Birch Creek Post Acute & Rehabilitation

glassy eyed.

When asked if he feeds her then, he stated yes, sometimes she'll open her mouth, she needs to eat. Resident 1's son confirmed they get frustrated if Resident 1 doesn't eat, and commented if they don't eat, they will die.On 07/30/2025 at 2:43 PM Resident 1's son said when food gets stuck in Resident 1's mouth they couldn't see anyway to remove it from their mouth except to open forcefully.

Staff F suggested telling Resident 1 to open their mouth, or putting spoon up to their mouth and Resident 1's son stated they had been told to try those methods before, but they did not work.On 07/30/2025 at 2:35 PM Resident 1's son stated they had brought food that was considered dangerous for his mom to eat, which he would feed her depending on her condition.

When Resident 1 was awake they were more agreeable than when sleepy.

At 2:52 PM when asked what they brought that was considered dangerous, Resident 1's son stated, soup with carrots, meat, dumplings and peaches. Resident 1's son was observed to feed Resident 1 the soup.

When Resident 1 coughed, their son stated, it happens sometimes. Resident 1 was observed to use their tongue to scan the inside of their mouth and then remove a slice of vegetable from their mouth. At 3:00 PM Resident 1's son explained that more natural (non-pureed) foods look familiar, more accurate, like they are supposed to, when everything is mashed up, you cannot even see what it is. At 3:33 PM Staff F explained that Resident 1's diet could not be upgraded from pureed without additional treatment sessions and told the resident's son they should not be giving foods that were not pureed. Resident 1's son stated that the staff had not told them that previously.

During an interview on 07/30/2025 at 3:33 PM, Resident 1's son acknowledged that during their previous stay at the facility their visits were supervised, when I fed her. Resident 1's son stated it was inconvenient for him, but he did not mind if they watched.On 07/30/2025 at 3:47 PM Staff F met with Staff A, and Staff B.

Staff F stated Resident 1's son wanted to bring foods into feed Resident 1 and the facility needed to be sure it was safe.

Staff F stated they would continue to see Resident 1 during the son's visitation and continue to work with them.

The investigator's concerns were shared including the facility's failure to implement the prior restrictions at readmission, the incident occurred again when it was preventable, and staff failed have documented monitoring after the incident.

Review of the facility incident investigation and summary sent 08/01/2025 showed the son had poor comprehension of why forcing Resident 1's mouth open to let it empty could cause harm, yet they documented there was no willful action or inaction that inflicts injury.

The summary did show the son was disregarding the resident's right to refuse food and drink and may ultimately lead to aspiration, physical or mental harm.REFERENCE: WAC 388-97-1060(3)(g)

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