Inspection·July 23, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete with Housekeeper #176 confirmed there was a strong odor of urine in the hallway, and she indicated there was a resident in this hallway that pulls at her urine bag and dumps urine everywhere. Housekeeper #176 stated she was working to get all the rooms clean to help eliminate the odor.Interview on 07/17/25 at 11:45 A.M. with the Director of Nursing (DON) confirmed the strong cleanser smell in the memory care unit on the morning of 07/16/25 was a result of the cleaner used to remove the mold noted on the wall in the hallways where the molding has not yet been replaced that was observed on the walls in the afternoon of 07/15/25.This deficiency represents noncompliance investigated under Complaint Number OH00166441 (1280566). Event ID: Facility ID: 365394 If continuation sheet Page 2 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NONCOMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY.Based on record review, review of a facility self-reporting incident (SRI), review of the facility's related investigation, staff interview, resident interview, family interview, and review of the facility's Abuse Policy, the facility failed to protect Resident #14's right to be free from sexual abuse by Resident #97. This resulted in Immediate Jeopardy and actual harm beginning on 07/08/25 at 7:20 P.M. when Certified Nursing Assistant (CNA) #119 observed Resident #97, who had a history of sexually inappropriate behaviors engaged in non-consensual sexual intercourse with Resident #14, a cognitively impaired and non-interviewable female resident, who lacked the cognitive ability to provide consent to sexual activity. CNA #119 observed Resident #97 lying on top of Resident #14 with his shorts pulled down to his ankles and Resident #14 was noted to be completely naked. Resident #14 was transferred to the emergency room for an evaluation including a SANE exam and a rape kit. Blood work was completed to rule out sexually transmitted diseases (Hepatitis/HIV) and Resident #14 received prophylaxis treatment. Resident #14's immediate reaction at the time of the incident included she was tearful, had scared facial expressions, and reported he hurt me. This affected one resident (#14) of two residents reviewed for sexual abuse. The facility census was 94. On 07/17/25 at 1:12 P.M., the Director of Nursing (DON), Assistant Director of Nursing (ADON), Regional Nurse, Regional Administrator, and Administrator in Training (AIT) were notified Immediate Jeopardy began on 07/08/25 at 7:20 P.M. when the facility failed to protect Resident #14's right to be free from sexual abuse by Resident #97. The Immediate Jeopardy was removed on 07/09/25 and subsequently corrected on 07/10/25 when the facility implemented the following corrective actions:On 07/08/25 at 7:20 P.M. the CNA observed Resident #14 and Resident #97 in Resident #14's bed. Resident #14 was completely naked, and Resident #97 had his shorts pulled down to his ankles lying on top of Resident #14. The CNA immediately intervened and stopped the sexual abuse from occurring separating the two residents. Resident #97 was placed on one-on-one staff supervision to ensure he remained separated from Resident #14, and Resident #14 remained free of further sexual abuse. On 07/08/25 at 7:25 P.M. the Licensed Practical Nurse (LPN) on duty called the facility DON and notified her of the incident between Resident #14 and Resident #97. The DON in turn notified the Executive Director (ED). On 07/08/25 at 7:35 P.M. the DON initiated the facility's investigation of the alleged sexual abuse of Resident #14 and interviewed all on-duty staff at the time of the incident that included four LPNs and four CNAs. On 07/08/25 at 7:45 P.M. the DON and the two LPNs on-duty initiated resident interviews and/or head-to-toe skin assessments on all current residents, excluding the residents residing on the facility's secured dementia unit. All other residents were interviewed and skin assessment completed with no negative findings. On 07/08/25 at 7:49 P.M. the DON completed a head-to-toe assessment on Resident #14. On 07/08/25 at 8:00 P.M., the Executive Director submitted the initial self-reported incident (SRI) of alleged sexual abuse of Resident #14 by Resident #97 to the Ohio Department of Health (ODH) via ODH Application Gateway. On 07/08/25 at 8:04 P.M. the DON called 911 to report the sexual abuse of Resident #14 to local law enforcement and local emergency medical service (EMS). On 07/08/25 at 8:09 P.M. the DON notified Resident #14 and Resident #97's responsible parties and medical providers of the incident that occurred between Resident #14 and Resident #97. On 07/08/25 at 8:20 P.M. the local law enforcement and EMS arrived at the facility. Resident #14 left the facility with EMS to be evaluated in the emergency room of a local hospital. On 07/08/25 at 8:35 P.M. Resident #97 left the facility with law enforcement. Resident #97 remained on one-on-one supervision the entire time (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 3 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few from incident to exiting the facility. On 07/08/25 at 9:00 P.M. the DON completed staff interviews with all nursing staff who worked the 500-hall unit that day (4 LPNs and 4 CNAs). On 07/08/25 at 10:15 P.M. the DON completed 72 resident interviews and/or head-to-the-skin assessments to identify any other residents that had potentially been abused. Those residents who could not be interviewed, had a head-to-toe skin assessments completed. On 07/09/25 at 12:20 A.M., Resident #14 returned to the facility. The LPN on duty completed a head-to-toe skin assessment. On 07/09/25 at 12:20 A.M., the LPN on duty updated Resident #14's family on her return and her condition. On 07/09/25 at 8:00 A.M, the DON/ED initiated education with all staff regarding the facility's Abuse Policy with focus on the definition and signs of sexual abuse. On 07/09/25 9:00 A.M., a whole house audit was conducted of all 72 residents residing in the facility to identify any other residents displaying inappropriate sexual behaviors and/or entering other residents' room inappropriately. On 07/09/25 at 10:30 A.M, facility Root Cause Analysis was completed by the [NAME] President (VP) of Clinical and Regional Clinical Support nurse. Facility Root Cause Analysis determined that lack of supervision of Resident #97, who had a history of sexually inappropriate behaviors, lead to the occurrence of an incident. Resident #97 does have a history of sexual behaviors and Tagamet (H2-receptor antagonist) was ordered on 03/05/25. All facility staff were educated on the Abuse Policy with emphasis on sexual abuse. On 07/09/25 at 10:30 A.M., Ad Hoc Quality Assurance Performance Improvement (QAPI) meeting was held with the DON, ED, ADON/Infection Preventionist, Medical Director, Regional Clinical Support and VP Clinical Support. The purpose of the meeting was to discuss the incident with the Medical Director to review, develop, and implement corrective actions. On 07/09/25 at 12:10 P.M., the ED notified the State's local Ombudsman of the incident of sexual abuse of Resident #14 by Resident #97. On 07/09/25 at 12:30 P.M., the ED issued an immediate discharge to Resident #97 and his guardian. Resident # 97 remained in custody of local law enforcement at this time. On 07/09/25 at 2:38 P.M the DON and ED completed education with all staff regarding the facility's Abuse Policy with focus on the definition and signs of sexual abuse. Staff educated include ED (1), AIT (1), DON (1), ADON (1), Registered Nurses (RNs) (5), LPNs (29), CNAs (43), Dietary staff (12), Laundry and Housekeeping Staff (15), Activities (3), Therapy (4), Social Services Director (1), Receptionists (2). The facility implemented a plan for the DON or designee to complete ongoing audits by resident interview to ensure there have not been any concerns or allegations of abuse. The audit would be completed with 10 random residents twice weekly for four weeks beginning on 07/08/25, then as determined necessary thereafter. Audit results will be reviewed in QAPI. The facility implemented a plan for the DON or designee to complete ongoing audits by staff interview to ensure they understand the abuse policy and what to do if they have any concerns or allegations of abuse. The audits would be completed with 10 random staff members of any discipline, twice weekly for four weeks beginning 07/08/25, then as determined necessary. Audit results would be reviewed in QAPI. The facility implemented a plan for the DON or designee to complete an observation audit of the residents' environment to ensure no residents were displaying inappropriate sexual behaviors and/or entering other residents' rooms inappropriately. Audits would be completed twice weekly for four weeks beginning 07/08/25, then as determined necessary. Results of audits would be reviewed in QAPI. On 07/10/25 at 3:00 P.M., the facility submitted conclusion of SRI to the ODH via ODH Application Gateway substantiating allegation of sexual abuse of Resident #14 by Resident #97. Findings include: Review of Resident #14's medical record revealed the resident was admitted to the facility on [DATE] with the diagnoses including memory deficit following a cerebral infarction, encephalopathy (group of conditions that cause brain dysfunction that can appear as confusion, memory loss, and personality changes), anxiety disorder, depression, and post-traumatic stress (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 4 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few disorder (PTSD). The resident's most current weight listed was 110 pounds. Review of Resident #14's active care plans revealed a plan of care initiated 08/12/24 related to PTSD. The care plan identified the resident as having PTSD and was a known rape survivor. The care plan indicated the resident had been physically and sexually assaulted by a guy. The resident's triggers included yelling, loud noises, and approaching her in a fast manner. The goal was for the resident to have a decreased effect from her triggers daily. The interventions included offering the resident empathy, compassion, and support as needed. Review of Resident #14's most recent quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had adequate hearing without the use of a hearing aid and clear speech. She was able to make herself understood and was usually able to understand others (misses some part/ intent of message but comprehends most of the conversation). The resident's vision was adequate with the use of corrective lenses. The assessment revealed the resident's cognition was severely impaired, and she was known to have physical behavioral symptoms directed towards others that occurred one to three days of the seven-day assessment period. The resident was not known to reject care. She did not have any functional limitation in her range of motion and used a wheelchair as a mobility device. The resident was dependent on staff for upper and lower body dressing and required substantial/ maximum assistance for transfers. Review of Resident #14's progress note revealed a nurse's note by the facility DON dated 07/08/25 at 7:20 P.M. that indicated Resident #14 had an observed resident interaction with a male resident. The staff were indicated to have intervened and separated. Resident #14 was assessed without negative effects. The resident's physician and resident representative were notified. A nurse's progress note by the DON on 07/08/25 at 8:20 P.M. revealed the resident was transferred out of the facility via EMS to a local emergency room (ER) for an evaluation. She returned to the facility on [DATE] at 12:20 A.M. in stable condition. Review of the resident's medical record revealed no nursing progress was entered by LPN #215, the nurse on duty at the time of the incident and who was assigned to care for Resident #14. The DON, who authored the progress note above, was not present in the facility at the time of the incident. The DON arrived to the facility 30-45 minutes after she was called and informed of the incident. The DON documented the effective date and time in the note she authored in the resident's medical record. Further review of Resident #14's progress notes revealed a nurse practitioner (NP) note dated 07/09/25 (untimed) that indicated the resident was being seen for a hospital follow up on a sexual assault. The resident was seen in the ER on [DATE]07/09/25 after a sexual assault. She was evaluated by the Sexual Assault Nurse Examiner (SANE) nurse. There were no signs of trauma or penetration to the oral cavity, rectum, or vagina. The resident was treated with prophylactic antibiotics, and a referral was placed to infectious disease. A Hepatitis panel and HIV test obtained at the hospital were unremarkable/ negative. The NP indicated she was unable to obtain a full review of systems due to the resident's cognitive impairment. Review of Resident #14's ER notes for her ER visit on 07/08/25- 07/09/25 (3 hours) revealed the resident had been seen for a reported sexual assault. She was diagnosed with a sexual assault of an adult, treated with prophylactics (Metronidazole 2000 milligrams (mg), Azithromycin 500 mg, and Rocephin 500 mg with Lidocaine intramuscularly) and discharged back to the nursing facility. A Hepatitis panel and HIV tests were administered at the hospital and found to be non-reactive at the time. The resident was to follow up with the infectious disease clinic. Review of Resident #97's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including major depressive disorder, severe, recurrent and without psychotic features, adjustment disorder with depressed mood, morbid obesity (severe), and antisocial personality disorder. The resident's most recent weight was 462 pounds.Review of Resident #97's progress notes revealed a nurse's note dated 03/04/25 at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 5 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few 10:07 P.M. by the DON that indicated the on-call physician service was updated on the resident entering another resident's room. Review of a social service note dated 03/05/25 at 8:13 A.M. revealed a referral had been made to a sister facility for Resident #97 to be transferred to their behavioral unit. The social worker indicated she would follow up and assist as needed. Review of a nurse's note dated 03/05/25 at 10:40 P.M. revealed the nurse manager for Resident #97's unit spoke with both the house NP and the psychiatric NP with a new order being given for Tagamet 200 mg po twice daily (BID) on a scheduled basis. The note indicated the resident was to remain on one-on-one supervision until 3:00 P.M. that day and then he was to be on every 15-minute checks for the next 72 hours. Review of Resident #97's active care plans revealed a plan of care initiated 03/05/25 indicating the resident had sexually oriented behaviors. The resident exhibited sexually inappropriate behavioral symptoms due to severe mental illness as evidenced by physical touching and grabbing. The goal was for the resident to comply with staff redirection and behave in a safe and respectful manner. Interventions included conducting an evaluation of the sexually oriented behavioral symptoms to determine what the resident was communicating through the behavior (e.g. need to feel in control, feeling inadequate, feeling angry/ hostile and disrespectful towards himself, and projecting those feelings onto others). The care plan also included the need to intervene and redirect when any inappropriate behavior was observed, communicate assertively the resident must exercise control over his impulses and behaviors, remind the resident to refrain from inappropriate touching, and refer the resident for a psychiatric evaluation and utilize psychoactive medications as warranted. Review of Resident #97's most recent quarterly MDS assessment dated [DATE] revealed the resident did not have any communication issues. The resident was able to make himself understood and was able to understand others. The assessment revealed the resident was cognitively intact and not known to display any behaviors during the seven-day assessment period. The resident did not have any functional limitations to his range of motion and did not require the use of any assistive devices for mobility. The assessment revealed the resident required supervision or touching assistance for transfers and ambulation. Review of a facility self-reported incident, tracking number 262557 dated 07/08/25 revealed the facility reported an allegation of sexual abuse involving Resident #97 and another female resident (Resident #14). Resident #97 was the alleged perpetrator and Resident #14 was the involved resident/ victim. The SRI revealed neither of the residents were able to provide any meaningful information when interviewed. Witnesses to the sexual abuse were identified as CNA #112, CNA #119, and LPN #215. The date/ time/ location of the occurrence was on 07/08/25 at 7:20 P.M. in Resident #14's room. The narrative summary of the incident revealed a CNA entered the room of Resident #14 and saw Resident #97 lying on top of Resident #14 in bed. Neither resident had clothes on. Both residents were immediately separated, and Resident #97 was placed on one-on-one supervision. Local law enforcement was notified. Resident #97 left the facility with the local law enforcement, and he was on one-on-one supervision from the time of the incident until he left with law enforcement. Resident #14 was sent to the ER for an evaluation and returned to the facility later that same night. The SRI included a head-to-toe skin assessment was completed on Resident #14 (after the incident) with no negative findings, signs of trauma, or injuries. The facility substantiated the allegation of sexual abuse based on their investigation. The facility DON was identified as the investigator of the allegation. Review of the facility's related investigation revealed personal witness statements were obtained from the two involved residents, Resident #14's roommate, and the three staff members identified as witnesses to the sexual abuse. Review of Resident #14's personal witness statement revealed a verbal statement was obtained from the resident by the DON regarding the incident that took place on 07/08/25 at 7:20 P.M. The statement was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 6 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few obtained on 07/08/25, without a time indicated. The resident was asked a series of four questions. She was asked if he (Resident #97) touched her and she replied yes. She was asked if he touched her with his hands and she replied yes. She was asked if he touched her with his penis and she said yes. She was then asked if she had any pain and responded no.Review of Resident #97's personal witness statement revealed a verbal statement was obtained from the resident by the DON regarding the incident that took place on 07/08/25 at 7:20 P.M. The statement was obtained on 07/08/25, but no time was indicated for when the statement was obtained. Resident #97 was asked what he was doing? He did not answer at first, but then finally stated I was just in visiting. Review of a personal witness statement obtained from Resident #15 (roommate of Resident #14) by LPN #215 on 07/08/25 at 8:35 P.M. regarding the incident occurring on 07/08/25 (time of incident not specified) revealed she did not see anyone enter the room. She did see him close the curtain. She could hear her roommate (Resident #14) asking for help. She started to yell and stopped. She then heard the aide open the door and tell him to get out. After that, the nurse came in. She thought the other male resident was in the room for about 10 minutes. Review of a personal witness statement from CNA #119 for the incident dated 07/08/25 at 7:20 P.M. revealed she and CNA #112 were looking for a dog toy when they were told Resident #14 was the one who had it last. When she went to Resident #14's room, knocked, and entered she saw Resident #14 and Resident #97 on the bed. Resident #14 was naked with her head on the pillow and her hands clasped together over her chest. Resident #97 had his shirt on and his shorts were down between her (Resident #14's) legs with what looked like his penis in her vagina. She told him (Resident #97) that this wasn't going to be happening. Resident #97 stood up grunting, pulled his shorts up, and then balled his fist while walking towards her. She told him he did not want to do this, and he then walked out the door. She shut the door and went to the bed and noticed Resident #14's depend (incontinent brief) was on her bedside table. Her shoes were beside the wall on the bed. She asked Resident #14 if she was okay and if it was consensual. Resident #14 replied no, he hurt me. CNA #14 then reported she started to put Resident #14's hospital gown on her so she would be covered up. CNA #112 then walked in and the aide told her to go get the nurse and also told the other aide what had happened. LPN #215 came in and she told her what she had seen. LPN #215 contacted the supervisors while she and the other aide stayed outside Resident #97's room until the local law enforcement arrived. She indicated in her statement that she had just seen Resident #14 approximately 20 minutes prior and the resident was in her wheelchair in the lobby playing with a staff member's puppy. Review of a personal witness statement from CNA #112 for the incident occurring on 07/08/25 at 7:20 P.M. given on 07/08/25 (no time indicated) revealed she walked into Resident #14's room and saw that she was naked. The aide that she was training (CNA #119) told her Resident #97 was on her (Resident #14) while she was naked and Resident #97 was naked from the waist down. CNA #119 told her Resident #97's penis was inside of Resident #14 and that he was touching her also. CNA #119 then told Resident #97 to get up. He got up, dressed, and left the room. She confirmed they had just seen Resident #14 20 minutes prior out in the lobby playing with a staff member's puppy while up in her wheelchair. Review of a personal witness statement from LPN #215 for the incident occurring on 07/08/25 at 7:20 P.M. given on 07/08/25 (no time indicated) revealed she was alerted by a CNA that a resident (Resident #97) was found on top of another resident (Resident #14) with his pants around his ankles and he was seen having intercourse. Upon entering the room, both residents were immediately separated. Vital signs were collected, and skin was assessed. She then notified appropriate staff. Both residents were placed on one-on-one supervision until EMS/ local law enforcement arrived. On 07/16/25 at 10:25 A.M., an interview with CNA #119 revealed it was her first day working at the facility when the incident between (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 7 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Resident #14 and Resident #97 occurred on 07/08/25. She stated she had been a CNA for 20 years in the past but had taken a different job outside of healthcare in the past five years. She confirmed she was one of the day shift aides working from 7:00 A.M. to 7:00 P.M. weekend. She further confirmed she was the staff member who found the two residents (#14 and #97) in bed and naked. The incident occurred at 7:20 P.M. She stated she was still there at the time as her relief was running late. She was being trained by CNA #112. She reported she and CNA #112 were looking for a dog toy and had been told Resident #14 was the last one known to have it. She went to Resident #14's room, knocked on the door, and entered finding Resident #14 in bed with her gown off and her incontinence brief lying across the bedside table. Resident #14's shoes were on her bed by the wall. Resident #14 had been in a hospital gown that evening. Resident #97 was lying on top of Resident #14 with his short pulled down. Resident #97 was thrusting his hips into Resident #14 and was making grunting noises. It looked as if his penis was inside of Resident #14. When Resident #97 stood up, he had some kind of liquid on his erect penis. She described the liquid as like fluids but was not sure if they were Resident #97's or Resident #14's. She was also not sure if the fluid was semen or urine. She stated, it just appeared like they were having sex. Resident #14 had her hands clenched in a fist and next to each other over her breast. She denied Resident #14 was making any sounds and did not hear Resident #14 say anything. She stated she saw a tear coming down the side of Resident #14's face and she had a scared look on her face. She had seen Resident #14 minutes prior to that incident in the lobby petting a dog. She was up in her wheelchair at the time and dressed in a gown. She had an incontinence brief on and was wearing shoes, as she was ready for bed. With the way Resident #14 went around in her wheelchair, she did not feel Resident #14 would have been able to transfer herself from the wheelchair to bed. She stated when she walked in and found them, she said oh no, we are not doing this. She then told Resident #97 he needed to get out of Resident #14's room. Resident #97 then started to get up, pulled his pants up, and made a growling noise. She was not sure at the time if Resident #97 was non-verbal or not. He balled his fist at her as he passed her by when leaving the room. After Resident #97 left the room, she went to Resident #14 and asked her if she was okay. Resident #14 replied no, he hurt me. She then put Resident #14's gown on her as she was trying to cover up her breasts. The other aide (CNA #112) peeked in the room at that time, and she told the other aide to go get the nurse as she believed Resident #14 had been raped. The other aide got the nurse (LPN #215) and the nurse came right in. She then informed LPN #215 what she walked in on, and the nurse notified the ADON and the DON. Another aide then came to sit with Resident #14 while she and CNA #112 sat outside the room of Resident #97. They sat outside his room to ensure the two residents remained separated from one another until the local law enforcement and EMS arrived. Resident #97 just sat in his room on his bed moving his hands up and down his leg while tapping his feet on the floor. She was not familiar with Resident #97 at the time to know if he was cognitively intact or not. Resident #97 resided on the same hall as the SR and his room was catty-corner from hers. They remained with Resident #97 until the police arrived. She then went to the shower room twice with the law enforcement officer to give them an account of what had happened. The second time she went to the shower room was so the law enforcement officer could ask her if she had cleaned Resident #14 after the incident. She informed the law enforcement officer that she had not and put the same gown on her that she had on prior to the incident. She remained in the facility until all the interviews were done and all the evidence was bagged. The Law enforcement officer then walked Resident #97 out of the building. She filled out an incident report for the DON before she left the facility around 10:00 P.M. that night. She confirmed what she filled out was the personal witness statement and further confirmed the statement in the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 8 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few facility's investigation was what she had written. She reported she had just come from the county courthouse earlier that morning (prior to her interview) where she had to give testimony to the Grand Jury. She stated the Prosecutor had indicated they were debating on whether the charges against Resident #97 would include any federal charges. If convicted for what they were wanting to charge him with, he could get between 66 and 88 years. On 07/16/25 at 3:05 P.M., an interview with CNA #112 confirmed she was working on 07/08/25 when the incident occurred between Resident #14 and #97. She recalled it was sometime around shift change and thought it was probably 7:25 P.M. to 7:30 P.M. when it happened. She only seen the aftermath of what had happened. She walked into Resident #14's room to check on her coworker (CNA #119) who she was training. Her coworker was the one that had seen what happened and separated the two residents. She suspected she went to check on CNA #119 about five to 10 minutes after CNA #119 went to Resident #14's room. By the time she arrived at Resident #14's room, Resident #14 was still undressed, and CNA #119 was in the process of redressing the resident. She was told what had happened and then she left the room to get the nurse. She confirmed LPN #215 was the nurse working who she went to get. Resident #97 was already in his room when she arrived at Resident #14's room, which was catty-corner from Resident #14's room. She was familiar with the two residents involved prior to the incident, as she would often help the aides on the 500 hall. Resident #14 was normally up in the lobby area by the nurses' station on the North unit. She denied she had any prior interactions with Resident #97 before that incident. She was a little bit familiar with him. She reported that Resident #14 needed help transferring in and out of bed. She described Resident #14 as a two-person assist that needed substantial to maximum assistance for transfers. Resident #14 was non-ambulatory and had the use of a wheelchair. She was only able to stand and pivot when transferred. She reported that Resident #14 was able to undress herself at times but normally needed help doing so. She denied she had ever noted Resident #14 to remove her own clothing herself. She was usually dressed in a T-shirt or long-sleeved shirt and sweatpants. When she went to bed or on shower days, she had a gown on. When she saw Resident 14, the resident had always been dressed in clothes. She reported Resident #14 was normally confused but the level of confusion depended on the day. She was able to talk in short sentences but could not carry a conversation on with you. She had heard Resident #14 say please help or the resident would tell her thank you. Resident #14 could also get agitated, anxious, and restless at times but for the most part was relaxed. She described Resident #97 as being independently ambulatory. He was typically in his room, in the dining room, or outside to smoke. He was known to visit other residents (naming a male resident he visited on the 700 hall) but denied knowledge of Resident #97 visiting any female residents prior to that incident. She then recalled there was one time when Resident #97 did go into one female resident's room a while back. She identified that female resident as Resident #68, who used to reside on the 600 hall. That female resident had since been moved to the facility's memory care unit and was currently out of the facility in the hospital. She reported Resident #97 seemed like he was okay. She was not aware of him having any behaviors. She denied she was aware of him displaying any prior sexually inappropriate behaviors. She then recalled hearing something about Resident #97 cornering an aide in the shower room but wasn't sure of any details. That occurred about a month two ago and she identified CNA #192 as the aide involved. She did not think that Resident #97 touched the aide, he just had her cornered. She reported the nurse (LPN #215) responded to the incident between Resident #14 and #97 immediately. LPN #215 assessed Resident #14 and then had her (CNA #112) call the ADON. The ADON then called the DON. The DON came into the facility. She confirmed she sat with Resident #97 until the DON and the local law enforcement arrived. The DON was on scene before the local law enforcement arrived. She was not (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 9 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete interviewed by law enforcement but did give a written statement to the DON. She was not sure how Resident #14 got into bed that night when she was found in bed with Resident #97 on top of her. They normally had to put her in bed, and no one had put her in bed that night. She denied there would be any other aides (other than her and the trainee) that would have put Resident #14 to bed. She believed Resident #97 had put Resident #14 in bed. She felt he would have been capable of lifting Resident #14 from her wheelchair into bed. She confirmed Resident #14 had a roommate who was present when the incident took place. She identified the roommate as Resident #15. She reported Resident #15 was alert and oriented and should be able to answer questions regarding the incident. She believed the roommate was asked to provide information regarding the incident to the facility as part of their investigation. Resident #14 resided in the bed by the door and Resident #15 was in bed by the window. On 07/16/25 at 4:40 P.M., an interview with Resident #15 revealed she recalled the incident that occurred on 07/08/25 and confirmed she was lying in her bed at the time the incident took place. She denied that she had seen anything. The resident stated he (Resident #97) pulled the curtain when he came in. She stated she got a quick look and only saw part of his face. She was not sure at the time if it was an employee or a resident. She just thought someone came in to get her roommate (Resident #14) ready for bed. She could not recall the time of the incident and was not sure if it occurred before or after dinner. She denied that she heard the male say anything. She reported her roommate was just carrying on. She heard her roommate say, get out. She denied she heard any other noises until the staff came in. The staff came in about 15 minutes after Resident #97 was there. They started yelling quite loudly at R[TRUNCATED] Event ID: Facility ID: 365394 If continuation sheet Page 10 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview, and review of the facility policies, the facility failed to maintain appropriate infection control and enhanced barrier precautions (EBP) for one (Resident # 87) out of 41 residents in EBP. The facility census was 94. Findings include: Review of the medical record for Resident #87 revealed an admission date of 06/26/25. Diagnoses included metabolic encephalopathy, hypertension, peripheral vascular disease, major depressive disorder, cirrhosis of liver, type two diabetes mellitus, bipolar disorder, and chronic pain syndrome. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed a Brief Interview for Mental Status (BIMS) of three out of 15, indicating Resident #87 had severe cognitive impairment. The resident was assessed to require partial/moderate assistance for meals/eating, and oral hygiene. Resident #87 was dependent on staff for toileting, shower/bathing, dressing, and personal hygiene. Resident #87 was admitted with one Stage III pressure ulcer (Full thickness tissue loss, subcutaneous fat may be visible but bone, tendon or muscle are not exposed, slough may be present but does not obscure the depth of tissue loss, may include undermining and tunneling). Review of the Care Plan revealed Resident #87 had an open wound on her coccyx/right buttock and her left lateral hip. Resident #87 required EBP related to wound care for skin openings and a history of multi-drug-resistant organism (MDRO). Resident #87 required EBP for dressing, bathing/showering, transferring, personal hygiene, changing linen, toileting, and peri-care. Observation on 07/16/25 at 10:10 A.M. of incontinence care for Resident #87 by Certified Nursing Assistants (CNAs) #207 and #224 revealed Resident#87 was noted to have a sign above her bed for EBP. Resident #87 was cleaned appropriately. Cleaning uncovered an open sore on the left buttock/hip area and reddened open area on right buttock. CNA #224 did the cleaning and removal of the old incontinence brief and then did not change her gloves prior to applying the new incontinence brief. The incontinence care was appropriately timed, and Resident #87 remained comfortable throughout the process. Interview on 07/16/25 at 10:20 A.M. with CNA #224 confirmed the resident had a sign for EBP, and by policy, staff were to wear gloves and a gown when the resident has a catheter, a known infection, or an open wound. CNA #224 indicated Resident #87 received Triad paste as a barrier cream, and Triad paste was considered a medication, so the nurse would need to come and apply it. CNA #87 did not apply a barrier cream, so she did not realize she needed to change her gloves before applying a clean incontinence brief. CNA #224 realized she should change gloves and did perform hand hygiene after Resident #87 was redressed and comfortable in bed. Interview on 07/17/25 at 11:45 A.M. with the Director of Nursing (DON) confirmed during the observed incontinence care for Resident #87, while CNA #224 was performing care she did not change her gloves and do hand hygiene between cleaning the resident and applying a clean incontinence brief as per the facility Incontinence Care Policy. The DON also confirmed that CNAs #204 and #224 did not wear gowns for EBP, they only wore gloves. Review of the facility policy titled Incontinence Care, dated 01/06/25, revealed gloves should be changed and hand hygiene performed after the staff member cleans the resident and before the staff member applies barrier creams to the resident and again before applying clean incontinence briefs and under pads. Gloves should be removed and hand hygiene performed before the staff member changes linen and clothing if needed. Gloves should be removed and hand hygiene performed when the process is complete. Review of the facility policy titled Enhanced Barrier Precautions, dated 01/2025, revealed EBP is used in conjunction with standard precautions when the resident has an infection or colonization with a center for disease control (CDC) - targeted multi drug resistant organism (MDRO) when contact precautions do not otherwise apply; or when the resident has wounds and/or an indwelling medical device even if the resident is not known Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 11 of 12 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 365394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Adams Lane 1856 Adams Lane Zanesville, OH 43701 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 0880 Level of Harm - Minimal harm or potential for actual harm to be infected or colonized with a MDRO. For residents for whom EBP are indicated, EBP is employed when performing the following hi-contact resident care activities: Dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, during device care, and providing wound care.This deficiency represents noncompliance investigated under Complaint Number OH00166441 (1280566) and Complaint Number OH00166153 (1280565). Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365394 If continuation sheet Page 12 of 12