Avenue at Lyndhurst: Infection Control Failures - OH
The August inspection at Avenue at Lyndhurst documented the infection control violation during morning care for a resident with type II diabetes, Alzheimer's disease, and morbid obesity who required complete assistance with eating, toileting, showering and dressing.
Federal inspectors observed the incident at 9:20 a.m. on August 20. Certified Nursing Assistant #365 gathered incontinence supplies, washed her hands and put on gloves before removing the resident's soiled brief and providing cleaning care. After finishing the intimate cleaning and applying a fresh brief, she continued repositioning the resident and adjusting the bed controls using the same gloves that had contacted bodily waste.
Only then did she remove the gloves, wash her hands, and leave the room.
The nursing assistant defended her actions when questioned nine minutes later. She told inspectors that since the gloves were not visibly dirty, she did not have to change them while repositioning the resident or adjusting the bed.
Her explanation contradicted the facility's own written policy. The March 2022 incontinence care procedure explicitly required staff to dispose of gloves immediately after cleaning and drying the resident, before any other tasks.
The resident receiving care had been at Avenue at Lyndhurst since September 2023. Medical records showed she was incontinent of both bowel and bladder, with impaired cognition that left her completely dependent on staff assistance.
Six other residents on the same nursing assistant's assignment also required incontinence care that day. All faced potential exposure to cross-contamination from the improper glove use.
The violation occurred at a 86-bed facility that had already drawn federal complaints. Inspectors noted this infection control deficiency represented noncompliance identified under two separate complaint investigations.
Cross-contamination through improper glove use poses particular risks in nursing homes, where residents often have compromised immune systems and multiple chronic conditions. The resident involved in this incident had diabetes, which can impair wound healing and increase infection susceptibility.
The nursing assistant's belief that visibly clean gloves remained safe for continued use reflects a fundamental misunderstanding of infection control principles. Harmful bacteria and viruses can contaminate surfaces without visible soiling, particularly during incontinence care involving bodily waste.
Federal regulations require nursing homes to maintain infection prevention and control programs specifically to prevent such cross-contamination incidents. The August inspection found Avenue at Lyndhurst failed to ensure proper implementation of these basic safety protocols.
The facility's own policy contained clear directives that could have prevented the violation. Staff were supposed to dispose of gloves immediately after cleaning residents, perform hand hygiene, and ensure call lights remained accessible before leaving rooms.
Instead, the contaminated gloves touched bed controls that other staff members and potentially the resident herself might contact later. The bed remote, positioned within the resident's reach for comfort and safety, became a potential vector for infection transmission.
Avenue at Lyndhurst houses vulnerable residents with complex medical needs. The woman involved in this incident represented a typical case load: elderly residents with dementia, diabetes, and incontinence requiring intensive daily care from nursing staff.
The inspection occurred in response to complaints about care quality at the Lyndhurst facility. Federal investigators found staff failing to follow basic infection control measures that form the foundation of safe nursing home operations.
The nursing assistant's casual dismissal of contaminated gloves as acceptable for continued use suggests inadequate training or supervision in fundamental safety protocols. Her actions put residents at unnecessary risk for preventable infections.
For residents like the woman with Alzheimer's disease who cannot advocate for themselves or recognize safety violations, proper staff adherence to infection control becomes literally a matter of life and death. A simple glove change could mean the difference between health and serious illness in a population already fighting multiple medical challenges.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Avenue At Lyndhurst from 2025-08-28 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
AVENUE AT LYNDHURST in LYNDHURST, OH was cited for violations during a health inspection on August 28, 2025.
Federal inspectors observed the incident at 9:20 a.m.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.