Health inspection·May 24, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident interview, staff interview, review of the shower schedule, and review of resident shower sheet documents, the facility failed to provide bathing as desired and as schedule. This affected two (#63 and #92) of three residents reviewed for showers. The facility census was 80. Findings include: 1. Review of the medical record for Resident #63 revealed an admission date of 08/21/19 with diagnoses of hemiplegia and hemiparesis, history of falls, and insomnia. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #63 had intact cognition, required extensive assistance of one person for hygiene, and was totally dependent on one person for bathing. Review of the shower schedule revealed Resident #63 received showers on Wednesdays and Fridays. Review of shower sheet documentation for Resident #63 revealed none were completed after 05/10/23. Interview on 05/22/23 at 3:25 P.M. with Resident #63 stated did not receive a shower the previous Friday as scheduled and wished he had. Resident #63 confirmed he received a shower the previous Wednesday. Interview on 05/24/23 at approximately 10:00 A.M. with the Assistant Director of Nursing (ADON) confirmed there were no additional shower sheets completed for Resident #63. 2. Review of the medical record for Resident #92 revealed an admission date of 05/03/23 with diagnoses of chronic obstructive pulmonary disease and difficulty walking. Resident #92 discharged to another long-term care facility on 05/16/23. Review of the most recently completed MDS assessment, dated 05/10/23, revealed Resident #92 had intact cognition, required extensive assistance of two people for transfers, extensive assistance of one person for bed mobility, dressing, toileting, and hygiene, and supervision with setup for eating. There was no assessment of Resident #92 rejecting care during the review period. Review of the activity assessment dated [DATE] revealed Resident #92 preferred a bed bath in the morning. (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 4 Event ID: 365447 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 365447 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookview Healthcare Center 214 Harding Street Defiance, OH 43512 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)