Inspection visit
Inspection
16 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 16 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper
authorities.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
medical record review, resident interview, staff interviews, review of Self-Reported Incidents (SRIs), and
review of facility policy, the facility failed to report an allegation of resident-to-resident verbal abuse. This
affected one (Resident #8) of two residents reviewed for abuse. The facility census was 20.
Findings include:
Medical record review revealed Resident #8 admitted to the facility on [DATE] and was cognitively intact.
Review of the progress note dated 05/29/22 at 11:51 A.M. revealed Resident #8's roommate (Resident #10)
was upset, cursing, and using racial slurs toward Resident #8 due to Resident #8's television (TV) volume.
The nurse entered the room and Resident #10 reported he could not sleep due to Resident #8's TV
volume. Resident #10 told the nurse, You're not doing me any good, so just get out. The nurse informed the
residents she was unable to leave due to the altercation and for the safety of all parties. Resident #10 then
turned over to go to sleep. The Director of Nursing (DON) was notified.
Review of the progress note dated 08/25/22 at 8:02 A.M. revealed a nurse entered Resident #8's room with
Resident #10, so Resident #10 could apologize to Resident #8 for using the 'N' word. Resident #8 said, He
is never allowed to speak to me and I am not going to accept his apologies . F*** him in the A**.
Interview on 08/25/22 at 8:02 A.M. with Resident #8 revealed the resident was alert and oriented and able
to answer questions. Resident #8 reported Resident #10 called him a racial slur during an argument. When
Resident #8 was asked if he felt this was abusive he stated, Absolutely, wouldn't you? Resident #8 verified
he was not offered to move rooms until several weeks later. Resident #8 reported he moved rooms and
enjoyed his current roommate.
Interview on 08/23/22 at 1:42 P.M. the DON verified nurses overheard Resident #8 and Resident #10
yelling at each other on 05/29/22. The DON reported Resident #10 used a racial slur toward Resident #8,
calling him the 'N' word. The DON stated the incident was reported to the Administrator.
Interview on 08/25/22 at 9:45 A.M. the Administrator reported he was on vacation during the incident
between Resident #8 and Resident #10 and verified the incident/allegation was not reported to the state
agency.
Review of the facility's Self-Reported Incidents (SRIs) for May and June 2022 revealed the incident
(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 8
Event ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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
between Resident #8 and Resident #10 was not reported.
Level of Harm - Minimal harm
or potential for actual harm
Review of the facility policy titled, Abuse Investigation and Reporting dated 07/2017 revealed all reports or
resident abuse would be reported.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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
medical record review, resident interview, staff interviews, and review of facility policy, the facility failed to
complete a thorough investigation of an allegation of resident-to-resident verbal abuse. This affected one
(Resident #8) of two residents reviewed for abuse. The facility census was 20.
Residents Affected - Few
Findings include:
Medical record review revealed Resident #8 admitted to the facility on [DATE] and was cognitively intact.
Review of the progress note dated 05/29/22 at 11:51 A.M. revealed Resident #8's roommate (Resident #10)
was upset, cursing, and using racial slurs toward Resident #8 due to Resident #8's television (TV) volume.
The nurse entered the room and Resident #10 reported he could not sleep due to Resident #8's TV
volume. Resident #10 told the nurse, You're not doing me any good, so just get out. The nurse informed the
residents she was unable to leave due to the altercation and for the safety of all parties. Resident #10 then
turned over to go to sleep. The Director of Nursing (DON) was notified.
Review of the progress note dated 08/25/22 at 8:02 A.M. revealed a nurse entered Resident #8's room with
Resident #10, so Resident #10 could apologize to Resident #8 for using the 'N' word. Resident #8 said, He
is never allowed to speak to me and I am not going to accept his apologies . F*** him in the A**.
Interview on 08/25/22 at 8:02 A.M. with Resident #8 revealed the resident was alert and oriented and able
to answer questions. Resident #8 reported Resident #10 called him a racial slur during an argument. When
Resident #8 was asked if he felt this was abusive he stated, Absolutely, wouldn't you? Resident #8 verified
he was not offered to move rooms until several weeks later. Resident #8 reported he moved rooms and
enjoyed his current roommate.
Interview on 08/23/22 at 1:42 P.M. the DON verified nurses overheard Resident #8 and Resident #10
yelling at each other on 05/29/22. The DON reported Resident #10 used a racial slur toward Resident #8,
calling him the 'N' word. The DON stated the incident was reported to the Administrator.
Interview on 08/25/22 at 9:45 A.M. the Administrator reported he was on vacation during the incident
between Resident #8 and Resident #10. The Administrator verified there was no evidence of an
investigation being completed, nor was there evidence staff interviewed residents to ensure they felt safe.
Review of the facility policy titled, Abuse Investigation and Reporting dated 07/2017 revealed all reports of
resident abuse would be thoroughly investigated by facility management.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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 0688
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM
and/or mobility, unless a decline is for a medical reason.
Based on medical record review, observations, and staff interviews, the facility failed to ensure services
were put into place to potentially prevent a decline in range of motion (ROM). This affected one (Resident
#7) of one resident reviewed for ROM. The facility census was 20.
Findings include:
Review of Resident #7's medical record revealed an admission dated on 12/17/17 with a diagnosis of
stroke. Review of the Minimum Data Set (MDS) assessments dated 04/04/22 and 07/01/22 revealed
Resident #7 had limitations in ROM to one side of her body and required a restorative program and use of
a splint.
Review of the occupational therapy discharge instructions dated 04/04/22 identified a new splint was
ordered for Resident #7's left hand and left ankle to assist with prevention of a decline in ROM. The starting
goal was to wear the splints for 40 minutes a day.
Observations on 08/22/22 at 8:32 A.M., 9:56 A.M., 12:19 P.M., and 3:22 P.M. revealed Resident #7's splint
device for her left hand remained on a stand across the room. Resident #7 was not observed wearing the
splint.
Observations on 08/23/22 at 7:14 A.M. and 7:45 A.M. revealed Resident #7's splint device for her left hand
remained on a stand across the room. The splint device appeared untouched from the previous day as it
was in the same position on the same stand.
Interview on 08/23/22 at 12:19 P.M. with State Testing Nurse Aide (STNA) #64 and #67 and Registered
Nurse (RN) #31 revealed staff were unaware if Resident #7 had any splint devices ordered.
Interview on 08/24/22 at 8:12 A.M. with Restorative RN #63 revealed Resident #7 was ordered splint
devices on 04/04/22 by therapy staff to treat ROM concerns with the resident's left side. Restorative RN #63
confirmed the original order recommended the splints be worn for a short period of time (40 minutes per
day). Restorative RN #63 verified she had not completed monthly or quarterly evaluations for Resident #7
to determine the resident's status of ROM or to assess if splint use should be increased. Ongoing
evaluations of ROM services should be completed, including staff education to ensure staff members are
aware of the program and services residents required. Restorative RN #63 reported she should have
increased the amount of time Resident #7 wore her splints.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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 0757
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review and staff interview, the facility failed to ensure blood pressure medication
parameters were followed as ordered. Additionally, the facility failed to complete labs as for monitoring
Coumadin use. This affected one (Resident #18) of give residents reviewed for unnecessary medication.
The facility census was 20.
Residents Affected - Few
Findings include:
Review of Resident #18's medical record identified an admission date of 05/22/19 with medical diagnoses
including atrial fibrillation, obesity, congestive heart failure and diabetes.
Review of Resident #18's physician orders for August 2022 revealed an order for Lisinopril (medication
used to treat blood pressure and heart failure) 30 milligrams (mg), twice a day (BID). There were
parameters in place to hold the Lisinopril if the resident's systolic blood pressure was less than 120.
Review of Resident #18's August 2022 medication regime included Lisinopril 30 mg BID (twice a day). The
physician order for the Lisinopril had parameters to hold for a systolic blood pressure (top number of the
blood pressure) less than 120. Additionally, there was an order for Coumadin (blood thinner) with
alternating doses of 4 mg and 6 mg. Continued review revealed no current lab orders for PT/INR (a test to
measure how long it takes for a clot to form in a blood sample). Further review of the medical record
revealed the last PT/INR completed was on 07/11/22, which showed no concerns.
Review of Resident #18's Medication Administration Record (MAR) for August 2022 revealed on 08/06/22,
08/07/22, 08/08/22, 08/13/22, 08/14/22, 08/16/22, 08/19/22 and twice on 08/23/22, Resident #18's systolic
blood pressure was less than 120 and the Lisinopril was still administered to the resident.
Interview on 08/24/22 at 7:56 A.M. with the Director of Nursing (DON) verified Resident #18's Lisinopril was
administered on 08/06/22, 08/07/22, 08/08/22, 08/13/22, 08/14/22, 08/16/22, 08/19/22 and twice on
08/23/22 when Resident #18's systolic blood pressure was less than 120, which was outside ordered
parameters. The DON also verified Resident #18 was ordered Coumadin and was ordered a PT/INR on
08/11/22, but it was missed and there were no updated/current orders for a PT/INR to be completed for
August 2022.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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 0760
Ensure that residents are free from significant medication errors.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review, observation, staff interview, and review of medication information, the
facility failed to ensure ordered antipsychotic medication was available for Resident #19. This affected one
(Resident #19) of four residents reviewed for medication administration. The facility census was 20.
Residents Affected - Few
Findings include:
Review of Resident #19's medical record revealed an admission date of 08/01/22 with medical diagnoses
including bipolar disorder, adjustment disorder, lymphedema, obesity and chronic respiratory failure. The
record identified Resident #19 had physician ordered Abilify 5 mg tablets twice a day for treatment of
psychiatric disorders.
Review of Resident #19's physician orders for August 2022 revealed an order for Abilify (antipsychotic) 5
milligrams (mg), twice per day for treatment of psychiatric disorders.
Observation, interview, and record review of medication administration on 08/23/22 at 8:15 A.M. revealed
Registered Nurse (RN) #31 was preparing medications for Resident #19. RN #31 reported Resident #19's
Abilify was not available in the medication cart. RN #31 reviewed the resident's Medication Administration
Record (MAR) and verified Resident #19 had not received Abilify since 08/19/22, missing nine doses. RN
#31 reported she would call the pharmacy to obtain the medication.
Review of Abilify.com revealed stopping Abilify may cause withdrawal. Abilify withdrawal symptoms included
anxiety, panic attacks and sweating.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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 0801
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the
food and nutrition service, including a qualified dietician.
Based on review of personnel files and staff interview, the facility failed to ensure the dietary manager met
required qualifications to manage the dietary department. This affected 19 of 20 residents who received
food from the kitchen. The facility census was 20.
Findings include:
Review of the personnel file for Dietary Manager (DM) #36 revealed a hire date of 12/01/21. Further review
of the file revealed no evidence DM #36 was a certified dietary manager, certified food service manager, or
had similar national certification for food service management and safety, or had an associates or higher
degree in food service management.
Interview on 08/24/22 at 11:26 A.M. with the Business Office Manager (BOM) #37 verified DM #36 did not
have any required training or certifications for the dietary manager position.
Interview on 08/24/22 at 9:46 A.M. with Registered Dietician (RD) #69 revealed she worked at the facility 32
hours per month.
Interview on 08/24/22 at 12:03 P.M. with DM #36 confirmed he previously worked in a restaurant prior to
being hired at the facility in December 2021. DM #36 verified he had not received any formal dietary
management training nor certification. DM #36 stated he was unaware he needed formal training for this
position and was never told what the requirements were.
Interview on 08/24/22 at 1:52 P.M. with the Director of Nursing (DON) revealed RD #69 worked for the
facility only 32 hours per month (indicating RD #700 did not work for the facility full-time).
Interview on 08/24/22 at 1:06 P.M. with Minimum Data Set Registered Nurse (MDS RN) #63 reported a
dietary manager for a sister facility (facility owned by the same corporation) provided some initial training to
DM #36, however DM #36 never completed certified training.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
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
366002
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/25/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crestline Rehabilitation and Nursing Center
327 West Main Street
Crestline, OH 44827
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 0803
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be
updated, be reviewed by dietician, and meet the needs of the resident.
Based on observation, resident interview, staff interview, review of facility menu, and review of food order
invoice, the facility failed to follow the planned menu and failed to ensure alternatives were listed and
approved by the dietician. This had the potential to affect 19 residents who received food from the kitchen.
The facility's census was 20.
Findings include:
Interview on 08/22/22 at 8:48 A.M. Resident #14 reported residents were not given menus to see what was
served for meals to determine if they wanted the meal served or an alternative. Resident #14 stated if she
was served a meal she did not like, she would order an alternative and have to wait until the meal was
served to all residents before alternatives could be made. Alternatives were typically cold meat sandwiches.
Review of the menu for 08/22/22 revealed lunch to be served was crispy baked chicken with sweet
potatoes.
Observation on 08/22/22 at 12:05 P.M. of Resident #14's lunch revealed mashed potatoes and diced
chicken mixed with gravy was served, rather than the crispy baked chicken with sweet potatoes as listed on
the menu.
Interview on 08/24/22 at 9:36 A.M. with Registered Dietitian (RD) #69 revealed she comes to the facility
every other week for eight hours.
Observation on 08/24/22 at 11:45 A.M. revealed [NAME] #53 plating the lunch meal. [NAME] #53 verified
he did not use the approved menu and/or recipe when preparing lunch. [NAME] #53 reported the menu had
the following listed: pork roasted with rosemary, red bliss potatoes, escalloped corn, and apple slices, but
[NAME] #53 did not have rosemary, so the pork was seasoned with a different (unknown) seasoning, and
he was serving mashed potatoes, creamed corn, and canned spiced apples.
Interview on 08/24/22 at 12:03 P.M. with Dietary Manager (DM) #36 revealed residents do not get a menu
to choose their meal or see what is being served and stated if a resident did not like what was served, they
could request an alternative, which would be provided following the end of regular meal service. DM #36
confirmed there was no specific food alternate list. The alternates were usually a deli meat sandwich, grilled
cheese sandwich, or a peanut butter and jelly sandwich with chicken noodle, tomato, or vegetable soup. DM
#36 did not have record of when and what substitutes had been made to the menus since he started
working for the facility in December 2021. DM #36 further verified the lunch modifications were not logged
on the menu or documented.
Interview on 08/24/22 at 1:52 P.M. with the Director of Nursing (DON) verified RD #69 was supposed to
review the foodservice menus.
Interview on 08/25/22 at 7:37 A.M. with DM #36 verified he did not order the listed menu items for crispy
chicken, sweet potatoes, or red bliss potatoes and used alternatives instead.
Review of the facility food order invoice dated 08/10/22 revealed sweet potatoes, red skin potatoes, and
crispy chicken were not ordered.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366002
If continuation sheet
Page 8 of 8
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Back to topCitations
16 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.
- 0015GeneralS&S Fpotential for harm
Address subsistence needs for staff and patients.
- 0161GeneralS&S Fpotential for harm
Use approved construction type or materials.
- 0222GeneralS&S Fpotential for harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- 0225GeneralS&S Epotential for harm
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
- 0232GeneralS&S Epotential for harm
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
- 0324GeneralS&S Fpotential for harm
Provide properly protected cooking facilities.
- 0353GeneralS&S Fpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0511GeneralS&S Epotential for harm
Have properly installed electrical wiring and gas equipment.
- 0531GeneralS&S Fpotential for harm
Have elevators that firefighters can control in the event of a fire.
F609 - The facility must develop and implement written policies and procedures that:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
F610 - In response to allegations of abuse, neglect, exploitation, or mistreatment, the
Respond appropriately to all alleged violations.
F688 - Mobility
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
F757 - Unnecessary Drugs—General
Ensure each resident’s drug regimen must be free from unnecessary drugs.
F760 - Residents are free of any significant medication errors
Ensure that residents are free from significant medication errors.
F801 - Staffing
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
F803 - Menus and nutritional adequacy
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
FAQ · About this visit
Common questions about this visit
What happened during the August 25, 2022 survey of CRESTLINE REHABILITATION AND NURSING CENTER?
This was a inspection survey of CRESTLINE REHABILITATION AND NURSING CENTER on August 25, 2022. The surveyor cited 16 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at CRESTLINE REHABILITATION AND NURSING CENTER on August 25, 2022?
Yes, 16 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Address subsistence needs for staff and patients."
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.
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.