Briarwood Village

In the surveyor’s words

From the most serious findings on record at Briarwood Village, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Aug 14, 2025

  Based on observation, medical record review, staff interview, review of facility investigation, physician interview, review of bed user service manual, and policy review, the facility failed to ensure Resident #01 was provided adequate supervision during the provision of activities of daily living. Resident #01 was cognitively impaired, and dependent on staff for transfer and bed mobility with bilateral lower extremity contractures. This resulted in Immediate Jeopardy, actual harm and death beginning on [DATE] at 10:11 A.M. when two Certified Nurse Aides (CNA) directed attention away from Resident #01, who was lying in bed on her left side with the bed elevated. […]

• Actual harm, isolatedF689Oct 14, 2021

  Based on medical record review, review of facility self-reported incidents (SRI's), review of a facility investigation, observation, staff and family interview and review of an electronic mail (email) communication, the facility failed to ensure a resident received appropriate assistance during a transfer in accordance with the residents' care plan which indicated the resident required two-person extensive assist. This resulted in Actual Harm when State tested Nursing Assistant (STNA) #299 transferred Resident #53 with a one assist and the resident subsequently sustained a spiral tibia fracture of the right leg which required casting. This affected one (#53) of three residents reviewed for safe transfers. The facility census was 81. […]

• No harm, potential for more than minimal, widespreadF880Apr 7, 2025

  Based on medical record review, staff interview, local health department staff interview, and review of facility policy, the facility failed to report norovirus cases and multiple resident's gastrointestinal (GI) symptoms (nausea/vomiting/diarrhea) to the local health department. This had the potential to affect all 92 residents of the facility. The census was 92. Findings include: 1. Review of Resident #4's medical record revealed an admitted [DATE]. Diagnoses listed included chronic kidney disease, obstructive sleep apnea, hypothyroidism, and morbid obesity. Review of a quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #4 was cognitively intact. […]

• No harm, potential for more than minimal, widespreadF727Oct 2, 2024

  Based on observation, staffing record review, and staff interviews, the facility failed to employ a Director of Nursing (DON) full time at the facility. This had the potential to affect all 86 residents. Findings include: Interview on 09/30/24 at 7:17 A.M. at the time of entrance with the Administrator revealed there was no DON employed at the facility. A second interview with the Administrator on 10/01/24 at 10:11 A.M. revealed the facility had not had a DON or acting DON since 09/18/24. Record review of the staffing sheets from 09/23/24 through 09/29/24 revealed no DON had been scheduled.

• No harm, potential for more than minimal, widespreadF730Aug 8, 2024

  Based on employee file review and interview the facility failed to ensure State tested Nursing Assistant (STNAs) had 90 day evaluations and/or annual performance evaluations. This affected four of six employee files reviewed. This had the potential to affect all residents. The facility census was 99. Findings include: 1. Review of employee file for STNA #353 with hire date of 05/14/19 revealed no annual evaluation for July of 2023 or any for 2024. 2. Review of employee file for STNA #374 with hire date of 11/06/18 revealed no annual evaluation for 2020, 2021, and 2023. 3. Review of employee file for STNA #370 with hire date of 01/10/24 revealed no 90 day evaluation. 4. […]