Medication Error, Missing Drugs, and Wound Care Failures Raise Alarms at Brookside Care Center

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Lynda Bogala – Director, Brookside Care Center
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KENOSHA, Wis. — A string of regulatory violations at Brookside Care Center has cast doubt on the facility’s oversight and operational integrity, raising serious questions about the leadership of Executive Director Lynda Bogdala, who makes $135,000 annually – about $15,000 more than her husband, Mayor Bogdala.. Recent state surveys document a range of failures — including a medication error that led to a resident’s hospitalization, improper reporting of missing narcotics, and breakdowns in pressure ulcer care — that could expose Kenosha County to legal and financial liabilities.

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According to federal and state inspection records obtained by Kenosha County Eye, the most troubling incident involved a resident being hospitalized after receiving the wrong medication — a mistake Brookside officials confirmed publicly for the first time this week. Bogdala described the February incident as “isolated” and attributed it to a “deviation from established protocols,” promising that staff have since been retrained. However, critics argue that the incident reflects deeper systemic failures that go beyond a one-time error.

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Of particular concern is the facility’s delayed reporting of missing narcotic medication, a violation that state officials cited during a March inspection. Documents show that a full 16 days passed between the discovery of the missing oxycodone and notification to law enforcement — a delay far outside the required reporting window set by both federal law and the facility’s own policies. Notably, the State Survey Agency was never notified at all.

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According to the citation, the delay in alerting the sheriff’s department only occurred after Brookside’s corporate counsel advised the facility to do so on February 28. By that time, internal investigations were already underway, and employee drug tests had been completed. Nonetheless, the Department of Health Services found that Brookside had violated federal requirements on both the timeliness of reporting and the thoroughness of investigation.

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Bogdala was reportedly working remotely during this period — a fact that has drawn criticism due to county policies discouraging remote work for department heads. While Human Resources Director Clara Tappa said Bogdala was officially off duty or on pre-approved PTO during the relevant days, her absence during a crisis of this magnitude has added fuel to concerns about leadership accountability.

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Brookside also received citations for failing to complete discharge summaries for departing residents, an omission that can jeopardize continuity of care. State inspectors found that discharge notes were either missing entirely or failed to include crucial medical summaries and care plans, violating federal standards and potentially putting residents at risk during transitions to other care settings.

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Additional inspections revealed a pattern of neglect in wound care. One resident entered Brookside without any skin injuries but developed a deep tissue injury that deteriorated into an unstageable pressure ulcer. Inspectors determined that the resident’s care plan was not followed, and interventions to prevent the injury were not documented or implemented. In a follow-up survey in March, state regulators found that Brookside had still not corrected similar deficiencies for another resident, who was being transferred in a manner that violated medical instructions and observed without necessary protective gear for pressure wounds.

In her public response, Bogdala emphasized Brookside’s “deficiency-free” state survey from August 2023 and touted accolades from U.S. News & World Report. Yet those recognitions now stand in sharp contrast to the facility’s recent citations.

When asked about allegations that her hiring was politically influenced by her husband, then-Alderman Dave Bogdala, and former County Executive Jim Kreuser, the county’s HR director pointed only to her résumé and the County Board’s 2018 unanimous confirmation vote — sidestepping direct acknowledgment of the claims.

Mayor David Bogdala and Lynda Bogdala During Mayoral Campaign
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County Executive Samantha Kerkman defended Bogdala’s participation in her husband’s 2024 mayoral campaign, stating that Bogdala complied with county expectations regarding political activity. But some staff and observers remain skeptical about the blurred lines between political engagement and public service, especially in a role responsible for vulnerable residents.

The accumulation of citations — from poor wound care and medication errors to delayed reporting and policy violations — presents a pattern that critics say reflects not just operational breakdowns but leadership shortcomings. As one state document concluded, the facility’s “designated personnel failed to ensure pressure injuries were assessed and addressed in a timely, thorough manner,” even after previous citations.

The county could face further scrutiny — and possibly financial penalties — if additional incidents occur or if corrective actions fail to meet compliance standards. For now, Brookside remains under a heightened level of state oversight.

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  1. The county is having difficulty attracting and retaining quality employees, largely because of Kerkman & Tappa.

    It’s not just Brookside- it’s county wide. Low taxes aren’t going to matter too much when taxpayer services suffer due to a lack of quality employees.

    Didn’t hear her address that in her speech last night, though, huh?

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    1. I don’t know where you are getting your data from. Personal hatred of Kerkman and Tappa do not reflect reality.

      I just looked at the job postings for Kenosha County. There are 11 openings posted if you exclude the seasonal golf/parks jobs. That is less than 1% of their workforce. Those are very low numbers for a “business” with so many employees.

      I’ll take Kerkman any day over Kreuser, who was more interested in using tax money for political payback than treating employees well.

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      1. Just be a a position isn’t currently posted, doesn’t mean it isn’t open. Positions close, interviews are held, offers are declined, and there’s a waiting period before the position is posted again.

        There is no “personal hatred” of Kerkman or Tappa. I don’t really know Tappa, and my encounters with Kerkman have been pleasant enough. But— there are more positions open than reflected online on any one given day. Open positions also don’t give a good idea of turnover- it doesn’t show when a position is filled and then the CNA quits three weeks later because of county policy. It doesn’t show the number of experienced CNA’s who came to Brookside several years ago, but are now leaving due to bad management, poor policy changes, and better benefits within other organizations.

        This article, as well as the lawsuit shown on Tuesday’s county board agenda, show that there are issues that are directly related to staff/staffing issues.

        1. I’m belong to one the families mentioned in the article. These events took place before Kerkman was County Executive

          1. There may have been a few issues before Kerkman, but they’ve gotten much, much worse since then. You may be one of the families mentioned in this report— but the issues have grown in severity & frequency since the Kerkman changes.

      2. A good example is this: A quick review of the public works committee agenda shows that Public Works is looking for an engineer and a mechanic. Neither is listed on the open jobs page.

        There’s one Brookside CNA posting, one Willowbrook CNA posting, and one Willowbrook RA posting. They’re looking for more than one of each- there’s just ONE posting for each, with multiple candidates being sought.

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  2. I work for the state as well and I’m sorry But if the taxpayers are paying your wages, COVID is over, GET YOUR BUTT BACK TO WORK!!!! and someone in a higher position such as this should not even be allowed to work remote!!!

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  3. Heartbreaking to read this. Sadly these problems are not new. Both of my parents were in the rehab facility in ’17 and ’18. We met with Lynda, Barb B ( head nurse) at one time to discuss issues. “It couldn’t be”. Like our observations, details were fabricated. Residents shared not to complain as things get worse for them. The nursing process of giving meds and later assessing the response to meds didn’t occur. Call lights, not answered,
    ( patients called 911 to get help), bed sores, missed medications, items stolen from a residents room. A couple of CNA’s were verbally abusive to patients. At dinner time there were 2 CNA’s on each wing and and 3rd to float . One was leaving to pump, and would leave the floor, one-two would take their scheduled breaks, all during meal time. Leaving 2 or 3 to deal with 15 -20 residents. I would help cut food, get dinner, etc. for several residents. One Sat the ONE registered nurse for rehab called in, the RN in the nursing home covered. They push the limits beyond what should be allowed. Families that could, would be present to help keep their loved one better cared for.There were a few really good staff that truly cared about patients and did what they could. Keep in mind this was rehab where patients were somewhat able to speak for themselves. Nursing home, long term care patients are much more vulnerable. Residents had to request showers. We were told Brookside is the best. Heaven help us, if that is the best care we can provide in this county. They are county employees, paid well with good benefits. Not an excuse, but there is a shortage of Healthcare workers, and caring for elderly is a calling, making it harder to staff. Staffing level mandates need to be increased from the state so appropriate care is possible. CNA training has decreased in hours to push more people into the workforce, including free tuition, so they are less qualified than pre-covid. It’s a train wreck, but as director she needs to be accountable for the poor services being delivered. Families need to file complaints with the state and be diligent in demanding quality care.

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  4. Having dealing with both Badgala’s came away with same impressions Kenosha is in trouble with them in charge.

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  5. A friend’s mother got released from Brookside with no instructions. No medications or prescriptions. No VA appointments. That’s unacceptable.

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  6. Mrs. Bogdala may or may not be politically connected but the unanimous county board approval of her hiring suggests she meets the qualifications for her job. She is also entitled to use her accumulated leave. But the story is incomplete.
    1. While everyone would like to have an error free workplace, is the ratio of violations out of synch with state and national averages?
    2. What actions, if any, did Mrs. Bogdala take to correct this and ensure that it does not happen again? And to what degree was there transparency in the process?
    Thanks.

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    1. Let’s not pretend like the County Board Supervisors have any actual qualifications for anything- like their unanimous vote to appoint someone means that person is qualified. Maybe some of them do their homework (looking at you, Tim Stocker- thank you!) but that absolutely does not mean that an individual is qualified because the county board voted to appoint.

      1. Is the ratio of violations out of synch with state and national averages?
        What actions, if any, did Mrs. Bogdala take to correct this and ensure that it does not happen again? And to what degree was there transparency in the process?

        1. Errors and service failures are unacceptable when caring for those who cannot care for themselves- relation to state & national averages do not matter to individuals suffering due to the facility failures.

          1. Your point is understandable but not always realistic, sad to say. Of course, one goof is one too many in a perfect world.

            1. As someone who has a longstanding career in SNF administration (starting as a CNA, then RN, the MDS RN, finally ADON, with no urge to work as a DON), these issues are relatively easy to avoid. So, again, regardless of averages, a facility that takes an attitude of, “…at least we’re better than…” really isn’t better than anything.

              A facility that attracts and retains the best staff they possibly can, and, in turn, is able to staff their units appropriately, will have no problems avoiding these issues.

              1. We should always strive for excellence but, as you know, doctors bury their mistakes.

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              2. Once upon a time— that was Brookside. Once upon a time, nursing staff was falling over themselves to be hired at Brookside. They would work per diem there, just to have the hope of maybe a full-time position opening up.

                Not anymore.

  7. Now report on all the other long term care facilities that are far worse off than Brookside, you’d be surprised at what you find.

  8. You think that Brookside is bad?
    You should see crossroads care center at 8633 32nd Ave. This place is really bad terrible food under staffed uneducated and lazy. They have nurses who have been fired and hired back. One of which was let go for stealing and taking drugs to stay awake (Tia) is her name. The administrator here Steve has been responsible for all that goes on here and he had a toilet removed from a bathroom/shower and the hole is only covered by a cheap plastic bag! By the way it stinks. Plus they don’t put human waste in storage they just leave it in the hallway and that has to be very dangerous for people who have breathing problems.
    Come on in and see for yourself

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