Saint John Paul Ii Center
SAINT JOHN PAUL II CENTER in DANBURY, CT — inspection on August 21, 2025.
Found 3 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Review of the facility policy titled Abuse and Neglect, undated, directed, in part, it is the policy of the facility to prevent any form of abuse or neglect towards a resident or residents whenever possible and to promptly and completely investigate and act upon the incident.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
08/21/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Saint John Paul II Center
33 Lincoln Avenue Danbury, CT 06810
SUMMARY STATEMENT OF DEFICIENCIES
Review of facility cardiopulmonary resuscitation (CPR) policy; in part, identified if a patient does not have a do not resuscitate order (DNR), CPR certified staff will initiate CPR and emergency medical services (EMS) will be activated. CPR should also be discontinued when a provider, including a nurse (RN) or nurse practitioner (NP) pronounces death provided they have the authority to do so.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
08/21/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Saint John Paul II Center
33 Lincoln Avenue Danbury, CT 06810
SUMMARY STATEMENT OF DEFICIENCIES
5:20 AM, 5:50 AM, 6:20 AM and 6:50 AM, LPN #2 documented Resident #2 was asleep, and had stopped evaluating Resident #2's neurological status.
The neurological evaluation flow sheet was completed again at 7:20 AM on 7/20/25 at 7:20 AM to 2:00 AM on 7/21/25 indicating Resident #2's neurological status was assessed.
Interview with RN #1 on 8/21/2025 at 11:12 AM identified on 7/22/25 at approximately 2:50 AM, LPN #1 notified him Resident #2 had a fall and was lying on the floor in his/her room. RN #1 indicated when he entered the room Resident #2 was lying on his/her back on the floor next to the bed and Resident #2 was alert and responsive, denied hitting his/her head, denied any pain, and no injuries were noted. RN #1 identified he assessed Resident #2's neurological status, Resident #2's neuros were within normal limits, and initiated neuro checks.
Interview with the 11PM-7AM nurse aide, Nurse Aide (NA) #4, on 8/21/25 at 11:19 AM identified on 7/22/25 at approximately 2:50 AM, LPN #2 yelled to her to come down to Resident #2's room. NA #4 identified when she entered the room Resident #2 was on his/her back lying on the floor next to the bed with his/her head next to the bottom of the bed. NA #4 indicated Resident #2 was alert, awake, and talking and after RN #1 assessed Resident #2, they assisted Resident #2 back into bed using a mechanical lift.
Interview with LPN #2 on 8/21/25 at 11:30 AM on 7/22/25 at approximately 2:50 A.M. Resident #2 was yelling out for help, so she ran down to the room and observed Resident on his/her back on the floor next to his/her bed with his/her head at the bottom of the bed. LPN #2 indicated she notified RN #1 who came to assess Resident #2 and no injuries were noted. LPN #2 identified Resident #2 was assisted back into bed by RN #1 and the nurse aides via a mechanical lift. LPN #2 identified she evaluated Resident #2's neurological status every fifteen (15) minutes from 2:50 AM until 4:50 AM but at approximately 5:20 AM Resident #2 fell asleep, so she did not wake Resident #2 up the remainder of her shift to evaluate Resident #2's neurological status and left at 7:00 AM.
Interview and clinical record review with the Director of Nursing (DON) on 8/21/25 at 1:25 PM identified her expectations are anytime a resident has an unwitnessed fall neurological evaluations are initiated and conducted per the frequency on the neurological flow sheet until complete.
The DON identified on 7/20/25 when Resident #2 was sleeping, LPN #2 should have woken up Resident #2 and assessed Resident #2's neurological status.
Although requested, a facility neurological assessment policy was not provided.
Facility ID:
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.