01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-10-17 | 7 | 2024-10-17 | 4 |
| Cycle 2 | 2022-07-07 | 4 | 2022-07-07 | 1 |
| Cycle 3 | 2019-06-13 | 3 | 2019-06-13 | 1 |
CMS CCN 3662172026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Autumn Court
1925 E Fourth St · Ottawa, OH 45875 · Putnam County
Certified beds50CMS provider file
Recent citation rows20current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
20 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-25 · HEALTHF0805Severity J · isolated immediate jeopardy
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Correction field: Past Non-Compliance · complaint2024-10-17 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · HEALTHF0805Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · HEALTHF0949Severity C · widespread; potential for minimal harm
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Correction field: Deficient, Provider has plan of correction · 2024-10-232024-10-17 · FIREK0271Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-10-302024-10-17 · FIREK0741Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2024-10-302022-07-07 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2022-09-042022-07-07 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2022-09-042022-07-07 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2022-09-042022-07-07 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2022-09-042022-07-07 · FIREK0222Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2022-09-042019-06-13 · HEALTHF0565Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2019-07-012019-06-13 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2019-07-012019-06-13 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2019-07-012019-06-13 · FIREK0741Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2019-07-0103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2026-06-25 | Fine | $25,495 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LIONSTONE HZ OPCO HOLDINGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/01/2023
- KAZARNOVSKY, SOLOMONIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST50% · since 01/01/2023
- STEIN, ABBAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST50% · since 01/01/2023
- CUSNER, ADAMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/27/2025
- DEGYANSKY, JEFFREYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2020
- GOLDISH, ELIEZERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/09/2023
- KAZARNOVSKY, SOLOMONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2023
- STEIN, ABBAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2023
- CUSNER, ADAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/27/2025
- DEGYANSKY, JEFFREYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2023
- GOLDISH, ELIEZERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/09/2023
- KAZARNOVSKY, SOLOMONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2023
- STEIN, ABBAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2023
- CUSNER, ADAMIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/27/2025
- DEGYANSKY, JEFFREYIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2023
- GOLDISH, ELIEZERIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/09/2023
- KAZARNOVSKY, SOLOMONIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2023
- STEIN, ABBAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2023
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.14per resident day
RN hours0.32per resident day
Weekend nurse hours2.84per resident day
Staff turnover51.2%CMS reported field
06 / LOCAL RECORDS
Open the Ottawa ledger →