Resident 2 at Birch Creek Post Acute & Rehabilitation exhibited persistent yelling and screaming that affected multiple patients across different shifts, according to a November inspection. The facility's care plan listed generic interventions like "approach with a calm quiet voice" and "divert attention" but contained no specific strategies for the resident's most problematic behavior.
"Staff don't go check and the screaming for help is what bothers me," Resident 3 told inspectors during a November 7 interview. "She gets louder and louder the longer it goes on and noted that if the staff go in and talk to them then the screaming goes down."
The facility's own behavior monitoring records documented Resident 2's yelling and screaming across multiple shifts: night shift November 5, day shift November 7, evening shift November 11, and night shift November 12. Progress notes showed the resident "yelling out for assistance, looking for momma" and becoming "restless, agitated and yelling out" before dialysis treatments.
Resident 10, who previously shared a room with Resident 2, described the impact during a November 19 interview. "Their previous roommate, Resident 2, would shout all the time," the resident said. "Resident 2 had dementia so they ignored some of it, but it bothered them, Resident 2 would wake up screaming Help me, Help me!"
The disruption extended beyond roommates. Resident 7 told inspectors "there was some lady down the hallway that frequently loudly screamed help, help."
Despite documented evidence of the behavior's impact, inspectors found no detailed assessment of Resident 2's yelling in the clinical record. The September 2 behavior care plan failed to include targeted interventions specifically addressing the screaming episodes that were disturbing other residents and creating roommate conflicts.
Progress notes revealed the scope of the problem. An November 3 entry at 12:15 PM showed "Resident 2 was yelling out for assistance, looking for momma. Resident and roommate with disagreement due to Resident 2 yelling out." Another note from November 4 at 3:57 AM documented that "Resident 2 was yelling out during the earlier parts of the evening shift."
The facility's care plan acknowledged Resident 2 had dementia and "did not exhibit behavioral symptoms" according to an October assessment, contradicting the documented reality of persistent screaming that affected multiple residents. Staff were directed to watch for signs of nonverbal pain including restlessness and yelling, but no connection was made between potential pain and the disruptive vocalizations.
Staff H acknowledged during a November 19 interview that "Resident 2 had called out in the past, it was hard for them to stay in their chair as they wanted to get out," but claimed "lately Resident 2 was pretty calm" despite ongoing documentation of screaming episodes.
The facility's generic behavior interventions included redirecting the resident "to subjects that matter to them when behaviors occur" and monitoring "behavior episodes and attempt to determine the underlying cause." However, inspectors found no evidence these broad approaches addressed the specific pattern of nighttime screaming that was disrupting other residents' sleep and creating conflicts.
One progress note captured the resident's distress directly, documenting Resident 2 "yelling out Get me off this bed and requesting to go sit in their wheelchair" during a November 6 afternoon shift.
The inspection revealed a pattern where staff recognized the disruptive behavior but failed to develop individualized interventions beyond generic redirection techniques. Resident 3's observation that the screaming decreased when staff actually went to check on Resident 2 suggested simple attention might reduce episodes, but this insight wasn't incorporated into formal care planning.
The violation affected multiple residents who complained about sleep disruption and stress from the persistent screaming. Roommate conflicts emerged as direct consequences of the unaddressed behavior, creating additional management challenges for staff who had no specific protocols for the situation.
Inspectors cited the facility for failing to provide comprehensive assessments and care plans that address residents' behavioral symptoms. The citation noted that while staff attempted some interventions like calm approaches and redirection, these generic strategies proved inadequate for managing behavior that significantly impacted other residents' quality of life and care environment.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Birch Creek Post Acute & Rehabilitation from 2025-11-19 including all violations, facility responses, and corrective action plans.
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