Peninsula Health Center by Harborview

In the surveyor’s words

From the most serious findings on record at Peninsula Health Center by Harborview, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600May 5, 2023

  Based on record review and interviews with facility staff, family member, physicians, and review of facility policies and medical records, the facility failed to protect the resident's right to be free from neglect by not providing the services to prevent necessary to avoid physical harm, pain, and mental anguish for one resident (#1) of 3 sampled residents. Resident #1, who was a physically impaired resident, and was dependent on staff for all care and services, required two persons assistance for bed mobility, and received care from one staff member. On [DATE], the resident fell from her bed while one staff person was providing care and hit her head on the wall. The resident was transferred out of the facility for acute care follow-up. […]

• Immediate jeopardy, isolatedF609May 5, 2023

  Based on record review and interviews with facility staff, family member, physicians, and review of facility policies and medical records, the facility failed to ensure freedom from neglect by not implementing the facility's policy and procedure for Resident Mistreatment, Neglect and Abuse Prohibition for one (Resident #1) of 3 sampled residents. The facility failed to recognize and report neglect for Resident #1, a physically impaired resident, who was dependent on staff for all care and services, required two-persons assistance, and received care from one (1) staff member. On [DATE], the resident fell from her bed while one staff person was providing care and hit her head on the wall. The resident was transferred out of the facility for acute care follow-up. […]

• Immediate jeopardy, isolatedF610May 5, 2023

  Based on record review and interviews with facility staff, family member, physicians, and review of facility policies and medical records, the facility failed to ensure freedom from neglect by not implementing the facility's policy and procedure for Resident Mistreatment, Neglect and Abuse Prohibition for one (Resident #1) of 3 sampled residents. The facility failed to recognize and report neglect for Resident #1, a physically impaired resident, who was dependent on staff for all care and services, required two-persons assistance, and received care from one (1) staff member. On [DATE], the resident fell from her bed while one staff person was providing care and hit her head on the wall. The resident was transferred out of the facility for acute care follow-up. […]

• Immediate jeopardy, isolatedF689May 5, 2023

  Based on record review and interviews with facility staff, family member, physicians, and review of facility policies and medical records, the facility failed to ensure supervision was provided to prevent a fall which resulted in the death of one (Resident #1) of 3 sampled residents. The facility failed to ensure Resident #1, a physically impaired resident, who was dependent on staff for all care and services received care as directed in her plan of care. The resident who required two-persons assistance received care from one (1) staff member resulting in a fall with fatal injuries. On [DATE], the resident fell from her bed while one staff person was providing care and hit her head on the wall. The resident was transferred out of the facility for acute care follow-up. […]

• No harm, potential for more than minimal, isolatedF550Sep 19, 2024

  Based on observation, interview, and record review, the facility failed to ensure two (#52 and #8) of eleven sampled residents , who dined in the main dining room, were provided and assisted with their meal until 30 and 40 minutes after all the others were served and ate their meal. Findings included: 1. On 9/16/2024 at 11:59 a.m., the main dining room was observed for lunch service. The room was observed with over twelve tables and many chairs. Prior to the meal observation, the room was used as a group activity, and there were many residents who were in attendance of that activity. After the activity was completed, there were nine residents who remained in the room to wait and be served their lunch. […]