Sycamorespring of Miamisburg

In the surveyor’s words

From the most serious findings on record at Sycamorespring of Miamisburg, in the surveyor’s own words.

• Actual harm, isolatedF689Sep 18, 2025

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, review of hospital records, review of a facility investigation, staff and family interviews, review of a video recording, and review of the facility policy, the facility failed to provide adequate assistance while transferring a resident resulting in an avoidable fall and failed to ensure staff timely report a fall when it occurred. This resulted in Actual Harm to Resident #78 on 08/25/25 when staff failed to provide adequate assistance when transferring the resident from a wheelchair to the bed which resulted in the resident falling to the floor, then staff assisted the resident back to bed without reporting the fall. […]

• Actual harm, isolatedF689Aug 27, 2021

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NONCOMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, review of hospital records, review of a facility investigation, observation, resident and staff interview, review of manufacturer's guidelines, and review of facility policy, the facility failed to ensure a resident was provided appropriate assistance with toileting and transfers per the plan of care. This resulted in actual harm when Resident #13 was transferred from the toilet to a wheelchair without the proper number of assistance and without use of a gait belt, the resident was lowered to the floor and the resident was subsequently admitted to the hospital for a fractured left ankle which required surgical repair. […]

• No harm, potential for more than minimal, isolatedF759Apr 9, 2026

  Based on medical record review, observation, staff interview, and review of the facility policy the facility failed to ensure medication error rate was below five percent (%). There were three medication errors observed over 33 medication opportunities resulting in a medication error rate of 9.09%. This affected two (Residents #3 and #48) of three residents observed for medication administration. The facility census was 93 residents.Findings include:1.Review of the medical record for Resident #48 revealed an admission date of 01/11/26 with diagnoses including peripheral vascular disease (PVD), atrial fibrillation, and dysphagia. […]

• No harm, potential for more than minimal, isolatedF880Apr 9, 2026

  Based on medical record review, observation, staff interview, and review of the facility policy, the facility failed to ensure enhanced barrier precautions (EBP) were followed during medication administration. This affected one (Resident #3) of three residents reviewed for medication administration. The facility census was 93 residents.Findings include: Review of the medical record for Resident #3 revealed an admission date of 04/19/19 with diagnoses including schizoaffective disorder, major depressive disorder, and convulsions. Review of the Minimum Data Set (MDS) assessment for Resident #3 dated 02/11/26 revealed the resident was cognitively impaired and dependent with activities of daily living (ADLs). […]

• No harm, potential for more than minimal, isolatedF622Nov 12, 2024

  Based on medical record review, staff interviews, and policy review, the facility failed to ensure a resident was permitted to stay in the facility once payer source changed from Medicare Part A to private pay. This affected one (#100) out of the three residents reviewed for discharges. The facility census was 98. Finding includes: Review of the medical record for the Resident #100 revealed an admitted [DATE] with medical diagnoses of nontraumatic subarachnoid hemorrhage, cirrhosis, hepatic encephalopathy, anorexia, and congestive heart failure. Review of the medical record for Resident #100 revealed a discharge date of [DATE]. […]