Treasure Isle Care Center

In the surveyor’s words

From the most serious findings on record at Treasure Isle Care Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Mar 26, 2021

  Based on observation, record reviews and interviews, the facility failed to provide care, services and supervision to prevent resident to resident abuse related to two (resident #2, and resident #5) out of five residents sampled. This deficient practice enabled resident #4 to strike resident #2 on 11/12/20 and resident #5 on 3/16/21 causing injury to both residents. There were 166 residents residing in the facility at the time of the survey. On March 26, 2021, it was determined the findings of the survey posed immediate jeopardy to the health and safety of the residents admitted to the facility. The facility's Administrator, Director of Nursing and Regional Nurse Consultant were notified of the immediate Jeopardy on March 26, 2021 at 2:00 PM. […]

• Immediate jeopardy, isolatedF607Mar 26, 2021

  Based on record reviews and interviews, the facility failed to implement their abuse policy to address resident to resident abuse as evidenced by staff failure to provide care and services including adequate supervision to prevent infliction of harm and injury to vulnerable residents for two (resident #2, resident #5) out of five residents sampled. This deficient practice enabled resident #4 to strike resident #2 on 11/12/20 and resident #5 on 3/16/21 causing injury to both residents. There were 166 residents residing in the facility at the time of the survey. On March 26, 2021, it was determined the findings of the survey posed immediate jeopardy to the health and safety of the residents admitted to the facility. […]

• Immediate jeopardy, isolatedF689Mar 26, 2021

  Based on observation, interviews and record review, the facility failed to provide adequate supervision to ensure the safety of vulnerable residents as evidenced by resident to resident abuse resulting in the injury of two (resident #2, resident #5) out of five residents sampled. This deficient practice enabled resident #4 to strike resident #2 on 11/12/20 and resident #5 on 3/16/21 causing injury to both residents. There were 166 residents residing in the facility at the time of the survey. On March 26, 2021, it was determined the findings of the survey posed immediate jeopardy to the health and safety of the residents admitted to the facility. […]

• Immediate jeopardy, isolatedF835Mar 26, 2021

  Based on observations, record reviews and interviews, the facility's administration failed to implement and provide services that effectively and efficiently related to ensuring safety measures were in place to prevent resident to resident abuse of two (resident #2, and resident #5) out of five residents sampled. As evidenced by resident to resident abuse resulting in the injury of two residents in two separate incidents by another resident. These system failures enabled resident #4 to strike resident #2 on 11/12/20 and resident #5 on 3/16/21 causing injury to both residents. The facility's administration failed to implement levels of supervision to meet the residents identified needs. There were 166 residents residing in the facility at the time of the survey. […]

• No harm, potential for more than minimal, widespreadF689Jun 13, 2024

  Based on observations, record review and interview, the facility failed to ensure safety for all residents the residents in the facility as evidence by a knife was observed in one (Resident #46) out of eight residents sampled. Staff failed to intervene in a timely manner during an argument between two residents (Resident #128 and Resident #170) that enabled Resident #170 to strike Resident #128, which led to Resident #170 being arrested by local law enforcement. The facility's incidents by incident types report from January 2023 to June 10, 2024 revealed there were six alleged abuse incidents and nine incidents of resident-to-resident altercation. […]