Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Otterbein Middletown during CMS and state inspections, most recent first.
Unsecured Hazardous Chemicals in Kitchen Cabinets: Surveyors observed multiple hazardous cleaning chemicals stored in unlocked kitchen cabinets in Houses #109 and #106, including liquid dish machine detergent, rinse aid, and a multi-purpose cleaner. Staff verified the chemicals were not secured, and a CNA stated about half of the residents in House #109 had dementia or other memory-related issues. The facility policy stated detergents and sanitizers are to be stored in a locked cabinet under the sink, with other items kept in locked cabinets in the dirty utility room.
Improper food storage, sanitation, and food handling were observed in multiple houses. A bag of salad mix was open and unsealed, several refrigerated and dry-storage items were unlabeled, undated, or past the best-by date, and kitchen equipment including an oven, air fryer, and hood slats had heavy residue buildup. In another house, a CNA was observed preparing sausage links and reaching into the pan with bare hands.
Infection control practices were not followed for residents on enhanced barrier precautions and contact isolation. A resident with multiple chronic conditions had no precaution sign posted outside the room despite an active order, an OT removed gloves from another resident’s room and did not sanitize hands as required, and another resident with influenza also had no precaution sign posted. Facility policy required hand hygiene after PPE removal and signage for transmission-based precautions at room entry.
Advance directive documentation was inconsistent for two residents. One resident with severe dementia had a physician order and care plan for DNRCC, but the signed DNR form was marked DNRCC-Arrest. Another resident with dementia, DM2, depression, and a prior CVA had a paper DNR form showing DNR-CCA while the EMR and care plan showed DNR-CC. An LPN confirmed the conflicting code status documentation.
A resident’s room had a ceiling vent heavily coated in a dark grey fuzzy material. The resident, who had moderate cognitive impairment and required assistance with several ADLs, said the vent had dust buildup and needed to be cleaned. A CNA confirmed the vent was dirty.
Delayed Admission MDS Assessments: The facility failed to complete admission MDS assessments in a timely manner for three residents. The residents had multiple medical conditions, including infections, CHF, DM, atrial fibrillation, cirrhosis, and mobility or ADL assistance needs, and their admission MDSs were completed beyond the 14-day timeframe verified by an RN.
Delayed Podiatry Services and Overgrown Toenails. A resident with DM and CKD had a care plan that included podiatry referral as needed, but staff did not timely arrange foot care. On observation, the resident’s right toenails were thick and over half an inch long, and the resident said they were long and painful. A CNA confirmed the condition, and the resident’s daughter said she had asked staff multiple times to address the toenails.
Delayed Documentation of Care Conferences: The facility failed to timely update the medical record for a resident with chronic respiratory failure with hypoxia, COPD, lung cancer, HTN, hypothyroidism, dysphagia, breast cancer, anxiety, PVD, and drug-induced constipation. Although care conferences were held for the resident, several were not created or completed until months later. The SW stated she had gotten behind on documentation, and the DON verified the care conferences were not documented in a timely manner.
A resident with multiple complex medical conditions was injured when her wheelchair tipped over during van transport due to only the rear straps being secured. Two CNAs miscommunicated during a handoff, resulting in the front wheelchair straps not being attached. The resident sustained a closed head injury and abrasions, and the incident was substantiated as neglect after facility investigation.
Unsecured Hazardous Chemicals in Kitchen Cabinets
Penalty
Summary
The facility failed to ensure potentially hazardous chemicals were not accessible to residents in Houses #109 and #106. On 01/05/26 at 9:26 A.M. in House #109, surveyors observed an unlocked cabinet below the sink containing two one-gallon containers of liquid dish machine detergent and two one-gallon containers of concentrated crystal dri rinse aid. The labels on the containers stated the products caused severe skin burns, serious eye damage, eye irritation, and skin irritation, and instructed to keep them out of reach of children. The Dietetic Technician verified the chemicals were not secured. At 9:28 A.M., surveyors also observed a spray bottle labeled Xcelente multi-purpose cleaner, half full, in an unlocked cabinet under the kitchen sink in House #109; the bottle label also stated to keep out of reach of children. The DT confirmed the bottle was in an unlocked cabinet and stated it should have been in a locked cabinet. At 10:23 A.M. on 01/05/2026, a CNA stated that approximately half of the residents in House #109 were diagnosed with dementia or other memory-related issues. On 01/06/26 at 3:44 P.M. in House #106, surveyors observed an unlocked kitchen cabinet containing one gallon of concentrated liquid dish machine detergent with a label warning that it causes severe skin burns and serious eye damage, is harmful if swallowed, and should be kept out of reach of children. The CNA verified the detergent was not secured and should be kept in a locked cabinet. Review of the facility policy titled Storage and Use of Poisonous Substances Policy & Procedure stated detergents and sanitizers are permitted to be stored in the locked cabinet under the sink next to the dishwasher, and other items are stored in locked cabinets in the dirty utility room.
Improper food storage, sanitation, and food handling
Penalty
Summary
Food was not stored and prepared in a manner to prevent the potential spread of foodborne illness, and kitchen equipment was not maintained in a clean and sanitary condition. In House #109, a bag of salad mix in the bottom refrigerator drawer was open and unsealed, and when lifted, the contents fell out onto the floor. The same area also contained an oven coated in a thick brown film and an air fryer coated in a thick brown residue, both of which the DT verified were in need of cleaning. In House #105, the refrigerator contained multiple improperly stored items, including a pitcher of pineapple in juice with two open dates and no contents label, carrots that were unopened but past the best-by date, opened carrots past the best-by date, brown celery that was not sealed or dated, unopened salad mix past the best-by date, yogurt in the freezer with no date for when it was frozen, and a bag of mixed fruit that was open and covered in ice crystals. Dry storage also contained an unlabeled frosted cake, open powdered sugar and baking soda in unsealed ziplock bags, and an open bag of flour spilling onto the shelf. In the kitchen of House #105, the hood slats were coated in a dark gray fuzzy substance, the oven was coated in a thick brown substance, and the air fryer was coated in a thick brown residue. In House #106, a CNA was observed preparing sausage links and reaching into the pan with bare hands while touching the sausage; the CNA stated she should not have reached into the pan with bare hands because of the potential contact with the food and cooking surface.
Infection Control Practices Not Followed
Penalty
Summary
The facility failed to follow appropriate infection control practices for residents on enhanced barrier precautions and contact isolation. Resident #19 was admitted with diagnoses including bacterial infection, bacteremia, atrial fibrillation, alcoholic cirrhosis with ascites, type 2 diabetes with neuropathy, hypertension, heart failure, low back pain, hyperlipidemia, gout, and congestive heart failure. The resident’s admission MDS showed cognitive intactness and need for varying levels of assistance with hygiene, toileting, dressing, bathing, bed mobility, and eating. Although there was an active order for enhanced barrier precautions, observation on 01/05/26 found a PPE cart outside the room but no sign on the door indicating the precautions, and CNA #323 confirmed the sign was missing. Resident #48 was admitted with acute kidney failure, type 2 diabetes without complications, chronic cough, and hyperlipidemia, and had an active order for enhanced barrier precautions. OT #500 was observed leaving the room wearing gloves, removing and discarding them, and not sanitizing her hands, despite a sign on the door instructing hand hygiene after leaving the room; OT #500 confirmed she had not sanitized her hands. Resident #80 was admitted with influenza with other respiratory manifestations, acute respiratory failure with hypoxia, acute kidney failure, anxiety disorder, chronic kidney disease stage 3b, and hyperlipidemia, and had an active order for contact isolation due to influenza. Observation found a PPE cart outside the room but no signage identifying the precautions, and OT #500 verified the sign was missing. The report also noted that the facility policy required hand hygiene after removing PPE and that transmission-based precaution signage be posted at the entry to the resident’s room.
Advance directive documentation was inconsistent for two residents
Penalty
Summary
The facility failed to ensure advance directives were correct for two residents reviewed. Resident #02 had an admission diagnosis history that included severe dementia with psychotic disturbance, atrial fibrillation, hypertension, anemia, congestive heart failure, asthma, vitamin deficiency, and hyperlipidemia. The quarterly MDS showed severely impaired cognition and dependence or extensive assistance with most activities of daily living. The active physician order and care plan identified the resident as DNRCC, but the signed DNR Order Form dated 03/11/25 had DNRCC-Arrest checked instead of DNRCC. Social Worker #314 confirmed the physician order was for DNRCC while the signed DNR form reflected DNRCC-Arrest. Resident #07 had diagnoses including type II diabetes mellitus with diabetic polyneuropathy, dementia, major depressive disorder, and cerebral infarction. The MDS showed severe problems with thinking and memory and varying levels of assistance with mobility and personal care. The paper medical record contained a DNR Order Form dated 03/14/2024 indicating DNR-CCA, while the EMR contained a physician order dated 08/04/2025 and a care plan dated 11/27/2025 indicating DNR-CC. LPN #377 confirmed the paper record documented DNR-CCA and the EMR documented DNR-CC. The facility policy stated DNR identification uses approved forms showing either DNR Comfort Care or DNR Comfort Care-Arrest and that a DNR order, if applicable, will be obtained from the physician and placed in the medical record.
Dirty Ceiling Vent in Resident Room
Penalty
Summary
The facility failed to maintain a clean environment in Resident #20’s room. Resident #20 was admitted on 12/12/2025 with diagnoses including osteochondropathies of the left ankle and foot, acute osteomyelitis of the left ankle and foot, congestive heart failure, and generalized anxiety disorder. The Minimum Data Set assessment showed moderate cognitive impairment, independence with eating, setup/cleanup assistance with oral hygiene, substantial to maximal assistance with toileting and bathing, and wheelchair use for mobility. During observation on 01/06/26 at 10:33 A.M., the ceiling vent in the resident’s room was heavily coated in a dark grey fuzzy material. Later that day, the resident stated concern about dust buildup on the ceiling vent and said it needed to be cleaned. A CNA also confirmed that the ceiling vent was heavily coated in a dark grey fuzzy material and needed to be cleaned.
Delayed Admission MDS Assessments
Penalty
Summary
The facility failed to ensure admission MDS assessments were completed in a timely manner for three of three residents reviewed. Resident #22 was admitted with diagnoses including bacterial infections of unspecified site, hypertension, and scoliosis, and the admission MDS assessment was not completed until 18 days after admission. Resident #20 was admitted with diagnoses including osteochondropathies of the left ankle and foot, acute osteomyelitis of the left ankle and foot, CHF, and generalized anxiety disorder, and the admission MDS assessment was not completed until 17 days after admission. Resident #19 was admitted with diagnoses including bacterial infection, bacteremia, paroxysmal atrial fibrillation, alcoholic cirrhosis of the liver with ascites, type 2 DM with diabetic neuropathy, hypertension, heart failure, low back pain, hyperlipidemia, gout, and CHF, and the admission MDS assessment was not completed until 20 days after admission. The RN verified during interview that the admission MDS assessments for Residents #22, #20, and #19 were not completed in a timely manner and stated that admission MDS assessments should be completed within 14 days of admission.
Delayed Podiatry Services and Overgrown Toenails
Penalty
Summary
Provide appropriate foot care. The facility failed to timely arrange podiatry services for one resident with diabetes mellitus and multiple chronic conditions, including diabetic chronic kidney disease, hypertension, paroxysmal atrial fibrillation, atherosclerotic heart disease, chronic kidney disease stage three, anxiety disorder, and a healing lumbar compression fracture. The resident’s care plan identified diabetes and risk for complications, with an intervention to refer to podiatry as needed. During observation, the resident’s right toenails were thick and some were over half an inch long, and the resident stated the toenails were long and painful. A CNA confirmed the toenails were thick and over half an inch long, and the resident’s daughter reported she had asked facility staff multiple times to address the resident’s toenails.
Delayed Documentation of Care Conferences
Penalty
Summary
The facility failed to ensure medical records were updated in a timely manner for one resident reviewed for care conferences. Resident #52 was admitted on 10/04/24 and had diagnoses including chronic respiratory failure with hypoxia, COPD, lung cancer, hypertension, hypothyroidism, dysphagia, breast cancer, anxiety, peripheral vascular disease, and drug-induced constipation. The resident’s quarterly MDS assessment showed intact cognition, independence with eating, supervision with toileting and bed mobility, partial/moderate assistance with bathing, and substantial/maximal assistance with transfers. Review of the medical record showed care conferences were held on 01/22/25, 04/15/25, 07/14/25, and 10/27/25, but the conferences dated 01/22/25 and 04/15/25 were not created and completed until 06/16/25, the 07/14/25 conference was not created and completed until 01/05/26, and the 10/27/25 conference was created on 01/05/26 and completed on 01/06/26. The SW verified the care conferences were not documented timely and stated she had gotten behind on documentation, and the DON also verified the care conferences were not documented in the medical record in a timely manner.
Failure to Properly Secure Wheelchair During Transport Results in Resident Injury
Penalty
Summary
A deficiency occurred when a resident's wheelchair was not properly secured during transport in the facility's wheelchair van, resulting in the wheelchair tipping over while the van was in motion. The incident involved two CNAs who were splitting transportation duties. One CNA was responsible for loading the resident into the van and securing the wheelchair, while the other CNA was responsible for driving the resident to her appointment. The CNA who loaded the resident into the van secured only the back two straps of the wheelchair and fastened the resident's seatbelt, but failed to secure the front two straps. The CNA intended to secure the front straps from the side doors but forgot to do so before handing off the transport to the other CNA. The CNA who drove the van did not verify that the wheelchair was fully secured before departing. The resident involved had multiple significant medical diagnoses, including chronic respiratory failure with hypoxia, COPD with exacerbation, centrilobular emphysema, paroxysmal atrial fibrillation, hypertension, dysphagia, malignant neoplasms, acquired absence of the right leg above the knee, peripheral vascular disease, chronic pain, and hyperlipidemia. The resident was cognitively intact and required moderate assistance for sitting, standing, and transfers. During the transport, as the van was making a left turn onto a highway ramp, the resident's wheelchair tipped backward, causing her to hit her head on the wheelchair ramp. Emergency services were called, and the resident was transported to the hospital for evaluation. She was diagnosed with a closed head injury and sustained abrasions to her chin, right cheek, and right neck, but imaging showed no acute traumatic pathology. Interviews with the involved staff confirmed that there was a miscommunication and lack of verification regarding the proper securing of the wheelchair. The CNA who loaded the resident admitted to forgetting to secure the front straps, and the CNA who drove the van did not check the straps before departure. The resident reported feeling scared during the incident and experienced pain in her neck and shoulders following the event. The facility's investigation substantiated the allegation of neglect related to the failure to ensure the resident's wheelchair was properly secured during transport.
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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 Franklin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Arlington Pointe Care Center | 2.3 mi | ★★★★★ | 0 | 0 |
| The Laurels Of Middletown | 3.3 mi | ★★★★★ | 2 | 0 |
| Willow Knoll Post-acute And Senior Living | 3.5 mi | ★★★★★ | 10 | 0 |
| Momentous Health At Franklin | 3.8 mi | ★★★★★ | 28 | 0 |
| Otterbein Lebanon Retirement Community | 4.1 mi | ★★★★★ | 8 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release June 2026) and official state health department websites.