Inspection·October 9, 2025

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the medical record, review of Minimum Data Set (MDS) admission assessments, staff interview, and policy review, the facility failed to ensure an admission MDS skin condition assessment was accurate. This affected one (#2) of three residents reviewed for MDS admission assessments. The facility census was 36. Findings include: Review of the medical record for Resident #2 revealed an admission date of 09/19/25. Diagnoses included surgical aftercare, colostomy status, pulmonary embolism, and malignant neoplasm of the colon. Review of the hospital documentation revealed upon discharge Resident #2 had a right buttock wound and a left buttock deep tissue injury. Review of the admission wound assessment dated [DATE] at 3:39 P.M., completed by the Director of Nursing (DON), revealed Resident #2 had a surgical incision to the abdomen and a stage two pressure ulcer of the left axilla. There was no documentation of wounds to the right or left buttock. Review of the admission MDS assessment dated [DATE] revealed the resident had intact cognition. Further review of Section M of the admission MDS revealed Resident #2 had one surgical wound, one stage two pressure ulcer, and one unstagable deep tissue injury. Interview on 10/08/25 at 11:26 A.M., MDS Registered Nurse (MDS) #264 verified Resident #2's admission skin assessment included a clinical assessment. MDS #264 revealed she had not assessed the resident. MDS #264 revealed she documented in Section M of the admission MDS the resident had a stage two pressure ulcer and a deep tissue injury. MDS #264 revealed this information was obtained from the hospital documentation. MDS #264 was asked what should be documented when the hospital documentation and the clinical assessment were not in agreement. MDS #264 revealed she was unsure what should have been documented as she was still in training. Observation on 10/08/25 at 1:06 P.M. of Resident #2 with the DON revealed the resident had a surgical wound to the abdomen and a scabbed area to the left axilla. Further observation revealed the resident had no pressure areas on the bilateral buttocks. Interview on 10/08/25 at 1:06 P.M., the DON verified completing the resident's admission wound assessment. The DON revealed the resident had no pressure ulcer or deep tissue injury to the bilateral buttocks upon admission. Interview on 10/08/25 at 2:52 P.M., Regional MDS Nurse #266 revealed Resident #2's admission MDS assessment was incorrect and the discrepancy between the hospital documentation and the clinical assessment should have been addressed prior to completing Section M. Regional MDS Nurse #266 revealed a modification of the admission assessment would be completed. Review of the facility policy titled Resident Assessments, revised 11/2019, revealed all members of the care team would be asked to participate in the resident assessment process. The resident assessment coordinator was responsible for ensuring the interdisciplinary team conducts timely and appropriate resident assessments and reviews. Residents Affected - Few 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 3 Event ID: 366081 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 366081 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Care Center 1406 Oak Harbor Rd Fremont, OH 43420 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)