Champion City Nursing and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Champion City Nursing and Rehabilitation Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Apr 3, 2025

  Based on review of facility policy, facility documentation, clinical records, and staff interviews, it was determined that the facility failed to protect Resident R3 with severe cognitive impairment from unwanted/non-consensual sexual contact by Resident R1 who had a history of sexually inappropriate behavior, including an unsolicited sexual contact with Resident R2 on February 18, 2025. This failure resulted in an Immediate Jeopardy situation when Resident R1 was found naked on top of Resident R3. (Resident R1, R2 and R3) Findings Include: Review of facility policy Abuse, Neglect, Exploitation and Misappropriation Prevention Program dated 2/3/25, indicated that residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. […]

• Immediate jeopardy, isolatedF689Nov 22, 2023

  Based on review of facility policy, clinical records, facility documents, resident interview, and staff interviews, it was determined that the facility failed to make certain each resident received adequate supervision that resulted in an elopement (resident exits to an unsupervised or unauthorized area without the facility's knowledge) for one resident. This failure created an immediate jeopardy situation for one of 53 residents who were identified as high risk for elopement (Resident R1). […]

• No harm, potential for more than minimal, widespreadF812Mar 27, 2026

  Based on review of facility policy, observations and staff interview, it was determined that the facility failed to properly store food products and maintain proper infection control practices in the main kitchen and dish room which created the potential for cross contamination in the designated main kitchen, dish room. The facility policy entitled Food Preparation and Service dated 10/29/25, indicated Food and nutrition employees prepare, distribute, and serve food in a manner, that complies with safe food handling practices. During an observation of the main designated kitchen on 3/23/26, at 9:45 a.m. […]

• No harm, potential for more than minimal, widespreadF881Mar 27, 2026

  Based on review of the facility policy and staff interview, it was determined that the facility failed to implement an antibiotic stewardship program for 12 of 12 months (March 2025, through February 2026) Findings include: Review of facility Antibiotic Stewardship policy dated 10/29/25, indicated that antibiotics will be prescribed and administered to residents under the guidance of the facility's antibiotic stewardship program. Review of the facility's Infection Control Program from March 2025, through February 2026, failed to include documented evidence that antibiotic (medications used to treat infections) monitoring and ensuring appropriate usage was completed. During an interview on 3/25/26, at 10:51 a.m. […]

• No harm, potential for more than minimal, widespreadF835Apr 3, 2025

  Based on review of job descriptions, clinical records, and staff interviews, it was determined that the Nursing Home Administrator and Director of Nursing did not effectively manage the facility to make certain that necessary care and services were provided to residents to prevent sexual abuse for 2 of 2 residents (Resident R2 and R3), which created an immediate jeopardy situation for all 152 of 152 residents. Findings include: Review of CFR S483.70 Administration. A facility must be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. […]