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Bay Crest Care Center: Medication Records Falsified - CA
Despite giving scheduled medications, she left no written record that any treatments had occurred....
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Despite giving scheduled medications, she left no written record that any treatments had occurred....
The medication errors at Bay Crest Care Center occurred on November 1, 2025, when LVN 4 failed to administer any of the scheduled 3 p.m....
His doctor also ordered nurses to verify the oxygen humidification bottle contains adequate distilled water at least every shift....
Nurses were ordered to verify the oxygen concentrator's humidification chamber contained adequate distilled water at least every shift....
She emphasized that no clinical discharge summary was provided with the transfer....
The resident required emergency surgery after the Hoyer lift canvas loosened during the solo transfer at Brooklyn Center for Rehab and Residential Health Care....
The devices were supposed to be worn at all times, removed only for skin checks and hygiene care....
Certified Nursing Assistant #6 was attempting to move Resident #3 from bed to a recliner chair using a hoyer lift when the equipment failed....
Federal inspectors found the facility violated care planning requirements by failing to revise safety protocols after the fall....
Despite his mental clarity, facility records showed he was completely dependent on staff for self-care activities....
Both residents reported the neglect to nursing assistant #116 when lunch trays arrived....
Resident #19 told investigators on October 17 that she had missed one dose of carbidopa-levodopa on October 11 and suffered immediate consequences....
Resident 5 swallowed four medications meant for someone else at 9:00 AM on October 17, according to inspection records....
Once they canceled the subscription, administrators could no longer access records showing what training staff had completed....
The resident's spouse discovered the problem after the regular meal period had ended....
Staff B, a registered nurse at Southeast Iowa Regional Medical - Klein Center, found the resident on the bathroom floor....
The medication shortage forced the resident to transfer to another facility....
The resident's medical record, known as a Kardex, clearly indicated she needed two-person assistance for all transfers using mechanical equipment....
When pressed by inspectors, the nursing director could not provide evidence that the individualized care plan interventions were actually implemented....
The resident, identified in inspection records as R3, had a Braden Scale score of 12, indicating high risk for pressure ulcers....