Inspection·August 28, 2025

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to ensure Minimum Data Set (MDS) assessments were accurately completed. This affected four residents (#9, #11,#27, and #86) out of the 26 residents whose MDS assessments were reviewed during the annual survey. The facility census was 85. Findings include:1. Record review for Resident #9 revealed the resident was admitted to the facility on [DATE] and had diagnoses which included major depressive disorder, schizophrenia, and morbid obesity. Residents Affected - Some Review of Section K of the quarterly Minimum Data Set (MDS) assessment, dated 08/05/25, revealed the resident was assessed to weight 208 pounds and to not have had a weight loss of over five percent in the past month or ten percent or more in the last six month. Review of the documented weights for the resident revealed the resident weighed 228.4 pounds on 07/01/25 and 207.6 pounds on 08/01/25 resulting in a loss of 20.8 pounds or 9.11 percent of the residents body weight. Interview with Registered Dietitian #233 on 08/27/25 at 1:45 P.M. confirmed Resident #9 had experienced a weight loss of 20.8 pounds from 07/01/25 to 08/01/25 which was equal to a 9.11 percent body weight loss in one month. Registered Dietitian #233 confirmed the quarterly MDS assessment for Resident #9 was dated 08/05/25 and the resident had experienced a weight loss of more than five percent in the 30 days prior to the assessment. 2. Record review for Resident #86 revealed the resident was admitted to the facility on [DATE] and had diagnoses which included heart disease, Chronic Obstructive Pulmonary Disorder (COPD), and chronic respiratory failure. Review of Section O of the quarterly MDS assessment, dated 08/08/25, revealed the resident was assessed to have not received oxygen while a resident of the facility during the 14-day lookback period. Review of the physicians order, dated 05/30/25, revealed the resident was to be administered oxygen at a rate of three liters per minute by nasal cannula continuously. Interview with MDS Licensed Practical Nurse (LPN) #63 on 08/26/25 at 2:03 P.M. confirmed Resident #86 was documented to have been administered oxygen as ordered during the 14-day lookback period for the MDS assessment dated [DATE]. MDS LPN #63 confirmed Section O of the MDS assessment had been completed inaccurately. 3.Review of the medical record for Resident #27 revealed an admission date of 04/23/25 with diagnoses including hemiplegia, hemiparesis, dementia, hyperlipidemia, depression and anxiety. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 5 Event ID: 365313 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365313 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/28/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bridgeport Health Care Center 2125 Royce Street Portsmouth, OH 45662 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)