Inspection·February 23, 2026

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, staff interview, review of Self-Reported Incident (SRI), review of the incident log, review of police statement, review of staff drug screening results, and policy review, the facility failed to ensure resident's controlled substances were not misappropriated. This affected four (#18, #31, #50 and #78) of five residents reviewed for misappropriation. The facility census was 49. Findings include: Review of the medical record for Resident #18 revealed an admission date of 09/29/23 with diagnoses including chronic obstructive pulmonary disease, type two diabetes, and vascular dementia. Review of the Minimum Data Set (MDS) dated [DATE] revealed Resident #18 is cognitively intact. Review of the physician orders revealed Resident #18 had an active order for Oxycodone. Review of the medical record for Resident #31 revealed an admission date of 12/26/24 with diagnoses including type two diabetes and inflammatory spondylopathy cervical region. Review of the MDS dated [DATE] revealed Resident #31 is cognitively impaired. Review of the physician orders revealed Resident #31 had an active order for Oxycodone. Review of the medical record for Resident #50 revealed an admission date of 09/26/25 with diagnoses including type two diabetes and chronic pain. Review of the MDS dated [DATE] revealed Resident #50 is cognitively intact. Review of the physician orders revealed Resident #50 had an active order for Oxycodone. Review of the medical record for Resident #78 revealed an admission date of 08/13/25 with diagnoses including chronic kidney disease and type two diabetes. Review of the MDS dated [DATE] revealed Resident #78 was cognitively intact. Review of the physician orders revealed Resident #78 had an active order for Oxycodone. Review of the incident log from 11/23/25 to 02/23/26 revealed Resident #18, #31, #50, and #78 had an alleged incident involving misappropriation of controlled substances on 02/05/26. Review of the facilities SRI dated 02/05/26 revealed on 02/05/26, Director of Nursing (DON) #100 noted an alteration in medication packaging involving controlled substances during a routine narcotic count. Bubble packaging had nicks and tears on the backside of the cards for multiple controlled substance. While popping the medications for waste, it was noted that the mediation was an unstamped white pill that was not consistent with manufacture markings of the pills in the rest of the narcotic pills. Each narcotic card with compromised packaging was identified as Oxycodone 5 milligrams (mg) tablets. Medication administration activities were immediately stopped and medication carts were secured. Audits of medication were started with 11 cards of Oxycodone being affected totaling 42 unstamped pills being identified. Four current residents were identified as potentially affected and were immediately assessed and interviewed. All nurses with access to the medication were directed to submit a urine drug screen and all nurses complied. The urine sample for Licensed Practical Nurse (LPN) #89 did not meet temperature requirements and was transported to complete a full-panel drug screen, that was pending at the time of the SRI investigation. Local law enforcement was notified of the incident. During an interview with LPN #89 she admitted Residents Affected - Some (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 2 Event ID: 365483 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 365483 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/23/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stillwater Skilled Nursing and Rehabilitation 75 Mote Drive Covington, OH 45318 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)