F 0712
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record reviews and staff interview, the facility failed to ensure regulatory physician visits were conducted by
the physician or authorized designee at least every 60 days. This affected four (#75, #84, #88, and #94) of
four residents reviewed for physcian services. The facility census was 102.
Residents Affected - Some
Findings include:
1. Record review for Resident #88 revealed the resident was admitted to the facility on [DATE] and had
diagnoses which included Alzheimer's disease, Diabetes Mellitus, and emphysema.
Review of the significant change Minimum Data Set (MDS) assessment, dated 05/28/25, revealed the
resident was assessed to have intact cognition.
Review of the facility assessments for Resident #88 revealed the most recent regulatory visit and exam had
been completed by the physician on 03/24/25.
2. Record review for Resident #75 revealed the resident was admitted to the facility on [DATE] and had
diagnoses which included Alzheimer's disease, dementia, and major depressive disorder.
Review of the quarterly MDS assessment, dated 04/16/25, confirmed the resident was assessed to have
severely impaired cognition.
Review of the facility assessments for Resident #75 revealed the most recent regulatory visit and exam had
been completed by the physician on 03/24/25.
3. Record review for Resident #74 revealed the resident was admitted to the facility on [DATE] and had
diagnoses which included cerebrovascular disease, hemiplegia and hemiparalysis, and seizures.
Review of the quarterly MDS assessment, dated 04/09/25, revealed the resident was assessed to have
intact cognition.
Review of the facility assessments for Resident #94 revealed the most recent regulatory visit and exam had
been completed by the Nurse Practitioner (NP) on 03/28/25.
4. Record review for Resident #84 revealed the resident was admitted to the facility on [DATE] and had
diagnoses which included non-traumatic brain dysfunction, heart failure, and hypertension.
Review of the quarterly MDS assessment, dated 04/23/25, revealed the resident was assessed to have
(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 2
Event ID:
366351
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
366351
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Ohio Veterans Home - Georgetown
2003 Veterans Blvd
Georgetown, OH 45121
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 0712
mildly impaired cognition.
Level of Harm - Minimal harm
or potential for actual harm
Review of the facility assessments for Resident #84 revealed the most recent regulatory visit and exam had
been completed by the NP on 03/25/25.
Residents Affected - Some
Interview with the Director of Nursing (DON) on 06/13/25 at 1:00 P.M. confirmed the facility did not currently
have a physician to conduct in-person regulatory visits. The DON confirmed the last regulatory visits for four
residents (#75, #84, #88, and #94) had been conducted in March 2025.
This deficiency represents non-compliance identified during the investigation of Complaint Number
OH00165866.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366351
If continuation sheet
Page 2 of 2