What happened next — or rather, what didn't happen — is the subject of a complaint inspection completed by Illinois regulators in September 2025.
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The facility's own investigation concluded that metal on the bed caused the injury.
The administrator and director of nursing told inspectors they were unaware any of it had happened.
A federal assessment from August 2025 documented him as cognitively intact, with no delusions or hallucinations.
Staff did not know the resident had left until they were contacted by the police department.
The resident, identified in inspection records only as R1, was documented as severely cognitively impaired.
The facility's floor-scrubbing machine was broken.
That admission came on September 18, 2025, when state inspectors visited Hardin Home following a complaint.
A resident had a seizure, and her physician and family weren't notified until after the fact.
Hot foods are supposed to be held at 140 degrees Fahrenheit or above.
That's what a federal inspector found at Otterbein Springboro at 9:12 on the morning of September 22, 2025.
Her care plan noted impaired balance, limited mobility, pain, and shortness of breath.