Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Maria Joseph Living Care Center during CMS and state inspections, most recent first.
Delayed skin checks and late wound identification led to advanced pressure injuries in two residents. One resident with dementia, DM II, and fragile skin developed multiple wounds, including stage III, unstageable, and DTI injuries to the buttocks, heel, hip, and feet that were first recognized only after they were already advanced. Another resident with ESRD and DM II developed a buttock/sacral pressure ulcer that was not timely assessed by the WNP and later progressed to a large stage IV wound. Staff documentation showed gaps in skin observations and inconsistent identification of new areas of concern.
Medication Labeling and Storage Deficiency: Five residents had opened medications in use without an open date, including nasal spray, oral liquid antipsychotic, potassium chloride liquid, Ingrezza, and omeprazole. RN, LPN, and unit management verified the missing open dates, and the Administrator and DON stated the facility had no medication storage or labeling policy.
Palatability of Pureed Diet Food: A resident with cerebral infarction, L-sided hemiparesis/hemiplegia, COPD, and cognitive impairment was served a pureed meal that she refused, describing it as "slop." A CNA said she had recently been changed to a pureed diet and had been refusing meals since the change. A test tray of premade pureed chicken was found to have an unpalatable flavor and dry consistency, and both the DS and RD stated the chicken was dry; the RD also said the facility had no policy related to serving palatable food.
A facility failed to serve pureed diet foods in a form that met residents’ needs. Surveyors observed pureed donuts with a sticky, pasty consistency, grits with a clumpy and uneven texture, and oatmeal that remained uneven rather than smooth. The RD verified that pureed foods should be smooth and stated the facility did not have a policy related to providing residents with pureed diets.
Unsafe food storage, handling, and sanitation practices were observed in the kitchen. Staff found food stored under a sewage line, expired items in the freezer, a walk-in cooler at unsafe temps with food held there for hours, dirty equipment and utensils, cracked tray lids leaking liquid onto meals, inaccurate dish machine logs, and multiple instances of staff handling food without hand hygiene or proper temp checks. An RD stated the facility lacked policies for kitchen maintenance, food storage, food handling, food temps, and hand washing.
Pest Control Program Not Maintained: Gnats were observed in the kitchen near the dry storage area and later around a trash can in the food prep area, and both the DS and RD verified the sightings. The RD stated the facility did not have a policy for controlling insects or pests in the kitchen. A resident with ESRD, DM2, CAD, and HTN required extensive assistance with ADLs.
A resident with bipolar disorder, schizoaffective disorder, mood disorder, and dementia repeatedly displayed verbally aggressive behavior in shared areas, including yelling at other residents, disrupting meals, and shouting during a smoke break. Other residents stated they were uncomfortable and had difficulty enjoying meals and activities, while staff reported the resident preferred common areas and that the facility did not have a policy for addressing resident rights.
Late NOMNC Issuance. The facility failed to provide a timely NOMNC for one resident whose Medicare skilled coverage ended, instead giving the notice to the guardian on the same day coverage stopped rather than 48 hours earlier. The resident had severe cognitive impairment, was dependent for most ADLs, and had multiple chronic diagnoses including aphasia following CVA, HTN, HLD, and DM2. The SSD confirmed the timing issue, and the Regional Nurse stated there was no policy for NOMNC issuance.
A resident with binocular dysfunction and an order for an eye patch was repeatedly observed without the patch, while staff said the resident kept the patches in the room and applied them independently; the DON verified there was no care plan for the resident's vision or eye patch use. Another resident with severe cognitive impairment and a fall-risk care plan was observed in a wheelchair without anti-rollbacks, and both the UM and PT verified the wheelchair safety equipment was missing and the wheel rubber was deteriorating.
Failure to provide timely incontinence care was identified for a severely cognitively impaired resident who was dependent on staff for ADLs and had documented bowel and bladder incontinence. The resident was observed with a heavy odor of urine while sitting in the TV room, and later the brief was found heavily saturated with urine and bowel. CNAs, an RN, and an LPN stated they had not provided incontinence care that day, and one CNA said the resident was supposed to be checked and changed every 2 hours. The Regional Nurse stated the facility did not have an incontinence program, despite the facility policy calling for incontinence care to maintain skin integrity, control odor, and provide comfort.
A staff member failed to follow infection control practices for a resident on EBP for a gastric tube. An SLP provided treatment while wearing a gown and mask, then left the room and walked down the hall without removing PPE or performing hand hygiene, despite the facility policy requiring PPE removal and hand hygiene before exiting the room.
A resident with ESRD, DM2, CAD, and HTN had a signed consent for an annual flu vaccine, but the immunization record showed no evidence the vaccine was given. The ICP verified the facility did not administer the flu shot after consent was obtained.
A resident with multiple chronic conditions had a physician's order for Coreg to be held if systolic blood pressure was below a certain threshold. On several occasions, the MAR showed the medication as given despite blood pressure readings below the hold parameter. The RN responsible stated she did not administer the medication but was unaware of the correct electronic charting procedure to document this, resulting in inaccurate MAR records. The DON confirmed the documentation did not accurately reflect the medication being held.
A resident requiring maximum assistance for toileting hygiene received incontinence care from two CNAs who placed soiled washcloths on the bedside table and failed to disinfect the area afterward. One CNA acknowledged this as an infection control concern, noting that a bag should have been used for soiled items.
A CNA failed to follow proper infection control procedures during incontinence care for a resident with intact cognition and multiple diagnoses. The CNA used the same washcloth for cleaning both the front and back perineal areas and did not change gloves or perform hand hygiene, contrary to the facility's infection control policy.
Delayed Skin Assessment and Late Identification of Advanced Pressure Ulcers
Penalty
Summary
The facility failed to thoroughly assess residents’ skin and failed to timely identify pressure ulcers until they had reached advanced stages. For Resident #209, the record showed a Braden Scale dated 11/07/25 indicating risk for pressure ulcers, but shower sheets on 01/05/26 and 01/08/26 documented no skin concerns. On 01/09/26, nursing documented an area on the right buttock with bloody drainage measuring 8 cm by 4 cm, and the wound was later assessed as an in-house acquired stage III pressure ulcer measuring 8.5 cm by 5.5 cm by 0.2 cm with granulation, slough, eschar, and drainage. The wound was not identified until it had reached an advanced stage. Resident #209 later developed additional wounds that were also identified at advanced stages. On 02/10/26, the resident was assessed with a new in-house unstageable pressure ulcer to the right lateral heel measuring 3.4 cm by 2.5 cm with eschar and purple/maroon tissue. On 05/11/26, staff documented new areas of concern to the right ankle, left lateral foot, and left hip, and the left hip was later assessed as an in-house acquired unstageable pressure ulcer measuring 8.6 cm by 7.2 cm with 90 percent eschar. The assessment did not address the new wounds on the right ankle and left lateral foot. On 05/14/26, staff documented new concerns to both feet, and the resident was assessed with a deep tissue injury to the right hallux, a deep tissue injury to the left dorsal great toe, and a stage III pressure ulcer to the left lateral fifth toe. The resident’s shower documentation around these dates did not consistently identify the skin concerns. Resident #2 also had a pressure ulcer that was not identified until it had advanced. The resident had diagnoses including ESRD, DM II, and major depressive disorder, and required assistance with multiple ADLs and was frequently incontinent. Although the resident was ordered to be turned and repositioned and had no pressure ulcer risk on the Braden Scale dated 04/15/25, the record showed no skin issues on the shower sheet or TAR before 07/01/25. On 07/01/25, nursing documented a reddened open area to the buttocks measuring 6 cm by 7 cm, which was later assessed as an in-house acquired stage II pressure ulcer and then documented as a stage III pressure ulcer extending into the sacrum and bilateral buttocks. The WNP was not timely assessed until 07/15/25, and the wound was later observed as a large stage IV pressure ulcer with undermining.
Medication Labeling and Storage Deficiency
Penalty
Summary
The facility failed to provide safe labeling and storage for medications administered to residents. During record review, five residents were identified with active medication orders: a resident with chronic respiratory failure, anxiety, and asthma had an order for fluticasone propionate nasal suspension; a resident with major depressive disorder, dementia, psychotic disorder, schizoaffective disorder, and mood disorder had orders for Risperdal solution; a resident with type 2 diabetes mellitus and anemia had an order for potassium chloride liquid; a resident with paranoid schizophrenia and type 2 diabetes had an order for Ingrezza; and a resident with GERD and depression had an order for omeprazole. These medications were being administered by the facility. On observation, each of the five medications was found opened without an open date. The RN, LPN, and Unit Manager who observed the medications verified that the containers had no open date and that the medications were being administered to the residents. During interviews, the Administrator stated the facility had no policy on medication or medication storage, and the DON stated she expected nurses to place an open date on medications that were opened and being administered, but the facility did not have a policy for labeling and storage of medications.
Palatability of Pureed Diet Food
Penalty
Summary
Food served was not palatable for a resident who had been changed to a pureed diet. Resident #180 was admitted with diagnoses of cerebral infarction with left-sided hemiparesis and hemiplegia and chronic obstructive pulmonary disease. The MDS assessment showed the resident was cognitively impaired and required supervision for eating. During observation, the resident was served a pureed meal and did not eat it. When interviewed, the resident said she did not like the pureed diet and referred to the food as "slop." A CNA stated the resident had recently been changed to a pureed diet and had been refusing meals since the change, whereas she had not refused meals before the diet change. A test tray observation with the Dietary Supervisor showed the facility used premade pureed chicken forms for residents ordered a pureed diet. A taste test of the chicken revealed an unpalatable flavor and consistency, and the Dietary Supervisor stated the chicken was dry. The Registered Dietician also stated the premade pureed chicken was dry. During interview, the Registered Dietician stated the facility did not have a policy related to serving palatable food to residents.
Pureed Diet Foods Served With Improper Texture
Penalty
Summary
The facility failed to ensure that residents ordered a pureed diet were served food prepared in a form that met their needs. This affected 12 residents identified by the facility as receiving a pureed diet. During observation, donuts prepared for the breakfast meal had been pureed, but a taste test found the texture was sticky and had a pasty consistency that was difficult to clear from the mouth. The Dietary Supervisor verified the sticky, pasty texture, and the Registered Dietician stated that pureed food should not have a sticky texture. The survey also found that grits were being served as a hot cereal option for residents on a pureed diet, and a taste test showed the grits had a clumpy and uneven texture. The oatmeal was prepared by pureeing it dry and then adding liquid, but observation and taste testing showed it remained uneven and not smooth. The Registered Dietician verified that pureed food should be smooth throughout, and later stated the facility did not have a policy related to providing residents with pureed diets.
Unsafe Food Storage, Handling, and Sanitation Practices
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in a safe and sanitary manner. During kitchen observations, surveyors found a pallet of food and shelving of paper products stored in the basement directly under a sewage line, and the maintenance director verified the finding. Surveyors also observed multiple expired food items in the freezer, including strawberry mighty shakes, chocolate mighty shakes, and chocolate magic cups with use-by dates from December 2025 through June 2026. Surveyors observed the walk-in refrigerator at 59 degrees F, with peas and carrots at 49 degrees F and chicken noodles at 53 degrees F. The dietary supervisor stated the refrigerator had been below 41 degrees F the night before, noticed the higher temperature upon arriving in the morning, and began moving food to another refrigerator. She verified that she did not know how long the food had been at unsafe temperatures and left the food in the broken refrigerator for hours before transferring it. Surveyors also observed a buildup of an unknown substance on the can opener blade, serving utensils stored in an uncovered plastic container on top of a clean dish rack with food debris in the container, and cracked and chipped thermal plate lids remaining on the tray service line. Additional observations showed unsafe food handling and inaccurate sanitation monitoring. A dietary employee touched their face and then assembled trays without hand hygiene, another employee served food without washing hands after touching clothing, and a staff member entered the kitchen, donned gloves, and began plating food without washing hands. Surveyors also observed a cracked thermal lid leaking liquid onto a plated meal and tray, chicken tenders served without a recorded temperature and later measured at 126 F, gravy heated in a microwave and served without a temperature check, and liquid eggs taken from a container stored in ice from an unclean ice machine. The dietary supervisor stated the ice machine had black substance inside, had not been fully cleaned since around January 2026, and that the ice should not be used. Review of dish machine logs showed wash and chlorine entries that were inaccurate, with rinse temperature documentation last recorded months earlier, and staff stated the rinse gauge was broken and the recorded temperatures were guesses. The registered dietitian also stated the facility did not have policies for maintaining the kitchen and equipment, food storage, food handling, food temperatures, or hand washing requirements.
Pest Control Program Not Maintained
Penalty
Summary
The facility failed to maintain an effective pest control program. During observation of the kitchen, gnats were seen near the dry storage area in the main kitchen and later flying around a trash can in the food preparation area. The Dietary Supervisor verified the gnats during the first observation, and the Registered Dietitian verified them during the second observation. During interview, the Registered Dietitian stated the facility did not have a policy related to controlling insects or pests in the kitchen. The deficiency was identified in a facility with a census of 237 and involved a resident with ESRD, DM2, CAD, and HTN who required extensive assistance with eating, oral and personal hygiene, toileting, bathing, dressing, bed mobility, and transfers.
Resident Rights Not Maintained Due to Repeated Verbal Aggression
Penalty
Summary
The facility failed to ensure resident rights were maintained when a cognitively intact resident with diagnoses of bipolar disorder, schizoaffective disorder, mood disorder, and dementia repeatedly displayed verbally aggressive and disruptive behavior toward other residents in common areas. During an interview, one resident stated that the aggressive resident was frequently verbally aggressive to other residents and made the environment uncomfortable. The surveyor observed the resident yelling at another resident in the hallway, making comments about a guitar the other resident did not have, which forced the conversation to move farther down the hall. During lunch, the same resident repeatedly yelled after staff refused to provide salt packets because of a no added salt diet order, remained verbally disruptive throughout the meal, and directed comments at other residents while they appeared visibly uncomfortable. Additional observations showed the resident continued to disrupt shared activities and common spaces. Staff reported attempts had been made to have the resident eat in his room, but he preferred the dining room, and staff stated residents had grown tired of his behavior. Another resident stated he was uncomfortable sitting at the same table because the behavior was frequent and made it difficult to enjoy meals. Staff also reported the resident was not allowed to go to the facility store because of his behavior, and when he was told he could not go, he yelled and swore near the elevator and later shouted during a smoke break about not being permitted to go and about his rights being taken away. Other residents quickly left the smoking area, and one resident stated the behavior made it difficult to enjoy the smoke break. The Administrator stated the facility did not have a policy for addressing resident rights.
Late Notice of Medicare Non-Coverage
Penalty
Summary
Beneficiary Notifications were not issued in a timely manner when the facility failed to ensure a Notice of Medicare Non-Coverage (NOMNC) was provided 48 hours before skilled services ended for one resident reviewed. The resident was admitted with hypertensive heart disease without failure, aphasia following cerebral infarction, essential hypertension, hyperlipidemia, and Type II diabetes, and had severe cognitive impairment with a BIMS score of 2. The resident required maximal assistance with oral hygiene and was dependent on staff for all other ADLs and bed mobility. Review of the NOMNC showed Medicare coverage of skilled services ended on 06/05/26, and the guardian was informed on the same day coverage ended. During interview, the SSD confirmed the notice was presented on the day coverage ended and stated it should have been given 48 hours prior to services ending. The Regional Nurse stated the facility did not have a policy regarding Beneficiary Notices - NOMNC issuance.
Care Plans Not Accurate or Implemented for Vision and Wheelchair Safety Needs
Penalty
Summary
The facility failed to ensure care plans were accurate and that ordered interventions were implemented for two residents. One resident had an admission diagnosis that included binocular dysfunction and a physician order for an eye patch to the right eye while awake. The resident was cognitively impaired, stated that covering the right eye helped correct the left eye and relieved discomfort, and was observed throughout the survey without an eye patch. Staff interviews revealed the resident kept the eye patches in the room and applied them independently, while the DON stated nursing staff should apply the eye patches and the resident should not keep them herself. The DON also verified there was no care plan for the resident's vision, eye patch use, or binocular dysfunction. The resident later stated the first time staff covered the right eye was on 07/08/26, and that the gauze used was uncomfortable because it required wearing reading glasses to keep it in place. For the second resident, the care plan identified fall risk related to weakness, impaired balance, and cognitive impairment with wandering behavior, and included interventions such as anti-roll back brakes on the wheelchair. The resident had severe cognitive impairment and required assistance with multiple activities of daily living. During observation, the resident's wheelchair had no anti-rollbacks and the rubber treads on the wheels were coming off. The Unit Manager verified the anti-rollbacks were not in place and the wheel rubber was coming off, and the Physical Therapist also verified there was no anti-roll back system on the wheelchair and that both rubber tires were falling off the wheels.
Failure to Provide Timely Incontinence Care
Penalty
Summary
Failure to provide timely incontinence care was identified for one resident who was admitted with diagnoses including hypertension, dementia, peripheral vascular disease, benign prostatic hyperplasia, and bilateral cataracts. The resident’s quarterly MDS showed a BIMS score of 04, indicating severe cognitive impairment, and the resident was dependent on staff for ADLs. The care plan documented an alteration in elimination with occasional bowel and bladder incontinence and included interventions for monitoring for UTI signs and symptoms, monitoring bowel movements, providing hydration, and providing incontinence care as needed. A bowel and/or bladder assessment also documented that the resident was incontinent of bowel and bladder. On observation, the resident was sitting in the main television room in a wheelchair and had a heavy odor of urine. Later, the resident was moved to his room for care, and observation showed the brief was heavily saturated with urine and bowel and the resident had a strong odor of urine. CNA #722 stated she had been assigned to care for the resident, that he was already up when she arrived at 7:00 A.M., and that she had not provided any incontinence care that day. CNA #722 stated the resident was supposed to be checked and changed every two hours. Additional interviews with CNA #957, RN #725, and LPN #712 confirmed they had not provided incontinence care that day, and CNA #701 stated he last provided incontinence care at 9:30 A.M. The Regional Nurse stated the facility did not have an incontinence program, and the facility policy stated incontinence care would be provided to maintain skin integrity, prevent skin breakdown, control odor, and provide comfort and self-esteem.
Failure to Remove PPE and Perform Hand Hygiene
Penalty
Summary
The facility failed to ensure staff followed appropriate infection control practices for a resident placed in enhanced barrier precautions due to a gastric tube. Resident #17 had diagnoses including Alzheimer's disease and anxiety, and a physician order dated 03/21/26 directed that the resident be housed in enhanced barrier precautions. During observation, the resident's room displayed EBP signage, and Speech Therapist #980 was seen providing treatment while wearing a gown and mask. After leaving the room, the therapist walked down the hall still wearing the gown and mask. When interviewed, the therapist stated she did not remove her gown or perform hand hygiene after finishing treatment and exiting the room, and said she should have discarded her PPE, completed hand hygiene, and exited the room. The facility's Contact Isolation Precautions Best Practice policy stated that PPE should be removed and hand hygiene performed before leaving the room.
Failure to Administer Consented Influenza Vaccine
Penalty
Summary
The facility failed to ensure that a resident who consented to receive the influenza vaccine actually received it. Resident #02 was admitted with diagnoses of ESRD, diabetes mellitus type 2, CAD, and hypertension, and the annual MDS showed intact cognition with significant dependence for many activities of daily living, including toileting, bathing, dressing, bed mobility, and transfers. The medical record included a flu vaccine informed consent form signed by the resident’s representative indicating consent for an annual flu vaccine, but the immunization record contained no documented evidence that the influenza vaccine was administered. During interview, the Infection Control Preventionist verified that the facility did not provide the flu vaccine after consent had been obtained.
Failure to Accurately Document Medication Administration
Penalty
Summary
The facility failed to ensure accurate documentation of medication administration for a resident with multiple diagnoses, including end stage renal disease, type two diabetes mellitus, depression, and hypertension. The resident had a physician's order for Coreg, with instructions to hold the medication if the systolic blood pressure (SBP) was less than 110 mm Hg. Review of the Medication Administration Record (MAR) showed that on three occasions, the resident's SBP was below the specified threshold, yet the MAR indicated that the medication was administered. During interviews, the registered nurse responsible for the resident on those dates stated that she did not actually administer the Coreg when the SBP was below parameters, but believed that documenting the low blood pressure was sufficient to indicate the medication was held. The nurse was unaware that the electronic charting system provided a specific code to document medications held due to parameters. The Director of Nursing confirmed that the MAR did not accurately reflect that the medication had been held according to the physician's order.
Infection Control Lapse During Incontinence Care
Penalty
Summary
During a complaint investigation, it was observed that infection control measures were not properly followed during incontinence care for a resident with multiple diagnoses, including end stage renal disease and diabetes mellitus. The resident, who had intact cognition and required maximum assistance for toileting hygiene, bed mobility, and transfers, received incontinence care from two CNAs. Both staff members donned PPE appropriately, and peri care was performed using two washcloths. However, after use, the soiled washcloths were placed on the resident's bedside table rather than being immediately disposed of in a designated bag. Following the completion of care, the CNAs did not disinfect the bedside table where the soiled washcloths had been placed. One CNA later acknowledged that placing the soiled items on the bedside table was an infection control concern and stated that a bag should have been brought to the bedside for proper disposal. The deficiency was identified based on direct observation, record review, and staff interview.
Infection Control Lapse During Incontinence Care
Penalty
Summary
The facility failed to ensure appropriate infection control measures during incontinence care for a resident. The incident involved a Certified Nursing Assistant (CNA) who, while providing incontinence care to a resident with intact cognition and multiple diagnoses including anxiety disorder and COPD, did not adhere to proper infection control protocols. The CNA used the same washcloth to clean both the front and back perineal areas of the resident, placing the soiled washcloth back into the water basin without changing gloves or performing hand hygiene. The CNA's actions were inconsistent with the facility's infection control policy, which mandates hand hygiene even when gloves are used, particularly after contact with body fluids or contaminated surfaces. The CNA confirmed during an interview that she did not change gloves or perform hand hygiene during the care process. This deficiency was identified during an observation and was corroborated by the facility's policy review, highlighting a lapse in infection prevention practices.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Dayton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Trotwood Health & Rehab Llc | 0.5 mi | ★★★★★ | 48 | 1 |
| Arc At Trotwood Llc | 1.1 mi | ★★★★★ | 12 | 0 |
| Aventura At Shiloh Springs | 1.7 mi | ★★★★★ | 26 | 1 |
| Siena Woods Care Center | 1.8 mi | ★★★★★ | 14 | 0 |
| Aventura At Carriage Inn | 1.9 mi | ★★★★★ | 8 | 0 |
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