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

EMBASSY OF LEBANON

LEBANON, OH · 79 certified beds · Last Life Safety survey October 12, 2022

CMS Certification Number 365920 · first certified September 1993

Ownership

Independently operated (no chain recorded by CMS) · For profit - Corporation

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

Citations on file

Rolling three-year window

Life Safety surveys

In the same window

Tags cited more than once

Across separate surveys

Inspection & testing records

Of the citations on file

Position within OH

25 citations — more than 77% 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 14 citations; the earlier surveys in the window averaged 5.5. 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 (June 2024 to June 2025), and past the point by which nine in ten OH facilities have been surveyed. This facility’s last Life Safety survey was October 2022. 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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5 inspection-and-testing tags have 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)

8 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 25 Life Safety citations above. The Physical Environment Index

F-0880 Provide and implement an infection prevention and control program.
F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

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.

Citations on file over three years, compared
Measure	Citations
This facility	25
Median facility in OH	16
Median facility nationally	11

Survey history

Citations at each Life Safety survey

Citations at each Life Safety survey
Survey date	Citations
August 9, 2018	4
October 31, 2019	7
October 12, 2022	14

Most-cited tags

Most-cited tags at this facility

Most-cited tags at this facility
Tag	What the surveyor checks	Times cited	Last cited
K-0712	Have simulated fire drills held at unexpected times.	3	2022-10-12
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	3	2022-10-12
K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals.	2	2022-10-12
K-0918	Have generator or other power source capable of supplying service within 10 seconds.	2	2022-10-12
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	2	2019-10-31
K-0353	Inspect, test, and maintain automatic sprinkler systems.	2	2022-10-12
K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.	1	2022-10-12
K-0291	Install emergency lighting that can last at least 1 1/2 hours.	1	2022-10-12

What the citations cover

Citations by CMS category

Gas, Vacuum, and Electrical Systems Deficiencies 7
Miscellaneous Deficiencies 7
Smoke Deficiencies 5
Services Deficiencies 3
Other 3

Citations by CMS category
Category	Citations
Gas, Vacuum, and Electrical Systems Deficiencies	7
Miscellaneous Deficiencies	7
Smoke Deficiencies	5
Services Deficiencies	3
Egress Deficiencies	3

Every citation on file

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

October 12, 2022 — 14 citations

Citations issued on October 12, 2022
Tag	What the surveyor checks	Status
K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.	Deficient, Provider has date of correction (January 3, 2023)
K-0223	Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.	Deficient, Provider has date of correction (January 3, 2023)
K-0291	Install emergency lighting that can last at least 1 1/2 hours.	Deficient, Provider has date of correction (January 3, 2023)
K-0324	Provide properly protected cooking facilities.	Deficient, Provider has date of correction (January 3, 2023)
K-0345	Have approved installation, maintenance and testing program for fire alarm systems.	Deficient, Provider has date of correction (January 3, 2023)
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (January 3, 2023)
K-0511	Have properly installed electrical wiring and gas equipment.	Deficient, Provider has date of correction (January 3, 2023)
K-0712	Have simulated fire drills held at unexpected times.	Deficient, Provider has date of correction (January 3, 2023)
K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.	Deficient, Provider has date of correction (January 3, 2023)
K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals.	Deficient, Provider has date of correction (January 3, 2023)
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	Deficient, Provider has date of correction (January 3, 2023)
K-0915	Have proper power supply for life support equipment.	Waiver has been granted (September 28, 2023)
K-0918	Have generator or other power source capable of supplying service within 10 seconds.	Deficient, Provider has date of correction (January 3, 2023)
K-0920	Ensure proper usage of power strips and extension cords.	Deficient, Provider has date of correction (January 3, 2023)

October 31, 2019 — 7 citations

Citations issued on October 31, 2019
Tag	What the surveyor checks	Status
K-0321	Ensure 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 (December 24, 2019)
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Deficient, Provider has date of correction (December 24, 2019)
K-0711	Provide a written emergency evacuation plan.	Deficient, Provider has date of correction (December 27, 2019)
K-0712	Have simulated fire drills held at unexpected times.	Deficient, Provider has date of correction (December 24, 2019)
K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals.	Deficient, Provider has date of correction (December 27, 2019)
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	Deficient, Provider has date of correction (December 24, 2019)
K-0918	Have generator or other power source capable of supplying service within 10 seconds.	Deficient, Provider has date of correction (December 24, 2019)

August 9, 2018 — 4 citations

Citations issued on August 9, 2018
Tag	What the surveyor checks	Status
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (September 7, 2018)
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Deficient, Provider has date of correction (September 7, 2018)
K-0712	Have simulated fire drills held at unexpected times.	Deficient, Provider has date of correction (September 7, 2018)
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	Deficient, Provider has date of correction (September 7, 2018)

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