Autumn Lake Healthcare at Berkeley Heights

In the surveyor’s words

From the most serious findings on record at Autumn Lake Healthcare at Berkeley Heights, in the surveyor’s own words.

• Immediate jeopardy, widespreadF728Jul 19, 2024

  Based on observation, interviews and review of pertinent facility documents, it was determined that the facility failed to ensure Nurse Aides (NAs) received the required training and competencies needed prior to receiving their own assignment to provide direct resident care independently. This deficient practice was identified for 2 of 2 NAs (NA #1 and NA #2) who worked on 2 of 3 Nursing units and were enrolled in a Nurse Aide Training School on 06/18/2024. The NAs failed to complete Module 2 of the NATCEP (Nurse Aide Training and Competency Evaluation Program) and there were no competencies provided by the facility to ensure training was adequate prior to receiving their own assignment. […]

• Actual harm, isolatedF600Jul 19, 2024

  Based on observation, interview, record review and review of pertinent facility documents, it was determined that the facility failed to follow their Abuse, Neglect and Exploitation Policy and Procedure, to protect residents from physical abuse and staff by failing to ensure: a.) Resident #37 was spoken to in a harsh and abusive manner which resulted in Resident #37 crying on 07/15/24, in the presence of the surveyor and b.) Resident #50 was protected from physical abuse by Resident #74, who had a history of wandering. On 01/24/2024, Resident #74 wandered into Resident #50's room and Resident # 74 physically assaulted Resident #50 by punching them in the mouth and knocking out their front tooth. […]

• Actual harm, isolatedF658Jul 19, 2024

  Based on observation, interview, record review and review of pertinent facility documents, it was determined that the facility failed to follow their Abuse, Neglect and Exploitation Policy and Procedure, to protect residents from physical abuse and staff by failing to ensure: a.) Resident #37 was spoken to in a harsh and abusive manner which resulted in Resident #37 crying on 07/15/24, in the presence of the surveyor and b.) Resident #50 was protected from physical abuse by Resident #74, who had a history of wandering. On 01/24/2024, Resident #74 wandered into Resident #50's room and Resident # 74 physically assaulted Resident #50 by punching them in the mouth and knocking out their front tooth. […]

• No harm, potential for more than minimal, widespreadF558Jul 19, 2024

  Based on observation, interview and document review it was determined that the facility failed to ensure an adequate supply of linens (sheets, pillowcases, towels, bed linens, wash cloths, bed pads and gowns) were provided to accommodate the number of residents who resided in the facility to meet their needs and maintain the dignity and well-being of all residents for 4 of 4 resident units. Reference N.J.A.C. 8:39 - 21.3: (a) The facility shall have a supply of linen appropriate to the resident's needs that is clean, in good repair, and is at least three times the number of residents. (b) The facility shall have a supply of blankets that is at least two times the number of residents. […]

• No harm, potential for more than minimal, widespreadF610Jul 19, 2024

  Complaint # NJ 159516 48422 Based on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to ensure their policy for Abuse Investigation and Icidents and Accidents was followed to ensure a thorough investigation was completed, and documented for: a.) an allegation of verbal abuse by staff to Resident #60, and b.) for a resident who was found on the floor, facing upright with a folded jacket under head, was saturated with urine, difficult to arouse and required emergent transport via 911 to the hospital (Resident #295). […]