Inspection·October 29, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few inappropriate to her and made her feel uncomfortable. She was asked if she reported it and confirmed that she had. She reported she told the unit manager (LPN #200) about it. She was given a paper to write out her statement and gave it back to LPN #200, after she completed it. On 10/28/25 at 11:08 A.M., an interview with the facility's Director of Nursing (DON) revealed she was not aware of any incident that had occurred between LPN #100 and Resident #14 on 10/05/25 (where inappropriate comments were made with sexual innuendoes). She denied she had received any witness statements pertaining to any incident occurring on that day and did not recall any concerns being reported by the unit manager on that day. She reported the unit manager was off on 10/28/25, but should be returning to work the following day. She would follow up with the unit manager to see if she had knowledge of any incidents occurring that day. She would also check with the facility's Administrator to see if she had anything on that. On 10/28/25 at 11:30 A.M., the facility's DON came in and reported she spoke to the unit manager about any incidents that occurred on 10/05/25 involving LPN #100 and Resident #14. The DON reported she had been made aware of the situation, but was looking at it more from the perspective of Resident #14's change in condition not being appropriately addressed or her receiving timely care. She thought the CNA's main concern was that the nurse was not addressing the change in condition. She was informed by the surveyor what was being investigated was an inappropriate comment that LPN #100 allegedly made when he was assessing Resident #14 for her change in condition on 10/05/25. She was told LPN #100 was allegedly observed to check Resident #14's hand grasp strength by asking Resident #14 to squeeze his fingers. He then allegedly made an inappropriate comment to the resident telling her that was not his fingers. She acknowledged an aide had reported she was present during that assessment and observed that to occur. She was informed the aide felt what she saw and heard was an inappropriate comment to make and it made her feel uncomfortable. She acknowledged the aide's interpretation of that comment was that the nurse was insinuating the resident was grabbing his penis, instead of his fingers. She was asked if she asked the unit manager about any written statements that the aide was given to fill out regarding the incident that she had witnessed. She reported the unit manager did confirm she gave the aide a witness statement form to fill out. She again denied she had been provided any written statements pertaining to that incident, nor had the Administrator. The DON stated she would have to follow up with the unit manager when she returned to work on 10/29/25 to see what occurred after the written statement was provided by the aide and where it went from there. On 10/28/25 at 1:04 P.M., a follow up interview with CNA #150 confirmed she filled out a written statement on paper that had been given to her by the unit manager regarding the incident she observed on 10/05/25. She was instructed by the unit manager to just leave it in her (unit manager's) office when she completed it, which she did. She reported she put the written statement under a keyboard to the unit manager's computer and then informed the unit manager where she put it. On 10/29/25 at 9:31 A.M., an interview with LPN #200 revealed she was one of four unit managers that worked in the facility. She confirmed she had been made aware of the incident that occurred between LPN #100 and Resident #14 on 10/05/25. She stated an aide came to her (after Resident #14 had been sent to the hospital) and told her she was in the room with Resident #14 when LPN #100 was assessing her. She further confirmed she was told LPN #100 asked the resident to squeeze his fingers, as part of his assessment, and then made a comment about that not being his fingers. She was not able to get a statement from the resident, since she had transferred out of the facility, and did not get a statement from LPN #100. She confirmed CNA #150 was the aide that reported it to her, after the incident occurred. She further confirmed she had CNA #150 provide a written statement on what had occurred. She then reported she contacted the DON and informed her of the situation and the inappropriate comment that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 2 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few was made by LPN #100. She told the DON she was not able to talk to Resident #14, as the resident had been sent out to the hospital. She was asked if the inappropriate comment made could have been considered verbal/ emotional abuse and replied, yes. She felt the comment was inappropriate, if it in fact had been said. She denied LPN #100 was sent home or suspended pending an investigation. She was asked what the DON said to her, after she reported the incident to the DON. She stated the DON told her she would follow up with it. She denied the DON provided any guidance to them to send the nurse home pending an investigation. She was not aware of the facility submitting a self-reporting incident (SRI) to report the allegation of potential verbal/ emotional abuse. On 10/29/25 at 9:46 A.M., an interview with the DON revealed she did not receive the written statement provided by CNA #150 pertaining to the incident between LPN #100 and Resident #14 that occurred on 10/05/25. She denied the Assistant Director of Nursing (ADON) or any other department head had received it by mistake. She checked all the mailboxes and asked around to see if anyone had received it by mistake. She reported no one had received it and she was not able to locate it anywhere. She confirmed she did receive a call from the unit manager regarding the incident that occurred on 10/05/25. The call was received on 10/05/25 at around 3:00 P.M. She reported when the situation was discussed, a lot of the aides did not like working with LPN #100. He would do push ups at the nurses' station and they found him to be weird. She was not sure if the aides were just targeting that nurse because they did not like him. The unit manager told her an aide had reported a situation to her. She thought the main concern was that the aide did not feel like the nurse was responding to a resident's change in condition as he should have. It was then mentioned the nurse made a comment during his assessment of Resident #14, after asking the resident to squeeze his finger. The comment made to the resident by the nurse was that it was not his fingers or hand that the resident was squeezing. She indicated the resident was unresponsive and would not have been affected by that comment. When she heard about the situation, her mind did not go to a possible allegation of verbal/ emotional abuse. She still did not feel what was said was abuse, as it did not meet the definition of abuse, and the resident was not able to understand. Due to the resident's unresponsiveness at the time, she did not feel the resident heard what was said. She confirmed it was an inappropriate comment, if it was said. She acknowledged that it could not be determined whether the resident was able to hear or comprehend the comment made, or not, based on her altered mental status. The comment made was inappropriate and had sexual innuendoes and should have at least been reported and investigated as a potential abuse allegation. She denied the facility investigated or reported that allegation of potential abuse and no SRI had been completed or submitted as required. Review of the facility's abuse Prohibition Policy last revised on 09/09/22 revealed each resident should be free from abuse. Abuse should include freedom from verbal, mental, sexual, or physical abuse. To assure residents were free from abuse, the facility should monitor resident care and treatments on an on-going basis. It was the responsibility of all staff to provide a safe environment for the residents. Staff members should immediately report incidents of abuse and suspected abuse. Abuse could be staff to resident. Abuse meant the willful infliction of injury with resulting physical harm, pain, or mental anguish. Instances of abuse of all residents was irrespective of any mental or physical condition, may cause physical harm, pain, or mental anguish. Willful, as used in the definition of abuse, meant the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Verbal abuse was the use of verbal or non-verbal communication which caused or had the potential to cause the resident to experience humiliation, intimidation, fear, shame, agitation, or degradation regardless of their age, ability to comprehend or disability. Verbal abuse may be considered to be a type of mental abuse. Verbal abuse included (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 3 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete the use of oral communication to residents within hearing distance, regardless of age, ability to comprehend, or disability. Allegations by anyone who became aware of verbal, physical, mental, sexual, or emotional abuse must immediately report it to his/ her Administrator. An incident report and/ or grievance forms per state specific requirements would be completed. A preliminary, on-site investigation would be initiated within 24 hours of any report. If the accused was an employee of the facility, he/ she would be suspended until the investigation had been completed. The staff would report any allegations or suspicions of mistreatment/ abuse to the Administrator and DON immediately. The Administrator would notify any State or Federal agencies of the allegations per State guidelines (two hours if abuse allegation, all others no later than 24 hours).This deficiency represents non-compliance investigated under Complaint Number 2639140. Event ID: Facility ID: 365466 If continuation sheet Page 4 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interview, and policy review, the facility failed to ensure an allegation of potential verbal/ emotional abuse was investigated by the facility when reported to management staff. This affected one (Resident #14) of two residents reviewed for abuse. Findings include:Review of Resident #14's medical record revealed the resident was admitted to the facility on [DATE]. Her diagnoses included metabolic encephalopathy (a condition where the brain did not function properly due to an underlying metabolic disturbance causing cognitive impairment, changes in behaviors, and other neurological symptoms), Bipolar disorder, malignant neoplasm of the uterus, adult failure to thrive, and depression. Review of Resident #14's admission Minimum Data Set (MDS) assessment dated [DATE] revealed the resident did not have any vision or hearing problems and had clear speech. She was able to make herself understood and was able to understand others. She was cognitively intact and was not noted to have any behaviors or rejection of care during the seven days of the assessment period. Review of Resident #14's progress notes revealed a nurse's note dated 10/05/25 at 9:11 A.M. by Licensed Practical Nurse (LPN) #100 that indicated the resident was unresponsive and was having apneic breathing patterns (a temporary cessation of breathing where the body does not inhale or exhale for a period of time). The nurse was unable to get a blood pressure or a recording of the resident's oxygen saturation level. The nurse's progress note did not provide details of any specific assessments that were performed to evaluate the resident's change in condition. The local hospital was called and made a pick-up at 9:15 A.M. Subsequent notes revealed the resident was admitted to the hospital with the diagnoses of sepsis (a life threatening medical emergency caused by the body's overwhelming response to an infection that could lead to tissue damage, organ failure, or death) and an acute kidney injury.Review of the Nursing Daily Schedule for 10/05/25 revealed Certified Nursing Assistant (CNA) #150 was one of two CNA's assigned to work Resident #14's unit when the resident had a change in condition requiring her to be in the emergency room for an evaluation. She was assigned to work day shift from 6:00 A.M. to 6:00 P.M. On 10/28/25 at 10:59 A.M., an interview with CNA #150 confirmed she worked on 10/05/25 when Resident #14 was found unresponsive. She reported the resident was known to go up and down a lot and the resident seemed tired that day. She was also not eating much and was just not herself. She reported she was present when LPN #100 was in Resident #14's room assessing her change in condition. The resident was able to respond verbally, but was not clear in what she was saying. That was somewhat normal for the resident, as she was not always able to make herself clear when speaking. She heard the nurse ask the resident to squeeze his fingers when assessing the resident. She then heard LPN #100 say Oh (saying resident's first name), that was not my fingers. She denied the resident made any acknowledgement to that comment as the resident was out of it. She felt the nurse was insinuating by that comment that the resident had grabbed his penis and not his fingers. She heard that nurse make comments like that in the past. She indicated the comment felt inappropriate to her and made her feel uncomfortable. She was asked if she reported it and confirmed that she had. She reported she told the unit manager (LPN #200) about it. She was given a paper to write out her statement and gave it back to LPN #200, after she completed it. On 10/28/25 at 11:08 A.M., an interview with the facility's Director of Nursing (DON) revealed she was not aware of any incident that had occurred between LPN #100 and Resident #14 on 10/05/25 (where inappropriate comments were made with sexual innuendoes). She denied she had received any witness statements pertaining to any incident occurring on that day and did not recall any concerns being reported by the unit manager on that day. She reported the unit manager was off on 10/28/25, but should be returning to work the following day. She would follow up with the unit manager to see if she had Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 5 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few knowledge of any incidents occurring that day. She would also check with the facility's Administrator to see if she had anything on that. On 10/28/25 at 11:30 A.M., the facility's DON came in and reported she spoke to the unit manager about any incidents that occurred on 10/05/25 involving LPN #100 and Resident #14. The DON reported she had been made aware of the situation, but was looking at it more from the perspective of Resident #14's change in condition not being appropriately addressed or her receiving timely care. She thought the CNA's main concern was that the nurse was not addressing the change in condition. She was informed by the surveyor what was being investigated was an inappropriate comment that LPN #100 allegedly made when he was assessing Resident #14 for her change in condition on 10/05/25. She was told LPN #100 was allegedly observed to check Resident #14's hand grasp strength by asking Resident #14 to squeeze his fingers. He then allegedly made an inappropriate comment to the resident telling her that was not his fingers. She acknowledged an aide had reported she was present during that assessment and observed that to occur. She was informed the aide felt what she saw and heard was an inappropriate comment to make and it made her feel uncomfortable. She acknowledged the aide's interpretation of that comment was that the nurse was insinuating the resident was grabbing his penis, instead of his fingers. She was asked if she asked the unit manager about any written statements that the aide was given to fill out regarding the incident that she had witnessed. She reported the unit manager did confirm she gave the aide a witness statement form to fill out. She again denied she had been provided any written statements pertaining to that incident, nor had the Administrator. The DON stated she would have to follow up with the unit manager when she returned to work on 10/29/25 to see what occurred after the written statement was provided by the aide and where it went from there. On 10/28/25 at 1:04 P.M., a follow up interview with CNA #150 confirmed she filled out a written statement on paper that had been given to her by the unit manager regarding the incident she observed on 10/05/25. She was instructed by the unit manager to just leave it in her (unit manager's) office when she completed it, which she did. She reported she put the written statement under a keyboard to the unit manager's computer and then informed the unit manager where she put it. On 10/29/25 at 9:31 A.M., an interview with LPN #200 revealed she was one of four unit managers that worked in the facility. She confirmed she had been made aware of the incident that occurred between LPN #100 and Resident #14 on 10/05/25. She stated an aide came to her (after Resident #14 had been sent to the hospital) and told her she was in the room with Resident #14 when LPN #100 was assessing her. She further confirmed she was told LPN #100 asked the resident to squeeze his fingers, as part of his assessment, and then made a comment about that not being his fingers. She was not able to get a statement from the resident, since she had transferred out of the facility, and did not get a statement from LPN #100. She confirmed CNA #150 was the aide that reported it to her, after the incident occurred. She further confirmed she had CNA #150 provide a written statement on what had occurred. She then reported she contacted the DON and informed her of the situation and the inappropriate comment that was made by LPN #100. She told the DON she was not able to talk to Resident #14, as the resident had been sent out to the hospital. She was asked if the inappropriate comment made could have been considered verbal/ emotional abuse and replied, yes. She felt the comment was inappropriate, if it in fact had been said. She denied LPN #100 was sent home or suspended pending an investigation. She was asked what the DON said to her, after she reported the incident to the DON. She stated the DON told her she would follow up with it. She denied the DON provided any guidance to them to send the nurse home pending an investigation. She was not aware of the facility submitting a self-reporting incident (SRI) to report the allegation of potential verbal/ emotional abuse. On 10/29/25 at 9:46 A.M., an interview with the DON revealed she did not receive the written statement (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 6 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few provided by CNA #150 pertaining to the incident between LPN #100 and Resident #14 that occurred on 10/05/25. She denied the Assistant Director of Nursing (ADON) or any other department head had received it by mistake. She checked all the mailboxes and asked around to see if anyone had received it by mistake. She reported no one had received it and she was not able to locate it anywhere. She confirmed she did receive a call from the unit manager regarding the incident that occurred on 10/05/25. The call was received on 10/05/25 at around 3:00 P.M. She reported when the situation was discussed, a lot of the aides did not like working with LPN #100. He would do push ups at the nurses' station and they found him to be weird. She was not sure if the aides were just targeting that nurse because they did not like him. The unit manager told her an aide had reported a situation to her. She thought the main concern was that the aide did not feel like the nurse was responding to a resident's change in condition as he should have. It was then mentioned the nurse made a comment during his assessment of Resident #14, after asking the resident to squeeze his finger. The comment made to the resident by the nurse was that it was not his fingers or hand that the resident was squeezing. She indicated the resident was unresponsive and would not have been affected by that comment. When she heard about the situation, her mind did not go to a possible allegation of verbal/ emotional abuse. She still did not feel what was said was abuse, as it did not meet the definition of abuse, and the resident was not able to understand. Due to the resident's unresponsiveness at the time, she did not feel the resident heard what was said. She confirmed it was an inappropriate comment, if it was said. She acknowledged that it could not be determined whether the resident was able to hear or comprehend the comment made, or not, based on her altered mental status. The comment made was inappropriate and had sexual innuendoes and should have at least been reported and investigated as a potential abuse allegation. She denied the facility investigated or reported that allegation of potential abuse and no SRI had been completed or submitted as required. Review of the facility's abuse Prohibition Policy last revised on 09/09/22 revealed each resident should be free from abuse. Abuse should include freedom from verbal, mental, sexual, or physical abuse. To assure residents were free from abuse, the facility should monitor resident care and treatments on an on-going basis. It was the responsibility of all staff to provide a safe environment for the residents. Staff members should immediately report incidents of abuse and suspected abuse. Abuse could be staff to resident. Abuse meant the willful infliction of injury with resulting physical harm, pain, or mental anguish. Instances of abuse of all residents was irrespective of any mental or physical condition, may cause physical harm, pain, or mental anguish. Willful, as used in the definition of abuse, meant the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Verbal abuse was the use of verbal or non-verbal communication which caused or had the potential to cause the resident to experience humiliation, intimidation, fear, shame, agitation, or degradation regardless of their age, ability to comprehend or disability. Verbal abuse may be considered to be a type of mental abuse. Verbal abuse included the use of oral communication to residents within hearing distance, regardless of age, ability to comprehend, or disability. Allegations by anyone who became aware of verbal, physical, mental, sexual, or emotional abuse must immediately report it to his/ her Administrator. An incident report and/ or grievance forms per state specific requirements would be completed. A preliminary, on-site investigation would be initiated within 24 hours of any report. If the accused was an employee of the facility, he/ she would be suspended until the investigation had been completed. The staff would report any allegations or suspicions of mistreatment/ abuse to the Administrator and DON immediately. The Administrator would notify any State or Federal agencies of the allegations per State guidelines (two hours if abuse allegation, all others no later than 24 hours).This (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 7 of 8 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 365466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Laurels of Heath 717 South 30th Street Heath, OH 43056 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0610 deficiency represents non-compliance investigated under Complaint Number 2639140. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365466 If continuation sheet Page 8 of 8