Beverly Park Place Health and Rehab

In the surveyor’s words

From the most serious findings on record at Beverly Park Place Health and Rehab, in the surveyor’s own words.

• Actual harm, isolatedF684Aug 9, 2022

  Based on facility policy review, medical record review, hospital record review, and interview, the facility failed to ensure facility staff assessed, monitored, and provided treatments for wounds for 1 resident (Resident #1) of 4 residents reviewed for wound care. The facility's failure to ensure the Nurse Practitioner (NP) and licensed nursing staff accurately assessed, monitored, and treated Resident #1's lower extremity wounds resulted in Resident #2 being admitted to the hospital with a diagnosis [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, widespreadF867Oct 26, 2022

  Based on facility policy review, review of the facility's 2567 dated 9/18/2019 and 9/22/2021, medical record review, observations, and interviews, the facility's Quality Assurance Performance Improvement (QAPI) program failed to have an effective system in place to sustain compliance with ensuring residents were free from abuse and reporting allegations of abuse for 1 resident (#58) of 24 residents reviewed for abuse. The QAPI committee's failure to effectively monitor previously identified deficient practices and corrective actions to ensure residents were free of abuse and reporting allegations of abuse had the potential to affect all 162 residents in the facility. […]

• No harm, potential for more than minimal, patternF842Aug 9, 2022

  Based on facility policy review, medical record review, and interview, the facility failed to document wound care treatments and dressing changes for 2 residents (Resident #4 and Resident #5) of 4 residents reviewed for complete and accurate medical records. The findings include: Review of the facility policy Charting and Documentation dated 7/2017, showed .All services provided to the resident .shall be documented in the resident's medical record . Medical record review showed Resident #4 was admitted to the facility on [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, isolatedF880May 13, 2026

  Based on facility policy review, medical record review, observations, and interview, the facility failed to maintain infection control practices for 1 resident (Resident #204) of 4 residents reviewed for urinary catheters. The findings include: Review of the facility policy titled, Catheter Care, dated 8/2022, revealed .The purpose of this procedure is to prevent urinary catheter-associated complications, including urinary tract infections .Be sure the catheter tubing and drainage bag are kept off the floor .Review of the medical record revealed Resident #204 was admitted to the facility on [DATE] with diagnoses including Schizophrenia, Anxiety Disorder, and Neuromuscular Dysfunction of Bladder. […]

• No harm, potential for more than minimal, isolatedF600Jul 17, 2024

  Based on facility policy review, facility investigation documentation review, observation, and interview the facility failed to protect 1 Resident (Resident #13) from physical abuse of 7 residents reviewed for abuse. The findings include: Review of the facility's policy titled, Abuse, Neglect, Exploitation, and Misappropriation Prevention Program, revised 9/2021, revealed .It is the policy of the facility to maintain an environment where residents are free from abuse, neglect, exploitation, and misappropriation of resident property .Abuse includes but is not limited to freedom from corporal punishment, involuntary seclusion, and any physical or chemical restraints not required to treat the residents' medical symptoms .Residents have the right to be free from abuse, neglect,… […]