Inspection Reports for
Bailey Creek Health and Rehab

The facility was found deficient in multiple areas including failure to ensure resident privacy and dignity, inadequate notification of hospital transfers and bed hold policies, unsafe environmental hazards, improper medication storage, failure to follow dietary and infection control standards, and insufficient dementia training for nursing aides.

The facility was found deficient in multiple areas including failure to ensure resident dignity during transport, lack of timely notification for hospital transfers and bed hold policies, unsecured cleaning carts and hazardous equipment, improper medication storage, failure to follow planned menus, poor food safety and hygiene practices, inadequate infection control PPE use, and insufficient dementia training for nursing aides.

The complaint investigation involved allegations against CNA #1 for verbal abuse and threatening behavior towards Residents #2, #3, #4, and #6. The facility initially found the allegations unsubstantiated, but residents reported continued mistreatment and retaliation. The Administrator admitted to unsubstituting the abuse allegation to protect employees and acknowledged a personality conflict. Multiple residents had cognitive assessments documented, with some residents severely cognitively impaired.

The facility failed to ensure a thorough investigation of verbal abuse allegations involving CNA #1. The investigation was deemed unsubstantiated by the facility, but residents reported ongoing issues and dissatisfaction with the handling of the complaints. The CNA was suspended during the investigation and later reassigned to avoid contact with certain residents.

The complaint investigation involved allegations that CNA #1 verbally abused Residents #2, #3, and #4, including threats of physical assault and discriminatory behavior. The facility concluded the incident was unsubstantiated, but residents reported continued verbal mistreatment and dissatisfaction with the investigation outcome.

The facility failed to thoroughly investigate allegations of verbal abuse involving CNA #1 towards Residents #2, #3, and #4, placing all 62 residents at risk. The investigation was deemed unsubstantiated by the facility, but residents reported ongoing issues and dissatisfaction with the handling of the complaints.

The complaint investigation was substantiated by findings that staff did not follow the care plan requiring two-person assistance for Resident #1, resulting in a fall on 11/17/2023. The resident sustained a head injury, was hospitalized, returned with hospice care, and passed away on 1/26/2024. Witness statements confirmed the fall occurred during one-person care despite the care plan.

The facility failed to ensure residents were free from accidents by allowing staff to not follow the resident's care plan, resulting in a fall of Resident #1 on 11/17/2023. The resident required hospital care and later passed away. The investigation revealed discrepancies in staff adherence to the care plan, which required two-person assistance, but care was often provided by one person.

The complaint investigation was substantiated based on the findings that staff did not follow the care plan requiring two-person assistance for Resident #1, leading to a fall on 11/17/2023. The resident was found on the floor with a head injury and later passed away on 1/26/2024 related to electrolyte imbalance. Witness statements confirmed the CNA was providing care alone despite the care plan.

The facility failed to ensure residents were free from accidents by allowing staff to not follow Resident #1's care plan, which required two-person assistance for bed mobility, dressing, and toileting. A fall occurred on 11/17/2023 when a CNA provided care alone, resulting in the resident falling out of bed and sustaining a head injury. The care plan was not consistently followed, and documentation was incomplete.

The facility was found deficient in maintaining a safe, clean, and homelike environment, including issues with dirty air-conditioning/heating units and corroded sinks. Deficiencies were also noted in care planning for oxygen use, personal hygiene related to fingernail care for dependent residents, and failure to post oxygen in use signage for residents requiring oxygen therapy.

The facility was found deficient in maintaining a clean and safe environment, including dirty air-conditioning/heating units and corroded sinks. Care planning deficiencies were noted for oxygen use for a resident. Additionally, inadequate personal hygiene care was observed, specifically untrimmed and unclean fingernails for some residents. The facility also failed to post required oxygen in use signage for a resident using oxygen therapy.

The facility was found to have multiple deficiencies including poor maintenance and cleanliness of bathrooms and ceilings, unsafe storage of equipment, and food safety violations such as uncovered food items, unclean kitchen vents, and improper hand hygiene among dietary staff. These issues posed minimal harm or potential for actual harm to residents.

The facility failed to maintain the bath and shower rooms and resident rooms in good repair, with issues such as stained ceiling tiles, broken tiles, and cluttered bathrooms posing potential hazards. Additionally, the kitchen had multiple sanitation violations including uncovered food items, unwashed hands by staff, rust and residue on equipment, and contaminated ice scoop holders, all posing risks of foodborne illness.