Inspection visit
Health inspection
5 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 5 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
Based on observation, interview, and record review, the facility failed to ensure that the urine collection bag
was covered and that complete privacy is provided during wound care for three of four residents (R25,
R217, R220) reviewed for resident's rights in a sample of 14.
Findings include:
1. R25's Profile Face Sheet indicated R25 was admitted in the facility on 02/26/2024 with diagnoses of not
limited to unspecified dementia and cardiomyopathy.
R25's Physician's Orders for 3/14/2024 indicated treatment order for right heel DTI (deep tissue injury).
On 03/13/2024 at 10:40AM during wound care observation, V11 (Wound Nurse) was observed proceeding
with R25's wound care treatment without closing the door and pulling the privacy curtain completely around
R25's patient care area. R25's room was observed as a 2-bed room.
On 03/13/2024 at 10:52AM, V11 stated even though the curtain was not completely pulled to cover R25's
patient care area, it was enough to provide privacy during R25's wound care treatment since R25 was not
visible from the hallway. V11 also stated since R25 was not visible from the hallway, closing the door is not
necessary to provide privacy.
On 03/14/2024 at 11:30AM, V2 (Director of Nursing), V2 stated, Before performing all procedures and
treatments, pulling the privacy curtain around the patient care area and closing the door has to be done to
provide privacy for the resident.
2. R217's Profile Face Sheet indicated R217 was admitted in the facility on 03/04/2024 with diagnoses of
not limited to crossing vessel and stricture of ureter without hydronephrosis.
R217's Physician's Orders for 3/14/2024 indicated foley orders with order date of 3/4/2024.
On 03/12/2024 at 10:22AM, R217 was observed lying in bed with urine collection bag placed on the side of
the bed facing the hallway, uncovered. R217's door was also observed wide open.
At 11:00AM, R217 was again observed lying in bed with urine collection bag placed on the side of the bed
facing the hallway, uncovered. R217's door was again observed wide open.
On 03/12/2024 at 11:00AM, V5, Registered Nurse, stated usually they do not provide a privacy bag if
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 8
Event ID:
145827
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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 0550
the resident is in the room; that is why R217's urine collection bag was not in the privacy bag.
Level of Harm - Minimal harm
or potential for actual harm
3. R220's Profile Face Sheet indicated R220 was admitted in the facility on 03/07/2024 with diagnoses of
not limited to benign prostatic hyperplasia without lower urinary tract symptoms and obstructive and reflux
uropathy.
Residents Affected - Few
R220's Physician's Orders for 3/14/2024 indicated indwelling catheter orders with order date of 3/7/2024.
On 03/12/2024 at 12:31PM, R220 was observed lying in bed with urine collection bag placed on the side of
the bed facing the hallway, uncovered. R220's door was also observed wide open.
At 12:40PM, R220 was again observed lying in bed with urine collection bag placed on the side of the bed
facing the hallway, uncovered. R220's door was again observed wide open.
On 03/12/2024 at 12:40PM, V5 stated usually they do not provide a privacy bag if the resident is in the
room; that is why R220's urine collection bag is not in the privacy bag.
On 03/14/2024 at 11:30AM, V2 (Director of Nursing), V2 stated, If the urine collection bag is visible from the
hallway, it should have a privacy bag for dignity.
Review of facility's policy entitled Quality of Life-Dignity reviewed on 2/20/2024 indicated the following:
Purpose: (Facility) supports that each resident shall be treated with respect and dignity to enhance the
quality of life. The following policy highlights procedures.
Policy Statement: Each resident shall be cared for in a manner that promotes and enhances quality of life,
dignity respect and individuality.
Procedures:
1. Residents shall be treated with dignity and respect at all times.
6. Residents' private space and property shall be respected at all times.
c. Staff will respect resident's privacy by closing their door/curtain when providing care.
10. Team Members shall promote, maintain and protect resident privacy, including bodily privacy during
assistance with personal care and during treatment procedures.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 2 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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 0640
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Level of Harm - Minimal harm
or potential for actual harm
Based on interview and record review, the facility failed to transmit admission and discharge assessments
within 14 days of completion for six of six residents (R6, R39, R40, R45, R52, R54) reviewed for resident
assessments in a sample of 14.
Residents Affected - Some
Findings include:
1. R39's Profile Face Sheet indicated R39 was admitted in the facility on 10/17/2023 and discharged on
11/4/2023.
On 03/14/2024 at 1:48PM, during review with V13 (MDS Coordinator), R39's admission date was noted at
10/17/2023, and admission assessment was scheduled on 10/23/2023, which was submitted on
11/21/2023. R39's discharge date and assessment were noted on 11/4/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R39's admission assessment should have been submitted by 11/5/2023, and R39's discharge
assessment should have been submitted by 11/17/2023.
On 03/15/2024 at 9:45AM, V13 stated R39's discharge assessment was not submitted until 03/14/2024,
when V13 tried to obtain a transmission documentation for R39.
2. R54's Profile Face Sheet indicated R54 was admitted in the facility on 10/25/2023 and discharged on
11/10/2023.
On 03/14/2024 at 1:48PM, R54's admission date was noted at 10/25/2023, and admission assessment was
scheduled on 10/30/2023, which was submitted on 11/21/2023. R54's discharge date and assessment
were noted on 11/10/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R54's admission assessment should have been submitted by 11/12/2023, and R54's discharge
assessment should have been submitted by 11/23/2023.
On 03/15/2024 at 9:45AM, V13 stated R54's discharge assessment was not submitted until 03/14/2024,
when V13 tried to obtain a transmission documentation for R54.
3. R52's Profile Face Sheet indicated R52 was admitted in the facility on 10/27/2023 and discharged on
11/10/2023.
On 03/14/2024 at 1:48PM, R52's admission date was noted at 10/27/2023, and admission assessment was
scheduled on 10/31/2023, which was submitted on 11/21/2023. R52's discharge date and assessment
were noted on 11/10/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R52's admission assessment should have been submitted by 11/14/2023, and R52's discharge
assessment should have been submitted by 11/24/2023.
On 03/15/2024 at 9:45AM, V13 stated R52's discharge assessment was not submitted until 03/14/2024,
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 3 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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 0640
when V13 tried to obtain a transmission documentation for R52.
Level of Harm - Minimal harm
or potential for actual harm
4. R45's Profile Face Sheet indicated R45 was admitted in the facility on 10/06/2023 and discharged on
11/3/2023.
Residents Affected - Some
On 03/14/2024 at 1:48PM, R45's admission date was noted at 10/06/2023, and admission assessment was
scheduled on 10/13/2023, which was submitted on 11/6/2023. R45's discharge date and assessment were
noted on 11/3/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R45's admission assessment should have been submitted by 10/26/2023, and R45's discharge
assessment should have been submitted by 11/16/2023.
On 03/15/2024 at 9:45AM, V13 stated R45's discharge assessment was not submitted until 03/14/2024,
when V13 tried to obtain a transmission documentation for R45.
5. R6's Profile Face Sheet indicated R6 was admitted in the facility on 10/16/2023 and discharged on
11/9/2023.
On 03/14/2024 at 1:48PM, R6's admission date was noted at 10/16/2023, and admission assessment was
scheduled on 10/23/2023, which was submitted on 11/21/2023. R6's discharge date and assessment were
noted on 11/9/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R6's admission assessment should have been submitted by 11/5/2023, and R6's discharge assessment
should have been submitted by 11/22/2023.
On 03/15/2024 at 9:45AM, V13 stated R6's discharge assessment was not submitted until 03/14/2024,
when V13 tried to obtain a transmission documentation for R6.
6. R40's Profile Face Sheet indicated R40 was admitted in the facility on 10/2/2023 and discharged on
10/19/2023.
On 03/14/2024 at 1:48PM, R40's admission date was noted at 10/2/2023, and admission assessment was
scheduled on 10/8/2023, which was submitted on 11/21/2023. R40's discharge date and assessment were
noted on 10/19/2023.
On 03/14/2024 at 1:48PM, V13 stated all assessments should be submitted within 14 days of completion,
so R40's admission assessment should have been submitted by 10/21/2023, and R40's discharge
assessment should have been submitted by 11/1/2023.
On 03/15/2024 at 9:45AM, V13 stated R40's discharge assessment was not submitted until 03/14/2024,
when V13 tried to obtain a transmission documentation for R40.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 4 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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 0695
Provide safe and appropriate respiratory care for a resident when needed.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, interview, and record review, the facility failed to implement infection control
practices for storage of respiratory care supplies for one of four residents (R59) reviewed for respiratory
care in a sample of 14.
Residents Affected - Few
Findings include:
R59's Profile Face Sheet indicated R59 was admitted in the facility on 02/15/2024, with diagnoses of not
limited to other pneumonia and malignant neoplasm of unspecified part of unspecified bronchus or lung.
R59's Physician's Orders for 3/14/2024 indicated nebulization treatment order, with the order date of
02/15/2024.
On 03/12/2024 at 10:50AM, R59's bare nebulization mask was observed placed on top of R59's nightstand.
At 12:40PM, R59's bare nebulization mask was again observed placed on top of R59's nightstand.
On 03/12/2024 at 10:59AM, V5, Registered Nurse, stated R59's nebulization mask should be placed in a
bag.
On 03/14/2024 at 11:30AM, V3 (Nurse Manager/Infection Preventionist), stated, If the nebulization mask is
not in use, it should be stored in a bag for protection.
Review of facility's policy entitled Infection Prevention and Control Program copyrighted 2023 indicated the
following:
Policy: This facility has established and maintains an infection prevention and control program designed to
provide a safe and sanitary, and comfortable environment and to help prevent the development and
transmission of communicable diseases and infections as per accepted national standards and guidelines.
Policy Explanation and Compliance Guidelines:
10. Equipment Protocol:
c. Reusable items potentially contaminated with infectious materials shall be placed in an impervious clear
plastic bag.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 5 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted
professional principles; and all drugs and biologicals must be stored in locked compartments, separately
locked, compartments for controlled drugs.
Based on observation, interview, and record review, the facility failed to label a multi-dose medication with
an open and a used by date. The facility also failed to lock the medication refrigerator in the medication
room for the first floor, for one of one medication rooms reviewed for medication storage.
Findings include:
On 3/13/24 at 9:30am, during medication observation with V2 (Director of Nursing), in the first-floor
medication storage room, the following were noted:
1. An opened medication fridge with the lock not secured.
2. An opened Tuberculin, Purified Protein Derivative, Diluted Aplisol 5TU/0.1ml vial with a dispense date of
3/6/24, with no open or discard date.
On 3/13/24 at 9:30am, V2 stated the vial should be labeled with an open and discard date, and the
medication fridge should be always be locked.
Facility policy titled, Administering Medications.
Medications are administered in a safe and timely manner, and as prescribed.
Policy Interpretation and Implementation .
12. The expiration/beyond use date on the medication liable is checked prior to administering. When
opening a multi-does container, the date opened is recorded on the container; or the medication delivery
date is used.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 6 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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
Based on observation, interview, and record review, the facility failed to maintain infection control practices
during wound care for one of one resident (R25) reviewed for wound care in a sample of 14.
Residents Affected - Few
Findings include:
R25's Profile Face Sheet indicated R25 was admitted in the facility on 02/26/2024, with diagnoses of not
limited to unspecified dementia and cardiomyopathy.
R25's Physician's Orders for 3/14/2024 indicated treatment order for right heel DTI (deep tissue injury).
On 03/13/2024 at 10:40AM , V11 (Wound Nurse) was observed putting all the wound dressing supplies on
the bedside table without disinfecting it and/or putting a liner on top of it, after V8 (Certified Nursing
Assistant) removed three empty cups on top of the bedside table. V11 was also observed not performing
hand hygiene in between changing gloves for the duration of the wound care treatment. V11 was also
observed not changing gloves and performing hand hygiene after removing the soiled dressing and before
cleaning the wound site.
On 03/13/2024 at 10:52AM, V11 stated she usually has a towel with her that she uses as barrier from the
surface and dressing supplies to keep it clean, but V11 did not have it at this moment because she was not
prepared. V11 also stated she should have performed hand hygiene in between glove changes but she did
not.
On 03/14/2024 at 11:30AM, V2 (Director of Nursing), V2 stated V11 should have put a barrier or liner on top
of the bedside table before she placed the dressing supplies on top of the bedside table. V2 also stated V11
should have removed her gloves after removing the soiled dressing, performed hand hygiene, put on
another set of gloves, and proceeded with cleaning the wound site. V2 also said V11 should have
performed hand hygiene in between glove changes.
Review of facility's policy entitled Wound Care revised October 2010 indicated the following:
Purpose: The purpose of this procedure is to provide guidelines for the care of wounds to promote healing.
Steps in the procedure:
1. Place all items to be used during the procedure on the clean field. Arrand the supplies so they can be
easily reached.
Review of facility's policy entitled Hand Hygiene copyrighted 2023 indicated the following:
Policy: All staff will perform proper hand hygiene procedures to prevent the spread of infection to other
personnel, residents, and visitors. This applies to all staff working in all locations within the facility.
Policy Explanation and Compliance Guidelines:
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 7 of 8
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
145827
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
03/15/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
British Home, The
8700 West 31st Street
Brookfield, IL 60513
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
6. Additional considerations:
Level of Harm - Minimal harm
or potential for actual harm
a. The use of gloves does not replace hand hygiene. If your task requires gloves, perform hand hygiene
prior to donning gloves, immediately after removing gloves.
Residents Affected - Few
Hand Hygiene Table indicated to use either soap and water or alcohol based hand rub (ABHR is preferred)
on conditions including after handling contaminated objects, and before and after handling clean or soiled
dressings, linens, etc.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145827
If continuation sheet
Page 8 of 8
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Back to topCitations
5 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F640 - Automated data processing requirement-
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
F695 - Respiratory care, including tracheostomy care and tracheal suctioning
Provide safe and appropriate respiratory care for a resident when needed.
F761 - Labeling of Drugs and Biologicals
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
F880 - Infection Control
Provide and implement an infection prevention and control program.
F550 - Resident Rights
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
FAQ · About this visit
Common questions about this visit
What happened during the March 15, 2024 survey of BRITISH HOME, THE?
This was a inspection survey of BRITISH HOME, THE on March 15, 2024. The surveyor cited 5 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at BRITISH HOME, THE on March 15, 2024?
Yes, 5 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.