm) The midodrine and metoprolol tartrate were
administered.
A nursing note dated 06/11/25 at 10:30 A.M. revealed a manual blood pressure of 70/50 was obtained. The
nurse practitioner was notified.
Review of Nurse Practitioner (NP) #230's progress note dated 06/11/25 indicated Resident #103 was seen
for hypoxia (low levels of oxygen in body tissues). Resident #103 had shortness of breath, wheezing was
auscultated (sound heard through use of a medical device such as a stethoscope), gurgling was noted
when Resident #103 was trying to cough, and the oxygen saturation was 60% on four liters of oxygen.
Resident #103 was not answering questions appropriately and his systolic blood pressure was in the 60's
and heart rate in the 40's. Resident #103 received a DuoNeb (medication used to prevent bronchospasm)
with oxygen saturation down to the 80's and dropping into the 60's. The note indicated Resident #103 did
not receive dialysis on 06/09/25 due to hypotension (low blood pressure) with the systolic blood pressure in
the 60's. The note indicated Resident #103's pulse was 42 at 10:30 A.M. and blood pressure was 64/50. An
oxygen saturation of 62%b (normal greater than 90%) was recorded. The physical part of the exam
indicated expiratory and inspiratory wheezing was auscultated in both
(continued on next page)
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
Page 1 of 15
Event ID:
365292
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0580
Level of Harm - Minimal harm
or potential for actual harm
lungs and was on four liters of oxygen. Resident #103 had trace edema in both legs. The oxygen saturation
had gone from 60% to low 89% with the use of the DuoNeb and then went back down to the 60's on four
liters of oxygen. The note indicated Resident #103 did receive metoprolol and midodrine that morning.
Resident #103 was lethargic. Lisinopril and bumex were held. 911 was called and Resident #103 was
transferred to the hospital for evaluation and treatment.
Residents Affected - Few
A nursing note dated 06/11/25 at 11:10 A.M. indicated Resident #103 was placed on four liters of oxygen
via a non-rebreather mask (a type of oxygen mask used in emergencies or hospital settings. It provides a
high concentration of oxygen to the patient but doesn't allow them to breathe in any outside or room air. The
mask covers both the nose and mouth and has one-way valves to prevent exhaled air or outside air from
entering the oxygen supply.) and his oxygen saturation increased from 72 to 85. Pulse was recorded as 48
and 911 was called.
On 06/16/25 at 3:20 P.M., the Director of Nursing (DON) was unable to provide an explanation why the
metoprolol which could lower blood pressure with a recorded blood pressure of 70/50 was administered.
On 06/16/25 at 3:27 P.M., Registered Nurse (RN) #235 verified she administered the metoprolol to
Resident #103 when he had a blood pressure of 70/50. RN #235 stated she did so without contacting the
physician or nurse practitioner at the time because she had been told to administer metoprolol to other
residents in the past with similar vital signs. When asked, RN #235 was unable to provide a resident's name
or time frame.
On 06/17/25 at 3:22 P.M., NP #230 stated RN #235 should have contacted her prior to administering the
metoprolol because of the blood pressure reading. Although the metoprolol was used as a beta blocker it
also had the potential to lower the blood pressure even further. Because the pulse was 59 she definitely
would have instructed RN #235 to hold the metoprolol. Even if the pulse would have been elevated she
would have held the metoprolol until she determined if the midodrine would raise the blood pressure. The
metoprolol should not have been administered. On 06/18/25 at 1:35 P.M., NP #230 added that she had not
been made aware of Resident #103 not receiving dialysis on 06/09/25 due to low blood pressure until
06/11/25. NP #230 stated at that time she went to talk to Resident #103 and his blood pressure could
hardly be heard and she spoke to the nurse. Resident #103 was in critical condition.
Review of the facility's Notification of Change in Condition policy (undated) revealed the facility must consult
with the resident's medical practitioner when there was a change requiring notification. Circumstances
requiring notification included deterioration of health status and a need to alter treatment.
This is an incidental finding discovered during the investigation.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 2 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper
authorities.
Based on medical record review, policy review and interview, the facility failed to report allegations of
misappropriation of money to the State Survey Agency. This affected one (Resident #49) of three residents
reviewed for missing property.
Findings include:
Review of Resident #49's medical record revealed diagnoses including congestive heart failure (CHF),
atherosclerotic heart disease, type two diabetes, bipolar disorder, and anxiety disorder. A nursing note by
Licensed Practical Nurse (LPN) #215 dated 06/15/25 at 12:55 A.M. indicated Resident #49 returned to the
facility from a leave of absence (LOA) and informed the nurse when he got into his lock box he had $350.37
missing from his box. Resident #49 stated he had the box locked all day in his room and had the key on his
bag out with him all day. Police were informed and took a report from Resident #49.
A social service note dated 06/16/25 at 8:48 A.M. indicated Resident #49 had voiced concerns which were
documented on appropriate forms. Resident #49 wanted out of the facility and indicated the prior two days
were tough as staff were reminding him of rules, including watching when he turned the chair. The note
indicated Resident #49 felt staff were on him too much.
No Facility Reported Incident was noted indicating the allegation of missing/stolen money was reported to
the State Survey Agency.
During an interview on 06/17/25 at 9:59 A.M., Licensed Social Worker (LSW) #220 revealed Resident #49
informed him of the missing money when they spoke about other concerns on 06/16/25. LSW #220 stated
he called Resident #49's fiance to determine if Resident #49 had the money. The fiance had not returned
his phone call. LSW #220 was unable to state why the State Survey Agency was not notified pending an
investigation.
On 06/17/25 at 11:07 A.M., Resident #49 stated he was unsure how long the money had been missing as
he did not get into his lock box every day. Resident #49 stated there were times when he left his keys in his
bag on the floor in his room and once he recalled leaving the key in the lock.
During an interview on 06/17/25 at 12:26 P.M., the Administrator stated he had not been informed of the
allegations of money missing from Resident #49's lock box until that morning so the information had not
been reported to the State Survey Agency prior to 06/17/25.
During an interview on 6/18/25 at 3:53 P.M., LPN #215 reported she informed the Director of Nursing
(DON) of the missing money within five minutes of Resident #49 reporting the missing money to her. LPN
#215 stated she also reported the information to Registered Nurse (RN) Unit Manager (UM) #225.
On 06/23/25 at 6:18 A.M., the DON verified he had been informed of the allegation of missing money by
LPN #215. The DON indicated he also contacted RN UM #225 who texted/informed the Administrator. The
DON was unable to state the reason the State Survey Agency was not notified.
On 06/23/25 at 6:50 A.M., RN UM #225 verified she had communicated back and forth with the
Administrator via text on 06/14/25 regarding Resident #49's allegation of stolen money. Review of the texts
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 3 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
revealed the Administrator was notified on 06/14/25 at 9:12 P.M. of Resident #49's allegation that someone
stole $350 from his lock box in the last 36 hours. The Administrator responded on 06/14/25 at 9:12 P.M.
indicating the facility did not give residents that kind of money. A follow up text from the Administrator on
06/14/25 at 11:22 P.M. inquired if Resident #49 called the police.
Review of the facility's Abuse, Neglect and Misappropriation policy (not dated) revealed reports of
misappropriation of property would be reported to the supervisor and investigated timely. The supervisor or
designee would notify the DON and Administrator of the allegation immediately. Required notification of
agencies would be completed.
This deficiency represents non-compliance investigated under Complaint Number OH00166349.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 4 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0610
Respond appropriately to all alleged violations.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review, policy review and interview, the facility failed to initiate a thorough
investigation of allegations of a resident's stolen money. This affected one (Resident #49) of three residents
reviewed for missing property.
Residents Affected - Few
Findings include:
Review of Resident #49's medical record revealed diagnoses including congestive heart failure (CHF),
atherosclerotic heart disease, type two diabetes, bipolar disorder, and anxiety disorder. A nursing note by
Licensed Practical Nurse (LPN) #215 dated 06/15/25 at 12:55 A.M. indicated Resident #49 returned to the
facility from a Leave of Absence (LOA) and informed the nurse when he got into his lock box he had
$350.37 missing from his box. Resident #49 stated he had the box locked all day in his room and had the
key on his bag out with him all day. Police were informed and took a report from Resident #49.
A social service note dated 06/16/25 at 8:48 A.M. indicated Resident #49 had voiced concerns which were
documented on appropriate forms. Resident #49 wanted out of the facility and indicated the prior two days
were tough as staff were reminding him of rules, including watching when he turned the chair. The note
indicated Resident #49 felt staff were on him too much.
No Facility Reported Incident was observed indicating the allegation of missing/stolen money was reported
to the State Survey Agency or that an investigation had been initiated.
During an interview on 06/17/25 at 9:59 A.M., Licensed Social Worker (LSW) #220 revealed Resident #49
informed him of the missing money when they spoke about other concerns on 06/16/25. LSW #220 stated
he called Resident #49's fiance to determine if Resident #49 had the money. The fiance had not returned
his phone call. LSW #220 indicated he was unaware of the allegation until 06/16/25 when he spoke with
Resident #49 so he was unaware of any other investigative action taken.
On 06/17/25 at 11:07 A.M., Resident #49 stated he was unsure how long the money had been missing as
he did not get into his lock box every day. Resident #49 stated there were times when he left his keys in his
bag on the floor in his room and once he recalled leaving the key in the lock.
During an interview on 06/17/25 at 12:26 P.M., the Administrator stated he had not been informed of the
allegations of money missing from Resident #49's lock box until that morning so he submitted a FRI and an
investigation would be started.
During an interview on 6/18/25 at 3:53 P.M., LPN #215 reported she informed the Director of Nursing
(DON) of the missing money within five minutes of Resident #49 reporting the missing money to her. LPN
#215 stated she also reported the information to Registered Nurse (RN) Unit Manager (UM) #225.
On 06/23/25 at 6:18 A.M., the DON verified he had been informed of the allegation of missing money by
LPN #215. The DON indicated he also contacted RN UM #225 who texted/informed the Administrator.
On 06/23/25 at 6:50 A.M., RN UM #225 verified she had communicated back and forth with the
Administrator and LPN #215 the night of 06/14/25. Review of a text dated 06/14/25 at 9:08 P.M. revealed
LPN #215 informed RN UM #225 that Resident #49 alleged someone stole $350 from his lock box within
the past 36 hours. RN UM #225 responded on 06/14/25 at 9:09 P.M. revealed that was an Administrator
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 5 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0610
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
thing. At 9:10 P.M., LPN #215 indicated via text she was calling the police so Resident #49 could write a
report. At 9:11 P.M., RN UM #225 reminded LPN #215 to obtain the police case number and instructed her
to get statements from everyone in the building at the time. A text from RN UM #225 to the Administrator on
06/14/25 at 9:12 P.M. revealed the Administrator was notified of Resident #49's allegation that someone
stole $350 from his lock box in the last 36 hours. The Administrator responded on 06/14/25 at 9:12 P.M.
indicating the facility did not give residents that kind of money. A follow up text from the Administrator on
06/14/25 at 11:22 P.M. inquired if Resident #49 called the police.
Review of the facility's Abuse, Neglect and Misappropriation policy (not dated) revealed reports of
misappropriation of property would be reported to the supervisor and investigated timely. The supervisor or
designee would notify the DON and Administrator of the allegation immediately. Required notification of
agencies would be completed.
This deficiency represents non-compliance investigated under Complaint Number OH00166349.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 6 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0676
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
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 and interview, the facility failed to provide restorative nursing programs to maintain a
resident's ability to ambulate. This affected two (Residents #26 and #82) of three residents reviewed for
restorative services.
Residents Affected - Few
Findings include:
1. Review of Resident #26's medical record revealed diagnoses including cerebrovascular disease,
hypertension, dizziness and giddiness, type two diabetes mellitus, unsteadiness on her feet, lumbar region
intervertebral disc degeneration, discogenic back pain, and generalized weakness related to a stroke. A
Physical Therapy (PT) Discharge summary dated [DATE] revealed a restorative nursing program had been
completed for ambulation with the interdisciplinary team to facilitate Resident #26 maintaining her current
level of performance and to prevent decline. A care plan initiated 03/14/25 indicated Resident #26 was on a
restorative ambulation program to increase confidence and safety with gait once daily six to seven times
per week for 15 minutes per day. Stand by assistance and verbal cues were to be provided with ambulation
125 to 200 feet as tolerated with staff offering encouragement and reassurance.
Review of restorative program delivery notes revealed in the prior 30 days, Resident #26 received the
ambulation program once on 05/28/25 at which time she was recorded as ambulating 240 feet.
A restorative evaluation dated 06/12/25 indicated Resident #26 participated in the restorative ambulation
program with a goal to maintain strength and be without decline. The restorative ambulation program was to
be continued.
On 06/18/25 at 11:55 A.M., Resident #26 was observed sitting in a recliner in her room with three
daughters visiting. All four individuals were in agreement that Resident #26 did not walk well and they had a
fear she would fall.
On 06/23/25 at 8:54 A.M., Resident #26 stated she used to ambulate with Restorative Aide #265 but she
retired and nobody else did the program.
On 06/23/25, Certified Nursing Assistant (CNA) #270 verified the restorative aide had retired. CNA #270
stated there was not enough time for aides to provide restorative programs in addition to all the other care
residents required.
On 06/23/25 at 10:45 A.M., Regional Nurse #275 verified Resident #26's documentation revealed she
received the restorative ambulation program once in the past 30 days. Upon investigation, she discovered
the ambulation program was entered into the aides' task section to provide the service as necessary
instead of six to seven times a week for 15 minutes a day.
On 06/23/25 at 12:57 P.M., CNA #280 stated she was unsure which residents were on restorative programs
or the type of programs which were to be provided. CNA #280 stated the only way nurse aides would have
time to provide restorative programs was if there were always two aides to each hall which did not happen
on a consistent basis.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 7 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0676
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
2. Review of Resident #82's medical record revealed diagnoses including hemiplegia and hemiparesis
(paralysis or weakness on one side of the body) following cerebrovascular disease, diabetes mellitus,
chronic kidney disease, depression, chronic obstructive pulmonary disease, anxiety disorder, low back
pain, peripheral vascular disease, and cognitive communication deficit. A plan of care initiated 12/09/24
indicated Resident #82 was on a restorative ambulation program to ambulate 50 to 100 feet with a quad
cane with contact guard assistance to minimum assistance to maintain strength in lower extremities once a
day for 6-7 days a week. Resident #82 required minimal instruction but staff were to encourage and praise
participation. One of the interventions was to reassess quarterly and as needed.
Review of restorative ambulation program delivery records revealed the week of 05/25/25 - 05/31/25 the
service was offered/provided five times. The week of 06/01/25 - 06/07/25, the service was provided three
times. The week of 06/08/25 - 06/14/25, the ambulation program was refused once. There was no other
indication of the program being offered. The week of 06/15/25 to 06/21/25, the program was documented
with one refusal and no other offers to provide it were documented.
Review of a restorative evaluation dated 06/13/25 indicated Resident #82 participated in the program as
ordered. The goal was to maintain current ambulation status and be without decline by the next review date.
The program would be re-evaluated quarterly and as necessary.
On 06/23/25 at 12:36 P.M., the Director of Nursing (DON) acknowledged records did not reflect Resident
#82's restorative ambulation program was offered in accordance with orders/plans of care/assessments.
This deficiency represents non-compliance investigated under Complaint Number OH00164989.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 8 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0680
Ensure the activities program is directed by a qualified professional.
Level of Harm - Potential for
minimal harm
Based on record review and interview, the facility failed to ensure the activities program was directed by a
qualified professional. This had the potential to affect all 101 residents residing in the facility.
Residents Affected - Many
Findings include:
Review of the personnel file for Activities Director #260 revealed a hire date of 09/22/99 in the role of
Certified Nursing Assistant (CNA). On 09/07/21 she applied and accepted the role of an activity assistant.
On 06/17/25, it was noted the position description for Activities Leader was signed by Activities Director
#260. Review of the position description for Activities Leader revealed she must be a qualified therapeutic
recreation specialist or an activities professional who is licensed by the state and is eligible for certification
as a recreation specialist or as an activities professional; or must have a minimum of two years experience
in a social or recreation program within the last five years, one of which was full-time in a patient activities
program in a health care setting; or must be a qualified occupational therapist or occupational therapy
assistant; or must have completed a training course approved by this state. There was no evidence in
Activities Director #260's employee file to prove she had the qualifications.
Review of the timeline of activities directors provided by the facility from 01/01/25 through 06/23/25
revealed Activities Director #260 assumed the role on 02/09/25.
Review of the invoice for a certified activities director course for Activities Director #260 revealed she
started the course on 04/21/25.
Interview on 06/23/25 at 12:04 P.M. with Divisional Director of Activities #255 verified Activities Director
#260 was not certified. She stated she had not assisted Activities Director #260 with overseeing the
activities program as she had started her employment with the corporation who owned the facility two
months ago. Divisional Director of Activities #255 stated she had started working with this facility on
06/20/25.
Interview on 06/23/25 at 12:38 P.M. with Activities Director #260 verified she did not have the qualifications
as listed in the position description above. She stated she had been doing the activities director position
since 02/09/25.
Interview on 06/23/25 at 12:49 P.M. with the Regional Administrator #250 verified Activities Director #260
did not have the qualifications required for activities director.
This is an incidental finding discovered during the complaint investigation.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 9 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review and interview, the facility failed to ensure medications were administered in
accordance with physician orders and set parameters. This affected one (Resident #103) of three residents
reviewed for medication administration.
Residents Affected - Few
Findings include:
Review of Resident #103's medical record revealed diagnoses including hypertensive heart disease,
paroxysmal atrial fibrillation (irregular heart rhythm), atherosclerotic heart disease, malignant neoplasm of
the scrotum and prepuce (a movable sheath of skin that covers the head of the penis), and pleural effusion.
On 05/29/25 orders were started for midodrine HCL (a medication that belongs to the class of medications
called alpha-adrenergic agonists. It works by causing blood vessels to tighten, which increases blood
pressure.) 5 milligrams (mg) three times a day with instructions to hold the medication for a systolic blood
pressure (top number of the blood pressure) greater than 120.
Review of Resident #103's June Medication Administration Record (MAR) revealed midodrine was
administered the morning of 06/03/25 with a blood pressure of 137/78 millimeters of mercury (mm Hg), the
morning of 06/06/25 with a blood pressure of 137/74 mm Hg and the morning of 06/07/25 with a blood
pressure of 138/74 mm Hg. All three of the doses were signed as administered by Registered Nurse (RN)
#225.
On 06/16/25 at 3:07 P.M., RN #225 was unable to provide an explanation regarding why the midodrine was
administered outside parameters in the orders.
On 6/16/25 at 3:20 P.M., the Director of Nursing (DON) had no explanation for why midodrine was
administered outside set parameters on 06/03/25, 06/06/25 or 06/07/25 when systolic blood pressures
were recorded greater than 120.
On 06/18/25 at 1:35 P.M., Nurse Practitioner (NP) #230 stated it was probably okay to administer the
midodrine with a systolic blood pressure greater than 120 on dialysis days (one of the three days it was
administered) occasionally but it could lead to issues depending on a resident's overall condition. NP #230
stated the three days it was administered outside parameters resulted in no adverse consequences.
This deficiency represents non-compliance investigated under Complaint Number OH00166349 and
Complaint Number OH00164924.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 10 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0688
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
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.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
medical record review and interview, the facility failed to provide restorative range of motion (ROM)
programs in accordance with physician orders for one (Resident #96) of three residents reviewed for
restorative services.
Findings include:
Review of Resident #96's medical record revealed diagnoses including hemiplegia (paralysis/weakness of
one side of the body) affecting the right dominant side, type two diabetes mellitus with diabetic neuropathy,
morbid obesity, need for assistance with personal care, generalized anxiety disorder and depression. A
quarterly Minimum Data Set (MDS) assessment dated [DATE] indicated Resident #96 was cognitively intact
with no rejection of care. Resident #96 had impaired functional ROM of both the upper and lower extremity
on one side of her body.
Review of a care plan initiated 02/27/23 indicated Resident #96 was on a restorative program for
active/passive range of motion. Interventions indicated passive range of motion (PROM) (movement of a
joint or body part without any effort from the individual) to the right upper extremity in all planes once a day,
six to seven days for 15 minutes a day to increase range of motion to the right upper extremity. The care
plan indicated Resident #96 required maximal assistance with minimal verbal cues. Interventions included
reassessment of the program quarterly and as needed.
Review of restorative program delivery records revealed the program was delivered five times the week of
05/25/25 - 05/31/25, four times the week of 06/01/25 and 06/07/25, five times the week of 06/08/25 and
06/14/25, and five times the week of 06/15/25 to 06/21/25.
A restorative evaluation dated 06/13/25 indicated Resident #96 participated in the restorative PROM
program as ordered. The goal was to maintain current ROM and be without decline. The assessment
indicated Resident #96's restorative program would be re-evaluated quarterly and as necessary.
On 06/23/25 at 12:36 P.M., the Director of Nursing (DON) verified documentation did not reflect the
program was offered a minimum of six times a week in accordance with the order and care plan.
This deficiency represents non-compliance investigated under Complaint Number OH00164924.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 11 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0725
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in
charge on each shift.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
medical record review and interview, the facility failed to provide sufficient staff to provide restorative
nursing programs on a consistent basis. This affected three (Residents #26, #82, and #96) of three
residents reviewed for restorative services. The facility identified 41 residents with orders for one or more
restorative programs (Residents #1, #2, #3, #4, #6, #7, #11, #15, #18, #24, #26, #32, #34, #37, #41, #42,
#43, #48, #51, #56, #61, #67, #68, #69, #70, #73, #75, #79, #81, #82, #86, #87, #90, #91, #92, #93, #94,
#95, #96, #98 and #100).
Findings include:
1. On 06/18/25 at 11:55 A.M., Resident #26 was observed sitting in a recliner in her room with three
daughters visiting. All four individuals were in agreement that Resident #26 did not walk well and they had a
fear she would fall.
Review of Resident #26's medical record revealed diagnoses including cerebrovascular disease,
hypertension, dizziness and giddiness, type two diabetes mellitus, unsteadiness on her feet, lumbar region
intervertebral disc degeneration, discogenic back pain, and generalized weakness related to a stroke. A
Physical Therapy (PT) Discharge summary dated [DATE] revealed a restorative nursing program had been
completed for ambulation with the interdisciplinary team to facilitate Resident #26 maintaining her current
level of performance and to prevent decline. A care plan initiated 03/14/25 indicated Resident #26 was on a
restorative ambulation program to increase confidence and safety with gait once daily six to seven times
per week for 15 minutes per day. Stand by assistance and verbal cues were to be provided with ambulation
125 to 200 feet as tolerated with staff offering encouragement and reassurance.
Review of restorative program delivery notes revealed in the prior 30 days, Resident #26 received the
ambulation program once on 05/28/25 at which time she was recorded as ambulating 240 feet.
A restorative evaluation dated 06/12/25 indicated Resident #26 participated in the restorative ambulation
program with a goal to maintain strength and be without decline. The restorative ambulation program was to
be continued.
On 06/23/25 at 8:54 A.M., Resident #26 stated she used to ambulate with Restorative Aide #265 but she
retired and nobody else did the program.
On 06/23/25, Certified Nursing Assistant (CNA) #270 verified the restorative aide had retired. CNA #270
stated there was not enough time for aides to provide restorative programs in addition to all the other care
residents required.
On 06/23/25 at 10:45 A.M., Regional Nurse #275 verified Resident #26's documentation revealed she
received the restorative ambulation program once in the past 30 days. Upon investigation, she discovered
the ambulation program was entered into the aides' task section to provide the service as necessary
instead of six to seven times a week for 15 minutes a day.
On 06/23/25 at 12:57 P.M., CNA #280 stated she was unsure which residents were on restorative programs
or the type of programs which were to be provided. CNA #280 stated the only way nurse aides
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 12 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0725
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
would have time to provide restorative programs was if there were always two aides to each hall which did
not happen on a consistent basis.
2. Review of Resident #82's medical record revealed diagnoses including hemiplegia and hemiparesis
(paralysis or weakness on one side of the body) following cerebrovascular disease, diabetes mellitus,
chronic kidney disease, depression, chronic obstructive pulmonary disease, anxiety disorder, low back
pain, peripheral vascular disease, and cognitive communication deficit. A plan of care initiated 12/09/24
indicated Resident #82 was on a restorative ambulation program to ambulate 50 to 100 feet with a quad
cane with contact guard assistance to minimum assistance to maintain strength in lower extremities once a
day for 6-7 days a week. Resident #82 required minimal instruction but staff were to encourage and praise
participation. One of the interventions was to reassess quarterly and as needed.
Review of restorative ambulation program delivery records revealed the week of 05/25/25 - 05/31/25 the
service was offered/provided five times. The week of 06/01/25 - 06/07/25, the service was provided three
times. The week of 06/08/25 - 06/14/25, the ambulation program was refused once. There was no other
indication of the program being offered. The week of 06/15/25 to 06/21/25, the program was documented
with one refusal and no other offers to provide it were documented.
Review of a restorative evaluation dated 06/13/25 indicated Resident #82 participated in the program as
ordered. The goal was to maintain current ambulation status and be without decline by the next review date.
The program would be re-evaluated quarterly and as necessary.
On 06/23/25 at 12:36 P.M., the Director of Nursing (DON) acknowledged records did not reflect Resident
#82's restorative ambulation program was offered in accordance with orders/plans of care/assessments.
3. Review of Resident #96's medical record revealed diagnoses including hemiplegia (paralysis/weakness
of one side of the body) affecting the right dominant side, type two diabetes mellitus with diabetic
neuropathy, morbid obesity, need for assistance with personal care, generalized anxiety disorder and
depression. A quarterly Minimum Data Set (MDS) assessment dated [DATE] indicated Resident #96 was
cognitively intact with no rejection of care. Resident #96 had impaired functional ROM of both the upper
and lower extremity on one side of her body.
Review of a care plan initiated 02/27/23 indicated Resident #96 was on a restorative program for
active/passive range of motion. Interventions indicated passive range of motion (PROM) (movement of a
joint or body part without any effort from the individual) to the right upper extremity in all planes once a day,
six to seven days for 15 minutes a day to increase range of motion to the right upper extremity. The care
plan indicated Resident #96 required maximal assistance with minimal verbal cues. Interventions included
reassessment of the program quarterly and as needed.
Review of restorative program delivery records revealed the program was delivered five times the week of
05/25/25 - 05/31/25, four times the week of 06/01/25 and 06/07/25, five times the week of 06/08/25 and
06/14/25, and five times the week of 06/15/25 to 06/21/25.
A restorative evaluation dated 06/13/25 indicated Resident #96 participated in the restorative PROM
program as ordered. The goal was to maintain current ROM and be without decline. The assessment
indicated Resident #96's restorative program would be re-evaluated quarterly and as necessary.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 13 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0725
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
On 06/23/25 at 12:36 P.M., the Director of Nursing (DON) verified documentation did not reflect the
program was offered a minimum of six times a week in accordance with the order and care plan.
The facility identified 41 residents with orders for one or more restorative programs (Residents #1, #2, #3,
#4, #6, #7, #11, #15, #18, #24, #26, #32, #34, #37, #41, #42, #43, #48, #51, #56, #61, #67, #68, #69, #70,
#73, #75, #79, #81, #82, #86, #87, #90, #91, #92, #93, #94, #95, #96, #98 and #100).
This is an incidental finding disovered during the investigation.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 14 of 15
Printed: 05/15/2026
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
365292
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hanover Healthcare Center
435 Avis Avenue NW
Massillon, OH 44646
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 0759
Ensure medication error rates are not 5 percent or greater.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, review of physician orders, policy review, and interview, the facility failed to ensure
medications were administered as ordered. Two medication errors were identified out of 27 opportunities
resulting in a 7.4% medication error rate. This affected one (Resident #74) of two residents observed for
medication administration.
Residents Affected - Few
Findings include:
On 06/17/25 at 7:57 A.M., Licensed Practical Nurse (LPN) #200 was observed administering medication to
Resident #74. Among medications administered were divalproex sodium (three 250 milligram tablets and
one 500 milligram tablet) and vitamin B-6 100 milligrams (mg).
Review of Resident #74's physician orders revealed an order dated 02/20/25 for pyridoxine HCl (vitamin
B-6) 50 mg every day. There were orders dated 05/08/25 for three divalproex sodium tablet delayed release
tablets to be administered in the morning for mood disorder and one divalproex sodium extended release
tablet 500 mg in the evening for mood disorder.
On 06/18/25 at 9:40 A.M., LPN #200 verified she administered all medications that had been included in
the medication packet dated 06/17/25 in the morning. LPN #200 verified Resident #74 had an order for
divalproex sodium 750 mg total in the morning and 500 mg in the evening. However, the amount included in
the packet totaled 1250 mg.
On 06/18/25 at 9:49 A.M., Registered Nurse (RN) #205 stated she had not administered Resident #74's
morning medications yet. Observations of the morning medication packets revealed it contained three 250
mg and one 500 mg tablets of divalproex sodium which was an incorrect dose. RN #205 also confirmed
only 100 mg tablets of vitamin B-6 were available and she had to split the tablet to give the correct dose.
On 06/18/25 at 9:55 A.M., LPN #200 verified she had administered a whole 100 mg tablet of vitamin B-6 to
Resident #74, stating the tablets were not scored (A scored tablet is a tablet that has a debossed line or
indentation across its surface, allowing it to be easily cut into smaller portions.).
On 06/18/25 at 3:18 P.M., Pharmacist #210 reviewed Resident #74's medication profile and stated in
February 2025 Resident #74 had an order for divalproex sodium 500 mg twice a day. On 05/08/25 an order
was received for divalproex sodium three tablets of 250 mg every morning. The 500 mg dose was not
canceled. Since 05/08/25, pharmacy had been sending the three 250 mg tablets as well as the 500 mg
tablet for the morning medication administration. Pharmacist #210 stated Resident #74 should have a new
depakote (divalproex sodium) level obtained.
Review of the facility's Medication Administration policy (no implementation date listed) revealed
medications were to be administered only as prescribed by the provider. Nurses were instructed to
observed the right dose was administered. The policy instructed nurses not to split or alter tablets.
Pharmacy was to be contacted for correct dosage. For emergency purposes, the tablet might be split if the
pill was scored. Unscored or coated pills would not be split.
This deficiency represents non-compliance investigated under Complaint Number OH00166349 and
Complaint Number OH00164924.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365292
If continuation sheet
Page 15 of 15
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Back to topCitations
9 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F759 - Medication Errors
Ensure medication error rates are not 5 percent or greater.
F580 - Notification of Changes
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
F609 - The facility must develop and implement written policies and procedures that:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
F610 - In response to allegations of abuse, neglect, exploitation, or mistreatment, the
Respond appropriately to all alleged violations.
F684 - Quality of care
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
F688 - Mobility
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.
F725 - Nursing Services
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
F676 - Based on the comprehensive assessment of a resident and consistent with
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
F680 - The activities program must be directed by a qualified professional
Ensure the activities program is directed by a qualified professional.
FAQ · About this visit
Common questions about this visit
What happened during the June 25, 2025 survey of HANOVER HEALTHCARE CENTER?
This was a inspection survey of HANOVER HEALTHCARE CENTER on June 25, 2025. The surveyor cited 9 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at HANOVER HEALTHCARE CENTER on June 25, 2025?
Yes, 9 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Ensure medication error rates are not 5 percent or greater."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.