Below 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 Pickaway Manor Care Center during CMS and state inspections, most recent first.
A resident with diabetes, spinal cord injury, and severe dependence for ADLs had a sacral pressure ulcer that progressed to stage IV and developed a right thigh pressure injury that worsened over time. The facility repeatedly failed to carry out wound tx as ordered, with missing or unclear orders, incorrect TAR entries, incomplete wound assessments/staging, and no documented orders for key pressure-relief interventions such as a low air loss mattress or turn/repositioning. The wounds deteriorated with slough, odor, tunneling, necrosis, and infection, and the resident required multiple hospitalizations for osteomyelitis, sepsis, and soft tissue involvement.
QAPI program failed to identify and track ongoing pressure ulcer care concerns for two residents. QA meetings reviewed residents with pressure ulcers and whether interventions were in place, but the DON and Regional Clinical Services confirmed that no resident was separately identified as an ongoing issue. The annual survey found pressure ulcer care noncompliance, including prevention and treatments, with IJ for one resident and Actual Harm for another.
Food items were found open, undated, or improperly stored in multiple kitchen and activity room refrigerators, including frozen foods, deli meats, cheese, lettuce, and condiments. A cook was also observed with a hairnet that did not fully cover the hair and using unsafe food-handling practices during lunch service, including handling a thermometer pad wrapper that fell into resident food. Facility policy required FIFO rotation and dating of foods removed from original packaging.
An LPN completed pressure ulcer staging and measurements for multiple residents, including wounds that changed in stage over time and were documented on the sacrum, coccyx, and heels. The residents had significant medical and functional needs, including diabetes, cognitive impairment, and dependence for transfers and toileting. The DON verified that Unit Manager LPNs were performing weekly and admission wound assessments when the wound doctor did not see the residents, and the facility job descriptions did not include pressure ulcer staging or measurement duties.
A CNA delivered a meal tray to a resident on contact precautions without performing hand hygiene before entering or after leaving the room, despite signage requiring hand cleaning and PPE use. The facility also did not timely order or implement EBP for multiple residents with wounds or surgical wounds, including residents with pressure ulcers and open surgical wounds, and the DON verified several delays or omissions in the orders.
Call Light Not Within Reach: A resident with severe cognitive impairment and multiple diagnoses, including HF, vascular dementia, and orthostatic hypotension, was observed several times with the call light on the floor, wrapped around the bed rail with the button between the mattress and rail, or draped over a recliner while the resident was in bed or seated and unable to reach it. The DON confirmed the call light was out of reach during the final observation.
Failure to Implement Ordered Fall Interventions: Two residents at risk for falls did not have ordered fall precautions consistently in place. One resident had a prescribed perimeter mattress for bed safety, but observations showed the mattress was not present and the resident was later found on the floor with abrasions after falls. Another resident’s care plan required the bed to be kept low with a fall mat, but observations and an LPN confirmation showed the bed was elevated instead of in the lowest position.
A resident with CKD stage 5, hydronephrosis, UTI, bacteremia, BPH, and urinary retention had an indwelling catheter ordered to be changed every 30 days. The TAR had no documentation that the monthly catheter change was completed, and progress notes also showed no evidence it occurred. An LPN stated missed monthly tasks should be reported and rescheduled, and the DON confirmed the catheter was not changed as ordered.
A resident with dementia and ESRD was identified as being at risk for malnutrition, with care plan directions to monitor and record meal intake for every meal. Review of meal records showed multiple days with missing breakfast, lunch, and dinner intake percentages, and no snacks were documented as offered or consumed. A CNA said intake percentages were entered later in the shift, and an RN confirmed the resident’s meal intake needed close monitoring due to nutritional risk.
A resident with ESRD and dialysis dependence had care plan directions to avoid BP checks and lab draws in the arm with the dialysis access port, but staff documented repeated BP measurements in that arm. The resident wore a bracelet indicating no BP or lab draws on that arm, and an RN and LPN confirmed the documentation showed multiple BP checks were still done on the access-port arm.
A resident with a preference for female caregivers was assisted by a male STNA despite her known preference, as documented in a video recording. The resident's POA had communicated this preference to the facility, but it was not documented in her care plans or kardex. Interviews with staff confirmed awareness of the preference, but it was not consistently honored due to staff availability issues.
The facility failed to notify the physician when a resident experienced significant weight changes, gaining 12.2 pounds (9%) and 22 pounds (16.3%) over a short period. Despite the resident's multiple serious diagnoses, there was no evidence that the physician was informed, as confirmed by the Corporate Dietitian. This was in violation of the facility's Change in Condition Notification policy.
A facility failed to ensure accurate PASRR documentation for a resident, omitting critical diagnoses such as bipolar disorder and schizoaffective disorder. The discrepancy was confirmed by the Social Services Coordinator, who noted that no new PASRR was completed until much later, delaying the appropriate level II review.
A resident with an indwelling catheter was observed multiple times with the catheter tubing hanging down the side of the bed and touching the floor or floor mat. The resident had severe cognitive impairment and was dependent on staff for personal hygiene. An LPN confirmed the improper storage and acknowledged that the tubing should be kept off the floor.
Pressure Ulcer Care and Treatment Order Failures
Penalty
Summary
The facility failed to ensure ordered wound treatments were completed as directed and failed to implement effective interventions to prevent the development and worsening of pressure ulcers for a resident with significant immobility and existing skin breakdown. The resident had diagnoses including type 2 diabetes and cervical spinal cord injury, was totally dependent for bed mobility and transfers, and had a sacral pressure ulcer present on admission that later progressed to stage IV. The record showed the resident was at moderate risk for skin breakdown on Braden scoring and required extensive assistance with activities of daily living. For the sacral wound and a later-developed right lateral thigh wound, the record showed repeated problems with wound assessment, staging, and treatment orders. An LPN assessed and staged wounds, including the sacral ulcer and the right thigh deep tissue injury, and treatment orders were entered with missing or unclear details such as Dakin’s solution strength and dressing frequency. The wound physician’s notes included multiple changes in treatment plans over time, but the corresponding physician orders and treatment administration records repeatedly reflected incorrect or incomplete treatments, and the wound physician was not contacted to clarify some orders. The record also showed that the resident’s wounds worsened over time, with increasing size, slough, odor, tunneling, and later necrosis and myositis documented in the right thigh wound. The resident was hospitalized multiple times for complications related to the pressure ulcers, including osteomyelitis of the sacrum with sepsis and later possible osteomyelitis of the sacrum with soft tissue necrosis and myositis of the right thigh. Hospital records documented advanced wound findings, including exposed bone, drainage, undermining, and worsening tissue loss. The facility record further showed that through the later course of care, there were still no physician orders for a low air loss mattress or turning and repositioning, and the resident remained dependent for care with ongoing pressure ulcer treatment issues.
QAPI Program Failed to Track Ongoing Pressure Ulcer Care Issues
Penalty
Summary
The facility failed to implement and maintain a comprehensive QAPI program and plan to address care issues and concerns related to pressure ulcer care. Review of QA committee attendance records showed monthly meetings were held over the previous 12 months, and at the September 26, 2025 meeting, prevention and interventions for residents with pressure ulcers were discussed. However, Resident #41 and Resident #5 were not separately identified as ongoing issues with their care, and the facility was unable to provide evidence of ongoing QAPI implementation specific to their pressure ulcer care. The annual survey dated 01/05/26 found noncompliance in pressure ulcer care, including prevention and treatments, resulting in substandard quality of care with Immediate Jeopardy beginning on 08/14/25 for Resident #5 and Actual Harm beginning on 08/26/25 for Resident #41. Interview with the Regional Clinical Services confirmed that, over the past year of QAPI meetings, no residents were identified as ongoing issues for pressure ulcer care. The DON stated that residents with pressure ulcers were reviewed based on Braden scales and skin conditions to ensure interventions were in place, but no resident had been brought forward as an ongoing concern by staff, including Unit Managers.
Food Storage and Preparation Lapses
Penalty
Summary
Food was not consistently stored, labeled, or protected from contamination in the kitchen, walk-in cooler, walk-in freezer, prep cooler, and activity room refrigerator. During observation, opened bags of frozen pizzas and frozen chicken fingers were stored with the bags left open, and the chicken fingers had no date marking. A large box of frozen hamburger patties was also stored with the box and bag open in the walk-in freezer. In the walk-in cooler, two heads of lettuce appeared wilted and brown with no date marking, and a block of yellow cheese that had been removed from its original packaging and wrapped in plastic wrap also had no date marking. Additional observations showed multiple items in the center kitchen prep cooler without date markings, including deli ham, bologna, boiled eggs, yellow cheese, white cheese, and sliced onions. The Dining Services Manager removed the undated items from the prep cooler and directed staff to discard them. Two squeeze bottles of sauces/dressings in the bottom of the prep cooler were dated November 2025 and were identified as employee food items stored in the same refrigerated unit with foods prepared for residents. In the activity room refrigerator, opened containers and bags of French onion dip, salami, cheese cubes, and salsa were also found without labels or date markings. During lunch service, a cook was observed plating food while wearing a hairnet that covered only the back portion of the hair, leaving most of the head uncovered. The cook wore a glove on only one hand while taking temperatures of hot food items and used a bare hand to open an alcohol prep pad to clean the thermometer tip. The torn wrapper from the alcohol pad fell directly into a tray of pureed green beans, and the cook then removed the wrapper with the gloved hand but kept the food item for service. The facility policy reviewed stated foods must be rotated using FIFO and that foods removed from original packaging must have arrival dates, with open dates added when applicable.
LPNs Completed Pressure Ulcer Staging and Measurements Outside Their Scope
Penalty
Summary
The facility failed to ensure LPNs acted within their professional standards and scope of training when completing pressure ulcer wound assessments and staging for four residents. The report states that Unit Managers, who are LPNs, were performing weekly and admission pressure ulcer staging and measurements when the wound doctor did not see the residents or did not see them at all. The facility policy titled Skin and Wound Guidelines states that pressure injuries are evaluated and documented by a licensed nurse and are evaluated weekly by the wound team or a licensed nurse per state and federal regulations, but the job descriptions for the Licensed Practical Charge Nurse and Unit Manager did not include pressure ulcer wound assessments, measuring, staging, or related assessment duties. For one resident, the record showed multiple pressure ulcer evaluations completed by an LPN on the sacrum and right lateral thigh, including staging changes from stage 3 to stage 4 and later documentation of a deep tissue injury, an unstageable ulcer, and then a stage 3 ulcer with tunneling. The resident had diagnoses including type 2 diabetes, central cord syndrome at C5, muscle disorder, anxiety disorder, and major depressive disorder, and the most recent MDS showed a BIMS score of 12 with substantial/maximal assistance needed for bathing, bed mobility, and total dependence for toileting and transfers. The DON, Regional Nurse, and Regional Clinical Services RN verified that an LPN completed the staging and measurements on multiple dates. For another resident, the record showed an LPN documented a coccyx pressure injury without staging and later documented the left heel as a deep tissue pressure injury on multiple occasions, including measurements that changed over time. The resident had diagnoses including type 2 diabetes with neuropathy, a femur fracture with routine healing, major depressive disorder, senile degeneration of the brain, and anxiety disorder, and the MDS showed a BIMS score of 5 with severe cognitive impairment and extensive assistance needs. The DON and Regional Nurse verified that an LPN staged and measured the left heel pressure ulcer on the dates reviewed. A third resident was admitted with a diagnosis of a sacral pressure ulcer and had an MDS showing a BIMS score of 13 with assistance needs for bed mobility, toileting hygiene, bathing, and transfers. The skin issue assessment documented a stage 3 pressure ulcer on admission, and the DON verified that an LPN completed the pressure ulcer measurement and assessment. For a fourth resident, progress notes showed an LPN identified a left heel wound, applied treatment, and later documented repeated Braden scale scores and wound assessments that changed from unstageable/deep tissue injury to stage 3 pressure injury with measurements and drainage descriptions. The DON stated that Unit Managers, who are LPNs, were assessing and staging pressure ulcers weekly and on admission when the wound doctor did not see the residents.
Hand Hygiene and Enhanced Barrier Precautions Not Followed
Penalty
Summary
The facility failed to perform hand hygiene before and after wearing contact precautions when a CNA delivered a lunch tray to a resident with an active order for contact precautions due to MSSA bacteremia. On 01/07/26 at 12:41 P.M., the CNA entered the resident’s room without performing hand hygiene, donned a gown and gloves, delivered the tray, then doffed the gown and gloves and returned immediately to the meal delivery cart without performing hand hygiene. The contact precautions signage on the door directed staff to clean their hands before entering and when leaving the room and to put on a gown and gloves before room entry and discard them before room exit. The Dining Services Manager verified seeing the CNA enter and exit the room without performing hand hygiene as indicated by the signage. The facility also failed to ensure enhanced barrier precautions were ordered timely for residents who had wounds or surgical wounds. Resident #5 returned from the hospital with a stage 4 sacral pressure ulcer, but the physician order for enhanced barrier precautions was not entered until 04/30/25. Resident #41 had a coccyx pressure ulcer identified on 08/25/25, but the enhanced barrier precautions order was not entered until 09/03/25. Resident #99 was admitted with a coccyx pressure ulcer, but the enhanced barrier precautions order was not entered until 01/01/26 with a start date of 01/02/26. Additional records showed the same issue for other residents. Resident #46 developed a new in-house stage 3 coccyx pressure ulcer on 12/30/25, and no evidence was found that enhanced barrier precautions were implemented. Resident #52 was admitted with multiple open surgical wounds, and no evidence showed enhanced barrier precautions were implemented or ordered. Resident #64 had stage 3 pressure ulcers of the sacral region and left heel, and no evidence showed enhanced barrier precautions were ordered or implemented. Resident #82 had an order for enhanced barrier precautions dated 12/03/25, but the DON verified the resident developed a left heel wound on 11/05/25 and that enhanced barrier precautions were not put in place until 12/03/25. The facility policy stated residents admitted with or developing a wound during their stay would be placed in enhanced barrier precautions with a physician order.
Call Light Not Kept Within Reach
Penalty
Summary
The facility failed to maintain Resident #25's call light within reach. Resident #25 had an admission date of 09/14/18 and a re-entry date of 11/03/22, with diagnoses including hypertensive heart disease with heart failure, vascular dementia, major depressive disorder, history of falling, hypothyroidism, orthostatic hypotension, and other abnormalities of gait and mobility. The quarterly MDS showed a BIMS score of 3 out of 15, indicating severe cognitive impairment. The resident required set up help for eating, partial/moderate assistance with moving about in bed, and was dependent on staff for toileting hygiene and transferring between chair and bed. Observations showed the call light on the floor while the resident was in bed, wrapped around the bed rail with the call button positioned between the bed rail and mattress, and later draped over the resident's recliner while the resident was resting in bed. At times the resident was seated in the recliner or in bed with the head of the bed elevated and was unable to reach the call light. During the final observation, the DON confirmed the call light was draped over the recliner while the resident was in bed and unable to reach it.
Failure to Implement Ordered Fall Interventions
Penalty
Summary
The facility failed to implement ordered fall interventions for two residents who were identified as being at risk for falls. Resident #38 had diagnoses including COPD, hemiplegia and hemiparesis following cerebral infarction affecting the right dominant side, major depressive disorder, vascular dementia, anxiety disorder, and CHF. Her physician’s orders and fall care plan both included a perimeter mattress for bed safety, but multiple observations showed her bed did not have a perimeter mattress in place. During the survey period, she was observed lying in bed with her buttocks at the edge of the bed, and the DON verified the mattress on her bed was not a perimeter mattress. The record also documented two falls, including one where she was found on the floor beside her bed with abrasions to her knee and toes, and another where she was found on the floor beside the bed after trying to look under the bed for her TV remote and slipping onto the floor. Resident #84 had diagnoses including osteoporosis, hypotension, and pain to both lower extremities, and her care plan identified her as at risk for falls with interventions including 15-minute checks, a 9-inch fall mat at bedside, and keeping the bed in the low position with the fall mat when occupied. However, observations showed the bed was elevated and not in the lowest position on more than one occasion. An LPN confirmed the resident was resting quietly in bed and the bed was not in the lowest position as required by the care plan. The report documents that the ordered fall interventions were not consistently in place for either resident.
Failure to Complete Ordered Foley Catheter Change
Penalty
Summary
The facility failed to properly maintain an indwelling catheter for one resident who had diagnoses including chronic kidney disease stage five, hydronephrosis, methicillin susceptible staphylococcus aureus carrier or suspected carrier status, urinary tract infection, bacteremia, benign prostatic hyperplasia, obstruction and reflux uropathy, retention of urine, and hypotension. The resident’s MDS showed intact cognition with a BIMS score of 15, no behaviors during the assessment look-back period, independence with most activities of daily living, continence of bowel, and an indwelling catheter. The physician ordered the Foley catheter to be changed on day shift every 30 days. Review of the December TAR showed the catheter change was due on 12/10/25, but there were no initials documenting that it was completed. Nursing progress notes for December also showed no evidence that the catheter change occurred. During interview, an LPN stated that if a monthly task could not be completed, the medical provider would be notified and an order obtained to complete the task at a different time and/or date so the task would not be missed for that month. The DON later confirmed the catheter was not changed in December as ordered.
Missing Meal Intake Documentation for a Resident at Nutritional Risk
Penalty
Summary
The facility failed to ensure meal intakes were monitored to maintain a resident’s highest nutritional status. Resident #84 was admitted with dementia, end stage renal failure, and osteoporosis, and the care plan identified the resident as being at risk for malnutrition related to end stage renal disease. The plan of care also noted that the resident continued to refuse nutritional supplements and directed staff to provide the ordered diet, monitor and record intake for every meal, and alert dietary if consumption was poor for more than 48 hours. A later care plan identified renal insufficiency related to end stage renal disease and included consultation with dietary to regulate protein, sodium, and potassium intake. Review of the resident’s MDS showed a BIMS score of 14 out of 15, indicating intact cognition for daily decision-making, and the resident required set up or clean up assistance for meals. The resident was 59 inches tall and weighed 117 pounds with no noted weight loss or gain. Review of breakfast, lunch, and dinner intake records over the reviewed period showed multiple days with no meal intake percentages documented, including 14 of 30 days for breakfast, 16 of 30 days for lunch, and 14 of 30 days for dinner. No snacks were offered or documented as consumed. A CNA stated that intake percentages were written on meal slips and entered later, most likely at the end of the shift, and an RN confirmed there were multiple days of missing meal intakes and that the resident’s meal percentage intake needed to be closely monitored due to nutritional risk.
Dialysis Access Arm Used for Repeated Blood Pressure Checks
Penalty
Summary
The facility failed to ensure dialysis-related orders and recommendations were followed for a resident with end stage renal disease, dependence on renal dialysis, and hypertension. The resident’s care plan included dialysis interventions such as checking the access site for lack of thrill or bruit, monitoring for infection, swelling, or excessive bleeding, changing the dressing daily at the access site, coordinating dialysis care with the center, and not drawing labs or checking blood pressure in the arm with the dialysis port. The resident also had a plan of care related to bleeding risk and was documented as having intact cognition with a BIMS score of 14 out of 15. Review of blood pressure records showed the resident’s blood pressure was checked 123 times from 10/14/2025 through 01/12/2026 using the left arm, which was the arm where the dialysis access port was located. The resident stated staff checked blood pressure in both arms and said she wore a bracelet on her left arm indicating no blood pressure checks or lab draws on that arm. Observation confirmed the bracelet was in place, and the RN and LPN confirmed there were multiple documented blood pressure checks completed on the left arm despite the dialysis port being located there.
Failure to Honor Resident's Preference for Female Caregivers
Penalty
Summary
The facility failed to honor a resident's preference for female caregivers, which was a known preference communicated by the resident's Power of Attorney (POA) for healthcare. The resident, who had a history of schizophrenia, depression, obesity, congestive heart failure, muscle weakness, unsteadiness on feet, abnormalities of gait and mobility, and repeated falls, was admitted to the facility and later transferred to another nursing facility at her request. Despite the resident's clear communication abilities and her POA's explicit instructions, the facility did not document or consistently honor her preference for female caregivers in her care plans or kardex. A video recording from the resident's in-room camera showed a male State Tested Nursing Assistant (STNA) entering the resident's room and assisting her with personal care, despite her request for a female caregiver. The STNA, identified as STNA #300, acknowledged during an interview that he was aware of the resident's preference but had assisted her with personal care due to the unavailability of female staff. The Director of Nursing (DON) confirmed the resident's preference was known and agreed that the male aide should have sought assistance from a female aide to honor the resident's choice. Interviews with various staff members, including the Social Services Coordinator and the unit manager, revealed that the resident's preference for female caregivers was discussed in a care conference and known to the staff. However, the facility's policy on accommodating residents' needs and preferences was not effectively implemented, as the resident's preference was not consistently communicated or respected, leading to the deficiency noted in the report.
Failure to Notify Physician of Significant Weight Change
Penalty
Summary
The facility failed to notify the physician when a resident experienced a significant weight change. This deficiency affected one resident who had a significant weight gain of 12.2 pounds (9%) from January 29 to February 5, and a further significant weight gain of 22 pounds (16.3%) from January 29 to February 12. Despite these significant changes, there was no evidence in the resident's nutritional notes and documentation to support that the physician was notified of these weight gains. The resident's medical record revealed that she was cognitively intact and had multiple diagnoses, including severe protein-calorie malnutrition, chronic kidney disease, pulmonary hypertension, cardiomegaly, congestive heart failure, atrial fibrillation, edema, cardiomyopathy, and hypertension. An interview with the Corporate Dietitian confirmed that there was no evidence to support the physician was notified of the resident's significant weight gains. The facility's Change in Condition Notification policy, dated August 9, 2023, requires the nurse to notify the resident, the resident's physician/practitioner, and the resident's designated representative when there is a significant change in the resident's physical, mental, or psychosocial status or a need to alter the resident's medical treatment significantly. This policy was not followed in the case of the resident's significant weight changes.
Inaccurate PASRR Documentation
Penalty
Summary
The facility failed to ensure that the Pre-Admission Screening and Resident Review (PASRR) documents for a resident were accurate. The resident, who was admitted with multiple diagnoses including bipolar disorder and schizoaffective disorder, had a PASRR document from another nursing facility that only listed panic or other severe anxiety disorder and major depressive disorder. The PASRR document did not include the resident's diagnoses of bipolar disorder and schizoaffective disorder, which were present upon admission. This discrepancy was confirmed by the Social Services Coordinator during interviews, who also noted that no new PASRR was completed for the resident until much later, resulting in a delay in the appropriate level II review being triggered.
Improper Storage of Catheter Tubing
Penalty
Summary
The facility failed to ensure proper storage of catheter tubing for Resident #283, who had an indwelling catheter. The resident, who had medical diagnoses including sepsis, obstructive and reflux uropathy, delirium, disorientation, and altered mental status, was observed on multiple occasions with the catheter tubing hanging down the side of the bed and touching the floor or floor mat. This was noted during observations on 05/05/24, 05/06/24, and 05/07/24. The care plan for the resident, dated 04/19/24, included interventions to complete catheter care per facility protocol, but these were not followed as evidenced by the improper storage of the catheter tubing. During an interview on 05/07/24, LPN #212 confirmed that the catheter tubing was laying on the floor mat by the resident's bed and acknowledged that it should be stored in a position where it can be kept off the floor and floor mat. The resident's admission Minimum Data Set (MDS) 3.0 assessment, dated 04/25/24, revealed that the resident had severely impaired cognition and was dependent on staff for toileting and personal hygiene, further emphasizing the need for staff to adhere to proper catheter care protocols to prevent infection.
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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 Circleville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Circleville Post-acute | 1.1 mi | ★★★★★ | 18 | 0 |
| Brown Memorial Home Inc | 1.2 mi | ★★★★★ | 8 | 0 |
| Logan Elm Health Care Center | 3.1 mi | ★★★★★ | 6 | 0 |
| Luxe Rehabilitation And Care Center | 16.6 mi | ★★★★★ | 3 | 0 |
| Arbors At Carroll | 17.3 mi | ★★★★★ | 8 | 0 |
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