New York Nursing Home Abuse Lawyer Blog

Smithtown Center for Rehabilitation and Nursing Care, located in Suffolk County, received sub-standard ratings from a Department of Health Certification Survey Dated November 2, 2011. Among the several deficiencies noted by the DOH were frequency of meals and providing/obtaining radiology services.

Section 483.35(f) of the CFR dictates that the facility provide three daily meals to residents, with no more than fourteen hours between dinner and breakfast the next day, unless a snack is provided at bedtime, in which case the interval may increase to sixteen hours. One logical reason for this rule is that the facility provides these meals, so the residents eating habits are subject to the staff providing them. Also, as it is the duty of the home to prevent the development of bedsores and infections, a consistent nutritional allowance is a necessity. Hunger can lead to distraction and accidents, which the facility is bound by law to make provisions to avoid. In this instance, residents reported that snacks were not provided on a regular basis by the staff, although these residents claimed feelings of hunger and that they would have readily accepted offered snacks.

For an elderly person, a fracture can have serious, and potentially life threatening, consequences. When a fall with a possible fracture occurs, it is essential to diagnose the results as quickly as possible to ensure that the correct treatment is given and the resident can begin to recover. For this reason, CFR 483.75(k)(1) provides that the facility must obtain radiology and diagnostics for its residents, and that the facility is responsible for the timeliness of obtaining these. In one instance noted in the report, a resident suffered a fall and complained of hip pain. Although an x-ray was ordered immediately, the results of this x-ray were not reported until almost sixteen hours later. As such, the injury, which was an acute right hip fracture, went undiagnosed during this interval. As evidenced by the DOH deficiency report, this lag is unacceptable.

A full list of deficiencies noted by the DOH with reference to Smithtown Center for Rehabilitation and Nursing can be located here.

Woodhaven Nursing Home, a Suffolk County-based nursing home facility, was cited for multiple deficiencies in a Department of Health Survey dated April 27, 2011. Among the violations were failure to have secure handrails in place, and failure to care for the resident in a matter maintaining dignity.

According to CFR 483.70(h)(3), a facility must ensure that corridors have firmly secured handrails on each side. In a facility in which numerous residents are fall risks, and the consequences of such falls are extremely serious, secured handrails are a necessity. The study found that three areas of Woodhaven's first floor were not equipped with handrails. Fortunately this did not result in actual harm for any of the residents. However, the study does note that the potential for more than minimal harm was present.

Section 483.15(a) of the Code specifies that the facility must promote the care of patients in such a manner that maintains or enhances his or her individuality. In three instances of Woodhaven failing to meet this standard, specific instructions for infection control were posted outside a residents' rooms, on some occasions left visible after the patient required such care. The information contained in the signs was plainly visible for other residents or visitors to see. When infections occur in nursing homes, as they sometimes do, it is the duty of the facility not only to treat the infection, but also to treat the resident suffering from the infection with dignity in the process. The DOH felt that Woodhaven failed to do this in these circumstances.

The full transcription of the Department of Health report can be found here.

Northern Riverview Health Care Center in Haverstraw, NY was cited in a Department of Health Deficiency Survey dated May 11, 2011. The DOH cited the facility for numerous violations, including failing to ensure that the facility was free of accident hazards, and failure to develop and implement written policies and procedures that prohibit mistreatment and/or neglect.

The Statement of Deficiencies documented incidents involving falls of five residents, with the falls resulting in actual harm to each. In one such incident, a resident was admitted with diagnoses including dementia and ataxia (unsteady gait). The care plan in place for this resident stated that an alarm was to be in use on his wheelchair at all times when the resident was out of bed. Despite this, the resident was discovered on the floor on the evening of February 20th, and it was discovered that an monitoring device was not in place, contrary to care plan specifications. Subsequent to the fall, the facility did not conduct a complete investigation. Additionally, no new interventions were put in place to prevent a repeat incident. As a result, the resident suffered another fall on April 20th while in the dining room, after which the assistant director of nursing stated that, again, a wheelchair monitor was not in place.

Nursing home facilities must ensure that residents receive proper supervision and assistive devices to prevent accidents. Such steps clearly were not taken in the case of this resident. After the initial fall, the facility should have ensured, at the very least, that the original care plan was followed. Despite the actual notice provided of his risk for falls after the first incident, no steps were taken to prevent additional accidents.

As stated above, the facility was also cited for failure to prevent abuse or neglect. This failure was evident for six residents out of a sample of 17. Among the indignities suffered by these residents were: corporal punishment that went without investigation (slaps about the face and head administered by the resident's son; a bruise of unknown origin to a resident's hip (this too was not investigated); and failure to implement proper alarm interventions for a resident known to be a fall risk.

A facility implements a care plan because the staff recognizes a risk of harm or injury due to the patient's physical or mental state. The plan is meant to limit further injury, or help to heal a current condition. The care plan has no effect if it is not implemented, however. In many of the incidents documented in the DOH survey, Northern Riverview recognized a risk, but failed to follow through on its own directives to minimize the risk. These failures resulted in the accidents and injuries above. The full reports, including additional citations and incidents, can be found here.