Symphony at Olmsted Falls — Ohio Facility Report

Inspections on file

Deficiencies cited

Visits with none

Substandard care

Immediate jeopardy

The most recent inspection on file for Symphony at Olmsted Falls took place on November 5, 2025. Across the 9 inspections published by the Ohio Department of Health, surveyors cited 9 deficiencies.

A deficiency is a rule the surveyor found the facility was not meeting. Ohio inspects against two rule books at once, so most findings carry a federal code and an Ohio code for the same problem; each is counted once here, the way the state counts it. Correction dates are the state's confirmation that the issue was fixed.

This report reproduces what Ohio publishes and nothing else. Of the 9 inspections listed, the state publishes the surveyor's written findings for 4; for the other 5 it publishes only the date, the type of visit and the number of deficiencies - 5 of which found none.

Facility Details

Ohio license number

#2320R

County

Cuyahoga

Administrator

Christine Grude

Director of nursing

Amanda Moran

Phone

(440) 235-2750

Ownership

For Profit - Limited Liability Company

Inspections

9 on file · 9 deficiencies

November 5, 2025Licensure survey3 deficiencies▼

R-0339Administered meds - given only to and as prescribedOhio citation▼

What the surveyor found

Based on observation, staff interview, and review of the facility policy, the facility failed to ensure medication was given per physician order. This affected one (#12) of two residents reviewed for medication administration. The facility census was 45. Findings include: Review of the medical record for Resident #12 revealed an admission on 05/31/25. Diagnoses included seizure disorder, aortic valve stenosis, and episodic confusion. Review of the Functional Needs Service Plan dated 10/29/25 Resident #12 needed assistance with medication administration. Staff was to administer medications per doctors' orders. Review of the physician orders for Resident #12 revealed an order on 06/05/25 for Azelastine 0.1% spray. Use two sprays in each nostril two times a day. Observation on 11/05/25 at 8:17 A.M. of Medication Technician (MT) #200 administering Resident #12's Azelastine nasal spray revealed only one spray was administered into each nostril. Interview on 11/05/25 at 10:30 A.M. with MT #200 confirmed Resident #12 was to receive two sprays of Azelastine into each nostril and only one was administered. Review of the policy titled Medication AdministrationBased on observation, staff interview, and review of the facility policy, the facility failed to ensure medication was given per physician order. This affected one (#12) of two residents reviewed for medication administration. The facility census was 45.

Findings include:

Review of the medical record for Resident #12 revealed an admission on 05/31/25. Diagnoses included seizure disorder, aortic valve stenosis, and episodic confusion. Review of the Functional Needs Service Plan dated 10/29/25 Resident #12 needed assistance with medication administration. Staff was to administer medications per doctors' orders.

Review of the physician orders for Resident #12 revealed an order on 06/05/25 for Azelastine 0.1% spray. Use two sprays in each nostril two times a day.

Observation on 11/05/25 at 8:17 A.M. of Medication Technician (MT) #200 administering Resident #12's Azelastine nasal spray revealed only one spray was administered into each nostril.

Interview on 11/05/25 at 10:30 A.M. with MT #200 confirmed Resident #12 was to receive two sprays of Azelastine into each nostril and only one was administered.

Review of the policy titled Medication Administration

Rule

Ohio Administrative Code - residential care rules

R-0559Procure, store, prepare, distribute and serve foodsOhio citation▼

What the surveyor found

Based on record review, observation, and staff interview, the facility failed to ensure holding food temperatures for special diets were in safe temperature range. This had the potential to affect five (#18,24,28,35,44) residents who receive special diets. The facility census was 45.

Findings include:

Review of the medical record for Resident #18 revealed an admission on 04/30/24. Diagnoses included Parkinson's disease, dysphagia, and chronic kidney disease. Review of the physician orders revealed an order for a mechanical soft diet. Review of the Functional Needs Service Plan dated 12/11/24 revealed Resident #18 was on a mechanical soft diet. Interventions included providing a mechanical soft diet for all meals and snacks.

Review of the medical record for Resident #24 revealed an admission on 11/15/24. Diagnoses included moderate protein calorie malnutrition, hypertension, and asthma. Review of the physician order dated 06/05/25 revealed Resident #24 had an order for a mechanical soft diet. Review of the Functional Needs Service Plan dated 09/02/25 revealed Resident #24 was on a mechanical soft diet. Interventions included receiving a mechanical soft diet for all meals and snacks.

Review of the medical record for Resident #44 revealed an admission on 05/18/23. Diagnoses included constipation and dementia. Review of the physician order for Resident #44 revealed an order for a puree diet on 04/04/24. Review of the Functional Needs Service Assessment dated 09/10/25 revealed Resident #44 received a puree diet. Interventions included receiving a puree diet for all meals.

Review of the medical record for Resident #28 revealed an admission on 06/13/25. Diagnoses included chronic obstructive pulmonary disease (COPD) and dementia. Review of the physician orders revealed an order for a puree diet. Review of the Resident Functional Needs Service Plan dated 11/05/25 revealed Resident #28 was on a puree diet. Interventions included receiving a puree diet at all meals.

Review of the medical record for Resident #35 revealed an admission on 08/14/23. Diagnoses included G

gastroesophageal reflux disorder, hyperlipidemia, and hypertension. Review of the physician order for Resident #35 revealed an order on 08/08/25 for a chopped diet. Review of the Functional Needs Service Plan dated 08/08/25 revealed Resident #35 received a chopped diet. Interventions included serving a chopped diet at all meals.

Observation on 11/05/25 at 11:30 A.M. of the second floor kitchenette revealed hot foot was brought up in metal containers and placed on the unused stove. There were no warmers for the food. Also noted was pea salad in separate four ounce containers on a tray.

Observation on 11/05/25 at 11:30 A.M. of Dietary Aide (DA) #300 taking temperature of the pea salad revealed a temperature of 43 degrees Fahrenheit (F), mechanical soft meatloaf at 115 degrees F, and puree meatloaf at 112 degrees F.

Interview with DA #300 on 11/05/25 at 11:35 A.M. revealed there are no steam tables to ensure the food remains warm. DA #300 stated soup is served first then the main meals. DA #300 further stated the residents who receive puree food are both fed by staff and have to wait until staff were in the dining room to eat. DA #300 stated after the second floor is done, the mechanical soft food and the puree food were taken down to the first floor to be served, without placing the food on a warmer. DA #300 confirmed the mechanical soft and puree meat were supposed to be above 140 degrees F, and the pea salad was to be below 41 degrees F.

Rule

Ohio Administrative Code - residential care rules

R-0615Fire drill requirementsOhio citation▼

What the surveyor found

Based on record review, staff interview and review of the facility policy, the facility failed to document the fire monitoring company received the fire alarm pull. The facility also failed to evacuate residents during fire drills. This had the potential to affect all residents. The facility census was 45. Findings include: 1. Review of the fire drills on 11/20/24, 12/20/24, 01/30/25, 02/27/25, 03/27/25, 04/28/25, 05/29/25, 06/27/25, 07/21/25, 08/28/25, 09/26/25, and 10/30/25 revealed no documentation of when the fire monitoring station received the fire alarm. Interview with Maintenance Director #100 on 10/05/25 at 10:30 A.M. confirmed there was no documentation of when the fire monitoring station received the fire alarm signal during the fire drills on 11/20/24, 12/20/24, 01/30/25, 02/27/25, 03/27/25, 04/28/25, 05/29/25, 06/27/25, 07/21/25, 08/28/25, 09/26/25, and 10/30/25. Review of the facility policy titled Fire Drill ProcedureBased on record review, staff interview and review of the facility policy, the facility failed to document the fire monitoring company received the fire alarm pull. The facility also failed to evacuate residents during fire drills. This had the potential to affect all residents. The facility census was 45.

Findings include:

1. Review of the fire drills on 11/20/24, 12/20/24, 01/30/25, 02/27/25, 03/27/25, 04/28/25, 05/29/25, 06/27/25, 07/21/25, 08/28/25, 09/26/25, and 10/30/25 revealed no documentation of when the fire monitoring station received the fire alarm.

Interview with Maintenance Director #100 on 10/05/25 at 10:30 A.M. confirmed there was no documentation of when the fire monitoring station received the fire alarm signal during the fire drills on 11/20/24, 12/20/24, 01/30/25, 02/27/25, 03/27/25, 04/28/25, 05/29/25, 06/27/25, 07/21/25, 08/28/25, 09/26/25, and 10/30/25.

Review of the facility policy titled Fire Drill Procedure

Rule

Ohio Administrative Code - residential care rules

July 16, 2025Complaint survey · listed in Ohio's index; no findings report publishedNo deficiencies▼

✅

No deficiencies cited

Ohio lists this visit in its inspection index with no deficiencies. The state publishes a findings report only when a visit cites something, so there is no further detail to show.

December 12, 2024Complaint survey · listed in Ohio's index; no findings report publishedNo deficiencies▼

✅

No deficiencies cited

Ohio lists this visit in its inspection index with no deficiencies. The state publishes a findings report only when a visit cites something, so there is no further detail to show.

June 24, 2024Licensure survey1 deficiency▼

R-0624Train all residents in fire drillsOhio citation · correction confirmed 11/05/2025▼

What the surveyor found

Based on record review and interview the facility failed to ensure monthly fire safety inspection were conducted. This affected 35 resident residing at the facility.

Findings include:

Review of the monthly safety fire inspection log for 2024 revealed no evidence of fire inspections from January 2024 through June 2024.

Interview with the Executive Director on 06/20/24 at 9:08 A.M. verified monthly self fire safety were not conducted in 2024.

Rule

Ohio Administrative Code - residential care rules

January 4, 2024Complaint survey · listed in Ohio's index; no findings report publishedNo deficiencies▼

✅

No deficiencies cited

Ohio lists this visit in its inspection index with no deficiencies. The state publishes a findings report only when a visit cites something, so there is no further detail to show.

November 6, 2023Complaint survey1 deficiency▼

R-0711Free from abuseOhio citation · correction confirmed 06/24/2024▼

What the surveyor found

Based upon record review, and interview the facility failed to ensure the residents were free from exploitation and treated with dignity and respect. This affected five Residents (#10, #13, #15, #36 and #38) with the potential to affect all 37 residents residing in the facility.

Findings include:

Review of the medical record revealed Resident #10 was admitted on 11/28/22 with diagnosis of mild cognitive impairment, osteoarthritis, and atrial fibrillation. Review of the mini mental state examination dated 11/28/22 revealed Resident #10 had moderate cognitive impairment.

Review of the medical record revealed Resident # 13 was admitted on 04/22/22 with diagnosis of dementia, hypertension, and hyperlipidemia. Review of the mini mental state examination dated 04/22/22 revealed Resident #13 had moderate cognitive impairment.

Review of the medical record revealed Resident #15 was admitted on 05/27/22 with diagnosis of unspecified dementia with behavioral disturbances, anxiety, depressive disorder, and delirium. Review of the mini mental state examination dated 05/28/22 revealed Resident #15 had moderate cognitive impairment.

Review of the medical record revealed Resident #36 was admitted on 05/31/23 with diagnosis of unspecified dementia without behavioral disturbance, and essential hypertension. Review of the mini mental state examination dated 06/01/22 revealed Resident #36 had mild cognitive impairment.

Review of the closed medical record revealed Resident #38 was admitted on 01/04/22 with diagnosis of dementia with behavioral disturbance, congestive heart failure and delirium due to known physiological condition. Review of the mini mental state examination dated 01/05/22 revealed Resident # 38 had questionable significant degree of impairment.

Review of the self-reported incident and facility investigation dated 10/19/23 revealed the Executive Director (ED) received the following pictures: a side picture of Resident #10 sitting on a bed without any pants or underwear on, two pictures of Resident #13 one with her standing in the bathroom with her pants and bra on and the other picture of her sitting on the toilet with her pants pulled down and her brief partially pulled down, a picture of Resident #15 sitting on the toilet with her brief and pants pulled down, a partial side picture of Resident #36 laying in a bed with an exposed hip and thigh area, and a picture of Resident #38 laying on the floor with her buttocks exposed. The pictures were sent from an anonymous person stating Caregiver #601 had sent him the pictures.

Further review of facility investigation dated 10/19/23 revealed Caregiver #601 wrote a statement admitting to taking the pictures and stated someone had taken her phone and sent the pictures to themselves.

Interview with the ED on 11/03/23 at 3:27 P.M. verified she was sent inappropriate pictures of Residents(#10, #13, #15, #36 and #38) on 10/19/23 at 1:00 P.M. The ED verified Caregiver #601 admitted to taking the inappropriate pictures.

The facility began the investigation on 10/19/23 and suspended Caregiver #601 pending the investigation of the inappropriate pictures. On 10/20/23 the ED reported the pictures to law enforcement, and in serviced staff. Caregiver #601 was terminated on 10/23/23 after she submitted her statement to the ED and admitted in writing she had taken the pictures of Resident #10, #13, #15, #36 and #38.

This violation represents non-compliance investigated under Complaint Number OH00147694

Rule

Ohio Administrative Code - residential care rules

May 11, 2023Complaint survey · listed in Ohio's index; no findings report publishedNo deficiencies▼

✅

No deficiencies cited

Ohio lists this visit in its inspection index with no deficiencies. The state publishes a findings report only when a visit cites something, so there is no further detail to show.

April 24, 2023Complaint survey · listed in Ohio's index; no findings report publishedNo deficiencies▼

✅

No deficiencies cited

Ohio lists this visit in its inspection index with no deficiencies. The state publishes a findings report only when a visit cites something, so there is no further detail to show.

January 25, 2023Licensure survey4 deficiencies▼

R-0140Background check requiredOhio citation · correction confirmed 06/24/2024▼

What the surveyor found

Based on staff interview and review of personnel files the facility failed to screen all employees prior to their first day of work against the State of Ohio Nurse Aide Registry to identify if an employee had a finding concerning abuse, neglect, exploitation, mistreatment of residents, or misappropriation of resident property as required. This affected three employees (Executive Director, Activities Director (AD) #900, and Resident Care Aide (RCA) #901) of six personal files reviewed. This had the potential to affect all residents. The facility census was 45.

Findings include:

Review of the personnel files for the Executive Director, AD #900, and RCA #901, revealed no evidence they were screened using the State of Ohio Nurse Aide Registry. The identification of findings would be necessary to determine if any employee had actions identified that would validate allegations of abuse, neglect, exploitation, mistreatment of residents, or misappropriation of their property.

Business Office Manager (BOM) #902 verified there was no evidence the Executive Director, AD #900 and RCA #901 were screened using the State of Ohio Nurse Aide Registry as required.

Rule

Ohio Administrative Code - residential care rules

R-0345Labeling of medicationsOhio citation · correction confirmed 06/24/2024▼

What the surveyor found

Based on observation, review of the Manufacturer Guidelines for Tuberculin, and interview the facility failed to properly label and discard expired tuberculin solution. This had the potential of affecting all 45 residents residing in the facility.

Findings Include:

During observation of medication administration on 01/25/23 at 11:00 A.M. an opened vial of tuberculin solution (Tubersol) was observed with an open date of 09/15/22.

Review, on 01/25/23 at 11:00 A.M., of the Manufacturer Guidelines for Tuberculin - Tubersol Solution dated 01/25/23, revealed an opened bottle of solution is to be used within 30 days after being opened. The bottle is to be discarded after 30 days of being opened.

Interview with Licensed Practical Nurse (LPN) #200 on 01/25/23 at 11:00 A.M. confirmed the tuberculin solution (Tubersol) open date was 09/15/22, the solution as being expired per manufacturer guidelines, and the solution was still located in the medication refrigerator.

Rule

Ohio Administrative Code - residential care rules

R-0392Establish/implement written infection control P/P; infection prevention and control program and designee requirementsOhio citation · correction confirmed 06/24/2024▼

What the surveyor found

Based on observation, interview, and policy review the facility failed to properly establish and implement infection control policies and procedures related to handwashing and disposal of soiled materials. This affected two residents (Resident #13 and Resident #40) out of 45 residents residing in the facility.

Findings include:

Observation on 01/25/23 at 10:46 A.M. during Resident #13's perineal care, Resident Care Assistant (RCA) #115 did not wash hands upon removal of gloves at the completion of the perineal care.

Interview with RCA #115 on 01/25/23 at 10:50 A.M. confirmed RCA #115 did not wash hands following removal of gloves at the completion of perineal care for Resident #13.

Observation on 01/25/23 at 12:56 P.M. during Resident #40's perineal care performed by RCA #101 and RCA #110. RCA #110 removed the soiled brief and placed it on the floor with no barrier underneath. RCA #110 also placed three soiled wipes on top of the brief on the floor. Following perineal care RCA #101 removed gloves, did not wash hands. RCA #110 did not remove gloves and left the room wearing gloves with the bag of soiled materials in hand.

Interview with RCA #101 on 01/25/23 at 1:00 P.M. confirmed RCA #110 placed a soiled brief and three soiled wipes on the floor, RCA #101 did not wash hands following removal of gloves at completion of perineal care for Resident #40, and RCA #110 did not remove gloves prior to leaving room with the bag of soiled materials.

Review of the policy titled Hand Hygiene

Rule

Ohio Administrative Code - residential care rules

R-0711Free from abuseOhio citation · correction confirmed 06/24/2024▼

What the surveyor found

Based on record review, review of facility self-reported incidents (SRIs) and staff interview the facility failed to ensure Resident #15 was free from verbal abuse. This affected one resident (#15) of three residents reviewed for abuse, neglect, and misappropriation. The facility census was 45.

Findings include:

Review of the medical record revealed Resident #15 was admitted to the facility on 09/22/15 with diagnoses including dementia with behavioral disturbance, depression, aphasia, and muscle weakness.

Review of SRI tracking number (#) 229819 revealed on 11/21/22 Resident Care Aide #300 (RCA) was heard yelling from Resident #15's room. RCA #301 was providing personal care to Resident #15. RCA # 301 was yelling about how Resident #15 was grabbing at her arms with her nails and drawing blood. RCA #301 continued to call Resident #15 mean using inappropriate language and the wrong tone of voice. RCA #300 reported the incident to her colleagues who subsequently reported the incident to administration on 12/05/22. The facility investigation began on 12/05/22, and statements were gathered from RCA #300 and RCA #301. RCA #301 was suspended pending investigation. The facilities Director of Nursing completed a skin assessment on Resident #15 on 12/06/22 with no significant findings. Resident #15 did not recall the incident. On 12/06/22. RCA #301 was terminated after admitting to losing her cool with Resident #15.

Interview with the Executive Director on 01/24/23 at 11:25 A.M. verified the events of the SRI.

This violation is a recite to the complaint survey completed on 07/19/21.

Rule

Ohio Administrative Code - residential care rules