Articles Posted in Choking/Aspiration

Hill Haven Nursing Home suffered 16 fatalities from Covid-19 as of July 12, 2020, state records report. The nursing home also received 29 citations over violations of public health code between 2016 and 2020, according to health records accessed on July 13, 2020.  The Webster nursing home’s citations resulted from a total of seven surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately protect residents from neglect. Section 483.12 of the Federal Code stipulates that nursing homes must ensure residents are kept free from abuse and neglect. A November 2019 citation found that Hill Haven Nursing Home did not ensure such for one resident. The citation states specifically that the resident “did not receive incontinence care, positioning, or bedtime care for two consecutive shifts resulting in skin issues.” After a Certified Nursing Assistant reported to a Licensed Practical Nurse that it appeared the resident had not received care—that the resident “was still sitting in the chair, wearing the same clothes as the previous day, and was soaked with urine and feces through the incontinence brief and the pants”—the Registered Nurse Manager initiated an investigation and found that the resident had not received care over two shifts and “remained in the chair all nigh.” A plan of correction undertaken by the facility included the re-education and disciplining of relevant staff.

2. The nursing home did not adequately protect residents from accidents. Section 483.25 of the Federal Code stipulates that nursing homes must ensure resident environments are kept as free as possible of accident hazards, and that residents are provided with adequate supervision to prevent accidents. A July 2019 citation found that Hill Haven Nursing Home did not ensure such. The citation specifically describes a resident who “rolled out of bed and was found with his legs resting on the baseboard heater that was next to his bed” and sustained a redacted injury to hi slower extremities. A plan of correction undertaken by the facility included the relocation of the resident to another room with a bed that was further from the baseboard heater.

Medford Multicare Center for Living received 63 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 4, 2020. The Medford nursing home’s citations resulted from a total of 19 surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not adequately protect residents from neglect. Section 483.12 of the Federal Code requires nursing homes to ensure each resident’s “right to be free from abuse, neglect, misappropriation of resident property, and exploitation.” A May 2018 citation found that Medford Multicare Center for Living did not ensure such for one resident. The citation states specifically that a Certified Nursing Assistant gave the resident food “that was intended for another resident,” and that the resident subsequently consumed the food from their tray and choked. A plan of correction undertaken by the facility included the termination of the CNA and the revision of the resident’s care instructions to include a “nothing by mouth” instruction.

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Hempstead Park Nursing Home received 30 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on March 5, 2020. The facility has also been the subject of a 2012 fine of $10,000 in connection to findings during a 2009 inspection that it violated unspecified health code provisions; and a 2011 fine of $8,000 in connection to findings in a 2010 inspection that it violated health code provisions regarding mistreatment and neglect, the investigation and reporting of alleged violations, social services, and administrative practices and procedures. The Hempstead nursing home’s citations resulted from a total of four surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not adequately supervise residents. Under Section 483.25 of the Federal Code, nursing homes must ensure residents receive “adequate supervision and assistance devices to prevent accidents.” A May 2019 citation found that Hempstead Park Nursing Home did not ensure such for one resident. The citation states specifically that the resident had been “identified as at risk for aspiration,” yet was observed eating in their bed without supervision. In an interview, a Certified Nursing Assistant told an inspector that “she was not aware the resident was supposed to eat in the dining room while supervised by staff.”

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Bezalel Rehabilitation and Nursing Center received 25 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on January 9, 2020. The Far Rockaway nursing home’s citations resulted from a total of three surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not ensure residents’ drug regimens were free from unnecessary psychotropic medications. Section 483.45 of the Federal Code requires that nursing homes keep residents’ drug regimens free from the unnecessary use of any drugs that affect “brain activities associated with mental processes and behavior. A June 2019 citation found that Bezalel Rehabilitation and Nursing Center did not ensure a resident properly received gradual dose reductions to discontinue the use of a psychotropic medication. The citation states specifically that the resident was admitted to the nursing home already receiving the medication, but the facility did not attempt a gradual dose reduction, and “there was no evidence that the resident displayed any mood or behavioral symptoms that warranted continued use of the medication without a GDR attempt.” The citation states further that the nursing home did not attempt, before the resident was admitted, to confirm their psychiatric history.

2. The nursing home did not maintain an environment free of accident hazards. Under Section 483.25 of the Federal Code, nursing homes are required to provide residents with an environment as free as possible from accident hazards, and with adequate supervision to ensure that residents do not experience accidents. A June 2016 citation found that the nursing home did not take adequate accident prevention measures with respect to one resident who had planned monitoring for swallowing difficulty and aspiration precautions. According to these citations, the precautions included “being observed while eating, sitting upright while eating and for at least 30 minutes after eating, never eat in bed and if resident experiences coughing or secretions, during or without meal hold the feed till totally clear.”

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