Inspection Reports for
Bickford of Davenport

Complaint #131587-C

No regulatory insufficiencies were cited during the investigation of Complaint #131587-C and the recertification visit.

The investigation was triggered by Complaint #129204-C. The complaint was substantiated as regulatory insufficiencies were cited regarding tenant evaluations, retention of a bed-bound tenant, and nurse review failures.

The program failed to complete required functional, cognitive, and health evaluations for 5 tenants, retained a bed-bound tenant contrary to admission criteria, and did not complete nurse reviews every 90 days for 2 tenants receiving prescription medications.

Complaint #129204-C was investigated during this visit.

Three regulatory insufficiencies were cited related to evaluation of tenants, criteria for admission/retention of tenants, and nurse review. The program failed to complete required evaluations, retained a bed-bound tenant improperly, and did not complete nurse reviews every 90 days for some tenants.

The investigation was triggered by complaints #125932-C and #125018-C. The findings included failure to follow incident reporting policies and retention of tenants with unsafe behaviors or conditions.

The program failed to follow established policies for incident reporting related to a tenant injury and retained tenants who were bed bound or displayed dangerous behaviors including verbal and physical aggression despite interventions.

Investigation of Complaint #123497-C and Mandatory Report #122759-M found no regulatory insufficiencies.

No regulatory insufficiencies were cited during the investigation of the complaint and mandatory report.

There were no regulatory insufficiencies cited during the investigation into Complaint #117601-C, Complaint #119817-C, and Complaint #120048-C.

The program was found to have multiple regulatory insufficiencies including failure to conduct health assessments prior to admission and within 30 days of occupancy for certain tenants, failure to evaluate tenant health status annually or with significant change, retention of tenants requiring two-person assistance for transfers, and retention of a tenant displaying unmanageable aggression.

The investigation was triggered by complaints #111838-C and #111846-C. No regulatory insufficiencies were cited during the investigation of Complaint #111633-C. Tenant #1 exhibited multiple incidents of aggression, exit seeking, and wandering into other tenants' apartments uninvited, requiring multiple 911 calls and hospital transports.

The investigation found regulatory insufficiencies including failure to provide adequate and appropriate care for a tenant with exit seeking behaviors, failure to evaluate functional, cognitive, and health status after significant changes, failure to develop individualized service plans, and failure to ensure all personnel, including contract staff, received appropriate dementia-specific training.

The complaint investigation involved multiple complaints (#108383-C, #108255-C, #107202-C, #107132-C, and #105750-C). No regulatory insufficiencies were found for complaints #108383-C, #108255-C, and #107202-C. Regulatory insufficiencies were cited for complaints #107132-C and #105750-C.

The investigation found regulatory insufficiencies related to tenant rights violations where tenants were not consistently treated with respect and dignity, and failures in documentation of routine personal or health-related care on task sheets for tenants receiving hospice care. Additionally, the program failed to retain tenant records for the required minimum of three years.

The inspection included investigations of Complaint #101520-C and Complaint #97727-C.

The facility was found deficient in multiple areas including failure to provide required dependent adult abuse training within six months of hire, failure to maintain incident reports for discharged tenants, failure to have all parties sign service plans, failure to update service plans to reflect identified needs and preferences, and failure to provide eight hours of dementia-specific education within 30 days of employment.

The complaint investigation was substantiated based on findings of medication diversion and failure to follow policies regarding abuse and neglect reporting and medication disposal. The program self-reported the allegation and failed to provide requested investigative documentation.

The program failed to consistently follow established policies and procedures related to medication management and nurse delegation. Specifically, medication diversion was identified involving Tenant #1, with missing Tramadol tablets and inadequate documentation of medication destruction and nurse delegation.

The program was found deficient in nurse delegation procedures, specifically the newly hired registered nurse failed to delegate tasks to existing staff within 60 days of employment and failed to ensure newly hired staff received training within 30 days. Additionally, the program failed to update tenant service plans when changes were needed.