Inspection visit
Inspection
8 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 8 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited
to receiving treatment and supports for daily living safely.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observations, interviews, and policy review, the facility failed to ensure allegations of missing items were
resolved to residents' satisfaction. This affected three (Residents #10, #20, and #36) of 12 residents
interviewed regarding personal property. The facility census was 65.
Findings include:
1. Review of Resident #20's medical record revealed diagnoses including major depressive disorder,
dementia, and anxiety disorder. A quarterly Minimum Data Set (MDS) assessment dated [DATE] indicated
Resident #20 was able to make herself understood, was able to understand others, and was cognitively
intact.
During an interview on 03/04/24 at 9:13 A.M., Resident #20 reported she was missing two pairs of gray
jogging pants and a black nightshirt with the saying dogs are my favorite people. Resident #20 stated she
received the items for Christmas and her name was marked in the items. Although staff had said they
looked for the missing items, they had been gone for a while and she had not heard anything.
On 03/04/24 at 4:03 P.M., upon request, the Director of Nursing (DON) provided lost item reports since
September 2023. The DON reported when a resident complained of a missing item, a form was filled out
and staff searched for it. Information regarding whether the item(s) was located or not was documented on
the form and the information was discussed with the Quality Assurance Committee.
On 03/04/24 at 4:17 P.M., Resident #20 gave permission for the missing items to be discussed with staff
because she wanted the items.
On 03/04/24 at 4:23 P.M., Housekeeping/Laundry supervisor #500 stated if a resident reported something
was missing, staff searched for it because sometimes clothing fell off hangers or items got placed in the
wrong closet. The facility had an unclaimed items rack. Housekeeping/Laundry Supervisor #500 verified
she was aware of the missing items stating Resident #20's pants had been located but that she had
originally reported the shirt was black and did not indicate it had writing on it. This writer requested to see
the pants. After speaking with Resident #20, searching her closet, and searching the unclaimed items rack,
Laundry Supervisor #500 verified she was unable to locate the items. A note would be posted on her desk
to alert laundry to look for the items.
On 03/04/24 at 4:44 P.M., the DON stated she had received no report of Resident #20 missing pants and a
shirt. When residents were admitted , an inventory sheet was completed. It was kept in medical
(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 14
Event ID:
365429
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
records. As more personal items were obtained, the list was supposed to be updated. The inventory list was
not immediately available.
On 03/5/24 at 7:43 A.M., after being informed one of the pair of Resident #20's pants had been found,
Resident #20 was interviewed and stated the gray knit pants she was wearing was not one of the two pairs
of gray jogging pants she reported missing. The jogging pants had elastic around the ankles.
Review of a progress note dated 03/05/24 at 8:49 A.M. indicated the DON spoke to Resident #20's
daughters with one reporting Resident #20 mentioned the clothing was missing near the holidays and she
thought she told somebody but was not positive.
On 03/05/24 at 1:29 P.M., Licensed Social Worker (LSW) #503 stated when she learned something was
missing, she initiated a lost items form and brought the information to the attention of other departments so
everybody could be searching. The forms were available for other departments but as far as she knew she
was the one who usually completed the missing items report. LSW #503 indicated staff usually reported
missing items to her. LSW #503 reported she had not been made aware of Resident #20's missing clothing
until 03/05/24.
2. Review of Resident #36's medical record revealed diagnoses including depression and generalized
anxiety disorder. A quarterly MDS dated [DATE] indicated Resident #36 was able to make herself
understood and was cognitively intact.
On 03/04/24 at 9:43 A.M., Resident #36 reported she had a missing lap robe since shortly after Christmas
and a couple pair of slacks.
On 03/04/24 at 4:03 P.M., when the DON provided information about missing items reported in the prior six
months, there was no information regarding reports of missing items for Resident #36.
On 03/04/24 at 4:23 P.M., Laundry Supervisor #500 stated she was aware of Resident #36 reporting the
missing items and stated the pants were found. Laundry Supervisor #500 stated the lap throw was not
located but a visitor (not identified) had indicated they never believed she had it at the facility.
Upon request, a search was completed of Resident #36's closet and a pair of beige pants were held up and
Laundry Supervisor #500 stated those were the missing pants that had been found. The lap throw was not
located.
On 03/05/24 at 7:45 A.M., Resident #36 stated the beige pants provided by Laundry Supervisor #500 the
afternoon of 03/04/24 were not the ones she had reported missing. The missing slacks were purple and
black.
On 03/05/24 at 1:29 P.M., LSW #503 stated she had not been informed of reports of missing pants and a
missing lap throw for Resident #36 prior to the survey and she was the one who usually completed the
missing items report and alerted staff to search for missing items. LSW #503 stated when she spoke with
Resident #36's son, he revealed he did not know where the purple and black checkered pants were and he
estimated it had been approximately one month since he observed the pants. He didn't know anything
about the lap blanket because somebody from church had given it to her.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 2 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0584
Level of Harm - Minimal harm
or potential for actual harm
On 03/05/24 at 3:05 P.M., the DON verified she had been unable to locate the personal inventory sheets for
Residents #20 and #36.
3. Record review revealed Resident #10 was admitted to the facility on [DATE] with diagnoses including
joint pain, diabetes mellitus, and falls.
Residents Affected - Few
Interview on 03/04/24 at 9:49 A.M., with Resident #10 revealed she had a brand-new nightgown that came
up missing that she got for Christmas. She had reported the missing item to the laundry department two or
three months ago, however they just said they couldn't find it and no more information was provided.
Interview on 03/05/24 at 10:35 A.M., with the Director of Nursing (DON) revealed she was not aware
Resident #10 was missing the nightgown.
Interview on 03/05/24 at 12:46 P.M., with the Administrator revealed the facility did not have a concern log
or policy or procedure.
Interview on 03/05/24 at 1:23 P.M., with LSW #503 revealed she was not aware the resident was missing a
nightgown until today, after it was reported by the surveyor. The LSW reported she had just called a family
member to make sure they did not take the nightgown home; however, they denied taking the nightgown
home. The LSW reported there was a Lost Article form that any staff member could complete when a
resident reported an item missing, however staff did not complete a form for Resident #10 when she
reported the missing item. The LSW reported if missing items were not found it would be up to the
Administrator or Director of Nursing (DON) to determine if the item would be replaced or not.
Interview on 03/05/24 at 1:53 P.M., with Laundry Staff #601 revealed she was notified after Christmas or
the first of the year, that Resident #10's nightgown was missing. Laundry searched in the lost and found,
the unmarked items, and the residents' closets and were not able to locate the nightgown. Laundry Staff
#601 reported she was not aware of a Lost Article form.
Interview on 03/05/24 at 1:56 P.M., with the Housekeeping/Laundry Supervisor (HLS) #500 revealed she
was not aware of the Lost Article form. HLS #500 reported she was aware the resident had a missing
nightgown sometime after Christmas. HLS #500 confirmed the facility never replaced the missing
nightgown.
Review of the facilities policy and procedure titled Lost Items undated revealed the purpose was to locate
lost articles in a timely manner, determine the cause of the lost article, and correct the problem to prevent
re-occurrence. The procedure included the person who finds out that an item was lost would complete the
Lost Article form and give it to the charge nurse or department head. The form would be forwarded to the
appropriate person and/or organize a search for the missing article. When the search has been completed,
the form will be completed and given to the Director of Nursing. The forms would be reviewed during the
weekly patient care meetings and in the monthly Quality Assurance meetings and problems or trends would
be addressed and corrected. Articles found should be placed in the lost and found box in the activity room if
the owner cannot be determined.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 3 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record review, observation, interviews, and policy review the facility failed to ensure skin alterations were
identified and treated timely and failed to ensure hospice records were available to ensure continuity of
care. This affected one (Resident #4) of one reviewed for non-pressure skin alterations and one (Resident
#29) of one reviewed for hospice services. The facility census was 65.
Residents Affected - Few
Finding included:
1. Record review revealed Resident #4 was admitted to the facility on [DATE] with diagnoses including type
two diabetes with polyneuropathy, congestive heart failure, glaucoma, muscle weakness, difficulty walking,
and unsteadiness on feet.
Review of Resident #4's medical record dated 02/01/24 to 03/05/24 revealed no evidence of skin alterations
or treatments to the resident's left foot or bilateral shins.
Review of the facility's wound book revealed no evidence Resident #4 had a skin sheet for skin alterations
to the left foot or bilateral shins.
Observation and interview on 03/04/24 at 9:00 A.M., with Resident #4 revealed the resident had a pea size
scab on the top of the left foot, two scabbed areas on the left shin and one on the right shin. The resident
reported the areas on her shins were caused by staff hitting her legs off the bedframe and she was not sure
how she got the area on the top of her left foot.
Observation and interview on 03/05/24 at 10:35 A.M., with the Director of Nursing (DON) confirmed the
resident had skin alterations on her left foot and bilateral shins. Resident #4 reported to the DON the areas
on the shins were caused by staff hitting her shins off the bedframe and the resident showed the DON
where on the bedframe staff where hitting her shins (when assisting the resident). The DON told the
resident the facility could pad the bedframe to prevent staff from potentially hitting her shins off the
bedframe. The DON verified there was no documentation regarding the areas and the DON would have the
nurse measure and document the areas.
Interview on 03/05/24 at 12:07 P.M., with Licensed Practical Nurse (LPN) #602 confirmed there was no
documented evidence of the resident's skin alterations as part of the medical record. The LPN reported she
had just completed an incident report regarding the areas to the resident's bilateral shins and the top of her
left foot, called the doctor and received new treatment orders. The LPN reported when she called the
daughter to update her on the new skin areas, the daughter reported she had seen the areas a few days
ago and was wondering about them (the areas). The LPN reported she had measured the areas, however
had not yet documented regarding the areas.
Review of Resident #4's care plan for potential skin breakdown revealed to report skin irritations.
Review of the facilities policy titled Skin Assessments dated 01/2019 revealed the nursing assistant would
monitor skin with routine care and report any abnormal findings to the nurse. The licensed nurse would
assess all residents head to toe every seven days and record the findings on the treatment administration
records. If an area was identified the nurse would document the appearance, measurements, and
characteristics on the [NAME] form. A treatment would be initiated as ordered by the
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 4 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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
provider and notify the responsible party, dietary, and the Director of Nursing (DON).
Level of Harm - Minimal harm
or potential for actual harm
2. Record review revealed Resident #29 was originally admitted to the facility on [DATE] with diagnoses
including multiple sclerosis (MS), anxiety, gastrostomy, dysphagia, encephalopathy, facial weakness,
obstructive and reflux uropathy, trigeminal neuralgia, anemia, malignant neoplasm of right kidney, prostate,
right adrenal gland, history of ischemic attack, severe protein-calorie malnutrition, and acute kidney failure.
Residents Affected - Few
Review of Resident orders dated 01/29/24 and revised on 02/05/24 revealed the resident was admitted to
hospice for sepsis and MS.
Review of Resident #29's medical record and all the hospice binders revealed no evidence of any type of
hospice notes including plan of care, certification, orders, assessments, or hospice contact information, etc.
Review of Resident #29's care plan for end of life due to sepsis and multiple sclerosis included the resident
was admitted to hospice care, however, did not indicate which hospice company the resident had hospice
services with, and the hospice doctor area was left blank.
Interview on 03/06/24 at 12:27 P.M., interview with the DON confirmed the facility had no paperwork from
hospice and she would have staff call and get the resident's plan of care, the certification, orders,
assessment, and other required documents.
Interview on 03/06/24 at 2:14 P.M., with the Administrator, revealed the hospice service was bought out by
another company a few months ago. The Administrator reported he had contacted the hospice
representative to bring out new binders to include updated phone numbers for the hospice and the resident
records. The facility currently has contracts and utilizes two hospice services in the area.
Interview on 03/06/24 at 3:30 P.M. with Hospice Registered Nurse (HRN) #603 revealed on 01/01/24 a new
company took over hospice and there has been an issue with staff not able to print reports/notes. The
corporation was aware of the issue; however, the issue has not been resolved at this time. Further interview
revealed HRN #603 had just delivered new binders with the updated contact number for hospice, as well as
records for Resident #29.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 5 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review, observation and staff interview, the facility failed to compressively assess,
document wounds upon discovery and to ensure weekly skin assessments were completed as ordered by
the physician. This affected one (Resident #33) of two residents reviewed for skin conditions. The facility
census was 65.
Residents Affected - Few
Findings include:
Review of Resident #33's medical record revealed an admission date of 05/04/18 with diagnosis that
included Alzheimer's disease with dementia, hypertension and osteoporosis.
Further review of the medical record including pressure ulcer wound risk assessments completed on
07/18/23 indicated Resident #33 was at very high risk of pressure ulcer wound development.
Review of the medical record including wound assessments revealed on 09/22/23 a wound was discovered
on the coccyx of Resident #33. Further review of the wound assessments, from onset on 09/22/23 through
02/28/24, revealed no staging of the wound completed. The wound measured 2.2 centimeters (cm) by 1.0
cm and 0.1 cm deep.
Review of the nursing notes for Resident #33 revealed no evidence of a nursing progress note related to
discovery of the wound to the coccyx of Resident #33.
Physician orders revealed weekly skin inspections to be completed. Review of the weekly skin inspections
revealed no evidence of weekly skin inspections completed between 09/05/23 and 09/26/23. No weekly
skin inspection was completed on 09/12/23 and 09/19/23 prior to wound discovery.
A certified wound nurse practitioner consult completed on 09/27/23 identified the wound as a stage two
pressure ulcer (partial thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound
bed, without slough). No additional certified wound nurse practitioner consults were completed.
Observation of Resident #33's coccyx wound with Licensed Practical Nurse (LPN) #510 on 03/06/24 at
10:20 A.M. revealed a wound to the coccyx which the wound based was covered with slough ( and
presented as an unstageable pressure ulcer (known but unstageable due to coverage of the wound bed by
slough or eschar).
Interview with LPN #510 on 03/06/24 at 10:50 A.M. verified Resident #33's weekly wound assessments do
not identify the type or stage of the wound, no nursing progress note was completed upon discovery of the
wound, no weekly skin inspection was completed on 09/12/23 and 09/19/23 prior to wound discovery. LPN
#510 also indicated the wound currently presents as an unstageable pressure ulcer wound to the coccyx.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 6 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0689
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to
prevent accidents.
Based on medical record review and staff interview the facility failed to complete elopement risk
assessments for a resident displaying exit seeking behaviors. This affected one (Resident #43) of one
residents reviewed for elopement risk. The facility census was 65.
Findings include:
Review of Resident #43's medical record revealed an admission date of 05/31/23 with diagnoses that
included Alzheimer's disease with dementia and cerebrovascular accident.
Review of the Minimum Data Set (MDS) 3.0 quarterly assessment with a reference date of 12/04/23
revealed Resident #43 had a severely impaired cognition level, utilized a walker for mobility and was
supervision assistance only with ambulation.
Further review of the medical record including nursing notes revealed wandering and exit seeking
behaviors documented as displayed on 02/20/24, 02/19/24 twice, 02/15/24 twice, 02/14/24, 02/09/24,
02/08/24, 02/05/24, 01/11/24, 01/05/24, 12/11/23, 12/11/23 and 10/22/23.
Review of the medical record revealed no evidence of any elopement risk assessment completed for the
resident or elopement risk care plan in place.
A wandering risk assessment completed on 12/04/23 indicated the resident was at risk to wander but did
not identify the resident displaying exit seeking behaviors.
On 03/05/25 at 2:20 P.M., interview with the Director of Nursing verified the facility did not complete an
elopement risk assessment or create a elopement risk care plan for Resident #43 despite displaying exit
seeking behaviors.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 7 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate
catheter care, and appropriate care to prevent urinary tract infections.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. Review of
Resident #36's medical record revealed diagnoses including rheumatoid arthritis, disorders of the bladder
and mixed incontinence. A plan of care initiated 09/27/23 indicated Resident #36 had an alteration in her
urinary system related to needed assistance with mobility and overactive bladder. Interventions included
completion of a bladder assessment/tracking and assessing for risk factors that might cause a decline in
urinary continence.
Review of a Bowel and Bladder Data Collection assessment dated [DATE] indicated Resident #36 had
three or more medical conditions present which could contribute to incontinence status, required extensive
assistance with weight bearing three or more times in seven days, was occasionally incontinent of bladder
less than seven episodes/week, always continent of bowel and had contractures. The summary indicated
Resident #36 had moderate restorative potential.
An admission Minimum Data Set (MDS) assessment dated [DATE] indicated Resident #36 was
occasionally incontinent of bladder but was not on a toileting program.
A bowel and bladder screener dated 12/26/23 indicated Resident #36 voided appropriately at least daily but
not always, was incontinent of stool one to three times a week, required one assist to get to the bathroom
or transfer to the toilet, adjust clothing and wipe, was forgetful but followed commands, and was sometimes
aware of the need to toilet.
A quarterly MDS dated [DATE] indicated Resident #36 had disorganized thinking that fluctuated, was
frequently incontinent of urine and occasionally incontinent of bowel. The MDS indicated no trial of a
toileting program.
On 03/05/24 at 3:05 P.M., the Director of Nursing (DON) stated when residents had bowel and bladder
tracking completed it was a part of the assessment to determine if residents were appropriate for a
restorative nursing program. The three day bladder tracking for Resident #36 was unable to be located.
Short of having that information, Resident #36 should have been evaluated for appropriateness of a
restorative toileting program based on the assessment completed 10/03/23.
Based on medical record review, interview, and policy review the facility failed to ensure a resident received
appropriate antibiotic treatment and initiate practitioner ordered intervention when the resident continued
exhibiting urinary symptoms. The facility also failed to ensure a resident received restorative bladder
training when noted to have a moderate restorative potential. This affected one (Resident #4) of one
reviewed for urinary tract infection and one (Resident #36) of one reviewed for bowel and bladder
incontinence. The census was 65.
Findings included:
1. Record review revealed Resident #4 was admitted to the facility on [DATE] with diagnoses including type
two diabetes mellitus, stress incontinence, urge incontinence, weakness, and difficulty walking.
Review of Resident #4 quarterly MDS dated [DATE] revealed the resident was always incontinent of
bladder and bowel and cognition was intact.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 8 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Review of Resident #4's alteration of urinary system plan of care related to needs assistance with mobility
revealed the resident was dependent on assistance with toileting hygiene and monitor and report additional
signs and symptoms of infection.
Review of Resident #4 progress notes revealed on 02/24/24 at 11:29 A.M. Resident #4 returned to the
facility from emergency room (ER). Resident noted to be confused. Per the ER, the resident's urine dip was
abnormal which was suggestive of UTI. Resident received one dose of ceftriaxone (antibiotic) injection and
was sent back with a prescription for cefdinir (antibiotic). The resident was diagnosed with acute confusion,
advance age, and abnormal findings in the urine. The Nurse Practitioner (NP) was notified and advised to
take cefdinir per discharge paperwork and hold Percocet (narcotic pain medication) with lethargy.
Review of the ER aftercare visit summary dated 02/24/24 revealed the resident's urine dip was abnormal
which is suggestive of a UTI (moderate amount of leukosterace). She was given a dose of IV ceftriaxone
(Rocephin) and was being prescribed cefdinir (Omnicef).
Review of the medication administration record (MAR) for February 2024 revealed cefdinir 300 milligrams
(mg) twice a day for 10 days beginning 02/24/24.
Review of Resident #4's laboratory results dated [DATE] to 03/06/24 revealed no evidence the facility had
obtained a urinalysis or culture.
Review of Resident #4's McGeer form (criteria used to determine if antibiotic use is appropriate for a
certain/potential infection) dated 02/22/33 (that was the date documented on the form however, the date
should have corresponded with the initiation of cefdinir) revealed the resident did not meet criteria for
treatment. There was a handwritten note on the bottom that indicated the NP updated on urine results and
the resident having no symptoms but would like resident to start antibiotics benefits outweigh the risk.
Further review of the progress notes revealed on 02/26/24 the hospital called and reported the urine
specimen (from the emergency room visit) was contaminated. Per the NP do not repeat urine, as the
resident has already started antibiotics.
Further review of the progress notes revealed on 02/27/24 the resident was noted to have increased
confusion.
Continued review of the progress notes revealed on 02/27/24 at 1:00 P.M., the NP was notified Resident
#4's urine culture was contaminated and the resident did not meet criteria for antibiotic treatment. The NP
wanted urine results to review and wrote new orders to continue the antibiotic for seven days instead of 10
days. The NP indicated if symptoms return, collect new specimen. The NP stated that benefits of the
resident continuing antibiotics outweigh the risk of discontinuing.
Continued review of the progress notes revealed on 02/29/24 at 7:40 A.M. the resident had complaints of
mild pressure/pain with urination and a mild odor was noted (to the urine). The resident denied flank pain,
urgency, and frequency, however, was incontinent of bladder. An additional progress note at 7:13 P.M.
revealed the resident continues taking antibiotics for UTI. The resident was incontinent of urine, urine has
mild odor noted. The resident denied flank pain, frequency, or urgency. Nursing will continue to monitor.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 9 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Review of the March 2024 MAR revealed the order for the cefdinir was changed to be discontinued
03/01/24.
Further review of the progress notes dated 03/03/24 revealed staff documented the resident continued
cefdinir for UTI without adverse effects noted, however according to the Medication Administration Records
(MAR) and orders, the cefdinir order was completed on 03/01/24.
Interview on 03/06/24 at 10:10 A.M., with Licensed Practical Nurse (LPN) #506 revealed she was new to
the infection control preventionist role. The LPN confirmed Resident #4's provider was not notified on
02/24/24, when the resident returned from the ER with an antibiotic order to treat a UTI, that the resident
did not meet McGeer Criteria for the treatment of a UTI. The LPN verified the provider was made aware the
resident returned from the ER with an antibiotic order. The LPN confirmed on 02/26/24 that the hospital
reported the urine culture was not performed due to the urine being contaminated. The LPN then contacted
the Nurse Practitioner (NP), and she did not want the urine culture completed since the resident had
already started the antibiotic, however the NP did decrease the antibiotic length of treatment from 10 days
to seven days. The LPN confirmed the NP did not give a specific rationale as to why she wanted the
antibiotic continued, just that the benefits would outweigh the risks. The LPN confirmed staff should have
repeated the urinalysis, per the NP order on 02/27/24, when the resident began to complain of symptoms,
however there was no evidence the facility had collected a urine specimen.
Interview on 03/06/24 at 10:23 A.M. the Director of Nursing (DON) reported she had worked over the
weekend and staff reported the resident was confused, however she didn't notice a change in the resident's
condition.
Interview on 03/06/24 at 10:26 A.M., with Resident #4 revealed she was still having burning upon urination
and had an odor to her urine.
Review of the facilities policy and procedure titled Antibiotic Stewardship undated revealed the facility
willingly participates in antibiotic stewardship to help promote the appropriate use of antibiotics in the least
number of occurrences to help eliminate the development of multi drug resistant organism.
The infection control nurse will evaluate all new admission and determine if the resident meets criteria for
the antibiotic use and if they do not, will contact the MD/and or CNP as soon as possible to see if they want
the antibiotic to be continued.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 10 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
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
to a resident receiving dialysis services in accordance with physician services. This affected one (Resident
#47) of one resident reviewed for dialysis. The facility identified one resident receiving dialysis services. The
facility census was 65.
Residents Affected - Few
Findings include:
Review of Resident #47's medical record revealed diagnoses including dependence on renal dialysis and
stage three chronic kidney disease. A care plan initiated 12/11/23 indicated Resident #47 received dialysis
three days a week (Tuesday, Thursday, and Saturday). Review of a physician order revealed an active order
dated 12/16/23 with instructions to hold all blood pressure medications before dialysis. Review of the
January 2024 to March 2024 Medication Administration Records (MARs) revealed the blood pressure
medications (Norvasc and metoprolol succinate extended release) were not held prior to dialysis
treatments.
On 03/06/24 at 9:57 A.M. the Director of Nursing (DON) verified nurses were administering blood pressure
medication prior to dialysis. The DON stated she spoke to the nurse practitioner that morning and received
an order to discontinue the order to hold Resident #47's blood pressure medication prior to dialysis. The
DON stated she reviewed dialysis notes and saw no documentation of hypotension (low blood pressure)
problems but acknowledged she had not spoke to dialysis.
On 03/06/24 at 10:23 A.M. Dialysis representative #600 stated according to dialysis records Resident #47
sometimes had issues with his blood pressure and that it fluctuated during treatment. Dialysis
representative #600 was unaware the nurse practitioner had discontinued the order to hold Resident #47's
blood pressure medication prior to dialysis.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 11 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0881
Implement a program that monitors antibiotic use.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. Review of
Resident #36's medical record revealed diagnoses including mixed incontinence, depression, disorders of
the bladder, and a history of transient ischemic attacks (mini-strokes) and stroke.
Residents Affected - Few
A nursing note dated 11/09/23 at 6:14 P.M. indicated Resident #36 complained of feeling weak, was
confused, and had a strong odor of the urine. A urine dip stick was completed and the Certified Nurse
Practitioner (CNP) was notified of the results. An order was received for an antibiotic (keflex) 500 milligrams
(mg) three times a day for seven days.
Review of the documentation for the urine dip stick on 11/09/23 indicated the urine was positive for a large
amount of ketones, had a large amount of blood detected and a moderate amount of leukocytes (white
blood cells).
Review of a nursing note dated 11/14/23 at 10:45 A.M. indicated the CNP reviewed partial lab results and
ordered to continue the keflex.
A nursing note dated 11/26/23 at 7:26 P.M. indicated the on call physician was notified of a change of
condition including increased confusion, incontinence, functional decline and pain with urination. The on call
physician was notified of previous urine results and ordered an antibiotic (Bactrim DS twice a day for 20
doses). The physician stated there was no need for further urinalysis or culture and sensitivity.
On 03/05/24 at 10:27 A.M., Licensed Practical Nurse/Infection Preventionist #506 stated when residents
received orders for antibiotics, she determines if the residents meet the criteria for an infection based on
McGeer's criteria. If the criteria were not met, she contacted the CNP and documents the contact. At 11:40
A.M., LPN #506 verified per the infection control tracking log, the criteria of infection was not met when
either antibiotic was ordered and there was no documentation indicating anybody had reached out to the
ordering physician or CNP. LPN #506 indicated she would search through her messages to determine if
contact was made that way.
On 03/05/24 at 12:54 P.M., LPN #506 stated the Bactrim was discontinued on 11/30/23 due to potential
side effects. The facility used the hospital for on call services. LPN #506 could not state for certain if the
on-call physician was familiar with long term care antibiotic stewardship and stated she should have
contacted the CNP when she determined the criteria for a urinary tract infection(UTI) was not met. The
incontinence referred to in the note was not new onset incontinence and there was no documentation of
increased frequency of urination. At 1:25 P.M., LPN #506 verified criteria for a UTI was not met for either
antibiotic used. She could find no documentation to indicate this was reviewed with the CNP/physician
when the antibiotics were ordered.
Based on medical record review, review of the infection control log, interview, and policy review the facility
failed to ensure residents met criteria for antibiotic treatment. This affected one (Resident #4) of one
reviewed for UTI and one (Resident #36) of one reviewed for bowel and bladder incontinence. The facility
census was 65.
Findings included:
1. Record review revealed Resident #4 was admitted to the facility on [DATE] with diagnoses
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 12 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0881
Level of Harm - Minimal harm
or potential for actual harm
including type two diabetes mellitus, stress incontinence, urge incontinence, weakness, and difficulty
walking.
Review of Resident #4 quarterly MDS dated [DATE] revealed the resident was always incontinent of
bladder and bowel and cognition was intact.
Residents Affected - Few
Review of Resident #4's alteration of urinary system plan of care related to needs assistance with mobility
revealed the resident was dependent on assistance with toileting hygiene and monitor and report additional
signs and symptoms of infection.
Review of Resident #4 progress notes revealed on 02/24/24 at 11:29 A.M. Resident #4 returned to the
facility from emergency room (ER). Resident noted to be confused. Per the ER, the resident's urine dip was
abnormal which was suggestive of UTI. Resident received one dose of ceftriaxone (antibiotic) injection and
was sent back with a prescription for cefdinir (antibiotic). The resident was diagnosed with acute confusion,
advance age, and abnormal findings in the urine. The Nurse Practitioner (NP) was notified and advised to
take cefdinir per discharge paperwork and hold Percocet (narcotic pain medication) with lethargy.
Review of the ER aftercare visit summary dated 02/24/24 revealed the resident's urine dip was abnormal
which is suggestive of a UTI (moderate amount of leukosterace). She was given a dose of IV ceftriaxone
(Rocephin) and was being prescribed cefdinir (Omnicef).
Review of the medication administration record (MAR) for February 2024 revealed cefdinir 300 milligrams
(mg) twice a day for 10 days beginning 02/24/24.
Review of Resident #4's laboratory results dated [DATE] to 03/06/24 revealed no evidence the facility had
obtained a urinalysis or culture.
Review of Resident #4's McGeer form (criteria used to determine if antibiotic use is appropriate for a
certain/potential infection) dated 02/22/33 (that was the date documented on the form however, the date
should have corresponded with the initiation of cefdinir) revealed the resident did not meet criteria for
treatment. There was a handwritten note on the bottom that indicated the NP updated on urine results and
the resident having no symptoms but would like resident to start antibiotics benefits outweigh the risk.
Further review of the progress notes revealed on 02/26/24 the hospital called and reported the urine
specimen (from the emergency room visit) was contaminated. Per the NP do not repeat urine, as the
resident has already started antibiotics.
Continued review of the progress notes revealed on 02/27/24 at 1:00 P.M., the NP was notified Resident
#4's urine culture was contaminated and the resident did not meet criteria for antibiotic treatment. The NP
wanted urine results to review and wrote new orders to continue the antibiotic for seven days instead of 10
days. The NP indicated if symptoms return, collect new specimen. The NP stated that benefits of the
resident continuing antibiotics outweigh the risk of discontinuing.
Review of the infection control log for the month of February 2024 revealed the resident did not meet
criteria for the treatment of a urinary tract infection on 02/24/24 and had mixed flora in the urine culture
report. The treatment was cefdinir 300 mg twice a day for 10 days. The resolve date was 03/05/24. The
infection control log was not updated to reflect new orders on 02/27/24 to decrease
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 13 of 14
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
365429
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/07/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Riverside Manor Nrsg & Rehab Ctr
1100 East State Road
Newcomerstown, OH 43832
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 0881
cefdinir from 10 days to seven days and treatment was completed on 03/01/24.
Level of Harm - Minimal harm
or potential for actual harm
Review of the March 2024 MAR revealed the order for the cefdinir was changed to be discontinued
03/01/24.
Residents Affected - Few
Further review of the progress notes dated 03/03/24 revealed staff documented the resident continued
cefdinir for UTI without adverse effects noted, however according to the Medication Administration Records
(MAR) and orders, the cefdinir order was completed on 03/01/24.
Interview on 03/06/24 at 10:10 A.M., with Licensed Practical Nurse (LPN) #506 revealed she was new to
the infection control preventionist role. The LPN confirmed Resident #4's provider was not notified on
02/24/24, when the resident returned from the ER with an antibiotic order to treat a UTI, that the resident
did not meet McGeer Criteria for the treatment of a UTI. The LPN verified the provider was made aware the
resident returned from the ER with an antibiotic order. The LPN confirmed on 02/26/24 that the hospital
reported the urine culture was not performed due to the urine being contaminated. The LPN then contacted
the Nurse Practitioner (NP), and she did not want the urine culture completed since the resident had
already started the antibiotic, however the NP did decrease the antibiotic length of treatment from 10 days
to seven days. The LPN confirmed the NP did not give a specific rationale as to why she wanted the
antibiotic continued, just that the benefits would outweigh the risks.
Review of the facilities policy and procedure titled Antibiotic Stewardship undated revealed the facility
willingly participates in antibiotic stewardship to help promote the appropriate use of antibiotics in the least
number of occurrences to help eliminate the development of multi drug resistant organism.
The infection control nurse will evaluate all new admission and determine if the resident meets criteria for
the antibiotic use and if they do not, will contact the MD/and or CNP as soon as possible to see if they want
the antibiotic to be continued.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
365429
If continuation sheet
Page 14 of 14
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Back to topCitations
8 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.
F684 - Quality of care
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
F584 - Safe Environment
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
F686 - Skin Integrity
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
F689 - Accidents
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F690 - Incontinence
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
F698 - Dialysis
Provide safe, appropriate dialysis care/services for a resident who requires such services.
F881 - Infection prevention and control program
Implement a program that monitors antibiotic use.
- 0324GeneralS&S Fpotential for harm
Provide properly protected cooking facilities.
FAQ · About this visit
Common questions about this visit
What happened during the March 7, 2024 survey of RIVERSIDE MANOR NRSG & REHAB CTR?
This was a inspection survey of RIVERSIDE MANOR NRSG & REHAB CTR on March 7, 2024. The surveyor cited 8 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at RIVERSIDE MANOR NRSG & REHAB CTR on March 7, 2024?
Yes, 8 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
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.