Health inspection·July 8, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Residents Affected - Few Based on review of the facility incident report, staff interviews and policy review, the facility failed to ensure staff appropriately disposed of an insulin needle after use. This had the potential to affect one (#70) out of three residents reviewed for infection control. The facility census was 61. Findings include: Review of the facility incident report dated 05/05/24 revealed while State Tested Nursing Assistant (STNA) #44 was emptying the trash can in Resident #70 bathroom when she was stuck by a hypodermic insulin needle. The investigation noted the facility was unsure who threw the needle away or who the needle was used on prior to being disposed of in Resident #70's bathroom. Interview with the Director of Nursing (DON) on 07/08/24 at 2:00 P.M. revealed an investigation ensued and all staff were educated to prevent any further incidents following STNA #44's needle stick on 05/05/24. The DON confirmed Resident #70 does not have orders for insulin or injections so the needle in the bathroom trash can did not belong to this resident. The DON further noted the facility could not identify who put the needle in the trash can and could not identify which resident it was used for prior to it being placed in Resident #70's trash can. The DON confirmed needles are to be properly disposed of in sharps containers. Review of the Infection Control Policy undated for disposal of sharp materials revealed no sharps should be thrown in the trash. Sharps should not be capped and placed in the sharps containers. As a result of the incident, the facility took the following actions to correct the deficient practice by 05/12/24: • On 05/05/24, the facility immediately began an investigation regarding the used needle found in Resident #70's room. • On 05/05/24, all sharps containers were checked and replaced if needed by the DON and Infection Preventionist #14. (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 2 Event ID: 366427 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 366427 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Liberty Nursing Center of Colerain Inc 8440 Livingston Road Cincinnati, OH 45247 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)