Average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Otterbein Union Township during CMS and state inspections, most recent first.
Quarterly care conferences were not consistently held or documented for multiple residents. Records showed several residents with dementia, stroke, COPD, heart disease, and other chronic conditions had only one or two care conferences during the year, while others had missing quarterly conferences altogether. In some cases, care conference forms did not show resident or resident representative attendance or explain why they were absent, and the SSD verified no additional conference documentation existed.
Failure to Provide an Ongoing Activities Program: Four residents did not receive a consistent activities program that matched the posted calendar or their stated interests. One resident was transported outside in inclement weather to reach activities in another unit, with no alternative offered. Other residents reported missing weekend church services, inconsistent pet therapy, no clear provision of the listed Daily Icon activity, limited one-to-one engagement, and no materials for preferred crafts or reading. Staff and the AD verified they did not know what Daily Icon was, that some listed activities were not provided, and that weekend church services were not actually offered by the chaplain.
Activities Program Not Directed by a Qualified Professional: The facility’s activity program was directed by an Activity Director who had not met the qualifications for the role when hired and had not completed a qualifying certification program. She created activity calendars, completed MDS activity assessments, and coordinated Resident Council meetings without documented direct oversight by a certified activity professional. One resident stated she did not want activities and preferred to remain in her room.
A resident was not issued an ABN before Medicare Part A services ended. Review of the SNF Beneficiary Protection Notification Review document showed the resident remained in the facility after Part A coverage stopped, and the Administrator confirmed the ABN was not provided.
Failure to Apply Ordered Positioning and Splint Devices: Two residents did not receive ordered devices to support positioning and prevent physical decline. One resident with severe cognitive impairment and hospice care was observed without a hand positioning device and pressure-relieving boots despite orders for both, and staff confirmed the devices were not in place. Another resident with quadriplegia and a right leg contracture was observed without an ordered right knee extension splint, which was found stored in the closet; the resident reported staff had not applied it for months, and the DON confirmed there was no documentation of refusal.
Two residents did not receive ordered adaptive feeding equipment during meals. One resident with heart failure, malnutrition, quadriplegia, and contractures was ordered a built-up plate and spoons, and another resident with arthritis was ordered a specialized drinking cup, built-up handled utensils, and a curved handled spoon. During meal observations, neither resident had the ordered equipment, and a CNA stated she was unaware the items were required at each meal; the DON later confirmed the orders should have been followed.
Unsafe food storage and kitchen monitoring practices were observed in multiple house kitchens. Opened food items such as cottage cheese, yogurt, sour cream, applesauce, coffee creamer, cheese, and cheese dip were left without use-by or discard dates, and staff reported using expiration dates after opening. Surveyors also found heavy debris on ventilation hoods, dried debris in an oven, refrigerators and freezers without thermometers, a refrigerator reading 52°F, and incomplete food temperature and dishwasher logs.
A nursing home area was found to have accident hazards and lacked adequate supervision, resulting in a deficiency for not preventing accidents as required.
A resident at risk for falls due to impaired mobility and obesity was assisted by only one staff member during a transfer, contrary to the care plan requiring two staff members. This led to the resident being lowered to the floor, resulting in bruises to the left forearm. The incident was confirmed by the facility's Administrator, highlighting a failure to adhere to the care plan.
Quarterly Care Conferences Not Held or Not Properly Documented
Penalty
Summary
The facility failed to ensure resident care conferences were held quarterly for all residents. Survey review identified missing or incomplete care conference documentation for Residents #1, #4, #5, #7, #9, #10, #36, and #51. The deficiency was based on interview and record review showing that several residents had only one or two documented care conferences during 2025, while others had no documentation of quarterly conferences for multiple quarters. Resident #4 was admitted with multiple sclerosis, type II diabetes mellitus, essential hypertension, and acute kidney failure. The most recent MDS showed the resident was cognitively intact with no behaviors, no rejection of care, and no wandering. The record showed one care conference on 08/29/25 and no further care conference documentation for 2025. Resident #9 had Alzheimer’s Disease, atherosclerotic heart disease, major depressive disorder, and generalized anxiety disorder; the record showed care conference summaries on 05/20/25 and 08/28/25 with no additional documentation. Resident #10 had care conference summaries dated 6/10/25 and 7/1/25, with no further care conferences documented. Resident #51 had care conferences documented on 12/19/24, 06/02/25, 11/13/25, 11/24/25, and 12/17/25, but the 06/02/25 documentation did not show resident or resident representative attendance or participation. Resident #1 had COPD, acute respiratory failure with hypoxia, MI, CVA with right-sided hemiplegia, and type II diabetes mellitus, and the quarterly MDS showed intact cognition with extensive assistance needs; the record did not show care conferences offered or held in the second, third, and fourth quarters of 2025. Resident #7 had Alzheimer’s disease, anxiety disorder, major depressive disorder, and heart failure, with severe cognitive deficit and total dependence in multiple ADLs; the record showed care conferences only in the first and third quarters, and the Social Services Director verified the conferences in the first and second quarters were meaningless due to the resident’s severe cognitive deficit. Resident #5 and Resident #36 both had dementia-related diagnoses and severe cognitive impairment with extensive dependence in ADLs; each had only two documented care conferences in 2025, and the documentation for the later conferences did not show resident or resident representative attendance or explain their absence. The Social Services Director verified that no additional care conference documentation existed for these residents and that no additional care conferences had occurred.
Failure to Provide an Ongoing Activities Program
Penalty
Summary
The facility failed to provide an ongoing activities program for four residents reviewed for activities. The report states that the facility census was 51 and that the deficiency affected Residents #42, #15, #39, and #16. Review of the facility policy titled, "Engagement and Activity," dated February 2009, stated the facility will provide a choice of meaningful engagement experiences and that staff are held accountable to properly document the engagement experience. Resident #16 had diagnoses including myocardial infarction, COPD, CHF, hypertension, and type II diabetes mellitus, and used a manual wheelchair with staff assistance. The resident was observed being transported to activities in another unit approximately 30 to 50 yards away from the resident's unit on two occasions, while the outside temperature was 39 degrees Fahrenheit and later 25 degrees Fahrenheit. Resident #16 stated that activities scheduled in an alternate location required transport outside in inclement weather, and that she would forego activities she wanted to attend because of the distance and weather. The resident also stated there was no alternative activity offered when weather was inclement. The Administrator verified residents were transported to various units, some up to approximately 50 yards away, outside in weather, and that no alternative activity was offered to those who chose not to go because of the weather. Resident #42 had diagnoses including heart failure, malnutrition, myocardial infarction, quadriplegia, carotid stenosis, and left leg amputation, and required maximum assistance for mobility. Her care plan included an activity program with meaningful activities and talking time, but the record showed only watching television in her room for two shifts and no other activities attended. A consultant activity representative documented a one-to-one visit, but there was no note that the resident resisted visits. The January activity calendar listed repeated activities such as Daily Icon, pet therapy, bingo, church service, yoga, and board games, but the resident stated she liked talking and crafts, did not receive materials for crafts, did not know what Daily Icon was, and did not receive consistent pet visits or one-to-one talking time. Staff, including the CNA and AD, verified they did not know what Daily Icon was, that CNAs were supposed to provide it as an all-house activity, and that there were no one-to-one activities documented for the resident. Resident #15 had diagnoses including morbid obesity, hypertension, and osteoarthritis, and was dependent on staff for mobility. The resident reported that participation in religious services was very important and group activities were somewhat important. The January calendar listed Sunday church services at 8:00 A.M. and Daily Icon at 8:00 A.M., but the resident's basic activity record showed church attendance during weekdays and not on Sundays. The resident stated Sunday services were important and that the facility did not always have them, and that there were very few weekend activity choices. The facility chaplain stated she did not provide weekend church services, while the AD verified she did not know who provided Sunday church services and stated Daily Icon was an all-house activity to be provided by CNAs. Observations from 01/12/26 through 01/15/26 at 8:00 A.M. revealed no Daily Icon activity in House #19, and no pet therapy was observed on the date listed on the calendar. Resident #39 had diagnoses including heart failure and insomnia, had intact cognition, and required set-up assistance. The resident's assessed interests included reading books and attending church services with others. The January calendar again listed Sunday Daily Icon and church services at 8:00 A.M., but the resident's basic activity record showed church attendance during weekdays and not on Sundays. The resident stated there was not much weekend activity, that church services were not provided as listed, that she liked evening games but they were not listed on weekends, and that Daily Icon was not offered. She also stated she was not offered additional reading materials and that CNAs on day shift did not do listed activities because of time constraints, while evening staff provided board games when it fit into the staff routine. The AD verified she did not know who provided Sunday church services, stated Daily Icon was to be provided in the mornings, and said board games were to be provided in the evenings by CNAs. CNAs #20 and #30 stated they did not know what Daily Icon was and did not provide it, despite it being listed as an all-house activity.
Activities Program Not Directed by a Qualified Professional
Penalty
Summary
The facility failed to provide an activity program directed by a qualified professional. Record review showed the hired Activity Director was employed on 10/21/25, but there was no evidence she was licensed, registered, or otherwise qualified to serve in that role at the time of hire. The record also showed a payment invoice dated 01/14/26 for enrollment in an activity professional certification program, indicating she had not yet been enrolled in the program when she was hired. Interviews confirmed the Activity Director had not met the qualifications for the position when hired and had not started or completed a qualifying activity director program since hire. She stated she created the activity calendars for December 2025 and January 2026, completed MDS activity assessments, and coordinated Resident Council meetings, while also reporting there was no qualified activity professional overseeing her work other than occasional phone contact with a sister facility activity person. The Administrator verified she had not met the requirements for the position and that there was no documentation showing direct oversight by a certified activity professional. Resident #22 stated she did not want activities and preferred to be left alone in her room, with satisfaction from family visits.
Failure to Provide ABN Before End of Medicare Part A Coverage
Penalty
Summary
The facility failed to provide an Advanced Beneficiary Notice of Non-Coverage (ABN) before discharge from Medicare Part A services for Resident #39. Review of the SNF Beneficiary Protection Notification Review document showed that Resident #39 was not issued a Skilled Nursing Facility ABN form prior to the discontinuation of Medicare Part A services on 09/29/25. An interview with the Administrator on 01/14/25 at 12:58 PM confirmed that Resident #39, who remained in the facility after Medicare Part A services ended, was not issued the Facility ABN form.
Failure to Apply Ordered Positioning and Splint Devices
Penalty
Summary
The facility failed to provide equipment to prevent physical decline for two residents. Resident #24 had diagnoses including Alzheimer’s disease, malnutrition, osteoporosis, adult failure to thrive, and congestive heart failure, and the MDS showed severely impaired cognition, extensive assistance with ADLs, and hospice care. The resident had physician orders for a positioning device to the left hand as tolerated and pressure relieving boots at all times as tolerated, but observations on 01/12/26 and 01/13/26 showed the resident in a reclining chair without the hand device and without the pressure relieving boots. The DT and CNA verified the devices were not in place, and the DON confirmed the resident should have had both devices and that there was no documentation showing the resident did not tolerate them on those dates. Resident #42 had diagnoses including heart failure, malnutrition, myocardial infarction, quadriplegia, carotid artery stenosis, and left leg amputation, and admission notes documented a right leg contracture. The MDS showed intact cognition and maximum assistance for mobility. The resident had an order for a right knee extension splint up to four to six hours a day as tolerated, but observations on 01/12/26 and 01/13/26 showed the splint was not on the resident. The splint was found at the bottom of the resident’s closet covered with items, and the resident stated staff had not applied it for months and had not attempted to reapply it after refusals. The DT and DON verified there was no documentation in the MAR, care plan, or nursing notes that the resident refused the splint, and the DON confirmed the splint should have been applied as ordered.
Failure to Provide Ordered Adaptive Feeding Equipment
Penalty
Summary
The facility failed to provide adaptive feeding devices as ordered for two residents who required assistance with meals. Resident #42 had diagnoses including heart failure, malnutrition, myocardial infarction, quadriplegia, carotid artery stenosis, and a left leg amputation, and the MDS indicated intact cognition and the need for feeding assistance. The resident was ordered to receive a built-up plate and spoons only, and the care plan stated the resident was to receive a plate with sides and spoons at meals. During observations at breakfast and lunch meals, the resident did not have a built-up plate, and the resident stated she was supposed to receive a built-up plate edge to scoop food onto the spoon and had not received it for the past two days. A CNA who worked those shifts verified the resident did not receive the built-up plate at breakfast and lunch and was unaware it was required at each meal. The DON later verified the resident should have received the built-up plate at all meals as ordered. Resident #22 had a diagnosis of arthritis, intact cognition, and required assistance with meals. The resident’s MDS indicated a regular diet, a supplement before breakfast every day, and orders for a specialized drinking cup, built-up handled utensils, and a curved handled spoon. During observations at breakfast and lunch meals, the resident did not have the built-up handled and curved handled utensils. The resident stated she was supposed to receive built utensils and had not received them for the past two days. The CNA who worked those shifts verified the resident did not receive the built-up handled utensils at breakfast and lunch and stated she was unaware the resident was to receive them at each meal. The facility policy stated specialized eating equipment is provided to residents who need devices to eat more independently.
Unsafe Food Storage and Incomplete Kitchen Monitoring
Penalty
Summary
The facility failed to store foods in a safe and sanitary manner in multiple house kitchens. During observations, surveyors found opened dairy and other food items in House #16, House #14, House #15, House #17, and House #19 that were not labeled with a use-by or discard date. Several items had only expiration dates, and staff stated they were using the expiration date after opening rather than dating the food when opened. In House #16, opened cottage cheese and yogurt containers lacked use-by or discard dates, and in House #14, an opened cottage cheese container also lacked a use-by or discard date. In House #15, opened applesauce, sour cream, and cottage cheese had no open dates or discard dates, and an opened resident food item was dated 12/28/25. In House #17 and House #19, opened coffee creamer, cottage cheese, cheese, cheese dip, and an unlabeled dry substance were observed without proper dating or labeling. Surveyors also observed sanitation and equipment concerns in the kitchens. Heavy gray debris was hanging from the ventilation hood above the stove in House #16, House #17, and House #19, and the inside bottom of the oven in House #15 had several areas of brown dried debris. In House #14, the reach-in refrigerator thermometer read 52 degrees Fahrenheit, and in House #15 and House #19, several refrigerators, freezers, and deep freezers had no internal thermometers. The facility’s food temperature monitor logs were incomplete, with missing meal temperature entries on multiple dates in House #16, House #14, and House #17. The dishwasher logs from 01/01/26 through 01/11/26 showed three shifts of temperatures recorded, but there was no record that temperatures were obtained for three meals or for nighttime food preparation shifts. Diet Technician #50 verified the observations and stated that opened foods should be labeled with the date opened and discarded within four to seven days of opening. The DT stated she had never used a use-by or discard date and had been relying on expiration dates after food was opened. A CNA stated she had been instructed to use the expiration date because no discard or use date was listed on food items, and she did not know the timeframe for discarding opened foods unless spoilage was noted. Facility policy required opened food to be covered, dated, and labeled with the month and day opened and used within four to seven days, and the hood cleaning policy required cleaning of hood screens with heavy grease buildup.
Failure to Maintain Safe Environment and Supervision
Penalty
Summary
A deficiency was identified due to the failure to ensure that a nursing home area was free from accident hazards and that adequate supervision was provided to prevent accidents. The report notes that the environment did not meet safety standards, and there was insufficient oversight to protect residents from potential accidents. This lack of appropriate supervision and the presence of hazards in the area directly contributed to the deficiency cited by surveyors.
Failure to Provide Adequate Assistance During Resident Transfers
Penalty
Summary
The facility failed to provide the appropriate level of assistance during resident transfers, affecting one resident who was at risk for falls due to impaired mobility, a history of falls, a fractured femur, and obesity. The resident required complete staff assistance by two staff members for bed mobility, transfers, and most activities of daily living care. However, during an incident, the resident was assisted by only one staff member, which led to the resident being lowered to the floor while receiving incontinence care. This resulted in multiple bruises to the resident's left forearm, although the resident denied pain and neurological checks were within normal limits. The incident occurred when an Elder Assistant (EA) provided care without the required assistance of a second staff member, as outlined in the resident's care plan. The EA was changing and turning the resident when the resident's legs dropped to the side of the bed, prompting the EA to lower the resident to the floor. The EA admitted to being the only staff member present during the incident, which was confirmed by the facility's Administrator. The care plan clearly indicated the need for two staff members to assist with bed mobility and incontinence care, but this protocol was not followed, leading to the deficiency.
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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 Batavia
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Glen The | 1.4 mi | ★★★★★ | 3 | 0 |
| Eastgate Health Care Center | 1.5 mi | ★★★★★ | 7 | 0 |
| Atlantes The | 1.6 mi | ★★★★★ | 0 | 0 |
| Siena Gardens Rehabilitation & Transitional Care | 2 mi | ★★★★★ | 2 | 0 |
| Forest Hills Healthcare Center. | 4.2 mi | ★★★★★ | 16 | 0 |
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