Gardens For Memory Care At Easton, The

Based on facility policy review, observation, and staff interview, it was determined that the facility failed to store food in a sanitary manner in the dietary department and on two of two nursing units. (Second floor and Third floor) Findings include: Review of the facility's policy entitled, Dietary Dress Code Policy, dated February 12, 2026, revealed that all staff were to cover all of their hair with a hair restraint when working with or around food. Observations during the kitchen tour on April 7, 2026, at 10:20 a.m., revealed the following: There was a hole in the wall above the floor next to the reach in refrigerator with a black substance. There was one flying insect in the dry storage area and one in the clean pan room next to the dish machine area. There was a bulk container of thickener that was not dated and had white dried food debris covering the length of the outside of the lid. The outside of the lid to the bulk container of flour was covered with white food debris. On the juice refrigerator, there were areas of dried food and liquid splatter along the side. During…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, it was determined that the facility failed to maintain a safe. clean, and sanitary environment on two of two nursing units. (Second floor and Third floor)Findings include: During an environmental tour of the second and third floor nursing units on April 7 and 9, 2026, from 10:10 a.m. until 2:20 p.m., the following was observed: In the second-floor small dining room, the wooden trim on the walls was marred. There were two stained ceiling tiles in the corridor between rooms [ROOM NUMBERS], and 208 and 209. In room [ROOM NUMBER], the privacy curtain for bed two had a brown/dark gray stain, and the window curtain above the air-conditioning unit was off the rod and had a brown stain on it. In room [ROOM NUMBER], the towel dispenser was not working and there were dark brown spots on the wall above bed three. In room [ROOM NUMBER], the grab bar in the bathroom was loose. There was a hole in the ceiling tile in front of room [ROOM NUMBER]. In room [ROOM NUMBER], the header of the window above the…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on facility policy review, observation, and staff interview, it was determined that the facility failed to administer medications in a manner that prevented the spread of infection for two of 22 sampled residents. (Residents 24 and 81) Additionally, the facility failed to properly handle soiled linen and failed to keep clean linen from becoming contaminated to prevent the spread of infection. Findings include: Review of the facility policy entitled Administering Oral Medications, last reviewed February 12, 2026, revealed that employees were not to touch the medication with their hands. Review of the facility policy entitled, Departmental (Environmental Services) - Laundry and Linen, last reviewed February 12, 2026, revealed that employees sorting or washing linen were to wear a gown and gloves and clean linen was to remain hygienically clean (free of pathogens in sufficient numbers to cause human illness) through measures designed to protect it from environmental contamination. Observation on April 8, 2026, between 8:25 a.m. and 8:58 a.m., revealed Licensed Practical Nurse…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on clinical record review, observation, and staff interview, it was determined that the facility failed to provide assistance with dining in a manner that promoted and maintained dignity for one of 22 sampled. (Resident 12)Findings include:Clinical record review revealed that Resident 12 had diagnoses that included dementia, and protein-calorie malnutrition, and had impaired vision. Review of the Minimum Data Set assessment, dated March 13, 2026, revealed that the resident had cognitive impairment and required assistance from staff with eating. Review of Resident 12's care plan revealed that the resident had self-care deficits and was at increased risk for nutrition problems related to dementia and included interventions for staff to encourage fluid and food consumption, provide cueing for eating, and reorient as needed. On April 7, 2026, from 12:45 p.m. through 1:25 p.m., Resident 12 was observed in the dining room with other residents and a lunch tray that included a covered drink, a banana, and a ham and cheese sandwich on a plate. The resident was observed having…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on clinical record review, observation, and staff interview, it was determined that the facility failed to implement physicians' orders for two of 22 sampled residents. (Residents 49 and 76)Findings include: Clinical record review revealed that Resident 49 had diagnoses that included peripheral vascular disease (a progressive circulation disorder involving damage or blockage in blood vessels often affecting legs and feet). A physician's order dated March 5, 2026, directed staff to apply specialized compression garments designed to improve circulation and reduce blood clot risks (TED stockings) in the morning and to remove them at bedtime. On April 7, 2026, at 1:00 p.m. Resident 49 was observed lying in bed, and the TED stockings were not in place. On April 9, 2026, at 11:05 a.m., 12:30 p.m., and 1:27 p.m., Resident 49 was observed ambulating on the nursing unit, and the TED stocking were not in place. In an interview on April 10, 2026, at 9:40 a.m., the Director of Nursing confirmed there was no evidence that the physician's order was followed or that the treatment was refused…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on clinical record review, observation, and staff interview, it was determined that the facility failed to provide the necessary device to prevent an incident or accident for one of 22 sampled residents. (Resident 90)Findings include: Clinical record review revealed that Resident 90 had diagnoses that included dementia with mood disturbance and had a history of falling. A review of the Minimum Data Set assessment (a periodic evaluation of resident care needs) dated March 23, 2026, revealed the resident had memory impairment. A review of Resident 90's care plan revealed that the resident had behaviors that included being territorial of her space and being combative. A nurse noted on July 11, 2025, that Resident 90 was observed lying on the floor by her bed holding on to the ankle of another resident who had walked into her room. The new intervention following the incident on July 11, 2026, was for staff to hang a stop sign across the doorway of her room to deter wandering residents from entering. Observations on April 8, 2026, between 11:17 a.m. and 3:15 p.m., and on April 9,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, review of facility policy, clinical record review, and staff interview, it was determined that the facility failed to maintain a medication error rate of less than five percent (%) for one of two nursing units observed during medication administration. (Second floor)Findings include: Observations of medication administration on April 8, 2026, from 8:40 a.m. to 8:58 a.m., revealed 29 medication opportunities with three medication errors that resulted in a medication administration error rate of 10.34%. Review of the policy entitled Crushing Medications, last reviewed on February 12, 2026, revealed that medications were to be crushed only when it was appropriate and safe to do so, consistent with physicians' orders and that nursing staff or the consultant pharmacist was to notify any attending physician who gave an order to crush a drug that the manufacturer stated should not be crushed, such as enteric coated medications. Review of the facility list of medications not to be crushed revealed that a Depakote tablet was not to be crushed due to the enteric coated…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, it was determined that the facility failed to provide a safe, clean, and comfortable environment on two of two nursing units. (Second floor and Third floor) Findings include: Observations on April 29, 2025, from 9:30 a.m. through 12:50 p.m., and on April 30, 2025, from 8:54 a.m. through 11:58 a.m., revealed the following environmental issues: The assist bars on the toilet in room [ROOM NUMBER] were loose and wobbly. The table in the dining room across from room [ROOM NUMBER] was scuffed and damaged. The assist bars on the toilet in room [ROOM NUMBER] were loose and wobbly. The towel racks were loose. The assist bars on the toilet in room [ROOM NUMBER] were loose and wobbly. There was a dried orange substance on the floor in front of the closets for beds three and four. The bathroom doorway in room [ROOM NUMBER] was soiled with a dried brown stain. The heater was damaged. The window curtain in room [ROOM NUMBER] was soiled. For bed two, the fall mat had dust and several dried, gray spots on…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, review of facility documentation, and staff interview, it was determined that the facility failed to ensure that safety interventions were in place for one of three sampled residents at risk for behavioral symptoms. (Residents 1, 2) Findings include: Clinical record review revealed that Resident 1 had diagnoses that included traumatic brain injury and dementia with behavioral disturbance. Review of the care plan revealed that the resident was to have a stop sign on his door to prevent other residents from entering his room. In addition, staff were to ensure the stop sign was at the door post at all times, deter other residents from entering the room, and replace the stop sign when it was detached. Further review of the care plan revealed that the resident had anxiety and ineffective coping when his belongings were touched. Review of a trauma assessment dated [DATE], revealed that Resident 1 exhibited physical behaviors towards another resident who had intruded on his space. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, facility policy review, observation, and staff interview, it was determined that the facility failed to ensure that assessed safety measures were in place for one of six sampled residents at risk for falls. (Resident 20) In addition, the facility failed to ensure that a resident at risk for elopement did not leave the secured nursing unit without staff knowledge for one of three sampled residents who were at risk for elopement. (Resident 75) Findings include: Clinical record review revealed that Resident 20 was admitted to the facility on [DATE], with diagnoses that included Alzheimer's disease, insomnia, and history of falling. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed that the resident had cognitive impairment. On August 23, 2023, the physician ordered for the resident to have bilateral (both sides) fall mats next to her bed. Review of the care plan revealed that Resident 20 was at risk for falls with an intervention for bilateral fall mats.…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.