Oaks of Brecksville

In the surveyor’s words

From the most serious findings on record at Oaks of Brecksville, in the surveyor’s own words.

• Actual harm, isolatedF684Jul 1, 2025

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on closed medical record review, review of hospital discharge paperwork, facility policy review and interview, the facility failed to ensure wound care orders were transcribed and implemented per physician's orders to promote healing and prevent infection for a surgical wound Resident #81 had upon admission to the facility. Actual Harm occurred on 05/26/25 when staff identified Resident #81 had not been provided wound care treatments to a surgical wound to the resident's back resulting in the infection. […]

• Actual harm, isolatedF689Jul 27, 2023

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on closed record review and staff interview the facility failed to ensure Resident #70 was properly secured in the facility transportation van to prevent a fall with injury during transport. Actual harm occurred on 04/20/23 when Resident #70 sustained a head trauma/forehead laceration that required hospitalization and multiple stitches/sutures, after being thrown forward and coming into contact with a metal object while being transported to dialysis in the facility transport van. This affected one resident (#70) of three residents reviewed for falls and safe transport. The facility census was 69. […]

• Actual harm, isolatedF689Oct 15, 2021

  Based on interview and record review, the facility failed to provide Resident #64 proper assistance with toileting. Actual harm occurred on 10/06/21 at 1:45 P.M. when Resident #64, who required extensive two person assistance with toileting assistance, was taken off a bed pan by one state tested nursing assistant (STNA) rather than two STNAs. Resident #64 slid to the ground resulting in a fractured femur. This affected one resident (Resident #64) of three residents reviewed for falls. Findings include: Resident #64 was admitted to the facility on [DATE] with diagnosis of muscle weakness, difficulty walking, arthritis, sciatica, chronic embolism and [CONDITION(S)] of other specified deep vein of bilateral lower extremity, and obesity. […]

• No harm, potential for more than minimal, patternF602Jul 1, 2025

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on interview, review of self-reported incidents (SRI), review of facility incident log, review of a local police report, review of Board of Nursing (BON) records, review of Board of Pharmacy records, and review of facility investigations, the facility failed to ensure residents were free from misappropriation. This affected five residents (#11, #29, #37, #41, and #85) out of five residents reviewed for potential misappropriation. The facility census was 75. Findings include: Review of the facility's incident log for February 2025 revealed there had been possible controlled medication misappropriation for Residents #11, #29, #37, #41, and #85. […]

• No harm, potential for more than minimal, patternF761Jan 23, 2025

  Based on observation, record review, and interview, the facility failed to ensure insulin multi-dose syringe pens were labeled appropriately with resident identifiers and open dates, and failed to ensure medications were properly stored and secured. These findings affected five (Resident #13, #26, #46, #49, and #50) of eight residents reviewed for medication storage and administration. The total census was 74. Findings include: 1. Observation of Registered Nurse (RN) #533 on 01/21/25 at 8:49 A.M. […]