Articles Posted in COVID-19

Robinson Terrace Rehabilitation and Nursing Center suffered 15 confirmed and 7 presumed COVID-19 deaths as of February 4, 2021, according to state records. The facility has also received 46 citations for violations of public health code between 2017 and 2020, according to New York State Department of Health records accessed on February 12, 2020, as well as three fines totaling $26,000 since 2012. The Stamford 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 provide adequate pressure ulcer care. Section 483.25 of the Federal Code requires that nursing homes provide residents with professional levels of care to prevent pressure ulcers from developing and to promote the healing (and prevent the infection of) existing ulcers. An October 2020 citation found that Robinson Terrace Rehabilitation and Nursing Center failed to ensure such. The citation states specifically that the nursing home did not implement professional standards of practice for infection control after changing the dressing on a resident’s pressure ulcer, and that the resident was not turned and positioned from one side to another every two hours in accordance with their care plan. The citation goes on to describe a dressing change in which a Licensed Practical Nurse did not perform proper hand hygiene or change gloves between the removal of one wound’s dressing and the removal of another, on the same resident. In an interview, the LPN stated that care for these wounds “was regularly performed together, despite the wounds being separate wounds” and having separate physicians’ orders for wound care. A plan of correction undertaken by the facility included the reeducation of the LPN in question.

2. The nursing home did not implement adequate infection control practices. Section 483.80 of the Federal Code stipulates that nursing homes must establish and maintain an infection prevention and control program that provides residents with a safe, sanitary, and comfortable environment. A January 2019 citation found that Robinson Terrace Rehabilitation and Nursing Center failed to ensure such. The citation specifically describes the facility’s failure to “investigate and document surveillance of the signs and symptoms of resident infections.” Despite policies requiring the facility to monitor resident infections, the citation states, in an interview, the nursing home’s Assistant Director of Nursing “was not able to state which residents had symptoms of infections or those who were currently being treated, and there was no day to day tracking of infections,” and instead needed to read another staffer’s report to identify this data. The citation states that this deficiency had the “potential to cause more than minimal harm.”

Humboldt House Rehabilitation and Nursing Center received 61 citations for violations of public health code between 2017 and 2021, according to New York State Department of Health records accessed on February 19, 2021. The facility has also received enforcement actions: a 2020 fine of $2,000 in connection to findings it violated Covid-19 testing regulations; a 2020 fine of $50,000 in connection to findings of health code violations; a 2018 fine of $10,000 in connection to findings of unspecified health code violations; and a 2017 fine of $2,000 in connection to findings it violated health code provisions regarding quality of care. The Buffalo nursing home’s citations resulted from a total of 11 surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not protect residents from neglect. Section 483.12 of the Federal Code ensures nursing home residents “the right to be free from abuse, neglect, misappropriation of resident property, and exploitation.” A September 2019 citation found that Humboldt House Rehabilitation and Nursing Center failed to ensure such. The citation states specifically that for a resident with a suspected fracture, the nursing home failed to implement a physician’s orders, the substance of which are redacted. The citation goes on to state that the facility did not apply “an immobilizer/sling and left wrist brace… to immobilize the resident’s left upper extremity (LUE) as ordered.” A plan of correction undertaken by the facility included the transfer of the resident to the emergency room to rule out a fracture.

2. The nursing home did not implement adequate accident-prevention measures. Section 483.25 of the Federal Code requires nursing homes to provide residents with an environment that “remains as free of accident hazards as is possible,” and where residents receive adequate supervision to prevent accidents. A September 2019 citation found that Humboldt House Rehabilitation and Nursing Center failed to ensure such. The citation states specifically that three resident units “had issues with water temperatures that exceeded 120 degrees Fahrenheit,” affecting six residents. The citation states that this deficiency had the “potential to cause more than minimal harm.” A plan of correction undertaken by the facility included the correction of water temperatures in the affected areas.

A new report in Gothamist examines the debate over a proposed state law setting requirements for staffing levels in New York nursing homes. The Safe Staffing for Quality Care Act, which has previously passed the New York Assembly but has never been approved by the full state legislature, would create minimum staffing levels in the state’s hospitals and nursing homes. In hospitals, this would mean 25,000 new employees; in nursing homes, it would mean 45,000 new employees. Continue reading

Bridgewater Center for Rehabilitation & Nursing suffered 26 confirmed and 15 presumed COVID-19 deaths as of February 4, 2021, according to state records. The facility has also received 41 citations for violations of public health code between 2017 and 2020, according to New York State Department of Health records accessed on February 12, 2020. The Binghamton nursing home’s citations resulted from a total of six surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not implement proper measures to prevent medication errors. Under Section 483.45 of the Federal Code, nursing homes are required to keep residents “free of any significant medication errors.” A June 2017 citation found that Bridgewater Center for Rehabilitation & Nursing failed to ensure such for three residents. In one case, the citation states, a resident’s orders for an antipsychotic medication “were not clarified when a change in dosage was made.” In two other cases, residents who had orders for fingerstick and sliding scale insulin administration during mealtimes were not administered such according to meal times. A plan of correction undertaken by the facility included the in-servicing of nursing staff on medication policies and procedures.

2. The nursing home did not provide adequate treatment and services to prevent and heal pressure ulcers. Section 483.25 stipulates that nursing homes must provide residents with receive care and services to prevent the development of pressure ulcers, and to provide residents with pressure ulcers necessary treatment and services to promote healing and prevent infection. A June 2017 citation found that Bridgewater Center for Rehabilitation & Nursing failed to ensure such. The citation states specifically that a resident who was documented at risk for pressure ulcer development, and who used a pressure-reducing device in their chair and bed, had no documented evidence that they were provided with off-loading boots per their care instructions, and ultimately developed a pressure ulcer on their left heel. In a pair of interviews, a nurse at the facility stated that the resident had refused to wear the boots. A plan of correction undertaken by the facility include the in-servicing of nursing staff on the facility’s pressure ulcer policies and procedures.

A recently released report by New York Attorney General Letitia James suggests that testing failures at the beginning of the Covid-19 pandemic may have put nursing home residents at increased risk of infection from the novel coronavirus. At the pandemic’s outset in March 2020, the report notes, there was limited Covid-19 testing capacity, and once many nursing homes received tests they nonetheless experienced delays in receiving results. “The lack of testing increased the risk of COVID-19 infection of residents and staff,” the Office of the Attorney General’s (OAG) report ultimately finds, especially with respect to asymptomatic cases. Continue reading

New York Governor Andrew Cuomo is facing allegations of covering up the true death toll of the novel coronavirus pandemic in New York’s nursing homes, according to a new report by the New York Times. One of Cuomo’s aides, Melissa DeRosa, allegedly acknowledged in a conversation with state lawmakers that the Cuomo administration “withheld data because it feared an investigation by the Trump Justice Department,” saying in a virtual conference that when the Department of Justice sought data from the administration over the summer, “basically, we froze.”

The Times describes a partial transcript of the call in which DeRosa said further: “We were in a position where we weren’t sure if what we were going to give to the Department of Justice, or what we give to you guys, and what we start saying, was going to be used against us and we weren’t sure if there was going to be an investigation.” Continue reading

A new report recently published by New York Attorney General Letitia James suggests that Governor Andrew Cuomo’s executive order providing certain Covid-19 immunity provisions for nursing home and other healthcare providers may have incentivized nursing homes “to make financially-motivated decisions” that may have resulted in harm.

According to the Office of the Attorney General’s (OAG) report, the April 6th, 2020 executive order provided immunity to “to health care professionals from potential liability arising from certain decisions, actions and/or omissions related to the care of individuals during the COVID-19 pandemic retroactive to Governor Cuomo’s initial emergency declaration on March 7.” The statute excluded harm or damages “caused by an act or omission constituting willful or intentional criminal misconduct, gross negligence, reckless misconduct, or intentional infliction of harm,” but the OAG notes that this section contains a loophole in which acts, omissions, or decisions “resulting from a resource or staffing shortage” were not included in the carveout. Continue reading

A report by New York Attorney General Letitia James details allegations reported by nursing home employees that nursing homes in the state failed to protect their residents in the early months of the Covid-19 pandemic, ultimately finding that the coronavirus’s death toll in New York’s nursing homes may be significantly higher than figures reported by the state Health Department. Three of the ways nursing homes allegedly failed their patients, according to the report, were by failing to isolate Covid-19 patients, allowing communal activities, and implementing lax staff screening practices.

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Genesis HealthCare, one of the biggest nursing home chains in the United States, paid one of its executives a $5.2 million bonus even as it lost thousands of residents to Covid-19. According to a recent report in the Washington Post, Genesis paid George Hager Jr. the bonus in late October. He retired as the head of the chain on January 5, 2021. Though he will pay back part of the bonus, the Post reports, he will also “be reimbursed over the next two years,” and received payments totaling $950,000 from the company as he left.

Over the course of the Covid-19 pandemic, “more than 300 Genesis nursing homes experienced 14,352 confirmed cases of covid-19 through mid-December,” according to the Post. A total of 2,812 nursing home residents had died from Covid-19 by December 20th. The Post also reports that Medicare data revealed that the company’s nursing homes “reported continuing shortages of personal protective equipment through the months of the pandemic,” an issue that only improved around the end of November 2020, after Genesis Healthcare’s board approved the $5.2 million bonus to Hager. Continue reading

A new report by New York Attorney General Letitia James’s office found that some nursing home facilities in the state had inadequate personal protective equipment at the outset of the Covid-19 pandemic, putting their residents at increased risk of harm.

The report, released last week, notes that both state and federal laws mandate that nursing homes provide adequate infection control supplies to their staff and residents in order to protect them from the risk of contracting or spreading diseases like Covid-19. The Attorney General’s office found that some nursing homes failed to comply with these requirements, and that if these failures had not taken place, New York’s nursing homes may have experienced “better health outcomes” for their residents. Continue reading

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