Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

ASHTABULA COUNTY NURSING HOME

KINGSVILLE, OH · 133 certified beds · Last Life Safety survey August 31, 2023

CMS Certification Number 365741 · first certified June 1989

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Other

No change of ownership on CMS record since January 1, 2016, when the records begin.

15
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
6
Inspection & testing records
Of the citations on file

Position within OH

15 citations — more than 44% of the 922 certified nursing homes in OH. Compared within OH rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Slippingmore citations at the latest survey than at its earlier surveys in the window.

The latest survey found 6 citations; the earlier surveys in the window averaged 4.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (April 2025 to April 2026), and past the point by which nine in ten OH facilities have been surveyed. This facility’s last Life Safety survey was August 2023. Facilities in OH are typically surveyed 20–32 months after the last one (median 26), measured over 889 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

1 inspection-and-testing tag has been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Physical environment (health survey)

4 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 15 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in OH, and nationally. Surveyors differ markedly between states, so the OH figure is the meaningful one.

This facility15OH median16National median11
Citations on file over three years, compared
MeasureCitations
This facility15
Median facility in OH16
Median facility nationally11

Survey history

Citations at each Life Safety survey
42018-1052019-1262023-08
Citations at each Life Safety survey
Survey dateCitations
October 23, 20184
December 5, 20195
August 31, 20236

Most-cited tags

Most-cited tags at this facility
K-03612K-03722K-05211K-03451K-01611K-07111K-01321K-07611
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0361Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.22023-08-31
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.22023-08-31
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.12023-08-31
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12023-08-31
K-0161Use approved construction type or materials.12019-12-05
K-0711Provide a written emergency evacuation plan.12019-12-05
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.12019-12-05
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.12018-10-23

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 6
  • Miscellaneous Deficiencies 3
  • Services Deficiencies 2
  • Construction Deficiencies 2
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies6
Miscellaneous Deficiencies3
Services Deficiencies2
Construction Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies1
Egress Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

August 31, 2023 — 6 citations

Citations issued on August 31, 2023
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (October 6, 2023)
K-0361Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.Deficient, Provider has date of correction (October 6, 2023)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (October 6, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (October 6, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (October 6, 2023)
K-0781Have restrictions on the use of portable space heaters.Deficient, Provider has date of correction (October 6, 2023)

December 5, 2019 — 5 citations

Citations issued on December 5, 2019
TagWhat the surveyor checksStatus
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.Deficient, Provider has date of correction (January 24, 2020)
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (January 23, 2020)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (January 24, 2020)
K-0361Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.Deficient, Provider has date of correction (January 24, 2020)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (January 23, 2020)

October 23, 2018 — 4 citations

Citations issued on October 23, 2018
TagWhat the surveyor checksStatus
K-0271Have exits that are accessible at all times.Deficient, Provider has date of correction (November 5, 2018)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (November 5, 2018)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (November 5, 2018)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (November 5, 2018)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.