Health inspection·December 29, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on resident interview, staff interview, review of facility self-reported incident (SRI), review of electronic medical record (EMR), and review of facility policy, the facility failed to ensure residents were free from verbal abuse. This affected one resident (#30) of three residents reviewed for abuse. The facility census was 70.' Findings Include: Review of the EMR for Resident #30 revealed an admission date of 08/05/24, with diagnoses including type two diabetes, hypothyroidism, anxiety disorder, atrial fibrillation, and hypertension. Review of the most recent Quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 15, indicating Resident #30 was cognitively intact. Resident #30 was dependent upon staff for toileting, showering/bathing, dressing, and transfers. Review of the facility SRI revealed that on 09/13/25 Resident #30 reported Certified Nursing Assistant (CNA) #401 was verbally abusive to her while assisting her with toileting. CNA #401 told Resident #30 to, Hurry up and pee because she had other people to take care of. Further review of the SRI revealed after investigation, the facility substantiated the verbal abuse from CNA #401 to Resident #30. CNA #401 was suspended on 09/13/25 and was terminated on 09/16/25 after the investigation was completed. Interview on 12/29/25 at 11:32 A.M. with Resident #30 revealed on 09/13/25, while assisting her with toileting, CNA #401 told Resident #30 to, hurry up and finish on the bedpan, so I can get you cleaned up. I have more people to take care of. Resident #30 stated she felt this comment was verbally abusive and caused her mental anguish. Interview on 12/29/25 at 12:10 P.M. with the Director of Nursing (DON) and Assistant Director of Nursing (ADON) #108 verified the facility substantiated the verbal abuse allegations made by Resident #30 about CNA #401 on 09/13/25. The DON stated CNA #401 was immediately suspended and subsequently terminated upon completion of the investigation. Review of the undated facility policy titled, Abuse, Neglect, Exploitation & Misappropriation of Resident Property, revealed abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment resulting in physical harm, pain, or mental anguish. Abuse also includes deprivation by an individual, including a caretaker of goods or services that are necessary to attain or maintain mental or physical condition, cause physical harm, pain or mental anguish. It includes verbal abuse, sexual abuse, physical abuse and mental abuse, including abuse facilitated or enabled through the use of technology, such as through the use of photographs or recording device to demean or humiliate a resident. The deficient practice was corrected on 10/01/25 when the facility implemented the following corrective actions: On 09/13/25 CNA #401, the alleged perpetrator, was suspended pending the facility investigation results. On 09/15/25 Resident #30 was interviewed regarding this incident. On 09/15/25 all residents in the facility were interviewed to determine if they had experienced abuse of any kind. On 09/15/25 all staff received education from the DON and ADON #108 on abuse policies. On 09/16/25, upon (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: 365681 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 365681 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Lane Healthcare Center 355 Windsor Lane Gibsonburg, OH 43431 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)