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 observation, interview, record review, and review of facility policy, the facility failed to ensure
Resident #9 received adequate monitoring as ordered by the physician prior to the administration of a
cardiovascular medication to ensure the medication was administered only when necessary. This affected
one resident (Resident #9) of two residents reviewed for medication administration. Facility census was
109.Findings include:Review of the medical record for Resident #9 revealed an admission date of 08/02/25
with diagnosis including atherosclerotic heart disease, hypertension and atrial fibrillation.On 10/22/25 from
8:54 A.M. to 9:15 A.M. observation of medication administration with Registered Nurse (RN) #10 revealed
the RN administered the resident's Metoprolol medication without first checking the resident's heart rate or
blood pressure as ordered. Review of the physician's orders revealed an order for Metoprolol Tartrate 25
milligrams (mg) one time a day for hypertension. The order indicated to hold the medication for systolic
blood pressure (SBP) less than 100 or heart rate (HR) less than 60. Interview on 10/22/25 at 9:15 A.M. with
RN #10 verified she failed to check the resident's SBP and heart rate as ordered prior to the administration
of the medication.Review of the facility policy titled, Administering Medications, revised December 2012
revealed the individual administering the medication must check the label three times to verify the right
resident, right medication, right dosage, right time, and right method (route) of administration before giving
the medication. This deficiency represents non-compliance investigated under Complaint Number 2645120.
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 2
Event ID:
366259
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
366259
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
10/22/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Scioto Rehabilitation & Care Center
433 Obetz Road
Columbus, OH 43207
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 0880
Provide and implement an infection prevention and control program.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, record review, interview, and review of facility policy, the facility failed to follow
appropriate transmission-based precautions for a resident on contact precautions. This affected one
resident (Resident #41) of three residents reviewed for infection control. The facility census was 109.Review
of Resident #41's medical record revealed an admission date of 09/23/25 with diagnosis of osteomyelitis.
Findings include:An observation on 10/22/25 at 1:19 P.M. revealed Certified Nursing Assistant (CNA) #3
entering Resident #41's room to prepare for incontinence care. A sign was posted outside of the room door
to Resident #41's room indicating he was on contact precautions and a cart containing personal protective
equipment (PPE) supplies was noted hanging outside the resident's room door. CNA #3 entered the room
without donning a gown or gloves.An interview on 10/22/25 at 1:25 P.M. with Licensed Practical Nurse
(LPN) #7 verified the resident had contact precautions in place for infection in his blood and CNA #3 did not
apply appropriate PPE consisting of gown and gloves prior to entering the room.Review of facility policy
titled Infection Control Prevention Program, revised November 2022 revealed the facility will utilize current
CDC (Centers for Disease Control) guidelines for current infection control monitoring and guidance.This
deficiency represents non-compliance investigated under Complaint Number 2645120.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366259
If continuation sheet
Page 2 of 2