01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-29 | 12 | 2025-05-29 | 5 |
| Cycle 2 | 2022-11-23 | 4 | 2022-11-23 | 2 |
| Cycle 3 | 2020-01-02 | 6 | 2020-01-02 | 5 |
CMS CCN 3659022026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Meadowbrook Manor
3090 Five Points Hartford · Fowler, OH 44418 · Trumbull County
Certified beds54CMS provider file
Recent citation rows34current 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
34 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-28 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2026-05-19 · complaint · under IDR/IIDR2026-04-28 · 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 · 2026-05-19 · complaint · under IDR/IIDR2026-04-28 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2026-05-19 · complaint · under IDR/IIDR2026-04-28 · HEALTHF0727Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2026-05-19 · complaint2026-04-28 · HEALTHF0745Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Correction field: Deficient, Provider has date of correction · 2026-05-19 · complaint2026-04-28 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2026-05-19 · complaint2025-08-28 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-08-29 · complaint2025-08-28 · 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 · 2025-08-29 · complaint2025-07-08 · HEALTHF0627Severity J · isolated immediate jeopardy
Resident Rights Deficiencies
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Correction field: Deficient, Provider has date of correction · 2025-07-09 · complaint2025-05-29 · HEALTHF0558Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · HEALTHF0569Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · HEALTHF0604Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · HEALTHF0847Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · FIREK0222Severity E · pattern; 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 · 2025-07-092025-05-29 · 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 · 2025-07-092025-05-29 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · FIREK0500Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Meet other general requirements that are deficient.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-29 · FIREK0912Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have power receptacles that are properly grounded.
Correction field: Deficient, Provider has date of correction · 2025-07-092024-10-09 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2024-10-25 · complaint2024-10-09 · HEALTHF0921Severity C · widespread; potential for minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2024-10-25 · complaint2022-11-23 · HEALTHF0809Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Correction field: Deficient, Provider has date of correction · 2022-12-142022-11-23 · 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 · 2022-12-142022-11-23 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2022-12-142020-01-02 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2020-02-2103 / 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 |
|---|---|---|---|
| 2025-05-29 | Fine | $24,850 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- AMSEL, HINDYIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST10% · since 06/02/2015
- GOLDSTEIN, JEFFERYIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST10% · since 06/02/2015
- SHERMAN, ALEXANDERIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST13% · since 06/02/2015
- SHERMAN, TZVIIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST13% · since 06/02/2015
- SHERMAN, YEHUDAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST13% · since 06/02/2015
- TRATNER, BATSHEVAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST10% · since 06/02/2015
- ELMERICK, PAULAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 02/06/2017
- ULRICH, AMYIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/01/2015
- VALIQUETTE, RYANIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 12/27/2018
- GOLDSTEIN, JEFFERYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2015
- SHERMAN, ALEXANDERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/02/2015
- SHERMAN, SAMUELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2015
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 hours3.12per resident day
RN hours0.38per resident day
Weekend nurse hours2.77per resident day
Staff turnover68.6%CMS reported field
06 / LOCAL RECORDS
Open the Ohio ledger →Other published facilities nearby
No second facility in the same city met the directory rule.