Brooke Haven Healthcare

In the surveyor’s words

From the most serious findings on record at Brooke Haven Healthcare, in the surveyor’s own words.

• Actual harm, isolatedF689Dec 6, 2024

  Based on interview and record review, the facility failed to provide a safe environment per the resident's assessed level of need, when Resident #21 received a second degree (a burn that damages the epidermis and dermis, the two layers of skin) burn from the spilled coffee in his/her lap after a Certified Nursing Assistant (CNA) handed the resident hot coffee in a coffee cup without a lid for one sampled resident. The census was 69. The facility did not provide a policy regarding accidents/incidents. 1. […]

• No harm, potential for more than minimal, widespreadF812Dec 6, 2024

  Based on observation, interview, and record review, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness. This had the potential to affect all residents. The facility census was 69. The facility did not provide a policy regarding the kitchen. 1. Observation on 12/03/24 at 9:34 A.M., and 12/05/24 at 11:38 P.M., of the kitchen showed: - No cleaning logs; - Two unlabeled white plastic food bins with clear unlabeled lids near the gas range with white sugar and brown sugar; - A metal backsplash behind the gas range with a 2 foot (ft.) diameter (dia.) area with dark brown carbon build-up; - The commercial style can opener with an oily film on the base and blade; - One 3 ft. by 4 ft. […]

• No harm, potential for more than minimal, widespreadF812Jul 6, 2023

  Based on observation and interviews, the facility failed to keep one of two facility ice machines clean and sanitary. The failure created the potential for contamination of the ice used for ice water and ice chips for 65 of 66 residents in the facility. 1. Observation on 07/03/23, at 3:35 P.M., of the ice machine utilized to provide ice for the facility residents, showed the following: -The inside of the blue ice scoop receptacle was dirty with dark black matter at the bottom where the scoop was placed;-The outside of the white ice scoop was black on one side; -Corrosion around the base of the condenser located on the top of the ice machine. […]

• No harm, potential for more than minimal, patternF584Jul 6, 2023

  Based on observation, record review, and staff interviews, the facility failed to provide a safe, clean, comfortable, and homelike environment for for all residents when the facility failed to maintain clean floors and failed to maintain one resident room, without holes in the walls, where two residents (Resident #6 and #10) resided. 1. Review of Resident #6's Clinical Census, found in the electronic medical record (EMR), under the Clinical tab showed the following: -admitted [DATE]; -Diagnoses included bilateral (both sides) hearing loss, legal blindness, adult osteochondrosis of spine (pathologic degenerative process involving the intervertebral disc and the respective vertebral body endplates), and major depressive disorder. […]

• No harm, potential for more than minimal, patternF883Jul 6, 2023

  Based on interview and record review,the facility failed to follow related Centers for Disease Control and Prevention (CDC) guidelines for pneumococcal vaccinations for four residents (Resident #26, #33, #35, and #49) of five sampled residents reviewed for influenza/pneumococcal vaccinations. Review of document provided by the facility titled Pneumococcal Vaccination Update/CDC/Advisory Committee on Immunization Practices (ACIP) Guidelines for Older Adults in Long-Term Care Facilities showed the following: -For resident of age greater of equal to [AGE] years of age, giving a dose of the Pneumococcal Conjugate Vaccine ( PCV) 13 was based on clinical decision-making; -For Pneumococcal Polysaccharide Vaccine (PPSV23), it would be one dose; -If PCV13 has been given, then give one year after… […]