Health inspection·January 30, 2025

F 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. Review of the medical record for Resident#25 revealed an admission date of 07/21/22 with diagnoses including diabetes mellitus type two, hypertension, congestive heart failure, and liver disease. Review of the nursing progress notes and resident census revealed Resident # 25 was transferred to the local hospital on [DATE]. Review of the medical record revealed no evidence the state Ombudsman was notified of Resident #25's transfer to the hospital on [DATE]. Interview on 01/28/25 at 1:23 P.M. with the Administrator revealed the Ombudsman was not notified in writing of the transfer to the hospital on [DATE] for Resident #25. 3. Review of the medical record for Resident #76 revealed an admission date of 02/03/23 with diagnoses including basal cell carcinoma, peripheral vascular disease, respiratory failure with hypoxia, hepatitis A, kidney failure, and neoplasm of bladder and kidney. Review of the nursing progress notes and resident census revealed Resident #76 was transferred to the local hospital on [DATE], 07/22/24 and 07/28/24. Review of the medical record revealed no evidence the state Ombudsman was notified of Resident #76's transfers to the hospital on [DATE], 07/22/24 and 07/28/24. Interview on 01/28/25 at 1:23 P.M. with the Administrator revealed the Ombudsman was not notified in writing of the transfers to the hospital on [DATE], 07/22/24 and 07/28/24 for Resident #76. Based on medical record review and staff interview, the facility failed to ensure the state Ombudsman's office was notified of resident discharge or transfer from the facility as required. This affected three (Resident #25, #76 and #99 ) of four residents reviewed. The facility census was 102. Findings include: 1. Review of the medical record for Resident #99, revealed an admission date of 09/12/24 and readmission date of 10/17/24. Diagnoses included but were not limited to infectious gastroenteritis and colitis, difficulty walking, abnormal posture, cerebral infarction and fracture of unspecified part of neck of left femur. (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 3 Event ID: 365564 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 365564 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harbor Healthcare of Ironton 1050 Clinton Street Ironton, OH 45638 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)