Above average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Bethel Health Care Center during CMS and state inspections, most recent first.
A deficiency was cited for not ensuring a resident's right to dignity, self-determination, communication, and the exercise of their rights. The report does not specify the exact circumstances or individuals involved.
A resident with multiple chronic conditions was placed on comfort measures only following a physician's order, but the facility failed to review and revise the comprehensive care plan to include interventions specific to comfort measures. The resident was aware of the comfort measures order but was not informed about specific treatments, and staff interviews confirmed that the required care plan updates were not completed as per facility policy.
A resident who was unable to perform activities of daily living did not receive the necessary care and assistance from staff, resulting in unmet care needs.
Staff did not maintain a resident's head of bed elevation as ordered by the physician for management of orthostatic hypotension, instead routinely lowering the bed when the resident expressed discomfort. The care plan lacked interventions for this issue, and there was no documentation or provider notification regarding the resident's inability to tolerate the upright position, despite facility policies requiring such actions.
Surveyors found that medications, including insulin pens and IV solutions, were not consistently labeled with opening dates or resident names, and expired medications were present in storage areas. An LPN was unable to confirm ownership of an unlabeled insulin pen, and the DNS could not specify which staff were responsible for checking medication expiration, contrary to facility policy.
Staff failed to follow required protocols for safe transfers, supervision, and smoking policy enforcement. A resident dependent on staff for transfers was moved by only one staff member using a mechanical lift, resulting in a strap detachment. Multiple residents with a history of smoking were able to smoke on facility grounds and possess smoking materials, despite a non-smoking policy. Another resident at high risk for aspiration was left unattended with food and fluids within reach, and a resident with dementia and high fall risk was left alone in the bathroom, leading to a fall.
Failure to Honor Resident Rights
Penalty
Summary
A deficiency was identified regarding the failure to honor the resident's right to a dignified existence, self-determination, communication, and the exercise of their rights. The report notes that the facility did not ensure these resident rights were upheld, but does not provide specific details about the actions or inactions that led to this deficiency, nor does it mention any particular events or residents involved.
Failure to Revise Care Plan for Comfort Measures Only
Penalty
Summary
The facility failed to ensure that the comprehensive care plan for a resident with chronic obstructive pulmonary disease, hypertensive heart disease with heart failure, and chronic pain was reviewed and revised to include interventions related to comfort measures only. After the resident was placed on hospice care due to heart failure and chronic pain, hospice care was later discontinued, and a physician's order directed comfort measures only. However, a review of the clinical record did not identify a care plan with interventions specific to comfort measures. The resident was aware of the comfort measures order but was not sure what specific treatments were in place to maintain comfort. Interviews with facility staff revealed that the MDS director was responsible for reviewing and revising care plans according to the resident's assessment schedule, and the social worker was responsible for care plans related to hospice and comfort measures. The MDS director acknowledged that a terminal diagnosis care plan should have been added and amended to reflect the comfort measures order, but this was not done. Facility policy required that care plans be reviewed and revised following significant changes in status and kept current by all disciplines, but this process was not followed for the resident in question.
Failure to Assist Residents with Activities of Daily Living
Penalty
Summary
A deficiency was identified when care and assistance were not provided to residents who were unable to perform activities of daily living (ADLs) independently. The report notes that residents requiring help with ADLs did not receive the necessary support from staff, resulting in unmet care needs for those individuals. No additional details about the specific residents involved, their medical history, or their condition at the time of the deficiency are provided in the report.
Failure to Follow Physician's Order for Bed Position and Notify Provider
Penalty
Summary
Staff failed to follow a physician's order for a resident with a history of orthostatic hypotension, which required the head of the bed to be elevated at all times, with some decline allowed at bedtime. Despite a visible sign above the resident's bed instructing staff to keep the head of the bed elevated, multiple observations over several days found the resident lying completely flat. Nursing staff reported that the resident would yell when the bed was elevated, leading them to routinely lower the bed, but there was no documentation that the physician or APRN was notified of the resident's inability to tolerate the upright position as ordered. The care plan did not include interventions related to the resident's hypotensive episodes or the need to remain upright in bed. Review of the clinical record showed no evidence of physician notification regarding the resident's intolerance to the ordered bed position. Interviews with clinical leadership confirmed they were unaware that staff were not maintaining the head of the bed elevation and had not been informed of the resident's reactions. Facility policies required notification of changes in condition and person-centered care planning, but these were not followed in this case.
Medication Storage and Labeling Deficiencies Identified
Penalty
Summary
Surveyors observed multiple deficiencies in the facility's medication storage and labeling practices. During an inspection of the medication storage room, expired medications were found, including a box of Ipratropium and Bromide and Albuterol with an expiration date of 6/2025, and two bottles of Lansoprazole syrup, both past their expiration dates. Additionally, an IV 5% dextrose 1000ml bag was found outside of its manufacturer plastic cover, with a label indicating it should be used by a specific date, as per pharmacy protocol. The Director of Nursing Services (DNS) confirmed that IV supplies sent by the pharmacy are labeled with a 28-day expiration after removal from the manufacturer bag, after which they should be discarded. However, the DNS was unable to specify which nurse or shift is responsible for checking medication expiration or how often this task is performed. Further inspection of a medication cart revealed that an opened Humalog Kwikpen was properly dated, but a Lantus Solostar Insulin pen was found opened without a resident name or date of opening. An LPN stated that the Lantus pen likely belonged to a specific resident, as they were the only one on insulin on that cart, but this was not clearly labeled. Facility policy requires that open-dose vials of insulin be maintained no longer than the manufacturer’s instructions or 28 days, whichever is shorter, and that they be properly labeled with the date opened. These findings indicate a failure to consistently date insulin pens when opened and to ensure all medications are within their expiration dates, as required by facility policy and professional standards.
Failure to Prevent Accident Hazards and Enforce Smoking and Supervision Policies
Penalty
Summary
Staff failed to follow physician orders and professional standards of practice for safe resident transfers and supervision, resulting in multiple deficiencies. In one instance, a resident with hemiplegia and muscle weakness, who was dependent on staff for transfers, was moved using a sit-to-stand mechanical lift by a single nursing assistant instead of the required two staff members. During this unsupervised transfer, a lift strap detached, though the resident did not fall. Facility documentation and interviews confirmed that the resident was supposed to be transferred with two staff, as per care plan and manufacturer guidelines, but this was not followed. Several residents with a history of smoking or current smoking behavior were not adequately supervised or prevented from smoking on facility grounds, contrary to the facility's non-smoking policy. Residents were found in possession of cigarettes and lighters, and some were observed smoking in designated outdoor areas without staff supervision or fire safety measures in place. Interviews revealed that staff were aware of these behaviors but did not consistently intervene or conduct searches for smoking materials after violations. Residents and visitors were able to bring in and use smoking materials, and there was a lack of clear communication and enforcement of the non-smoking policy. Additionally, a resident at high risk for aspiration due to severe dysphagia was left unattended with a meal tray and accessible fluids at the bedside, despite orders and care plans requiring total assistance and supervision during feeding. Observations showed that the resident was unable to feed themselves or safely access food and drink, yet staff left food and thickened liquids within reach, increasing the risk of aspiration. Another resident with dementia and a high fall risk was left alone in the bathroom by a nursing assistant, resulting in an unwitnessed fall and subsequent injury. Staff interviews indicated a lack of awareness and education regarding which residents required continuous supervision during toileting.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Bethel
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Autumn Lake Healthcare At Glen Hill | 2.6 mi | ★★★★★ | 0 | 0 |
| Civita Care Center At Danbury | 2.7 mi | ★★★★★ | 0 | 0 |
| Saint John Paul Ii Center | 4 mi | ★★★★★ | 9 | 0 |
| Havencare At Hancock Hall | 4.3 mi | ★★★★★ | 0 | 0 |
| Havencare At Filosa | 4.3 mi | ★★★★★ | 1 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.