Health inspection·October 16, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff interview, resident family interview, and review of self-reported incidents, the facility failed to conduct an investigation and report an allegation of potential neglect related to a resident elopement to the State Survey Agency. This affected one (#94) of three residents reviewed for elopements. The census was 89.Findings include:Review of the medical record for Resident #94 revealed an admission date of 08/29/25. Diagnoses included senile degeneration of the brain, chronic kidney disease, hypertension, diabetes, and heart failure.Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #94 had impaired cognition. The resident was assessed as independent for ambulation. Review of the nursing notes dated 09/05/25 at 3:26 P.M. revealed on that date, a staff member reported seeing a resident (#94) in her power wheelchair outside of a pizza restaurant down the street from the facility. Staff located the resident on [NAME] Road and escorted her back to the facility by 2:08 P.M. Resident #94 was assessed with no visible injuries but appeared confused and indicated she was trying to find her son's house and got lost. Further review revealed earlier the resident asked staff to remove her oxygen so she could go outside to smoke, and was last seen near the facility around 1:00 P.M.During an interview with Certified Nurse Aide (CNA) #164 on 10/05/25 at 3:17 P.M. confirmed she was off duty on 09/05/25 and was running errands about a mile away from the facility. She noticed Resident #94 riding away on her electric scooter from the facility. CNA #164 stated she called the facility staff to report the sighting of Resident #94 and the facility staff admitted to not realizing Resident #94 was outside the facility.Interview on 10/15/25 between 11:30 A.M. and 4:00 P.M. with three staff members who were working at the facility on 09/05/25 (Maintenance Director #136, Receptionist #119, and Licensed Practical Nurse (LPN) #179) all confirmed Resident #94 was found by staff about a mile from the facility on the afternoon of 09/05/25, and she appeared confused. During an interview with LPN #179 at 3:34 P.M. on 10/15/25, she stated she was not aware Resident #94 was outside of the facility prior to receiving the telephone call from CNA #164. She also confirmed Resident #94 had not signed herself out of the facility that day to notify the nursing staff that was leaving.During an interview with Resident #94's Family Member on 10/15/25 at 5:21 P.M., confirmed she was notified by the facility of Resident #94's elopement from the facility on 09/05/25. She confirmed Resident #94 had dementia and when Resident #94 was found by facility staff, the resident did not know where she was.Review of self-reported incidents submitted to the State Survey Agency from September and October 2025 revealed no submissions related to potential allegations of neglect regarding Resident #94's elopement from the facility on 09/05/25. No documentation was provided related to an investigation into the elopement.The elopement investigation file and the self-reported incident information were requested from the facility staff during the complaint investigation on 10/15/25 and 10/16/25. Interview on 10/15/25 at 2:40 P.M. with Regional Leader #800 confirmed a formal investigation did not commence regarding Resident #94's elopement and the (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 5 Event ID: 366481 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 366481 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Laurels of West Columbus, The 441 Norton Road Columbus, OH 43228 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)