Health inspection·November 26, 2025

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few bottle of mouthwash for him to use when receiving oral hygiene care. CNA #177 stated oral hygiene care should be provided as part of the resident's morning care. CNA #177 stated she did not know why there were no oral hygiene supplies in Resident #54's room. CNA #177 verified that prior to looking in Resident #54's mouth during the interview, she did not know he was edentulous. Review of the facility's policy on Oral Hygiene updated 11/05/24 revealed the facility recognized the importance of good oral hygiene practice to cleanse mouth, teeth, and dentures. It was to be provided to prevent infection, irritation, periodontal disease and odors. The policy only included directives for residents who had their own teeth and/ or dentures. It did not address residents who did not have any of their natural teeth (edentulous) and/ or the use of dentures. This deficiency represents non-compliance investigated under Complaint Intake Number 2665757. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366286 If continuation sheet Page 2 of 4 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 366286 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Cedar Hill 1136 Adair Avenue Zanesville, OH 43701 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 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on record review and interview the facility failed to follow physician orders to apply ice packs several times a day to the left knee of Resident #72 who was status post left total knee replacement. This affected one (Resident #72) of three residents reviewed for admission and post-surgical physician orders. The facility census was 71. Findings Include:Findings Include:Review of the medical record for Resident #72 revealed an admission date of 10/16/25 after having a left total knee replacement on 10/13/25. Resident #72's diagnoses included diabetes, anemia, heart disease, high blood pressure and gastric reflux.Review of the initial nursing assessment completed on 10/16/25 revealed Resident #72 had a brief interview for mental status score of 14/15, meaning the resident was cognitively intact. Review of the Minimum Data Set (MDS) 3.0 assessment revealed Resident #72 was dependent for toileting, substantial assistance for dressing lower body, and dependent on applying foot wear. Review of the hospital After Visit Summary (AVS) printed on 10/16/25 at 9:14 A.M. and provided by the medical transport team to the facility on admission revealed Resident #72 was ordered post-operative care and treatment to include ice packs to operative leg several times a day 10 to 20 minutes on and 10 to 20 minutes off to decrease pain and swelling.Review of the Treatment Administration Record (TAR) for Resident #72 revealed on 10/20/25 ice packs to be applied to operative site to aide in decreasing pain and swelling. This should be done multiple times a day 10 to 20 minutes on and 10 to 20 minutes off. Place barrier, such as towel between ice and skin, four times a day for pain and swelling. The treatment was signed off as completed only once on 10/20/25 at 8:00 P.M.Further review of the medical record for Resident #72 revealed on 10/20/25 the Resident/Resident Representative requested a transfer to another skilled rehabilitation facility. On 10/21/25 Resident #72 was discharged from the facility, and his daughter transported him to another facility for further care and treatment.Interview on 11/25/25 at 9:05 A.M. with Resident #72's daughter revealed on 10/20/25 she reported to facility administration that Resident #72 had not received any ice packs or application of ice packs since arrival on 10/16/25 and it was ordered on the AVS from the hospital.Interview on 11/25/25 at 3:05 P.M. with licensed practical nurse (LPN) #125 revealed she recalled admitting Resident #72 to the facility on [DATE] between 11:30 A.M. and 12:00 P.M. LPN #125 reported that Resident #72 had a knee replacement. Interview with LPN #125 further revealed she received the AVS from the transporting team and reviewed it. LPN #125 reported she reconciled the AVS orders with the nurse practitioner around 1:30 P.M. and then entered them into the computer system. LPN #125 did not recall an order for ice pack application and stated if its not in the computer then it wasn ' t on the AVS. Interview on 11/26/25 at 3:45 P.M. with the Director of Nursing (DON) revealed she was notified by the daughter of Resident #72 on 10/20/25 that he had not received ice to operative knee since admission and the ice application was ordered on the AVS. The DON further explained that the AVS was reviewed, and an order was placed immediately, and ice application was offered to Resident. The DON could not explain why the ice application was only marked once on the treatment record as completed on 10/20/25 at 8:00 P.M. The DON further reported the facility began a self-imposed action plan on 10/22/25 due to the ice not being implemented as ordered upon admission. The deficient practice was corrected on 11/20/25 when the facility implemented the following corrective actions:-Chart audits were completed for all new admissions dated 10/01/25 through 10/22/25 and then for an additional four weeks ending on 11/20/25. The audits were completed to review resident discharge orders to the orders entered on admission to the facility for accuracy and correction if needed. Audit details included: admission Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366286 If continuation sheet Page 3 of 4 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 366286 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Healthcare at Cedar Hill 1136 Adair Avenue Zanesville, OH 43701 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete orders matching the discharge orders including the Medication Administration Records and TAR orders, completion of the admission checklist, and verification of two nurses for admission orders.-All nursing staff were educated on the expected admission process, utilizing the admission checklist, and having two nurses review admission orders for accuracy.-The concern involving Resident #72 and follow-up actions taken was added to the quality assurance and performance improvement committee meeting agenda for review.As of the date of the survey on 11/26/25 no further non-compliance was identified pertaining to following admission and post-surgical physician orders. This deficiency represents non-compliance investigated under Complaint Number 2650857. Event ID: Facility ID: 366286 If continuation sheet Page 4 of 4