Birchwood Rehab: Dementia Care Plan Failures - PA
The resident at Birchwood Rehabilitation & Healthcare Center also intruded into other residents' rooms, made accusatory statements toward staff, and physically attacked a visiting family member of another resident. Nursing documentation from April through mid-August revealed the resident was "often difficult to redirect" despite the ongoing behavioral episodes.
Resident 1 was admitted with diagnoses of dementia and anxiety disorder. A June assessment showed moderate cognitive impairment with a score of 12 on the Brief Interview for Mental Status, a standardized tool that measures attention, orientation and memory recall. Scores between 8 and 12 indicate moderate cognitive decline.
The facility's care plan for the resident's cognitive impairment failed to identify any of the specific violent behaviors documented by nursing staff over the four-month period. Inspectors found no individualized interventions designed to address or manage each behavioral symptom.
The care plan also lacked information about the resident's preferences, social history, daily routines or personal interests that could inform effective behavioral management strategies. Federal regulations require nursing homes to incorporate such details into person-centered care plans for residents with dementia-related behavioral symptoms.
Staff documented multiple instances of verbal and physical aggression throughout the spring and summer. The resident yelled at staff, refused care, and physically struck employees who attempted to provide assistance. The violence extended beyond staff to include at least one incident involving a family member visiting another resident.
Despite the documented pattern of aggressive behavior, facility administrators took no apparent action to modify the resident's care approach or develop targeted interventions. The existing care plan remained generic and failed to address the specific challenges posed by the resident's behavioral symptoms.
When interviewed on August 14, the Director of Nursing confirmed the facility could not provide evidence of developing or implementing an individualized, person-centered plan to address the dementia-related behaviors. The admission came after inspectors reviewed nearly four months of nursing documentation showing repeated violent incidents.
Dementia affects cognitive function, memory and personality, often leading to behavioral changes as the condition progresses. Effective care plans typically incorporate non-pharmacological interventions tailored to each resident's background, preferences and triggers for aggressive behavior.
The facility's failure to address the behavioral symptoms left staff vulnerable to continued attacks while potentially compromising the resident's quality of care. Proper behavioral management strategies can reduce aggressive incidents and improve outcomes for residents with dementia-related symptoms.
State inspectors cited the facility for failing to provide appropriate treatment and services to residents with dementia. The violation was classified as causing minimal harm or potential for actual harm, though the four-month duration of documented incidents suggests ongoing risk to staff and other residents.
The inspection was conducted in response to a complaint, indicating concerns about the facility's dementia care may have originated from staff, residents or family members. Complaint investigations typically focus on specific allegations rather than comprehensive facility reviews.
Birchwood Rehabilitation & Healthcare Center operates at 395 Middle Road in Nanticoke, serving residents requiring skilled nursing and rehabilitation services. The facility is required to submit a plan of correction addressing how it will prevent similar violations in the future.
The case illustrates broader challenges nursing homes face in caring for residents with dementia-related behavioral symptoms. Without proper assessment and individualized interventions, aggressive behaviors can escalate and create unsafe conditions for everyone in the facility.
For Resident 1, the months of documented violence occurred while living with moderate cognitive impairment and anxiety disorder, conditions that required specialized attention the facility failed to provide. The resident's care plan remained inadequate even as nursing staff continued documenting aggressive incidents week after week.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Birchwood Rehabilitation & Healthcare Center from 2025-08-20 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
BIRCHWOOD REHABILITATION & HEALTHCARE CENTER in NANTICOKE, PA was cited for violations during a health inspection on August 20, 2025.
Nursing documentation from April through mid-August revealed the resident was "often difficult to redirect" despite the ongoing behavioral episodes.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.