Based on resident interview, record review, and staff interview, it was determined that the facility failed to notify the ombudsman of a resident's transfer to the hospital. This was evident for 1 (Resident #8) out of 1 resident reviewed for hospitalizations. The findings include: On 4/29/25 at 9:44 AM, an interview was conducted with Resident #8. When asked whether they were hospitalized recently, Resident #8 stated that they had just returned from the hospital a few days ago. On 4/29/25 at 1:02 PM, a review of Resident #8's progress notes was conducted. In the note from 4/18/25 at 2:44 pm, it was documented that the resident was transferred to the hospital for further evaluation of shortness of breath. …
F623 citations in Maryland
Notice before transfer or discharge · Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Maryland cites F623 more often than its own record predicts
1.05 times the share F623 takes of citations nationally.
Of every deficiency written in Maryland in 2025, this is the portion that was F623.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Maryland surveyors wrote
F623 findings written in Maryland, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on medical record review and staff interview it was determined the facility failed to notify the resident/resident representative in writing of a transfer/discharge of a resident along with the reason for the transfer. This was evident for 3 (#52, #65, #218) of 3 residents reviewed for hospitalization . The findings include: 1.) Resident #52's medical record was reviewed on 10/11/23 at 11:20 AM. Review of a RN nursing note (staff #5) on 7/28/23 at 11:31 AM revealed Resident #52 was evaluated by a nurse practitioner and a doctor and an order for transfer to the emergency room via 911. Review of a nurses note of 8/1/22 effective for 6:30 PM revealed that after a nurse practitioner's skin wound assessment, the nurse practitioner ordered to transfer resident back to the hospital. …
The short window
Recent years
| Year | Share of Maryland citations | vs expected |
|---|---|---|
| 2023 | 2.03% | 2.23× |
| 2024 | 2.39% | 2.34× |
| 2025 | 0.43% | 1.05× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Maryland surveyors cite →
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