Health inspection·September 20, 2023

F 0637 Assess the resident when there is a significant change in condition Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to complete a comprehensive assessment after a hospice admission. This applies to 1 of 24 (R33) residents reviewed for comprehensive assessments in the sample of 24. Residents Affected - Few The findings include: R33's facesheet dated 9/19/23 shows R33 has the following diagnoses: Sepsis, Methicillin Resistant Staphylococcus Aureus Infection, Anemia, Dementia, Hypertension, Chronic Respiratory Failure, Chronic Kidney Disease Stage 3, Gastro-Esophageal Reflux Disease, Cerebrovascular Disease, Enterocolitis due to Clostridium Difficile, Malignant Neoplasm of Lung, Protein-Calorie Malnutrition, Hypercholesterolemia, Anxiety Disorder, Depression, Atherosclerotic Heart Disease, Chronic Obstructive Pulmonary Disease, Fracture of the Elbow, and Fracture of the Femur. R33's Physician's Order Report dated 9/19/23 shows R33 has an active order for, admitted to [Hospice Company] 8/20/23 . R33's Social Service Progress Note Dated 8/21/23 at 3:30 PM states, Notified by [Hospice Company] that hospice care started on 8/20/23 diagnosis: cerebrovascular disease. Care plan initiated for hospice care. SS to remain available to assist as needed. R33's Minimum Data Set (MDS) List shows on 8/12/23 a quarterly MDS was completed and on 9/19/23 a Significant Change MDS was initiated. On 9/19/23 at 11:54 AM, V5 (Clinical Care Coordinator) said that an MDS assessment must be completed within 14 days after admission to hospice. On 9/19/23 at 2:02 PM, V5 said there was an error and the Significant Change MDS for R33's hospice admission had not been completed or transmitted. The facility's Completion of Minimum Data Set (MDS) policy dated 3/22 states, . Any additional assessment such as Significant Change in Status, Quarterly assessments, IPA/NPE, or other required assessment will be completed per RAI guideline not unless it is an insurance payer which will only be 'completed'. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 2 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to provide assistance to residents that needed extensive assist with activities of daily living (ADL's) to 5 of 24 residents (R70, R22,R23, R19, R65) reviewed for ADLs in the sample of 24. Residents Affected - Some The findings include: 1. On 9/18/23 at 11am, R70 was in bed. A strong smell of stool was noted. Smears of stool was noted on R70's sheets and linens. V15 (Certified Nursing Assistant- CNA) was in R70's room and removed R70's incontinent pad full of dried stool. Dried stool was also noted in R70's back and thighs. R70 said he had been needing to be changed. V15 (CNA) said she had not had a chance to provide incontinence care or morning care to R70. R70's facility assessment dated [DATE] show R70 need extensive assist for ADL's for toileting and hygiene and is always incontinent of bowel functions. 2. On 9/18/23 at 10:15 AM, R22 was sitting in bed. A strong smell of urine was noted coming from R22. R22 asked this surveyor Are you here to change me? R22 said she had been needing to be changed and that she had not been changed since last night. R22 said this is uncomfortable. This surveyor asked V7 (Wound Nurse) to check on R22. V7 removed R22's incontinent pad totally soaked with urine. At 10:30 AM, V15 (CNA) said she had been so busy and has not given any care to R22. On 9/20/23 at 9:15 am V2 (Director of Nursing-DON) said residents should be provided morning care and incontinence care in the mornings then 3-4 times a day and as needed. R22's facility assessment dated [DATE] show R22 needs extensive assist with toileting. 3. R23's Minimum Data Set assessment dated [DATE] shows she requires extensive assist with toileting and is freqeuntly incontinent. On 9/18/23 at 10:30 AM, R23 was lying in her bed. A strong permating smell of urine was present. At 10:41 AM, V10 (Certified Nursing Assistant-CNA) entered the room to provide care. V10 removed two incontient breifs from R23. Her incontient breif was saturated with urine and stool and redness to her peri-area. V10 said she had not changed R23 until now. 4. R19's Minimum Data Set assessment dated [DATE] shows she's cognitively intact, requires extensive assist with toileting and frequently incontinent. On 9/18/23 at 11:02 AM, R19's call light was on. She said she needed to be changed and told V10 (CNA) when V10 was in the room cleaning up her roommate. I've been waiting since 10:00 AM. R19 said she was last changed last night. V9 (Restorative Aide) entered the room to answer the call light. R19 told V9 she was soiled and needed to be changed. V9 said you'll have to wait, V10 is giving a shower to a resident. At 11:11 AM, V9 returned back to the room to provide incontinence care. R19 was wearing two incontinent breifs. Her incontinent breifs were heavily soiled with urine. On 9/19/23 at 1:59 PM, V11 (CNA) said residents should not be double briefed, we are not allowed to do that. Residents should be checked and changed every two hours for incontinence care. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 3 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some The facility's Incontinent and Perineal Care Policy revised 7/2023, states It is the policy to provide perineal care to ensure cleanliness and comfort to the resident, to prevent infection and skin irritation and to observe the resident's skin condition .1. Do rounds at least every two hours to check for incontinence during shift . 5. R65's Facility assessment dated [DATE] showed R65 is an eighty year old cognitively impaired residents with diagnoses which include: unspecified dementia with other behavioral disturbances. This assessment also showed R65 needs extensive assistance with getting dressed. On 9/18/23 at 12:55 PM, R65 was walking in the hallway with V19 (R65 family). R65 had on a gray sweatshirt with red lettering and dark blue pants. V19 stated they had visited over the weekend, and R65 had been in the same clothes since Friday (9/15/23). R65 hoped would be changed today. On 9/19/23 at 11:20 AM, V16 (CNA) stated she had worked with R65 over the weekend. V16 described R65's clothing as a gray sweatshirt with red letters and blue pants. V16 stated R65 was in the same clothes yesterday morning (9/18/23). V16 stated R65 is unable to get dressed himself. R65 does not know how to dress himself anymore. On 9/19/23 at 1:30 PM, V2 stated the facility did not have a policy in regards to assisting a resident with getting dressed. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 4 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to ensure the prescribed treatment order was in place for a resident with unstageable sacral pressure ulcer. This applies to 1 of 7 residents (R14) reviewed for pressure ulcers in the sample of 24. Residents Affected - Few The findings include: R14's Wound Physician Progress note dated 9/13/23 documents she has a unstageable sacral pressure ulcer measuring 4.1 cm (centimeters) x 2.3 cm x 0.2 cm with treatment orders, include to apply calcium alginate and cover with foam dressing daily. R14's Treatment Administration Record for September 2023 shows orders to cleanse the sacrum, apply medihoney and cover with foam dressing daily. The T.A.R. shows the order was not changed until 9/19/23 (6 days later) to cleanse sacrum, apply calcium alginate and cover with foam dressing. On 9/19/23 at 9:21 AM, R14 was observed lying in bed with foam dressing to her sacrum. On 9/19/23 at 1:50 PM, V7 (Wound Nurse) said she rounds with the wound physician weekly and she transcribes the treatment orders. She confirmed the treatment order was not changed until today. We should follow the prescribed treatments orders by the wound physician. R14's wound should have been receiving calcium alginate instead of the medihoney. The facility's Skin Treatment Regime policy reviewed 7/2023 states, It is the policy of this facility to ensure prompt identification, documentation and to obtain topical treatment for residents with skin breakdown .charge nurses must document in the nurse's notes/and or the Wound Report form any skin breakdown upon assessment and identification. Furthermore, topical skin treatment must be obtained form the the patient's physician. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 5 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure the safety of a resident by not having interventions in place while eating for a resident with a diagnosis of dysphagia which applies to 2 of 24 (R27, R24) residents reviewed for safety in a sample of 24. The findings include: 1. R27's Facility assessment dated [DATE] showed R27 to me an eighty three year old female with cognitive impairment, needing extensive assistance with eating, and having diagnoses which include: dysphagia, and unspecified dementia. R27's Orders Report printed on 9/1/23 showed R27's diet consistency order a mechanical soft. R27's Speech Therapy Discharge summary dated [DATE]-[DATE] showed R27's eating recommendations include a mechanical soft diet, monitoring for safety, and for R27 to be in an upright position during and for 30 minutes after meals. R27's Swallowing care plan initiated on 6/12/23 showed R27 Swallowing Problems interventions include: small bites/sips, upright 90 degrees for safe and efficient intake, instruct resident to eat slowly, and to monitor resident for shortness of breath, choking, pocketing food, prolonged swallowing time, and repeated swallows per bite or difficulty swallowing. 2. R24's Facility assessment dated [DATE] showed R24 is a cognitively impaired [AGE] year old female resident with admitting diagnoses which include: dysphagia following cerebral infarction and unspecified dementia. R24's Physician Orders printed on 9/19/23 showed R24's diet consistency orders as mechanical soft. R24's Careplan printed on 9/19/23 showed R24 has a focus of swallowing problems with an interventions including sitting in an upright position, and observe resident for swallowing complications. On 9/18/23 at 12:40 PM, V16 and V17 Certified Nursing Assistants (CNA) were delivering noon meal trays for R24 and R27. V16 and V17 placed the trays in the rooms, placed the residents trays on the bedside tables in front of the residents, uncovered the trays, and left the room. R24 and R27 were lying in bed at less than a 45 degree angle and started eating. R24 and R27 were not repositioned to a higher sitting position while eating. On 9/19/23 at 1:45 PM, V8 Speech Language Pathologist stated residents with dysphagia should be sitting as close to an upright position as possible to lower their risk of chocking. Residents with altered diets should be monitored during meals to ensure a residents does not have an increase of swallowing issues. During the survey the facility did not provide a policy in regards to assisting a resident with feeding. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 6 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0812 Level of Harm - Minimal harm or potential for actual harm Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview and record review the facility failed to handle and store bulk bin scoops in a sanitary manner. This failure has the potential to effect all residents in the facility. Residents Affected - Many The findings include: The CMS 672 dated 9/18/23 shows the facility has 114 residents residing in the facility. On 9/19/23 at 9:41 AM, V4 (Cook) prepared puree crab cakes, puree spinach, and mashed potatoes for lunch. On 9/19/23 at 9:54 AM, V4 opened the food thickener bulk bin, grabbed the scoop from inside the bin, scooped food thickener into the scoop, and the food thickener to the puree spinach. When finished, V4 placed the used scoop back inside the food thickener bulk bin. On 9/19/23 at 10:02 AM, V4 closed the food thickener bulk bin with the used scoop still inside without washing it after use. On 9/19/23 at 10:03 AM, V3 (Food Service Director) said the scoops that are stored inside the bulk bins are washed once a week. V3 said this practice was okay but the scoops should ideally be washed after each use. On 9/20/23 at 9:15 AM, V6 (Registered Dietitian) said per the facility's ware washing policy, the scoops should be washed and sanitized after each use before storage. The facility's Ware Washing Policy dated 10/19/23 states, It is the center policy that all dishware and service ware will be cleaned and sanitized after each use. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 7 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 3. On 9/18/23 at 10:35 AM, R76 who has a tube feeding and R109 who has indwelling foley catheter and pressure sore were both in room [ROOM NUMBER]. The room was not on any Enhance Barrier precaution. V15 (Certified Nursing Assistant) CNA provided care to both R76 and R109 without wearing any gown. V15 said R76 has a tube feeding and R109 has foley catheter but they are not on any precautions. Residents Affected - Many On 9/19/23 at 9:20 AM, a sign was now posted in room [ROOM NUMBER] for Enhance Barrier Precautions There was no isolation cart outside the room. V10 (CNA) was in room [ROOM NUMBER] with no gown on. V10 saw the Enhance Barrier sign but said I have no idea what that meant. and said no one told her to wear a gown when in room [ROOM NUMBER]. V14 (Clinical Director) who was by the room [ROOM NUMBER] said there should be on isolation carts outside the room and staff should be wearing a gown and gloves when providing care to R76 and R109 due to both residents were on enhance barrier precautions. On 9/20/23 at 9:40 AM, V2 (Director of Nursing) said room [ROOM NUMBER] is on Enhance Barrier precautions for R76 who has a tube feeding and R109 who has wounds and catheter for additional precautions to prevent cross contamination. Based on observation, interview, and record review the facility failed to ensure staff performed hand hygiene after direct care, failed to ensure enhanced barrier precautions were in place and failed to ensure staff wore PPE (Personal Protective Equipment) during direct care for residents on isolation to prevent cross contamination. This applies to 7 of 24 residents (R23, R1, R14, R76, R109, R270 & R267) reviewed for infection control in the sample of 24. The findings include: 1. On 9/18/23 at 10:30 AM, V10 (Certified Nursing Assistant) provided incontinence care to R23. R23's incontinent brief was soiled with urine and stool. V10 cleansed R23's peri-area and with the same contaminated gloves touched multiple surfaces including the bedding, R23's gown, and the bed control. She then removed her gloves and left the room without performing hand hygiene. On 9/19/23 at 1:59 PM, V11 (CNA) said staff should wash hands or hand sanitize after providing cares to prevent the spread of infections. The facility's Hand Hygiene Policy revised 7/23 states, Hand Hygiene is important in controlling infections. Hand Hygiene consists of either hand washing or the use of alcohol gel .Hand hygiene using alcohol-based hand rub is recommended during the following situations .before and after direct care .before moving from work on soiled body site to a clean body site on the same resident . 2. On 9/19/23 at 9:21 AM, R1 and R14's door had a sign posted with Enhanced Barrier Precautions. There was no isolation cart located outside of the room. Upon entering the room V2 (Director of Nursing) and V12 (CNA) were providing direct care to R1 without wearing gowns. R1 was observed in her bed with a gastric tube in place. In bed two, R14 was observed with a dressing to her sacrum. V8 (Activity Director) and V13 (CNA) were providing direct care to R14 without wearing gowns. On 9/20/23 at 10:10 AM, V2 said R1 and R14 are both on enhanced barrier precautions. R1 has a gastric tube and her roommate R14 has a wound. V2 confirmed she and V12 were not wearing gowns. We should have been wearing gowns when providing direct care for the protection of the resident. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 8 of 9 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 145307 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grove of Lagrange Park, The 701 North Lagrange Road LA Grange Park, IL 60526 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 0880 Level of Harm - Minimal harm or potential for actual harm R1's face sheet shows she is a [AGE] year old female with diagnosis including gastrostomy status, hemiplegia affecting left non-dominant side and history of traumatic brain injury. R14's face sheet shows she is [AGE] year old female with diagnosis including pressure ulcer of sacral region, chronic kidney disease, hypertension and type 2 diabetes. Residents Affected - Many The facility's Enhanced Barrier Precaution List provided on 9/19/23 shows R1 is on isolation for her gastric tube and R14 for her wound. 6. On September 18, 2023 at 10:50 AM, R267 was lying in bed watching television. She had a urinary drainage bag attached to the side of her bed. There was no sign on her door saying Enhanced Barrier Precautions. On September 18, 2023 at 11:05 AM, R270 was lying in bed. He had a feeding pump pole next to his bed. He also had a drainage bag attached to his bed. There was no sign on his door saying Enhanced Barrier Precautions. The facility's enhanced barrier precaution list (no date) shows, R267 is on enhanced barrier precautions for a wound (the list doesn't show she also has an indwelling urinary drainage tube). R270 is on enhanced barrier precautions for a wound (the list doesn't show he has a drainage bag and g-tube for his feeding). On September 19, 2023 at 1:50 PM, V20 Infection Control Nurse stated, they are using enhanced barrier precautions in addition to standard precautions for residents who have indwelling urinary drainage bags, wounds, central lines and any opening in the skin. We have to wear gowns, mask if there is splashing and gloves to protect residents from MDROs (multi-drug resistant organisms) because of openings in the body. Staff would know a resident is on enhanced barrier precautions by a sign on the door. The facility's Enhanced Barrier Precaution policy last revised July 26, 2023 shows, Policy: The facility will use Enhanced Barrier Precautions (EBP) to reduced transmission of infectious organisms. EBP are an infection control intervention designed to reduce transmission of resistant organisms that employs targeted gown and glove use during high contact resident care activities. Procedure: 1. EBP will be used for any resident in the facility with: an open wound/s, has indwelling medical devices (e.g. central line, urinary catheter, feeding tube, tracheotomy/ventilator) regardless of MDRO colonization status for the duration of their stay, is colonized with multi-drug resistant organisms (MDROs) and contact precautions do not apply . 3. The EBP requires the use of gown and gloves during high-contact resident care activities that provide opportunities for transfer of MDROs to staff hands and clothing. Use of eye protection may be necessary when splash or spray may occur but is not necessary in other situations. Examples of high-contact resident care activities requiring gown and glove use among residents that trigger EBP use include: a) dressing, b) bathing/showering, c) transferring, d) providing hygiene, e) Changing linens, f) Changing briefs or assisting with toileting, g) Device care of use: central line, urinary catheter, feeding tube, tracheotomy/ventilator, h) Wound care: any skin opening requiring a dressing . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145307 If continuation sheet Page 9 of 9