Health inspection·October 20, 2025

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few saline, apply Skin-prep to the base of the wound, secure with bordered foam gauze, and change three times weekly and PRN. Preventative measures included: recommend head of bed limited to 30 degrees or less as tolerated unless contraindicated, float heels while in bed with use of heel boots, apply moisturizer to resident's skin routinely, do not massage over bony prominences, minimize friction and shear by using an approved material to assist with positioning up in bed, continue with turning and repositioning schedule per protocol for pressure prevention, recommend resident out of bed as tolerated for limited intervals of time, alternating activity to minimize pressure, use pillows for positioning to prevent pressure to bony prominences. New recommendations: The resident has a treatment change listed above. Please reference the recommended orders for updated treatments. The resident is currently under hospice services. Goals of care remain to minimize pain and risk of infection. Continue palliative wound management. The risk of complications and/or morbidity/mortality of the patient's management is moderate. Review of the hospice notes dated 07/12/25 authored by Hospice RN #1008 revealed wound care was performed to the unstageable pressure ulcer (full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed) to Resident #681's right lateral ankle. The wound measured 1.5 cm by 1.5 cm with 0-25% necrotic tissue slough and 76-100% eschar. The wound was cleansed with wound cleanser, covered with a dry dressing, instructed caregiver/facility staff in wound care. RN #1000 will be notified of new wound and wound care orders. RN #1000 instructed to call hospice for questions, concerns, or change in status. Review of the progress note dated 07/13/25 at 1:30 P.M. authored by Licensed Practical Nurse (LPN) #973 revealed the hospice nurses in this shift to check on Resident #681. No new orders at this time. Plans for the resident to discharge home tomorrow in the A.M. Resident #681 was alert when her name was called and/or with movement The resident remains on side-to-side turns, pad and protect treatments in place as ordered. Review of the Braden Scale for Predicting Pressure Ulcer Risk dated 07/14/25 at 4:10 A.M. completed by LPN #977 revealed Resident #681 was at very high risk for pressure ulcer development. Review of the physician's progress note dated 07/14/25 at 7:51 A.M. revealed a discharge summary stating Resident #681 to be discharged to home today, medication and orders reconciled. I have advised her to follow up with her primary care physician in one week. She is being discharged in stable condition, long-term prognosis is FAIR. Interview with LPN #972 on 10/07/25 at 11:50 A.M. revealed the discharge assessment of Resident #681 only noted was right lateral ankle and was addressed with continuing orders already in place. LPN # 972 was not given any new or additional orders for right ankle wound. No other wounds were noted on discharge skin assessment. Interview with Wound Care RN #1006 on 10/08/25 at 12:48 P.M. revealed she was not given any orders or additional care from Hospice. Interviews with LPN #1000 on 10/08/25 1:14 P.M. revealed she was not notified by Hospice of any worsening wounds or any changes in wound care orders. Interview with the guardian of Resident #681 on 10/08/25 at 3:17 P.M. revealed Resident #681 arrived at home with additional wounds to bilateral feet and pictures were obtained. Both wounds appeared reddened and excoriated. Guardian of Resident #681 indicated she was not aware of any additional wounds, right lateral ankle wound was addressed during respite stay. Interview on 10/14/25 at 3:56 P.M. with Manager of Clinical Operations from Grace Hospice #1008 revealed she followed Resident #681 prior to her admission at Austintown HCC, during her respite stay, and post respite stay. When the resident was admitted on [DATE], she had a pink area to her right outer ankle that had an order to pad and protect. She saw her on Saturday, 07/12/25, and that pink area had deteriorated to an unstageable pressure ulcer. She stated she told the nurse, and there is no evidence the nurse notified the physician. She came to see the resident again on Sunday, 07/13/25, and upon entering the room the resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 365732 If continuation sheet Page 2 of 3 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 365732 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Austintown Healthcare Center 650 S Meridian Road Youngstown, OH 44509 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)

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete was sitting up in bed and due to contractures was sitting directly on her feet. It appears staff fed her meal and did not reposition her. Hospice staff repositioned her and went and informed the nurse how she was found. She stated that she believed the facility did not follow the preventative measures to prevent the pressure ulcer from deteriorating from a Stage I pressure ulcer to an unstageable pressure ulcer during her respite stay. (The observation from 07/13/25 of the resident sitting on her feet was not in the hospice record). Interview on 10/16/25 at 10:15 A.M. with Wound Care RN #1006 revealed the Hospice note from 07/12/25 indicated she was notified of Resident #681's right ankle progression to an unstageable pressure ulcer with 76-100% eschar. Wound Care Nurse #1006 stated she was not notified at all of any changes in the wound. She indicated she was not given any new orders for the resident's right ankle wound, and the facility documentation indicated there were no changes in Resident #681's wound care. She documented the right lateral ankle wound as a SDTI on 07/07/25 at 10:38 A.M., and Wound NP #1007 documented the right ankle as Stage I pressure/wound ulcer on 07/08/25 10:38 A.M. Review of the medical record revealed no additional wound assessments completed during Resident #681's respite stay after 07/08/25 including the change in the right ankle wound deteriorating to unstageable on 07/12/25. There was no documented evidence that the physician was notified of the deterioration of the right ankle wound after RN #1000 was notified by Hospice RN #1008 on 07/12/25. Review of the undated facility policy titled Wound Care revealed residents admitted with or develop skin integrity issues will receive treatment as indicated based on location, stage and drainage. This deficiency is an incidental finding identified during the complaint investigation. Event ID: Facility ID: 365732 If continuation sheet Page 3 of 3