Ark Healthcare & Rehabilitation at Branford Hills

In the surveyor’s words

From the most serious findings on record at Ark Healthcare & Rehabilitation at Branford Hills, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Oct 2, 2024

  Based on clinical record review, facility documentation review, facility policy review, and interviews for one of three residents (Resident #1), reviewed for wandering, the facility failed to ensure adequate supervision for a resident with known exit seeking behaviors, to ensure the resident was not able to exit the facility without staff knowledge, and the facility failed to ensure interventions were placed after elopement behaviors were identified. The failures resulted in a finding of Immediate Jeopardy. The findings include: Resident #1 was admitted with diagnoses that included dementia and status post right hip fracture and malnutrition. […]

• Actual harm, isolatedF600May 19, 2026

  Based on review of the clinical record, facility documentation, facility policy, police reports, forensic laboratory findings and interviews for one (1) of two (2) residents (Resident #3) reviewed for abuse, the facility failed to protect a cognitively impaired, non-verbal resident from sexual abuse by another resident. Resident #3 lacked the cognitive ability to consent to sexual activity and forensic DNA testing confirmed the presence of Resident #2's DNA on Resident #3's oral and genital swabs. The findings include:1. Resident #3 was admitted with diagnoses that included congenital malformation syndrome predominantly affecting facial appearance, dementia, aphasia, intellectual developmental disability, dysphagia, autistic disorder, and speech disturbance. […]

• Actual harm, isolatedF689Mar 25, 2021

  Based on clinical record reviews, review of facility documentation and interviews for one of three sampled residents (Resident #1) who required staff assistance with bathing, the facility failed to ensure safety measures were in place to prevent a fall from a shower chair that resulted in an injury. The findings include: Resident #1's diagnoses included [CONDITION(S)] and [CONDITION(S)], generalized muscle weakness and anxiety disorder. The quarterly Minimum Data Set assessment dated [DATE] identified Resident #1 had no memory problems, was alert and oriented, was totally dependent on one (1) person assistance for a shower and bath, had functional limitations in range of motion on one (1) side and had no falls in the past ninety (90) days. […]

• No harm, potential for more than minimal, patternF687Feb 5, 2026

  Based on review of the clinical record, facility documentation, facility policy and interviews for 1 of 6 residents (Resident #57) reviewed for activities of daily living, the facility failed to ensure podiatry services were provided timely. The findings include: Resident #57 was admitted to the facility in January 2024 with diagnoses that included Alzheimer's disease, onychomycosis (fungal infection of the toenails), and left and right toe pain. A Physician Consult Form dated 1/30/24 and signed by Resident #57 identified he/she agreed for podiatry services contracted by the facility. A podiatry consult form dated 3/20/25 identified Resident #57 had moderately aching, painful toenails in shoes and with pressure and walking which was alleviated by cutting nails out. […]

• No harm, potential for more than minimal, patternF812Feb 5, 2026

  Based on a tour of the Dietary Department, review of facility policy and staff interview, the facility failed to ensure stored food was dated when opened, expired food was discarded, and a cleaning chemical was not stored in a refrigerator designated for resident food. The findings included: A tour of the Dietary Department on 1/27/26 at 10:31 AM with the Food Service Director (FSD) identified:1. The walk-in freezer was observed to have the following items with open boxes that contained opened plastic bags within the boxes that were undated when they were opened:a. One opened plastic bag of riblets (1/4 full)b. One opened plastic bag of onion rings (1/2 full)c. One opened plastic bag of pork chops (1/2 full)d. One opened plastic bag of hamburger patties (3/4 full)e. […]