F 0558
Reasonably accommodate the needs and preferences of each resident.
Level of Harm - Minimal harm
or potential for actual harm
Based on medical record review, resident interview, and staff interview, the facility failed to ensure residents
were provided with necessary transportation to attend outside appointments as scheduled. This affected
one (Resident #150) of three residents reviewed for transportation to outside appointments. The facility
census was 112 residents.
Residents Affected - Few
Findings include:
Review of the medical record for Resident #150 revealed an admission date of 09/17/20 and a readmission
date of 11/30/22 with diagnoses including unspecified injury at T2-T6 level of thoracic spinal cord, morbid
obesity due to excess calories, bipolar disorder, anxiety disorder, paraplegia, unspecified mood (affective)
disorder, and depression.
Review of the care plan for Resident #150 initiated 11/30/22 revealed the care plan did not address the
resident's need for transportation to outside appointments.
Review of the Minimum Data Set (MDS) assessment for Resident #150 dated 10/09/24 revealed the
resident had intact cognition and required staff assistance with activities of daily living (ADLs).
Interview on 12/12/24 at 4:23 P.M. with Resident #150 confirmed she had missed several scheduled
outside medical appointments with different physicians due to the facility not making arrangements for
needed transportation to the appointments. The resident stated she was supposed to receive Botox
injections in her legs every three months to treat leg spasms. Resident #150 stated she last received the
injections on 06/12/24. The resident missed her scheduled appointment in September 2024 due to the
facility not being able to secure bariatric transportation. Resident #150 stated her neurologist had ordered
outpatient neurological rehabilitation for the resident back in June or July 2024. The resident had not been
able to attend any scheduled therapy appointments due to not having transportation. Resident #150 stated
the outpatient rehabilitation facility dropped her as a patient due to excessively missing appointments.
Resident #150 also reported she had missed two scheduled gynecologist appointments as well due to not
having transportation. Resident #150 stated her legs hurt badly because she hadn't had the Botox
injections.
Interview on 12/12/24 at 4:37 P.M. with Scheduler #455 confirmed Resident #150 had missed multiple
scheduled outside medical appointments due to not being able to secure needed transportation for the
resident.
Interview on 12/12/24 at 4:45 P.M. with the Administrator confirmed Resident #150 had missed multiple
scheduled outside medical appointments due to not being able to secure the transportation needed for the
resident. The Administrator stated he had been trying to find another provider who was able
(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:
366353
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
366353
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/12/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Tuscany Gardens
7400 Hazelton Etna Road SW
Pataskala, OH 43062
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 0558
Level of Harm - Minimal harm
or potential for actual harm
to accommodate Resident #150's need for bariatric transportation as well as the ability to provide additional
people to assist the resident but had not been able to find a provider yet.
A facility policy was requested at the time of the survey. The Director of Nursing (DON) confirmed the facility
did not have a policy that addressed providing transportation for outside appointments when needed.
Residents Affected - Few
This deficiency represents noncompliance investigated under Complaint Number OH00160217.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
366353
If continuation sheet
Page 2 of 2