Health inspection·November 12, 2024

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, review of a self-reported incident (SRI), record review and review of the facility policies, the facility failed to ensure residents were free from unauthorized video recordings by staff. This affected one resident (#4) of three residents reviewed for abuse. The facility census was 88. Residents Affected - Few Findings include: Review of Resident #4's medical record revealed an admission date of 11/21/16 and diagnoses including Alzheimer's disease, type II diabetes, dementia with other behavioral disturbance, depression, anxiety, and adult failure to thrive. Review of Resident #4's quarterly minimum data set (MDS) 3.0 assessment dated [DATE] revealed Resident #4 had short and long term memory problems and severe cognitive impairment with continuous inattention and disorganized thinking. Resident #4 rejected care one to three days in the seven-day look-back period. Resident #4 required substantial to maximum assistance with toileting, set up to dress her upper body, supervision to dress her lower body and supervision for sitting to standing and to complete toileting transfers. Resident #4 was frequently incontinent of bowel and bladder. Review of a facility self-reported incident dated 10/23/24 revealed on the morning of 10/23/24, Housekeeper #344 reported to the Director of Nursing (DON) that a friend of hers (Community Person #350) called her to let her know he saw a live feed on a web-based application called Tagged where a facility staff member was at work in the resident ' s room with the resident in the background of the video. He reported he was not able to record the video but did take several screenshots (still photos) during the live feed. The DON reported this to the Administrator and an investigation was immediately started. Certified Nursing Assistant (CNA) #349 and Resident #4 were identified in the video. CNA #349 was suspended immediately pending outcome of the investigation. Interviews were completed with staff; CNA #349 denied the allegation and reported Licensed Practical Nurse (LPN) #244 was in the room while she got Resident #4 dressed as she tended to be combative. LPN #244 denied the allegation and denied seeing CNA #349's phone or a camera while in the room. Interview with Community Person (CP) #350 confirmed he saw the live video and reported the recording device was across the room from where Resident #4 was being provided care. He stated it appeared as though the employee was changing the residents' brief but at no time was Resident #4 observed to be naked or with private areas exposed to the viewer and the staff member did not make fun of the resident or disparage her in any way. Residents on the 300 hall (where Resident #4 resided) were interviewed by Social Service Designee (SSD) #325 with no additional concerns reported; Resident #4 was not able to provide coherent information when interviewed due to her advanced dementia. The facility determined the allegation to be unsubstantiated for abuse as Resident #4 was in the background of the video but the content of the video was not demeaning or humiliating to the resident. The facility disciplined CNA #349 for violation (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 3 Event ID: 365746 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 365746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brentwood Health Care Center 907 Aurora Rd Sagamore Hills, OH 44067 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)