Health inspection·April 17, 2025

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview and policy review, the facility failed to maintain infection control principles during tracheostomy care. This affected one (Resident #19) of one resident observed for tracheostomy care. The facility identified one resident who currently has a tracheostomy. The facility census was 94. Residents Affected - Few Findings include: Review of the medical record revealed Resident #19 was admitted to the facility on [DATE] with diagnoses of tracheostomy, stenosis of larynx, post-procedural subglottic stenosis, paranoid schizophrenia, drug induced dyskinesia and morbid obesity. Review of the Minimum Data Set (MDS) quarterly assessment dated [DATE] revealed Resident #19 had intact cognition and was always continent of bowel and bladder. The resident required supervision with eating, oral and personal hygiene, toileting, bathing, dressing, bed mobility and transfers. Review of physician orders revealed an order dated 02/22/24 for Resident #19 to have her tracheostomy inner cannula cleansed during tracheostomy care every day and as needed, and to apply a dressing around the tracheostomy to protect the skin. Review of physician orders revealed an order dated 04/17/24 for Resident #19 to have Enhanced Barrier Precautions (EBP) implemented for tracheostomy care, dressing, bathing, showering, transfers in room or therapy gym, personal hygiene, changing linen, providing hygiene, changing briefs or assistance with toileting. Review of physician orders revealed an order dated 02/27/25 for Resident #19 to have tracheostomy care completed every shift and as needed. The nurse is to cleanse the stoma with soap and water, assist the resident with removal of tracheostomy and clean with tracheostomy care cleaning kit solution, reinsert the tracheostomy and apply tracheostomy after care. Ensure tracheostomy ties are secure. During an observation on 04/16/25 at 11:00 A.M., Licensed Practical Nurse (LPN) #46 attempted to provide tracheostomy care to Resident #19 who had Enhanced Barrier Precautions (EBP) in place. Observation revealed that LPN #46 did not perform hand hygiene with alcohol-based hand sanitizer or soap and water prior to entering the resident's room and putting on Personal Protective Equipment (PPE) that included gown, mask and gloves. LPN #46 was observed using her gloved hand to push down overflowing trash in the trash can, then used the same gloved hand to pick up a cup, to be used for saline solution for suctioning, with her thumb inside the cup, and used the same gloved hand to open the tracheostomy care kit, pick up the tracheostomy inner-cannula cleaning brush and place it on the overbed (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: 365925 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 365925 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/17/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookside Healthcare Center 315 Lilienthal Street Cincinnati, OH 45204 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)