Inspection·December 4, 2023

F 0569 Review of the quarterly MDS dated [DATE] revealed Resident #33 was cognitively intact. Level of Harm - Minimal harm or potential for actual harm A nursing note dated [DATE] at 9:50 A.M. revealed Resident #33 was discharged home. Residents Affected - Few Review of current trust accounts dated [DATE] revealed Resident #33 had $120.00 in a resident fund account. Interview on [DATE] at 9:03 A.M. with BOM #46 verified Resident #33 was discharged on [DATE] and still had $120.00 in a resident funds account that should have already been provided to the resident. 3. Review of the medical record for Resident #34 revealed an admission date of [DATE] and the resident expired on [DATE]. Diagnoses included dementia, anxiety, and COVID-19. A nursing note dated [DATE] at 5:18 P.M. revealed the hospital called and stated Resident #34 expired on [DATE] at 3:38 P.M. Review of current trust accounts dated [DATE] revealed Resident #34 had $4,405.26 in a resident fund account. Interview on [DATE] at 9:03 A.M. BOM #46 verified Resident #34 had expired on [DATE] and still had $4,405.26 in a resident funds account. This deficiency represents non-compliance investigated under Complaint Number OH00148291 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 2 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many 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** Based on observation, record review including review of facility payroll records, review of facility billing/financial information, review of the [NAME] County Auditor website, review of the facility assessment, review of the employee handbook, review of the facility admission agreement, review of the facility Abuse/Neglect policy and procedure and interviews, the facility neglected to meet financial obligations for the delivery of care and maintenance and to operate in a manner to ensure all bills were being paid timely to prevent potential interruption in services and to meet the total care needs of all residents admitted to and/or retained in the facility and failed to have adequate and effective systems in place to ensure staff were compensated via payroll benefits based on their hired agreement and payroll schedule. This resulted in Immediate Jeopardy beginning on 10/13/23 when the identified lack of financial solvency placed all facility residents at risk for serious harm, injury, hospitalization, displacement due to potential interruption in staffing regarding non-payment of payroll benefits and continued 10/16/23 due to non-payment of essential bills. This had the potential to affect all 31 residents residing in the facility. On 11/20/23 at 5:08 P.M., the Director of Nursing (DON) and the Assistant Administrator were notified Immediate Jeopardy began on 10/13/23 when an onsite investigation determined the facility neglected to meet all financial obligations for the delivery of care and maintenance of the facility by not paying vendors and staff in a timely manner. This included insufficient funds to meet staff payroll on 10/13/23, delinquent balances owed to the facility food vendor resulting in delayed food delivery and the facility utilizing emergency food supplies, a city water disconnect notice due to non-payment and/or returned checks due to insufficient funds, outstanding balances with the electric company with potential shut off notices if payments were not received, delinquent property taxes since 02/21, non-payment for therapy services resulting in a change of therapy providers and a hold placed on the oxygen and respiratory supply account by the vendor due to non-payment of the outstanding balance causing potential interruption of services and the inability to meet the total care needs of the residents admitted to and/or retained in the facility. The Immediate Jeopardy was removed on 11/28/23 when the facility implemented the following corrective actions: • On 11/20/23 at 6:00 P.M. the Assistant Administrator and the DON verified the residents had the needed supplies (food, oxygen, medication, medical supplies) to meet the needs of the residents and there were no negative outcomes resulting from negative practice. • Beginning on 11/20/23 and concluding on 11/21/23, the Administrator and/or designee re-educated, through in-person and phone communication, all facility staff on the abuse policy. This education included the requirement to meet financial obligations for the delivery of care and maintenance and to operate in a manner to ensure all bills were being paid in a timely manner to prevent potential interruption in services and to meet the total care needs of all the residents admitted to and/or retained in the facility. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 3 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 • Level of Harm - Immediate jeopardy to resident health or safety Beginning on 11/20/23 and concluding on 11/21/23 the DON and Assistant Director of Nursing (ADON) completed education with all clinical staff (nine Registered Nurses (RN), nine Licensed Practical Nurses (LPN), 17 State Tested Nursing Assistants (STNA) & four Hospitality Aides) on communicating if there are any supply, vendor and/or food supply concerns to immediately notify the DON and the Administrator. Residents Affected - Many • On 11/21/23, the DON, ADON and RN Supervisor #47 completed a review of all 31 residents to verify that there were no resident condition changes related to the facility's lack of payment to vendors. • Beginning on 11/21/23, the Administrator and/or designee monitors and ensures essential resident care services are provided by daily communication in the stand-up meeting with the facility leadership team by asking if there are any essential vendor concerns. • Beginning on 11/21/23, the Administrator and or designee communicates needs to the management company (Compliance Officer #602, Chief Executive Officer (CEO) #601, and/or Chief Financial Officer (CFO) #600) as they arise via email communication. • The Business Office Manager (BOM) was re-educated by the Administrator on 11/21/23 regarding the Stampli process. BOM and/or designee scan bills into Stampli, the online portal for the Management Company's approval and payment. • On 11/21/23, Corporate Compliance Officer #602 re-educated the Administrator, the Assistant Administrator and the DON on the abuse policy. This education included the requirement to meet Financial obligations for the delivery of care and maintenance and to operate in a manner to ensure all bills were being paid in a timely manner to prevent potential interruption in services and to meet the total care needs of all the residents admitted to and/or retained in the facility. • On 11/27/2023, the Administrator verified with the Management Company (CEO, CFO, Corporate Compliance Officer) that the following vendors bills were made current; AEP (Electric), [NAME] (Trash), [NAME] Gas (Natural Gas), Respiratory Care Partners (Oxygen), and City of Cambridge (Water/Sewer). The Administrator also verified with the Management Company (CEO, CFO, Corporate Compliance Officer) that the following vendors were placed on a payment plan: [NAME] County Treasurer (Property Taxes), MedOne (Medical Director), Medline (Medical Supplies), and Broad River (Therapy). • (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 4 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Level of Harm - Immediate jeopardy to resident health or safety The facility provided a payment plan dated 11/27/23 for delinquent taxes with a balance of $79,428.51. The contract started on 11/27/23 with a down payment of $10,000 (no date) and a payment of $5,000 on 12/22/23. A payment of $4,964.28 would be made the twenty-second of each month through 02/22/25 and a final payment of $4,964.31 would be made on 04/22/25. • Residents Affected - Many Beginning on 11/28/23, the DON or designee will interview five clinical employees weekly for four weeks and randomly thereafter to verify that staff have adequate supplies, food and staffing to meet the needs of the residents. • On 11/28/23 Administrator provided a copy of check #1008 dated 11/28/23 to RCP in the amount of $1,897.19. • On 11/28/23 the Administrator provided a copy of check #1005 dated 11/15/23 for $765.55 was submitted to [NAME] Refuse for payment in full. • On 11/28/23 the Administrator provided a copy of check #1006 dated 11/17/23 to the City of Cambridge for $11,786.96, for the water bill to be paid in full. • Interviews on 11/29/23 at 9:03 A.M. with BOM #46, at 10:05 A.M. with DD #48, at 10:24 A.M. with LPN #5, at 10:34 A.M. with STNA #30, at 10:40 A.M. with Housekeeper #58, at 10:42 A.M. with LPN #10, and 10:45 A.M. with Laundry/Housekeeping Supervisor #55 revealed they had received education on abuse and reporting any calls regarding outstanding bills, and any concerns with supplies not being delivered. • Beginning on 11/29/23, weekly conference calls will be held on Wednesdays at 11:00 A.M. with the Administrator and/or designee with management company (Corporate Compliance Officer, CEO, or CFO) to communicate any concerns with essential resident care services weekly for 12 weeks. • Beginning on 11/29/23, the Administrator and/or designee and CFO #600 of the management company and/or designee, will complete weekly audits for four weeks and then randomly thereafter of financial obligations to essential resident care services (food, pharmacy, oxygen, medical supplies, therapy, staff) by ensuring that invoices are being paid and that no disconnect/cut off/end of service notifications were delivered within the week. • (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 5 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Beginning on 11/29/23 Social Services #45 and/or designee will interview four residents weekly for four weeks and then randomly thereafter to ensure their needs are being met. Level of Harm - Immediate jeopardy to resident health or safety • Residents Affected - Many Beginning on 11/29/23 Social Services #45 and or designee will interview four residents weekly for four weeks and then randomly thereafter to ensure their needs are being met. • Beginning on 12/19/23 (the next scheduled meeting date) results of all audits and interventions will be brought to the Quality Assurance Performance Improvement (QAPI) meeting monthly for three months and as needed for review and recommendations. Although the Immediate Jeopardy was removed on 11/28/23, the facility remained out of compliance at a Severity Level 2 (no actual harm with potential for more than minimal harm that is not Immediate Jeopardy) as the facility was still in the process of implementing their corrective action and monitoring to ensure compliance. Findings Include: On 11/16/23 at 8:32 A.M., an interview with the Director of Nursing (DON) revealed some of the employee checks had been returned for insufficient funds but corporate (management located in Florida) had wired money to the employees the same day. Further interview revealed corporate also covered any fees that occurred at the employees' banks. Interview on 11/16/23 at 8:36 A.M. with State Tested Nursing Assistant (STNA) #32 revealed they had a paycheck from 10/13/23 returned due to insufficient funds. At 8:38 A.M. interview with Housekeeper #56 revealed they had a paycheck from 10/13/23 returned due to insufficient funds. At 8:40 A.M. interview with Housekeeper #58 revealed they had a paycheck from 10/13/23 returned due to insufficient funds. STNA #32, Housekeeper #56 and Housekeeper #58 stated corporate wired money to their accounts the same day the checks were returned and covered any penalties/fees that occurred due to the facility's insufficient funds to make payroll. Interview on 11/16/23 at 8:53 A.M. with Dietary Director (DD) #48 revealed some of the emergency supply of food had to be used due to food not being delivered by the food vendor ([NAME]) on 10/16/23. DD #48 stated a delivery truck arrived on 10/16/23 but did not unload any food (due to non-payment of the food bill) and left the facility. Review of the menus and substitutions revealed on 10/16/23 the dinner meal did not have cabbage available due to no truck delivery. On 10/17/23 and 10/18/23 the lunch and dinner meals were substituted with other food items due to no truck delivery on 10/16/23. DD #48 revealed a food delivery was made on 10/18/23 and 10/23/23 with the 10/23/23 delivery duplicating the items from the 10/18/23 order. Review of an invoice dated 10/18/23 and invoice dated 10/23/23 verified the duplicate orders. Review of meal substitutions revealed substitutions were made for dinner on 10/27/23, lunch and dinner on 10/28/23, and lunch and dinner on 10/29/23. DD #48 clarified the menu was followed from 10/19/23 until 10/27/23 but since there was a duplicate delivery on 10/23/23, substitutions were made on 10/27/23, 10/28/23, and 10/29/23 so residents were not served the same meals two weeks in a row. Some of the emergency food supply was used to prevent duplicate meals and some of the food on hand was used to make different meals. The facility started using [NAME] Food Service on 10/27/23 and stopped using [NAME]'s services for food delivery. Review of the invoice (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 6 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 dated 10/31/23 revealed [NAME] Food Service delivered food on 10/31/23. Level of Harm - Immediate jeopardy to resident health or safety Interview on 11/16/23 at 12:37 P.M. interview with Business Office Manager (BOM) #46 revealed most bills were sent directly from vendors to Epic Healthcare Solutions. All bills and invoices received at the facility were scanned and emailed directly to Stampli (company that processes and pays invoices) every Wednesday. If there were any disconnect notices or notice that services would be stopped, those bills would be emailed to the Administrator, Epic Healthcare Solutions, and Stampli immediately. Residents Affected - Many On 11/16/23 at 12:42 P.M. an interview with the Administrator regarding the facility finances and billing/payment process revealed BOM #46 would forward invoices and bills received at the facility to Stampli via email. The facility did not pay any of the vendors directly for services rendered at the facility, the payments were being made by an accounts payable department based in Florida. The Administrator stated there had been a few disconnect notices, but no utilities had ever been disconnected. An additional interview on 11/16/23 at 2:28 P.M. with the Administrator revealed any disconnect notices were forwarded to Epic Healthcare Solutions. The Administrator stated he received an email (sender not identified by the Administrator) dated 09/08/23 that Arbor Rehabilitation and Healthcare Services (the previous therapy provider) would be ending their services. Another therapy department (Broad River Rehabilitation) would start providing services. The Administrator stated there was no disruption in therapy services for the residents. The Administrator also shared BOM #46 sent payroll information to corporate on a Monday and paper checks were sent overnight to the facility for payday (every other Friday). The Administrator stated paper checks had been used for several months but he was unsure why this was changed from direct deposit. Further interview revealed the Administrator called corporate on 10/13/23 when his check and 20 additional employees were returned on 10/13/23 due to insufficient funds. The Administrator identified himself; RN #6, RN #66, and RN #509; Maintenance Director #20, Hospitality Aide (HA) #24, #56, #57, #58 and #59; STNA #36, STNA #41, Social Services Designee #45, BOM #46, Dietary Staff (DS) #49, #52; Marketing #61, Beautician #62, the Assistant Administrator, Activity Aide #64 and #65 that had payroll checks returned due to insufficient funds. Corporate had wired money to employees in the amount of their pay and any fees that had occurred when they were notified a check was returned for insufficient funds. The 21 staff (the Administrator, RN #6, RN #66, and RN #509; Maintenance Director #20, Hospitality Aide (HA) #24, #56, #57, #58 and #59; STNA #36, STNA #41, Social Services Designee #45, BOM #46, Dietary Staff (DS) #49, #52; Marketing #61, Beautician #62, the Assistant Administrator, Activity Aide #64 and #65) identified were verified with facility payroll records to have payroll checks dispersed and dated 10/13/23. On 11/20/23 at 9:12 A.M. Dietician #508 revealed food suppliers had been changed in October of 2023 from [NAME] to [NAME]. Dietician #508 stated she was unaware some of the emergency supply of food had been used but was aware there were several substitutions made in October and it was protocol to make substitutions if a food item was not available. Further interview verified DD #48 followed the procedure of making substitutions and identifying the reason why it was necessary. An additional interview on 11/27/23 at 11:28 A.M. with Dietician #508 revealed she was aware substitutions had been made due to delivery truck not delivering food on the correct day and then sending the same food items two weeks in a row. Dietician #508 stated she approved of the substitutions that were made. On 11/20/23 at 9:39 A.M. an additional interview with DD #48 revealed she contacted [NAME] on 10/16/23 when the food delivery was not made. An employee of [NAME] stated orders could not be placed until a payment had been made to [NAME] food distribution. The emergency food supply had to be used (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 7 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 during this time. Level of Harm - Immediate jeopardy to resident health or safety On 11/20/23 at 10:59 A.M. interview with RN #509 revealed she had worked at the facility for 12 years but had recently quit due to insufficient funds on 10/13/23 and then her bank held her next pay dated 10/27/23 until 11/07/23 since the facility had a previous issue with insufficient funds. The RN stated she resigned due to instability of the paycheck system and needing to be paid on time. RN #509 stated there had been times the trash dumpster was overflowing at the facility because the bill had not been paid and food was not delivered due to nonpayment to the supplier. Lastly, the facility had purchased t-shirts for the staff for nurse's week and the vendor was calling the facility asking for payment. Residents Affected - Many On 11/20/23 at 11:07 A.M. RN #6 verified they had a paycheck return for insufficient funds. RN #6 stated a food delivery truck had arrived at the facility but left without unloading any food due to nonpayment. The trash dumpster had overflowed because the refuse company was owed money. A lot of vendors call the facility all hours of the day and night asking for payment. The staff would tell the vendors to call back when someone was in the office. Sometimes the staff left a note at the front desk about a vendor calling and wanting payment. On 11/20/23 at 1:31 P.M. CFO #600 revealed Epic Healthcare Solutions was in the process of transferring financial accounts to a different bank (from Regency Bank to the Bank of Oklahoma). There had been an issue with funds being moved from one account to another account. This had caused problems with payroll being covered. A conscious decision as an organization was made to use paper checks to help with timing and cash flow and there had been a change in banks due to Regency Bank not moving money from one account to another quick enough to meet the facility's financial needs. CFO #600 stated communication and payments were handled at the corporate office so the facility staff could focus on the residents. CFO #600 stated no services had been disconnected and stated he would have to check to see if any disconnection notices had been received. CFO #600 stated they would investigate trash service not being provided in September. When asked about the disconnect notice from the City of Cambridge, CFO #600 revealed the corporation made sure everyone got paid and residents and staff had everything they needed. CFO #600 verified there had been multiple checks that were returned for insufficient funds to the City of Cambridge and banks were being changed due to returned checks. CFO #600 stated they had made an agreement last week with the [NAME] County Auditor's Office for the delinquent property taxes and had made a payment for the first two months of a 12-month agreement. CFO #600 verified money was still owed to the two previous food vendors. A payment had been made to Avalon (a previous food vendor) not too long ago and there was communication daily with [NAME] (a previous food vendor). When asked why bills were not being paid on time, CFO #600 stated there was communication with vendors to make sure they received payments. CFO #600 stated most of the payment agreements were verbal and there were no written agreements. CFO #600 stated the therapy providers changed due to corporate wanted to try a different provider and he was unable to recall how much was owed to Arbor Rehabilitation. CFO #600 verified corporate did not always pay for services quickly but made sure the facility had the essential supplies. Payments were based off cash flow and corporate worked with vendors daily, but the CFO could not provide a reason the bills were not paid on time when he was asked. Interview on 11/24/23 at 10:04 A.M. interview with the Administrator revealed any final notices and/or disconnect notices were also sent to Epic Healthcare Solutions. The Administrator stated the only disconnect notice he could recall was from the city for water and sewage and he was aware food was not delivered one time but was not aware it was due to nonpayment. Dietary Director #48 was given money from petty cash to purchase anything that was needed for the residents. Additionally, the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 8 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many Administrator verified the facility did not receive a bill for the medical director and was not aware the medical director was not being paid. On 11/24/23 at 10:41 A.M. an interview with BOM #46 revealed any calls received at the facility about bills being owed were emailed to accounts payable at Epic Healthcare Solutions. BOM #46 stated the email to accounts payable included multiple people and not one specific person (the multiple people were not identified by the BOM). The following vendor/suppliers were reviewed as part of the State agency investigation: a. Review of bill from the City of Cambridge Utilities Department dated 11/02/23 revealed $11,786.96 was owed and this was a final shut off notice. If payment was not received by 11/15/23, service will be turned off on 11/16/23 without further notice. On 11/16/23 at 2:22 P.M. interview with City of Cambridge Office Manager #500 revealed the facility was sent a final shut-off notice dated 11/02/23 due to nonpayment for water and sewage in the amount of $11,786.96. If payment was not received by 11/15/23, service would be turned off without further notice on 11/16/23 and a delinquency charge would be made. City of Cambridge Office Manager #500 shared a check from Epic Healthcare Solutions had been received on 11/14/23 but Epic Healthcare Solutions had checks returned for insufficient funds in July, twice in August, and in September. An additional interview on 11/28/23 at 8:49 A.M. with City of Cambridge Office Manager #500 revealed the previous check received on 11/14/23 had been returned for insufficient funds after speaking with surveyor on 11/16/23. The City of Cambridge Office Manager #500 stated another check was received and deposited and had not been returned at the time of the interview. b. On 11/16/23 at 4:33 P.M. interview with Sales/Service #501 for [NAME] Innovative Management Partners verified Epic Healthcare Solutions owed $132,100.42. Sales/Service #500 stated there was a tentative schedule for weekly payments, but the vendor did not share what the agreed upon amount was with the facility. If Epic Healthcare Solutions was unable to adhere to the schedule, then there would be a meeting to brainstorm about payments. Review of statement from [NAME] Innovative Management Partners dated 11/18/23 revealed invoice amounts from 06/15/23 through 10/28/23 a total balance of $132,100.42 was owed. c. Review of statement from Avalon Foodservice dated 10/31/23 revealed there were outstanding charges from 12/06/22 through 10/31/23 totaling $31,106.05. On 11/20/23 at 8:31 A.M. an interview with Credit Manager #505 at Avalon Foodservice revealed the facility elected to stop services on 01/24/23. The facility still had an outstanding balance of $29,106.05 owed to Avalon Foodservice. d. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 9 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many Review of monthly statements from American Electric Power (AEP) revealed a payment in the amount of $8890.42 was made on 07/03/23. The check was returned on 07/07/23. A statement dated 07/13/23 revealed there was a balance of $12,614.68 including a previous balance of $8890.42. A payment of $8950.20 was made on 07/20/23 and was returned on 07/28/23. The monthly bill dated 08/11/23 revealed an outstanding balance of $16,645.91. A payment of $12672.88 was made on 08/28/23 and returned on 09/05/23. The monthly bill dated 09/12/23 revealed an outstanding balance of $20,908.49. The monthly bill dated 10/11/23 revealed a balance of $7,858.82. The monthly bill dated 11/09/23 revealed a balance of $13,260.14 with an outstanding balance of $7,907.19 and a current balance of $5,352.95. On 11/20/23 at 10:07 A.M. an interview with a representative of AEP revealed there was an outstanding balance of $5,401.32. If payment was not received by 12/14/23 the facility would be at risk for disconnection of service e. On 11/20/23 at 10:46 A.M. Chief Executive Officer (CEO) #503 for Arbor Rehabilitation and Healthcare Inc. revealed therapy services were ended due to a lack of payment. The representative supplied documentation dated 11/15/23 showing an outstanding balance of $247,604.28. CEO #503 stated Epic would not commit to a payment plan as it was too binding, and they wanted flexibility, so he was not receiving money monthly and had not received payment for a while. CEO #503 verified he speaks with the company frequently, but they are not easy to work with since they won't set a payment amount and don't send routine payments, He also stated he had to take out a line of credit due to the facility's failure to make payments on their owed debt. f. On 11/20/23 at 11:14 A.M. Representative #504 at Broad River Rehab revealed services were started on 09/18/23. The first invoice #106862 was sent on 10/03/23 for $8,897.76 and was due on 11/02/23. g. On 11/20/23 at 11:22 A.M. a representative at [NAME] Refuse company revealed the facility currently had service of trash pickup six days a week. There was an outstanding bill for $760.55 and the present bill was $766.55. Review of an invoice dated 08/01/23 revealed a balance due of $1,538.05 including a past due amount of $772.50. An invoice dated 09/01/23 revealed a balance due of $2,303.60 including a past due amount of $1,538.05. An invoice dated 11/01/23 revealed a current balance due of $760.55 and no past due amounts. h. On 11/20/23 at 12:15 P.M., an interview with Medical Director #506 revealed he was not aware of vendors not being paid. Medical Director #506 stated he had not been paid since June 2023 and payments prior to that had been sporadic. Medical Director #506 was aware there had been a change in therapy services but did not know it was due to the previous company not being paid. There was no bill or statement provided for review. i. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 10 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many Review of the property taxes owed at https://auditor.guernseycounty.gov revealed unpaid taxes with a total of $432.44 with $260.42 delinquent for parcel number 04-0000094.000. There were also unpaid taxes with a total of $79,428.51 with $47,626.26 delinquent for parcel number 04-0000038.000. On 11/20/23 at 12:49 P.M. interview with Representative #507 of [NAME] County Treasurers Office #507 verified the facility owed a total of property taxes in the amount of $79,860.95. The last tax payment was received on 02/18/21. j. On 11/20/23 at 4:41 P.M., an interview with Accounts Receivable Specialist #510 at Respiratory Care Partners (RCP) revealed there was an outstanding balance of $1,897.19. A hold had been put on delivery of services until a payment was received. An additional interview on 11/27/23 at 11:05 A.M. with Accounts Receivable Specialist #510 revealed a payment had been promised and the owner of RCP had lifted the hold on deliveries. However, no confirmation of the promised payment amount or payment arrangements had been shared. k. Attempts were made to contact Medline, the facility's medical supply company regarding payments and outstanding balances. Medline did not return calls and the facility did not provide billing statements from the medical supply company as requested. Review of the Nursing Facility admission Agreement provided to all residents revealed the facility would provide routine nursing care and supplies, meals, housekeeping, social services, activities, and medical supplies. Review of the Facility assessment dated [DATE] revealed the facility's residents were at a clinically complex and special high categories who oftentimes have one or more chronic or comorbid conditions including their acuity. Residents of the facility were at risk for falls, pressure ulcers, infections, incontinence, increased disability, weight loss, depression, and other potential areas of decline. Review of Employee Handbook revealed employees would receive their pay reimbursement for hours worked either through Pay Card or Direct Deposit. During orientation, the human resources representative will assist with signing up for either direct deposit or a Pay Card. Review of the facility's policy titled, Abuse Prevention, Identification, Investigation and Reporting Policy revised 08/15/22 revealed, Neglect was the failure of the facility, its employees or service providers to provide goods and services to a resident that were necessary to avoid physical harm, pain, mental anguish, or emotional distress. This deficiency represents non-compliance investigated under Complaint Number OH00148291. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 11 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0837 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, facility policy review and interview, the facility failed to establish an effective governing body, legally responsible to establish and implement policies regarding the management and operation of the facility, including but not limited to compliance with all financial obligations for the delivery of care and maintenance. This had the potential to affect all 31 residents in the facility. Findings include: Review of the facility's undated Governing Body policy revealed the Governing Body had a fiduciary duty, duty of care, and duty of loyalty to act in the best interests of the Facility. The governing body should be comprised of the operator (s), c-suite level executives, and other individuals who were legally responsible for the establishment and implementation of policies regarding management and operations of the facility. The Governing Body member responsibilities included to be active, engaged, and involved in the affairs of the facility and to have direct access to the administrator and to the compliance and ethics officer by scheduling executive board sessions with the compliance and ethics officer that allows for a free flow of information without potential for conflict. Review of the administrator job description revealed he worked with the office manager to disburse money, record transactions, and obtain receipts for any monetary transactions. The job description indicated the administrator was ultimately responsible for petty cash and all accounts receivable; and, establishing contracts with consultants and review and evaluate the consultant reports and recommendations. Review of the facility assessment dated [DATE] revealed the facility provided all care and services as required in the requirements of participation including, but not limited to: assistance with activities of daily living, personal care services, medication administration, pain management, infection prevention and control, nutritional services, skin care, fall and injury prevention, pharmacy, and therapy services. Additionally, the facility provided medical director, attending physicians, physician assistants, nurse practitioners, dentist, podiatrist, ophthalmologist, and psychiatrist services, and pharmacist. The governing body consisted of Chief Financial Officer #600, Chief Executive Officer #601, and Chief Nursing Officer/Compliance Officer #602. Interview on 11/20/23 at 1:31 P.M. Chief Financial Officer (CFO) #600 revealed most of the facility bills were handled at the corporate office so the facility staff could focus on residents. CFO #600 stated the corporate office was located in Florida. CFO #600 indicated there was close contact with vendors vial email or telephone. When asked if there had been any disconnection notices in the last six months, CFO #600 stated no services had been disconnected but they would have to check to see if there were any disconnection notices. When asked about a disconnect notice from the city water and sewage, and four checks being returned due to insufficient funds, CFO #600 stated everyone gets paid and the residents and staff got everything they needed. CFO #600 stated an agreement with the auditors office was made the previous week and payments for two months had been made. CFO #600 stated payments and communication were being completed with the previous food vendors. When asked why bills were behind and payments were not made on time, CFO #600 stated there was communication with vendors (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 12 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0837 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many to make sure payments were received and essential supplies were provided to the facility. CFO #600 stated most of the payments plans were verbal agreements and payments were based on the cash flow. Between 11/16/23 and 11/28/23 additional information was requested from the facility to include a more detailed description of current balances, outstanding balances, dates last payments were made and information from the actual vendor/supplier/utility to review. The following information was provided: a. Review of statement from Avalon Food service dated 10/31/23 revealed there were outstanding charges from 12/06/22 through 10/31/23 totaling $31,106.05. On 11/20/23 at 8:31 A.M. an interview with Credit Manager #505 at Avalon Food service revealed the facility elected to stop services on 01/24/23. The facility still had an outstanding balance of $29,106.05 owed to Avalon Food service. b. Review of monthly statements from American Electric Power (AEP) revealed a payment in the amount of $8890.42 was made on 07/03/23. The check was returned on 07/07/23. A statement dated 07/13/23 revealed there was a balance of $12,614.68 including a previous balance of $8890.42. A payment of $8950.20 was made on 07/20/23 and was returned on 07/28/23. The monthly bill dated 08/11/23 revealed an outstanding balance of $16,645.91. A payment of $12672.88 was made on 08/28/23 and returned on 09/05/23. The monthly bill dated 09/12/23 revealed an outstanding balance of $20,908.49. The monthly bill dated 10/11/23 revealed a balance of $7,858.82. The monthly bill dated 11/09/23 revealed a balance of $13,260.14 with an outstanding balance of $7,907.19 and a current balance of $5,352.95. On 11/20/23 at 10:07 A.M. an interview with a representative of AEP revealed there was an outstanding balance of $5,401.32. If payment was not received by 12/14/23 the facility would be at risk for disconnection of service c. On 11/20/23 at 11:22 A.M. a representative at [NAME] Refuse company revealed the facility currently had service of trash pickup six days a week. There was an outstanding bill for $760.55 and the present bill was $766.55. Review of an invoice dated 08/01/23 revealed a balance due of $1,538.05 including a past due amount of $772.50. An invoice dated 09/01/23 revealed a balance due of $2,303.60 including a past due amount of $1,538.05. An invoice dated 11/01/23 revealed a current balance due of $760.55 and no past due amounts. d. The facility provided a list of 21 employees that had paychecks dated 10/13/23 returned due to insufficient funds. Interview on 11/16/23 at 2:28 P.M. with the Administrator revealed the Administrator identified himself; RN #6, RN #66, and RN #509; Maintenance Director #20, Hospitality Aide (HA) #24, #56, #57, #58 and #59; STNA #36, STNA #41, Social Services Designee #45, BOM #46, Dietary Staff (DS) #49, #52; Marketing #61, Beautician #62, the Assistant Administrator, Activity Aide #64 and #65 that had payroll checks returned due to insufficient funds. Corporate had wired money to employees in the amount of their pay and any fees that had occurred when they were notified a check was returned for insufficient funds. e. Review of bill from the City of Cambridge Utilities Department dated 11/02/23 revealed $11,786.96 was owed and this was a final shut off notice. If payment was not received by 11/15/23, service would be turned off on 11/16/23 without further notice. On 11/16/23 at 2:22 P.M. interview with City of Cambridge Office Manager #500 revealed the facility (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 13 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0837 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many was sent a final shut-off notice dated 11/02/23 due to nonpayment for water and sewage in the amount of $11,786.96. If payment was not received by 11/15/23, service would be turned off without further notice on 11/16/23 and a delinquency charge would be made. City of Cambridge Office Manager #500 shared a check from Epic Healthcare Solutions had been received on 11/14/23 but Epic Healthcare Solutions had checks returned for insufficient funds in July, twice in August, and in September. An additional interview on 11/28/23 at 8:49 A.M. with City of Cambridge Office Manager #500 revealed the previous check received on 11/14/23 had been returned for insufficient funds after speaking with surveyor on 11/16/23. The City of Cambridge Office Manager #500 stated another check was received and deposited and had not been returned at the time of the interview. f. On 11/16/23 at 4:33 P.M. interview with Sales/Service #501 for [NAME] Innovative Management Partners verified they were owed $132,100.42. Sales/Service #500 stated there was a tentative schedule for weekly payments. Review of a statement dated 11/18/23 revealed invoices from 06/15/23 through 10/28/23 totaled$132,100.42. g. On 11/20/23 at 10:46 A.M. Chief Executive Officer (CEO) #503 for Arbor Rehabilitation and Healthcare Inc. revealed therapy services were ended due to lack of payment. The representative supplied an excel spreadsheet dated 11/15/23 showing an outstanding balance of $247,604.28. CEO #503 stated the facility would not commit to a payment plan because it was too binding, and they wanted flexibility. CEO #503 stated monthly payments were not being made and a payment had not been made for awhile. h. On 11/20/23 at 12:15 P.M., an interview with Medical Director #506 revealed they were not aware of vendors not being paid. Medical Director #506 stated they had not been paid since June 2023 and payments prior to that had been sporadic. Medical Director #506 was aware there had been a change in therapy services but did not know it was due to the previous company not being paid. Review of email to administrator dated 11/06/23 revealed an electronic funds transfer of $5,000.00 was made to the company the Medical Director #506 was employed at. i. Review of the property taxes at https://auditor.guernseycounty.gov revealed unpaid taxes with a total of $432.44 with a $260.42 delinquent amount for parcel number 04-0000094.000. There were also unpaid taxes with a total of $79,428.51 with a $47,626.26 delinquent amount for parcel number 04-0000038.000. On 11/20/23 at 12:49 P.M. interview with Representative #507 of [NAME] County Treasurers Office #507 verified Astoria of Cambridge owed a total of property taxes in the amount of $79,860.95. The last tax payment was received on 02/18/21. j. On 11/20/23 at 4:41 P.M., an interview with Accounts Receivable Specialist #510 at Respiratory Care Partners (RCP) revealed there was an outstanding balance of $1,897.19. A hold had been put on delivery of services until a payment was received. An additional interview on 11/27/23 at 11:05 A.M. with Accounts Receivable Specialist #510 revealed a payment had been promised and the owner of RCP had lifted the hold on deliveries. Interview on 11/28/23 at 11:41 A.M. Accounts Receivable Specialist #510 verified they had not received a check at this time. On 11/28/23 Administrator provided a copy of check #1008 dated 11/28/23 to RCP in the amount of $1,897.19. This deficiency represents non-compliance investigated under Complaint Number OH00148291 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 14 of 15 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 366273 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Enclave at Cambridge 8420 Georgetown Road Cambridge, OH 43725 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 0908 Keep all essential equipment working safely. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview, the facility failed to ensure functioning equipment was maintained in the kitchen. This had the potential to affect all 31 residents. The census was 31. Residents Affected - Many Findings include: A tour of the kitchen on 11/16/23 at 8:53 A.M. revealed the walk-in cooler was being used for storage. A freestanding commercial refrigerator was observed to be unplugged and not being used. Dietary Director (DD) #48 verified the walk-in cooler and the freestanding commercial refrigerator were not working. DD #48 stated the walk-in cooler had not worked since sometime in June and the freestanding commercial refrigerator stopped working 11/05/23. DD #48 stated residential refrigerators being used to replace the commercial refrigerators. The facility provided two estimates for the walk-in cooler. The first estimate was dated 07/19/23 for $18,125 with full payment required prior to installation. The second estimate was dated 07/27/23 for $10,568 with 50-percent prior to ordering and the balance upon completion. Interview on 11/20/23 at 2:42 P.M. Regulatory Environmental Health Specialists (REHS) #511 for [NAME] County Health Department revealed they had just completed an inspection of the kitchen and noted the facility walk-in cooler and commercial freestanding refrigerator were no longer working. REHS #511 stated per the county health department regulations, residential equipment was not permitted to be used after 2021. The residential refrigerators may not have the proper circulation to keep food at the proper temperatures and were not designed for commercial use. Interview on 12/20/23 at 2:49 P.M. with an anonymous Dietary Staff revealed prep for meals had to be done daily before meals and it was difficult to keep enough refrigerated items on hand for seven days due to lack of storage without the walk-in cooler. Interview on 11/27/23 at 9:26 A.M. with the Administrator revealed he emailed corporate weekly asking about the plans for the walk-in cooler, but had not receive a definite answer about replacing or repairing the walk-in cooler. This deficiency represents non-compliance investigated under Complaint Number OH00148291 FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366273 If continuation sheet Page 15 of 15