Health inspection·September 26, 2025

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed provide appropriate assistance for a resident during care to prevent a fall. This effected one (#8) of three residents reviewed for falls. The census was 93.Findings include:Review of the medical record for Resident #8 revealed the resident was admitted to the facility on [DATE]. Diagnoses included nontraumatic intracerebral hemorrhage, traumatic compartment syndrome of the right upper and lower extremities, paraplegia, and dysphagia. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #8 had impaired cognition evidenced by a Brief Interview for Mental Status (BIMS) score of six and was assessed to require self-care assistance and mobility assistance.Review of Resident #8's admission comprehensive evaluation dated 09/15/25 revealed for toileting the resident was determined to be a two-person assist.Review of the care plan for Resident #8 dated 09/19/25 revealed he was at risk for fall related injury and falls related to impaired activities of daily living (ADLs) performance and communication deficit. Interventions include placing the resident's bed against the wall and having two staff members present at time of mobility and hygiene care.Review of the medical record for Resident #8 revealed on 09/22/25 he was receiving perineal care by Certified Nurse Aide (CNA) #150. The resident was being turned to his left side when he slid off of his bed, hitting his head on a nearby chair before landing on his back. The resident was alert and responsive, with no visible injuries, but complained of right-sided neck pain. The resident's physician and the resident's family were subsequently notified.During an interview with the Director of Nursing (DON) on 09/26/25 at 5:15 P.M. she explained the expectation for a resident assessed as two-person assist would be provided care by two people. The DON confirmed only one staff member was present and providing care for Resident #8 at the time of the fall on 09/22/25 when there should have been two staff members assisting. This deficiency represents non-compliance investigated under Complaint Number 2575413. 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 2 Event ID: 365457 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 365457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Middletown 751 Kensington Street Middletown, OH 45044 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)