Berkley East Healthcare Center

In the surveyor’s words

From the most serious findings on record at Berkley East Healthcare Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Oct 15, 2023

  Based on interviews and record review, the facility failed to protect the rights of one of four sampled residents (Resident 1) to be free from physical abuse (any intentional act not limited to slapping, pinching, choking, kicking, shoving) by caregiver 1 (CG1) in accordance with the facility's undated policy and procedures titled Prohibition Of Abuse, Neglect and/or Misappropriation of Resident Property and Mandating Reporting by failing to: 1. Ensure CG1 did not hit and slap Resident 1 on the leg on 10/11/2023 at 6 a.m. Resident 1's diagnoses included dementia (progressive, persistent loss of intellectual functioning, especially with impairment (significant disturbance in an individual's cognition, emotional regulation, or behavior) of memory and abstract thinking). 2. […]

• Immediate jeopardy, isolatedF607Oct 15, 2023

  Cross Reference F600 Based on interview, and record review, for 35 of 35 caregivers, the facility failed: 1. To make reasonable efforts to ensure contracted workers received training in elder and dependent adult abuse protocols and abuse prevention in accordance with the facility's undated Prohibition of Abuse, Neglect and/or Misappropriation of Resident Property and Mandated Reporting, Orientation Program for Newly Hired Employees, Transfers, Volunteers revised on 5/2019, and Caregiver, Non-Staff Reviewed on 1/2023, 2. To provide orientation program for all contracted caregivers in accordance with the facility's policy and procedures titled Orientation Program for Newly Hired Employees, Transfers, Volunteers, revised on 5/2019, by failing to: a. […]

• Immediate jeopardy, isolatedF760Aug 14, 2023

  Based on interview and record review, the facility failed to administer as needed (PRN) glucagon (a lifesaving medication for low blood glucose [BG-sugar]) per physician order for one of 22 sampled residents (Resident 1) who was found on bed, with difficulty to arouse (wake up) and a BG of 44 milligrams per deciliter (mg/dl-unit measure that shows concentration of a substance in a fluid) on 8/8/2023 at 5:30 a.m. This deficient practice delayed prompt treatment care resulting in Resident 1 ' s BG dropped from 44 mg/dl to 34 mg/dl upon paramedics ' arrival to the facility on [DATE] at 5:40 a.m. […]

• Actual harm, isolatedF689Jun 6, 2024

  Based on interview and record review, the facility failed to ensure one of five sampled residents (Resident 3), who was assessed as a high risk was not left unattended in the bathroom unsupervised. This deficient practice resulted in Resident 3 falling while in the bathroom on 5/9/2024 at 6:45 p.m. and sustained a mild displaced comminuted subcapital (is a difficult hip injury that can have serious complications) fracture (a break in a bone) of the right femoral neck (right hip fracture). Resident 3 was transferred to General Acute Care Hospital (GACH) on 5/10/2024. […]

• Actual harm, isolatedF678Jan 16, 2024

  Based on interview, and record review, the facility failed to ensure Licensed Vocational Nurse 1 ( LVN 1) immediately initiated Cardiopulmonary Resuscitation (CPR- a medical procedure involving repeated compression of a patient's chest, performed to restore the blood circulation, and breathing of a person who has suffered cardiac arrest) for one of the three sampled residents (Resident 1) and did not leave Resident 1 unattended when LVN 1 found Resident 1 unresponsive (Unconscious, and possibly dead or dying) on [DATE] at 7:30 p.m. As a result, Resident 1 did not receive the necessary emergency life-saving services immediately. […]