Trotwood Health & Rehab LLC

In the surveyor’s words

From the most serious findings on record at Trotwood Health & Rehab LLC, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Apr 30, 2026

  Based on record review, review of a facility self-reported incident (SRI), review of a police report, staff interview and policy review, the facility failed to ensure residents were from staff to resident physical abuse with serious injury. This resulted in Immediate Jeopardy and Actual Harm on 04/18/26 at approximately 10:40 A.M. when Dietary Aide (DA) #51 punched Resident #4 in the face. Resident #4 was admitted to the hospital with a broken jaw. This affected one (Resident #4) of three residents reviewed for abuse. The facility census was 29 residents. On 04/23/26 at 10:32 A.M., the Administrator was notified Immediate Jeopardy began on 04/18/26 at approximately 10:40 A.M. […]

• Actual harm, isolatedF689Oct 25, 2023

  Based on medical record review, hospital documentation review, staff interview, and review of facility policies, the facility failed to follow facility procedures for leave of absences (LOAs), failed to implement interventions and provide education to residents and family members to reduce falls and incidents while on LOAs, and failed to investigate causative factors and determine a root cause analysis of repeated fall incidents while on LOA from the facility. This resulted in actual harm when Resident #100 left the facility for LOAs with family and had repeated fall incidents and injuries during the LOAs. […]

• Actual harm, isolatedF692Sep 25, 2023

  Based on medical record review, staff and family interviews, and review of facility policy and procedures, the facility failed to ensure nutritional interventions were initiated and sustained to prevent unplanned weight loss for one (#52) of three residents reviewed for weight loss. This resulted in actual harm for Resident #52 who experienced a severe unplanned weight loss of 25.9 percent (%) in less than a one-month period of time. The facility census was 51 residents. Findings include: Review of the medical record for Resident #52 revealed an admitted [DATE] with diagnoses including bacteremia, cannabis abuse, cocaine abuse, pneumonia, protein calorie malnutrition, human immunodeficiency virus (HIV), and major depressive disorder. […]

• Actual harm, isolatedF686Nov 7, 2022

  Based on record review, observation, staff, family, and Wound Physician (WP) #315 interviews, review of facility policy, review of wound physician notes, and review of guidelines from the National Pressure Injury Advisory Panel (NPIAP), the facility failed to implement interventions/treatments to prevent the development of pressure ulcers and/or aid in the healing of existing pressure ulcers as ordered by the physician. This resulted in Actual Harm when Resident #35 was found to have avoidable pressure ulcers which were first identified as a stage III pressure ulcer on his right heel on 09/21/22 and an avoidable unstageable pressure ulcer in the palm of his left hand discovered at the time of the survey on 11/02/22. […]

• Actual harm, isolatedF684Oct 6, 2022

  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 the hospital record, staff interview, review of the facility investigation, review of the self-reported incident, and policy review, the facility failed to ensure timely care and follow-up was provided when a resident had a change in condition. This resulted in Actual Harm when Resident #15 appeared lethargic, was not eating, and an abrasion was noted on the left side of his forehead without immediate assessment, treatment, or follow-up care provided. […]