Inspection Reports for Bethel Health Care Center

A desk audit was conducted to review the implementation of the Plan of Correction for a violation letter dated August 7, 2025.

Violations #1 through #6 were identified as corrected as of August 28, 2025. The Director of Nursing was notified of the corrections on September 22, 2025.

The inspection was conducted as a licensing renewal inspection and included review of complaint investigations #CT#42588 (Aspen) and #121748 (Iguis).

Violations of the General Statutes of Connecticut and/or regulations were identified at the time of this inspection, as noted in an attached violation letter. Certification files were also reviewed.

Complaint investigations #CT#42588 (Aspen) and #121748 (Iguis) were reviewed during this inspection.

A complaint investigation survey was conducted to determine compliance with 42 CFR Part 483 requirements for long term care facilities.

No deficiencies were cited as a result of this complaint investigation survey.

Complaint Investigation Survey, ACT Reference Numbers CT#25310 and CT#25941, conducted to assess compliance with federal long term care regulations.

The inspection was conducted as a licensure renewal inspection and included a complaint investigation.

The report indicates that no violations of the General Statutes of Connecticut or regulations were identified at the time of this inspection. Certification file verification was completed.

Complaint investigation was conducted under complaint numbers 21-216411 and 21-134006.

The inspection visit was conducted as a complaint investigation (#34274) following allegations of verbal abuse at Bethel Health Care Center.

The investigation found that the facility failed to protect a resident from verbal abuse by a housekeeper, and failed to ensure immediate notification to the Administrator following the incident. The housekeeper was terminated due to poor conduct. The facility policies on resident rights and abuse were reviewed, and plans of correction were outlined.

Complaint #34274 was substantiated with findings that a housekeeper verbally abused Resident #1 and the facility failed to notify the Administrator immediately. The housekeeper was terminated effective 3/24/23 due to poor conduct.

The inspection was conducted as a complaint investigation related to Complaint Investigation #32557, focusing on violations of Connecticut State regulations identified during unannounced visits to Bethel Health Care Center.

The inspection found multiple violations related to failure to notify physicians of weight discrepancies and meal refusals for Resident #1, inadequate documentation of incontinence care, and inconsistent weight monitoring practices. The facility was cited for deficiencies in nutrition monitoring, weight documentation, and incontinent care documentation.

Complaint Investigation #32557 was substantiated with violations identified related to nutrition and weight monitoring, and incontinent care documentation.

The inspection visit was conducted as a licensing inspection for renewal purposes.

Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection. The facility was found to be in compliance with visitation.

Unannounced visits were made to Bethel Health Care Center which concluded on July 21, 2021 by representatives of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting a licensure renewal and a certification inspection.

The report details multiple violations of Connecticut State Agencies regulations noted during the visits, including deficiencies in medication self-administration assessments, advanced directive consent completion, timely medication administration, specialty mattress settings, employee performance evaluations, dental services, and infection control practices. Plans of correction with completion dates were provided for each violation.

The inspection was conducted as an unannounced licensure renewal and certification inspection to assess compliance with state regulations and statutes.

Violations of Connecticut State Agencies regulations were identified during the inspection, including deficiencies related to medication self-administration, advanced directives, medication administration timeliness, specialty mattress settings, employee performance evaluations, dental services, and infection control. Plans of correction were submitted for each violation with completion dates.

A COVID-19 Focused Survey and a Complaint Investigation Survey were conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

No deficiencies were cited as a result of this survey, indicating compliance with infection prevention and control requirements.

The visit was complaint-related as indicated by the Complaint Investigation Survey, ACTS Reference Number CT00028303. No deficiencies were found.

A Complaint Investigation Survey was conducted at Bethel Health Care Center on August 4, 2020 to determine compliance with 42 CFR Part 483 requirements for Long Term Care Facilities.

No deficiencies were cited as a result of this survey. The facility was in compliance with the requirements of 42 CFR Part 483, Subpart B, at the time of the investigation survey.

The survey was conducted as a complaint investigation under ACTS Reference Numbers CT00027181 and CT#28144. No deficiencies were found.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

No deficiencies were cited as a result of this COVID-19 Focused Survey.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

No deficiencies were cited as a result of this COVID-19 focused survey at Bethel Health Care Center.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

No deficiencies were cited as a result of this COVID-19 focused survey conducted at Bethel Health Care Center.

An unannounced visit was made to Bethel Health Care Center on May 20, 2020 by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting a COVID-19 focused infection control survey.

The facility failed to utilize Personal Protective Equipment (PPE) according to policy, including staff not wearing surgical masks while handling clean laundry, a nurse aide wearing a surgical mask underneath an N95 mask incorrectly, and a COVID-19 symptom resolved resident remaining on the COVID-19 positive unit for seven days post symptom resolution despite an available empty room.

The visit was conducted as a COVID-19 infection control monitoring visit to assess compliance with infection control practices during the pandemic.

Violations of Connecticut State regulations were identified related to infection control practices, including failure to wear masks properly and failure to transfer a COVID-19 symptomatically resolved resident off the COVID-19 positive unit. A citation was issued and a plan of correction was required.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

The facility failed to utilize Personal Protective Equipment (PPE) in accordance with policy, failed to ensure a staff member wore an N95 mask properly to optimize effectiveness, and failed to transfer a COVID-19 symptom resolved resident off the COVID-19 positive unit in a timely manner.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

The survey found the facility compliant with no deficiencies cited related to infection prevention and control practices for COVID-19.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

The survey found that the facility was in compliance with infection prevention and control requirements related to COVID-19. No deficiencies were cited as a result of this survey.

An unannounced visit was made to Bethel Health Care Center on April 21, 2020, by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting an inspection related to COVID-19 infection control.

The facility failed to ensure the proper use of PPE when providing care to residents with known positive COVID-19 status and residents identified as negative. Staff were observed not removing disposable rain ponchos and isolation gowns when entering or providing care to residents who were not confirmed positive for COVID-19, contrary to facility policy.

The visit was complaint-related, focusing on infection control practices regarding PPE use with COVID-19 positive and negative residents. The report does not explicitly state substantiation status.

A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.

The facility failed to ensure the proper use of PPE when providing care to residents known to be positive for COVID-19 and then to residents identified as negative. Staff were observed wearing a disposable rain poncho over a paper isolation gown continuously throughout their shift without doffing between residents, including those who were COVID-19 negative. The facility policy required extended use of gowns and ponchos for the entire shift, which was not consistent with infection control best practices.

The inspection was conducted as a complaint investigation related to complaint #26158.

No violations of the General Statutes of Connecticut or regulations were identified at the time of this inspection.

Complaint investigation #26158 was conducted. No violations were found during the inspection.

An unannounced visit was made to Bethel Health Care Center on May 8, 2019 by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting an investigation.

The facility was found to have violations related to failure to provide incontinent care prior to hospital transfer for one resident and failure to ensure timely administration of IV medications for another resident. The findings were based on documentation reviews and staff interviews.

Complaint #25351. The investigation was complaint-driven as indicated by the complaint number referenced in the letter and the nature of the findings.

The inspection was conducted to evaluate the accuracy of assessments related to resident discharge status, specifically reviewing documentation and coding for Resident #125.

The facility failed to accurately reflect the discharge status of Resident #125 in the Minimum Data Set (MDS) assessment, as the resident was discharged to the community but the MDS indicated discharge to an acute hospital. The facility acknowledged the error and planned to correct the coding.

Unannounced visits were made to the facility on April 1, 2, 3, and 4, 2019 by representatives of the Facility Licensing & Investigations Section for the purpose of conducting a certification survey, a licensure inspection and multiple investigations.

The facility was cited for multiple deficiencies including failure to honor residents' advanced directives, failure to notify of significant changes such as weight loss, failure to report injuries of unknown origin, inadequate discharge planning, failure to provide adequate grooming and showers, failure to implement physician medication orders and monitor psychotropic medications appropriately, improper medication storage, failure to follow up on dental recommendations, failure to maintain dishwasher temperatures, and infection control lapses including improper catheter bag placement and sharps storage.

The inspection was conducted due to a complaint investigation involving multiple complaint numbers and for licensing inspection purposes.

The facility was found to have multiple violations including failure to notify the Advanced Practice Registered Nurse (APRN) of significant weight loss, failure to implement policies for injury of unknown origin, failure to accurately reflect resident discharge status, failure to provide adequate grooming and documentation for residents, failure to ensure medications were appropriately stored and administered, and failure to maintain infection control practices.

The visit was complaint-driven with complaints #23061, 23876, 23077, 23703, 23084, 25046, and 24515 investigated. The complaints involved issues such as failure to notify APRN of weight loss, injury of unknown origin, medication management, and infection control.

The document is a Plan of Correction submitted in response to a survey conducted at Bethel Health Care Center on April 1, 2, 3, and 4, 2019 by the Facility Licensing Investigations Section of the Department of Health.

The survey identified multiple violations related to failure to ensure residents' advanced directives were honored, failure to notify APRN of significant weight loss, failure to implement policies for injury of unknown origin, failure to provide adequate grooming and showering, failure to accurately reflect resident status at discharge, failure to monitor and address behaviors related to antipsychotic medication, failure to implement infection control practices, and failure to follow up on dental recommendations among others.

The visit was conducted as a desk audit to review the plan of correction for a violation letter dated 2018-03-06.

The review found that violations 1a,b,c; 2a,b,c,d; 3a,b,j; 4a,b; 5a; 6a,b,j; 7a; and 8a have been corrected.

The document is a plan of correction filed by the facility in response to violations related to improper use of PPE and infection control practices during the COVID-19 pandemic.

The facility failed to ensure proper use of PPE, including wearing N95 masks effectively, and failed to transfer a COVID-resolved resident off the unit timely. The plan outlines corrective actions including resident relocation, staff education, and audits.