OTTERBEIN NORTH SHORE

9400 NORTH SHORE BLVD
LAKESIDE, OH, 43440
4197988203
CCN: 366358
4
Overall
4
Health
4
Staffing
3
Quality
ChainOTTERBEIN SENIORLIFE
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
OTTERBEIN LSC, LLC5% OR GREATER DIRECT OWNERSHIP INTEREST100%
OTTERBEIN HOME5% OR GREATER INDIRECT OWNERSHIP INTEREST100%
APP, LYNNCORPORATE DIRECTORNOT APPLICABLE
WILSON, JILLCORPORATE OFFICERNOT APPLICABLE
GREEN, JAMESCORPORATE OFFICERNOT APPLICABLE
MILLER, JASONCORPORATE OFFICERNOT APPLICABLE
BAYLIFF, BECKYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BROWNSON, WILLIAMOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BURKE, DANIELOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
COLEMAN, ROBERTOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FRALEY, RALPHOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
GLOSSER, HEIDIOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
GREEN, JAMESOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
HAWKINS, RITAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
HAZELBAKER, TOMASOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
LENTHE, JENNIFEROPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PIERCE, JOHNOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
VONDERHAAR, STEVEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
OTTERBEIN HOMEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FUNCTIONAL PATHWAYS OF TENNESSEE LLCOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
APP, LYNNOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BARTLETT, VICTORIAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (15)
2025-09-22 · Health
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2025-04-17 · Health
D
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
B
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F656 · 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.
B
F575 · Resident Rights Deficiencies
Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
2024-06-17 · Health
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
D
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
2023-03-23 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
C
F868 · Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
D
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
2020-02-12 · Health
D
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
5.42
3.68
RN Hrs/Resident/Day
1.95
0.54
LPN Hrs/Resident/Day
0.03
0.81
CNA Hrs/Resident/Day
3.44
2.33
PT Hrs/Resident/Day
0.15
0.12
Data as of 2026-03-01