Abington Of Glenview Nursing

F-F179 and Resident R329) residents in the sample of 25 reviewed for Infection Control Prevention and Control Management.

Findings include:

On 4/1/25 at 10:57AM, Observed Resident R54 up in wheelchair in his room. Resident R54 is on Enhanced barrier precaution. Observed urinary drainage bag with visible yellow sediments in the tubing hanging over the grab bar next to emesis basin in the bathroom. V11 LPN (Licensed Practical Nurse) said that CNA (Certified Nurse Assistant) change Resident R54's urinary catheter bag to leg bag when he is up in wheelchair. V11 said that emesis basin should not be placed next to the urinary drainage bag. Observed emesis basin is dirty with dried white colored toothpaste inside.

On 4/1/25 at 11:35AM, Observed V15 LPN took portable Blood Pressure (BP) machine equipment from another resident in 3 north unit. V15 went to Resident R8 with medication cart and BP equipment. V15 did not disinfect

the BP cuff before placing it on Resident R8's left arm and obtained her BP. Informed V15 of observation made. She said BP equipment should be clean/disinfect before and after taking resident's BP.

On 4/2/25 at 8:32AM, V19 RN (Registered Nurse) gathered medical equipment for vital signs (portable wrist BP machine, pulse oximeter, and oral thermometer) from her medication cart and prepared medications inside Resident R179's room. Resident R179 is on Enhanced barrier precaution. V19 entered the room without donning appropriate PPE. V19 is wearing mask, she donned gloves when entering the room. She placed the medical equipment for vital signs on bedside tray table. V19 placed the BP wrist on Resident R179's left wrist, then placed the pulse oximeter on left index finger and took oral temperature. After obtaining vital signs, she then administered prepared medications. She brought her medical equipment on top of the medication cart. She wiped the medical equipment with disinfectant wipes.

On 4/2/25 at 8:50AM, Informed above observation with V19 RN and V17 Restorative Nurse. V19 said that

she did not don gown because she was just taking vital signs and performing oral administration of medication. V17 Restorative Nurse said that appropriate PPE is observed during medication administration and taking vital signs in EBP. V17 said that they should follow manufacturer recommendation in using disinfecting wipes which is contact time of disinfectant of 3 minutes.

On 4/2/25 at 11:01AM, Informed V3 Infection Preventionist of above observation. V3 said that vital signs equipment is only disinfected after using and not before. V3 said that no need to don PPE when taking vital signs and medication administration to resident on EBP. V3 said that disinfectant wipes manufacturer recommended keeping wet for 3 minutes. V3 said that emesis basin should not be placed next to urinary drainage bag in the bathroom.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 9 of 12 145683 Department of Health & Human Services Printed: 08/31/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 145683 B. Wing 04/04/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Elevate Care Abington 3901 Glenview Road Glenview, IL 60025

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)

F 0880 On 4/2/25 at 11:16AM, Informed V2 DON (Director of Nursing) of above observation. V2 said that they should disinfect medical equipment for taking resident vital signs before and after using. V2 said that they Level of Harm - Minimal harm or should don appropriate PPE when taking vital signs and administration of medications to resident on EBP. potential for actual harm V2 said that they should not place emesis basis next to urinary drainage bag in the resident's bathroom.

They placed order in resident's chart for resident on transmission-based precaution including EBP. Residents Affected - Some

On 4/3/25 at 9:40AM, Review Resident R8's medical record with V3 Infection Preventionist. Informed V3 that Resident R8 does not have order for Enhanced Barrier Precaution. Resident R8 has colostomy and receiving Triamcinolone Acetonide cream treatment for itching to upper back, BUE, shoulder and BLE. Resident R8 has red rashes on her upper extremities.

Facility's policy on Enhanced Barrier Precaution (EBP) revision 4/1/24 indicated:

Purpose: To minimize the risk of acquiring, transmitting, or complications resulting from multi-drug resistant organism (MDRO) colonization among residents in this setting. (Contact precautions would be warranted over EBP when there is risk of transmission of an actively infectious agent)

Guidelines:

*Residents will require the use of personal protective equipment (PPE) for high-risk activities such as:

-Any situation where expected contact of blood, bodily fluids, skin breakdown, or mucous membrane will be encountered.

*PPE required:

-Gown

-Gloves

*Persons expected to encounter these circumstances are to don PPE (gown and gloves) in accordance with

the activity that will be encountered when caring for the resident.

Facility's policy on Cleaning & Sanitizing- wheelchairs and other medical equipment revision 1/25/18 indicated:

Purpose: To assure that devices are cleaned and sanitized on a regular or as needed basis.

Guidelines:

5. Devices/equipment used for more than one resident shall be cleaned between each resident.

Manufacturer's recommendation for Germicidal bleach wipes (surface cleaning chemicals and disinfectants) indicated:

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 10 of 12 145683 Department of Health & Human Services Printed: 08/31/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 145683 B. Wing 04/04/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Elevate Care Abington 3901 Glenview Road Glenview, IL 60025

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)

F 0880 Overall contact time of 3 minutes. Contact time for a disinfectant is the amount of time a surface must remain wet with the product to achieve disinfection. Level of Harm - Minimal harm or potential for actual harm 49871

Residents Affected - Some On 4/1/2025 at 10:55 AM, V4 (Director of Guest Relation) removed and discarded his gloves then proceeded to resident room [ROOM NUMBER] without performing hand hygiene.

On 4/1/2025 at 10:56 AM, V4 stated he performed hand hygiene before putting gloves on but not after removing it. V3 (Infection Control Nurse) said hand hygiene should be performed before and after removing gloves.

On 4/2/2025 at 9:40 AM, V2 (Director of Nursing) said hand hygiene should be done after removing gloves and if hands are visibly soiled then hand washing with soap and water need to be performed.

On 4/1/2025 at 11:00 AM, Resident R329 seated on the wheelchair said she gets breathing treatments. Nebulizer treatment machine on top of the nightstand table with mask and tubing attached to the machine.

On 4/1/2025 at 11:02 AM, V3 (Infection Control Nurse) said nebulizer kit, mask and tubing, should be kept in

a ziplock/plastic bag for privacy. Mask should be rinse and air dry after each used.

On 4/2/2025 at 9:40 AM, V2 said nebulizer mask and tubing should be kept in a ziplock bag when not in used for infection control. Nebulizer mask should be rinsed and air dry after each used.

Review of Admission record read: admitted [DATE REDACTED], Diagnosis Information include PNEUMONITIS DUE TO INHALATION OF FOOD AND VOMIT; Order Summary indicate Ipratropium-Albuterol Inhalation Solution 0. 5-2.5 (3) MG/3ML (Ipratropium-Albuterol) 1 dose inhale orally every 6 hours for SOB while awake. Care Plan Report indicate Administer respiratory treatment (Ipratropium-Albuterol) as ordered.

Policy and Procedure

Title: Hand Hygiene/Handwashing, Revisions: 1-10-18

Definition:

Hand hygiene means cleaning your hands by using either handwashing (washing hands with soap and water), antiseptic hand wash, or antiseptic hand rub (i.e. alcohol-based hand sanitizer including foam or gel).

Guidelines:

When to Wash Hands With Soap and Water ONLY (may use Alcohol Based Hand Sanitizer for All Other):

After glove removal

Policy and Procedure

Title: Oral Inhalation Administration, Date: 10/25/2014

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 11 of 12 145683 Department of Health & Human Services Printed: 08/31/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 145683 B. Wing 04/04/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Elevate Care Abington 3901 Glenview Road Glenview, IL 60025

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)

F 0880 Purpose: To allow for safe, accurate, and effective administration of medication using an oral inhaler (with or without a spacer/chamber) or nebulizer. Level of Harm - Minimal harm or potential for actual harm Nebulizer - Administering Medications through a Small Volume (Handheld) Nebulizer

Residents Affected - Some U. Rinse and disinfect the nebulizer equipment according to manufacturer's recommendations, or:

1. Wash pieces (except tubing) with warm, soapy water daily. Rinse with hot water. Allow to air dry completely on paper towel.

W. When equipment is completely dry, store in a plastic bag with resident's name and date on it.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 12 of 12 145683