She had a perfect score on a cognitive screening test, was her own legal decision-maker, and knew exactly what was happening to her.
Nursing Home News — Page 723
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The September 3, 2025 inspection focused on allegations of physical abuse affecting multiple residents at the facility.
The resident at Horsham Center for Jewish Life had been showing escalating signs of agitation for weeks.
Those facts come from a federal inspection completed September 3, 2025, triggered by a complaint at the 188th Street Southwest facility.
The incident at Sunnycrest Manor occurred during the evening meal on July 29, when the resident insisted he had more chicken on his plate.
The resident is identified in inspection records only as Resident 4, an individual living at Height Street Skilled Care on Height Street in Bakersfield.
Federal inspectors documented the arrangement during a complaint inspection on August 14, 2025.
The resident, identified in inspection documents only as Resident 7, was admitted on June 14, 2025.
The Certified Nursing Assistants were observed at 10:14 a.m.
Her nasal cannula lay wrapped on top of the shut-off oxygen machine.
But the underlying finding was not minor.
The August 20th incident at Fort Worth Transitional Care Center revealed systematic failures in fall prevention protocols.