01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-04-22 | 4 | 2026-04-22 | 5 |
| Cycle 2 | 2024-04-04 | 4 | 2024-04-04 | 5 |
| Cycle 3 | 2022-04-07 | 7 | 2022-04-07 | 5 |
CMS CCN 3660932026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Park Village Health Care Center Inc
1525 Crater Avenue · Dover, OH 44622 · Tuscarawas County
Certified beds90CMS provider file
Recent citation rows30current CMS citation release
Penalty rows2current 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
30 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-22 · 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 · 2026-06-092026-04-22 · 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 · 2026-06-092026-04-22 · HEALTHF0849Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Correction field: Deficient, Provider has date of correction · 2026-06-09 · complaint2026-04-22 · 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 · 2026-06-092026-04-22 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-06-092026-04-22 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2026-06-092026-04-22 · FIREK0521Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2026-06-092026-04-22 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-06-092026-04-22 · FIREK0920Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2026-06-092024-04-04 · HEALTHF0625Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has plan of correction · 2024-05-102024-04-04 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2024-05-102024-04-04 · HEALTHF0812Severity E · pattern; 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 · 2024-05-102024-04-04 · HEALTHF0881Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Correction field: Deficient, Provider has date of correction · 2024-05-102024-04-04 · FIREK0293Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2024-05-102024-04-04 · 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 · 2024-05-102024-04-04 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2024-05-102024-04-04 · FIREK0761Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-05-102024-04-04 · FIREK0923Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2024-05-102024-02-28 · HEALTHF0880Severity F · widespread; 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 · 2024-03-19 · complaint · infection control2023-12-27 · 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 · 2024-03-19 · complaint2023-12-27 · HEALTHF0684Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-03-19 · complaint2023-12-27 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-02-01 · complaint2023-12-27 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2024-03-19 · complaint2023-12-27 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-03-19 · complaint03 / 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 |
|---|---|---|---|
| 2023-12-27 | Fine | $77,552 | 0 |
| 2023-12-27 | Payment Denial | $0 | 55 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUSTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST26% · since 12/31/2016
- ODONNELL, ROBERTIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST49% · since 03/01/1993
- ODONNELL, THOMASIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST21% · since 01/01/1997
- ODONNELL, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/1993
- TUCKER, JEFFREYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2015
- ODONNELL, ROBERTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/1993
- ODONNELL, THOMASIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/1997
- TUCKER, JEFFREYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2015
- HOHMAN, MICHAELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/18/2018
- ODONNELL, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/17/1992
- ODONNELL, THOMASIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/1997
- SHUTT, MARCINAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/18/2000
- TUCKER, JEFFREYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2015
- ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUSTOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/16/2016
- HOHMAN, MICHAELIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/18/2018
- MCCLAIN, BRIANIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/31/2019
- SHUTT, MARCINAIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/18/2000
- TUCKER, JEFFREYIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2015
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 hours4.19per resident day
RN hours0.82per resident day
Weekend nurse hours3.71per resident day
Staff turnover33.7%CMS reported field