Health inspection·August 27, 2025

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, medical record and facility policy review, the facility failed to securely store medications. This affected one resident (#57) of five reviewed for medication administration. The facility census was 89.Findings include:Review of the medical record for Resident #57 revealed an admission date of 01/22/25 with diagnoses including but not limited to dysphagia following cerebral infarction, type two diabetes, hemiplegia and hemiparesis affected the non-dominant side. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] for Resident #57 revealed an intact cognition. Resident #57 required set up assistance for eating. Resident #57 was totally dependent on staff for toileting, transfers and bed mobility.Review of the physician orders for Resident #57 revealed an order stating resident required assistance from staff to complete self-care and mobility due to hemiplegia dated 06/17/25 and an order for Fluticasone Propionate Nasal Suspension 50 micrograms two spray in both nostrils two times a day for allergies dated 05/16/25. The resident did not have an order to self-administer medications. Observation on 08/26/25 at 8:18 A.M. of medication administration with Licensed Practical Nurse (LPN) #281 revealed nurse prepared medication for Resident #57 including gathering the Fluticasone Propionate Nasal Suspension 50 micrograms nasal spray and entered the resident room. LPN #281 attempted to administer Fluticasone Propionate Nasal Suspension 50 micrograms to resident when he responded that he already did that pointing a bottle of nasal spray which was sitting on his bedside table. Resident #57 stated the night shift left the nasal spray in his room the night before. LPN #281 administered the other prescribed medications, removing the bottle of Fluticasone Propionate Nasal Suspension 50 micrograms off of the resident's bedside table when she left the room.Interview on 08/26/25 at 8:25 A.M. with LPN #281 verified the bottle of Fluticasone Propionate Nasal Suspension 50 micrograms should not have been in the room and verified the resident did not have a physician order for medication self-administration. Interview on 08/26/25 at 2:41 P.M. with Director of Nursing (DON) verified medications should not be left in the resident's room. Review of the facility policy titled Medication Labeling and Storage dated 02/2023 states that medications and biologicals are in locked in compartments and only authorized personnel have access to keys. 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 3 Event ID: 365309 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 365309 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arc at Trotwood LLC 5790 Denlinger Road Dayton, OH 45426 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)