01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-04-30 | 12 | 2026-04-30 | 7 |
| Cycle 2 | 2024-12-19 | 14 | 2024-12-19 | 8 |
| Cycle 3 | 2024-02-15 | 19 | 2024-02-15 | 9 |
CMS CCN 3656192026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Unger Park Post Acute
1170 W Mansfield Street · Bucyrus, OH 44820 · Crawford County
Certified beds86CMS provider file
Recent citation rows69current CMS citation release
Penalty rows0current 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
69 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 13 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-30 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2026-05-22 · complaint2026-04-30 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · 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 · 2026-05-222026-04-30 · HEALTHF0582Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · HEALTHF0584Severity D · isolated; 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 · 2026-05-22 · complaint2026-04-30 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · HEALTHF0791Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
Correction field: Deficient, Provider has date of correction · 2026-05-222026-04-30 · 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 · 2026-05-22 · complaint2026-04-30 · HEALTHF0880Severity E · pattern; 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 · 2026-05-222026-04-30 · HEALTHF0921Severity E · pattern; potential for more than 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 · 2026-05-22 · complaint2026-04-30 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-30 · FIREK0331Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Construct fire resistant interior walls.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-30 · 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 · 2026-06-022026-04-30 · FIREK0361Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-30 · 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 · 2026-06-022026-04-30 · FIREK0521Severity F · widespread; 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 · 2026-06-022026-04-30 · FIREK0711Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2026-06-022025-07-17 · HEALTHF0606Severity F · widespread; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Correction field: Deficient, Provider has date of correction · 2025-08-05 · complaint2024-12-19 · HEALTHF0553Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Correction field: Deficient, Provider has date of correction · 2025-02-032024-12-19 · 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 · 2025-02-032024-12-19 · HEALTHF0584Severity D · isolated; 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 · 2025-02-032024-12-19 · HEALTHF0606Severity B · pattern; potential for minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Correction field: Deficient, Provider has plan of correction · 2025-01-1303 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- APT, FREDERICKIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/01/2024
- JERGENSEN, JOSHUAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/01/2024
- MITCHELL, JOHNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/01/2024
- PROVIDENCE GROUP NH, LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2024
- KELLOGG, SHANNONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2024
- 1170 WEST MANFIELD STREET OH OWNER LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- SNF OH HOLDCO LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- WELL INTEGRA MASTER JV LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- WELL PM HOLDCO JV LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- WELLTOWER INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- WELLTOWER OP, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- KELLOGG, SHANNONIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
- STORMONT, MICHAELIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/01/2024
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 hours3.17per resident day
RN hours0.64per resident day
Weekend nurse hours2.86per resident day
Staff turnover29.4%CMS reported field
06 / LOCAL RECORDS
Open the Bucyrus ledger →