Gallatin Manor
Inspection Findings
F-Tag F0628
F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
stated, she did talk to V5 on 11/07/25 and they did not discuss the discharge to the new facility. V3 stated,
she did not document any phone calls to V5 or document anything about the upcoming transfer in Resident R1's progress notes. V3 stated, she failed to do the documentation that she would typically do. On 11/25/25 at 3:30 PM, V4 (receiving facility Social Services Director) stated V5 told her she did not know Resident R1 was coming to (facility name) until she (V4) called her to discuss V5 coming to discuss signing the admission paperwork. Resident R1's medical record did not include evidence that a 30-day written notice of transfer was provided to V5 or V6. The facility policy dated 2025 documents: Notice before transfer: before the facility transfers or discharges a resident, the facility shall; notify the resident and the resident's representative of
the transfer or discharge and the reasons for the move in writing and in a language and manner they understand, send a copy of the notice to a representative of the office of the state long term care ombudsman. The facility shall maintain evidence that the notice was sent to the ombudsman, record the reasons for the transfer or discharge in the resident's medical record in accordance with this policy and procedure. The contents of the notice; the written notice shall include the following, the reason for transfer or discharge, the effective date of transfer or discharge, the specific location to which the resident is transferred or discharged , a statement of the resident's appeal rights, including the name of the entity which receives such requests and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request; the name, address and telephone number of the office of the state long-term care ombudsman. Timing of the notice: except as specified in section IV (C)(b) below and except in cases of facility closure, the notice of transfer or discharge required shall be made by the facility as least 30 days before the resident is to be transferred or discharged . Document, complete on a timely basis based on the resident's needs, and include in the clinical record, the evaluation of the resident's discharge needs and discharge plan. The results of the evaluation shall be discussed with
the resident or resident's representative. Discharge summary; when the facility anticipates discharging a resident, the resident shall have a discharge summary that includes, but is not limited to the following: a post discharge plan of care that is developed with the participation of the resident and , with the resident's consent, the resident representative, which will assist the resident to adjust to his or her new living environment. The post discharge plan of care shall indicate where the individual plans to reside, any arrangements that have been made for the resident's follow up and care and any post-discharge medical and non-medical services.
Event ID:
Facility ID:
If continuation sheet
GALLATIN MANOR in RIDGWAY, IL inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in RIDGWAY, IL, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from GALLATIN MANOR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.