Articles Posted in COVID-19

Schulman and Schachne Institute for Nursing and Rehabilitation suffered 26 fatalities from Covid-19 as of June 23, 2020, per state records. The nursing home also received 12 citations finding it violated public health code between 2016 and 2020, according to health records accessed on June 24, 2020. One of those citations concerned infection control procedures. The facility has also received a 2012 fine of $12,000 in connection to findings in a 2010 inspection that it violated health code provisions regarding accidents and the maintenance of residents’ nutritional status. The Brooklyn nursing home’s citations resulted from a total of 3 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not take adequate measures to prevent infection. Section 483.80 of the Federal Code stipulates that nursing homes must establish and maintain an infection prevention and control program in order to ensure residents a safe and sanitary environment. A February 2018 citation found that Schulman and Schachne Institute for Nursing and Rehabilitation did not ensure such. The citation states specifically that a surveyor observed an uncovered oxygen mask and tubing “wrapped around the metered oxygen valve, and exposed to room air.” The surveyor also observed two residents’ Foley catheter tubes touching the facility’s floor. Both were in contravention of infection prevention and control best practices. A plan of correction undertaken by the facility included the re-education of relevant staff.

2. The nursing home did not ensure physician consults were completed in a timely manner. Section 483.30 of the Federal Code stipulates that nursing homes must ensure a residents’ primary care physicians review the resident’s program of care in a timely fashion, including specialist consultations. A June 2017 citation found that Schulman and Schachne Institute for Nursing and Rehabilitation did not ensure such. The citation states specifically that when a resident requested a podiatry consult and subsequently received it, their primary physician was not made aware of it until over a week later. As such, the citation states, a treatment recommended by the podiatrist was not promptly implemented. A plan of correction undertaken by the facility included the implementation of a policy to address prompt notification of primary care physicians regarding consultants’ recommendations.

The Phoenix Rehabilitation and Nursing Center suffered 17 fatalities from Covid-19 as of June 23, 2020, per state records. The nursing home also received 32 citations finding it violated public health code between 2016 and 2020, according to health records accessed on June 24, 2020. One of those citations concerned infection prevention and control deficiencies. The facility has also received a 2010 fine of $4,000 in connection to findings in a 2009 inspection that it violated health code provisions regarding accidents and administrative practices. The Brooklyn nursing home’s citations resulted from a total of 5 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately implement infection prevention and control protocols. Under Section 483.80 of the Federal Code, nursing homes must create and maintain infection prevention and control programs. An October 2019 citation found that The Phoenix Rehabilitation and Nursing Center did not ensure such. The citation states specifically that employees did not wear proper personal protective equipment when they entered the room of a resident on contact precautions, and that the facility’s Infection Prevention and Control Program had not been reviewed and/or revised since a redacted year. The citation goes on to describe a Licensed Practical Nurse entering the room of a resident on contact precautions with only a mask over her nose and mouth, and no gown. She was observed checking a resident’s identification band and applying a cuff to the resident’s arm “without the use” of gloves she was holding in one of her hands, which she through away after checking the resident’s blood pressure. The resident was observed coughing and covering her mouth, according to the citation, but “was not encouraged or reminded to wash her hands after coughing into her hand.” The resident was observed wiping her nose with a tissue, placing it on a table, and then extending her fingers for a fingerstick test, but the LPN “did not encourage the resident to wash her hands after wiping her nose and before doing the fingerstick test,” according to the citation. A plan of correction undertaken by the facility included the educational counseling of relevant staff.

2. The nursing home did not follow food safety standards. Section 483.60 of the Federal Code stipulates that nursing homes must store and prepare food “in accordance with professional standards for food service safety.” An October 2019 citation found that The Phoenix Rehabilitation and Nursing Center did not ensure such. The citation states specifically that internal temperatures of cold foods were not maintained at professional standards. An observer noted various sandwiches at temperatures above the standard maximum temperature of 41 degrees Fahrenheit, the citation states. In an interview, the facility’s Food Service Director said that “the sandwiches should be stored in the 2 inch pan shingles in the refrigerator.” A plan of correction undertaken by the facility included the discarding of the offending sandwiches and the replacement of the sandwich refrigerator.

Autumn View Health Care Facility has received 18 citations over violations of public health code between 2016 and 2020, according to health records accessed on July 13, 2020. The Poughkeepsie nursing home’s citations resulted from a total of four surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not employ adequate infection control procedures. Section 483.80 of the Federal Code mandates that nursing homes must establish and maintain infection prevention and control procedures so as to ensure residents a safe and comfortable environment. A July 2019 citation found that Autumn View Health Care Facility did not ensure such. The citation states specifically that while caring for a resident, a Certified Nursing Assistant “did not change gloves and wash hands after cleaning feces prior to washing another area on the resident.” The citation goes on to state that the CNA touched surfaces in the room with contaminated gloves. According to the citations, all of the above conduct was in contravention of facility infection prevention and control policy. A plan of correction undertaken by the facility included the disinfection of surfaces in the room and the counseling of the CNA.

2. The nursing home did not take adequate measures to protect residents from abuse. Section 483.12 of the Federal Code stipulates that nursing homes must ensure residents are free from abuse, including verbal abuse. A May 2018 citation found that Autumn View Health Care Facility did not ensure such for one resident. The citation states specifically that a Certified Nursing Assistant “verbally and mentally abused the resident and used an obscene gesture toward the resident.” According to the citation, another CNA witnessed the incident, but did not immediately report it to facility staff. A plan of correction undertaken by the facility included the counseling and disciplining of the offending CNA.

Rome Memorial Hospital suffered 14 fatalities from Covid-19 as of July 12, 2020, per state records. The nursing home also received six citations finding it violated public health code between 2016 and 2020, according to health records accessed on July 13, 2020, including two concerning its infection prevention procedures. The Rome nursing home’s citations resulted from a total of two surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not take adequate infection control measures. Section 483.80 of the Federal Code stipulates that nursing homes must create and maintain infection prevention and control programs that ensure residents a safe and sanitary environment. A September 2017 citation found that Rome Memorial Hospital did not ensure such. The citation states specifically that a nurse at the facility “did not disinfect a shared glucometer… with an approved disinfectant before, between, or after testing blood sugars” for two residents. In an interview, the LPN said that policy required that she wipe down the thermometer with a germicidal wipe or alcohol pad between resident uses, and that she usually used alcohol wipes, but that she did not in this instance because “she was nervous.” A plan of correction undertaken by the facility included the re-education of Registered Nurses and LPNs.

2. A January 2019 citation also found that Rome Memorial Hospital fell short in its infection control practices. According to this citation, a resident “was observed with his catheter tubing and collection bag uncovered and directly on the floor.” In an interview, a CNA stated that when the resident was in bed, the CNAs “hung his catheter on the side of the bed” and that it should not be touching the floor, as this posed an infection risk. A plan of correction undertaken by the facility included the in-servicing of staff on infection control practices related to drainage bags.

A new column in the New York Times discusses what the author calls a “rapidly growing phenomenon” in nursing homes and assisted living facilities during the Covid-19 pandemic: “lives stripped of human contact, meaningful activity, purpose and hope that things will get better in a time frame that is relevant to people in the last decades or years of life.” The most extreme cases of  this phenomenon involve “startling numbers of suicide attempts by older adults,” according to the author, a professor of medicine in San Francisco.

The suffering of elder Americans documented over the last few months includes deaths by neglect and starvation, hopelessness, and patients suffering from dementia “fighting draconian restrictions they cannot understand” and being sedated as a result, the column states. It cites one assisted living facility whose director said that after it ended group meals and activities, as well as visitors, its resident population experienced an increase in depression symptoms and suicidal thinking, and that more residents were “complaining of weakness and muscle atrophy, and more have had falls.” The author notes that suicide in elder care facilities was already increasing before the pandemic, arguing that circumstances are now “worse—much worse.”

While older adults who live at home may have the advantages of outdoor exercise and digital activities, “poorer people are less likely to have access to safe walks or digital solutions, and  they are more likely to live in smaller apartments or homes. And increasing numbers of older Americans live at home.” This is compounded by the enhanced risk of death from Covid-19 for elderly people, which compels many who could go outside to instead stay in. The author concludes that authorities advising citizens to stay inside are wrongfully treating the virus as “the only threat to health and well-being,” when elder citizens face other psychological threats that may be fatal for some.

Sunharbor Manor suffered 26 fatalities from Covid-19 as of June 23, 2020, per state records. The nursing home also received 26 citations finding it violated public health code between 2016 and 2020, per health records accessed on June 24, 2020. Two of those citations concerned infection prevention and control policies and procedures. The Roslyn Heights nursing home’s citations resulted from a total of five surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not adequately protect residents from infection. Section 483.80 of the Federal Code states that nursing homes must create and maintain an infection prevention and control program with the goal of preventing the development and transmission of infection. A November 2019 citation found that Sunharbor Manor failed to ensure adequate practices were in place. the citation states specifically that a Registered Nurse “did not… wash his hands or change his gloves” after cleaning a resident’s pressure ulcer wound. It goes on to state that the nurse cleansed the wound with saline, but did not remove his gloves or perform hand hygiene before applying medication with a tongue depressor, then applying a medication to the wound and covering it with dry protective dressing. In an interview, the nurse stated that “he should have washed his hands and changed his gloves” after cleaning the wound.

2. A February 2017 citation also found that Sunharbor Manor violated Section 483.80 of the Federal Code, which concerns infection prevention and control practices. The citation states specifically that a Licensed Practical Nurse did not perform proper hand hygiene while caring for a resident’s pressure ulcer wound, and that a resident with physician-ordered contact precautions had no signage on their door indicating such. With respect to the first deficiency, an inspector observed a nurse wiping down a resident’s wound with skin prep and then covering it with gauze without cleansing her hands in between. In an interview, the LPN “stated that she should have removed her gloves and cleansed her hands prior to dressing the wound.” A plan of correction undertaken by the facility included the in-servicing of licensed nurses on the need for signage indicating rooms where the resident is on contact precautions.

New York nursing homes have asked state officials to relax a mandate that they test their employees for coronavirus twice a week, according to local news reports.

Nursing home umbrella organizations sent New York Health Commissioner Howard Zucker a letter this week arguing that the mandate “creates financial and practical burdens that make it harder to provide quality care to residents,” and requested that the testing requirement be reduced to one test per week. A spokesperson for the Department of Health said that it is reviewing the letter, as well as testing data and advice from “other stakeholders.”

Of the 46 new Covid-19 deaths reported by the state on Tuesday, 16 occurred in nursing homes. On Wednesday, Zucker said he recommended the reduction of testing mandates to once-a-week in regions that have reached phase two of reopening. He said in a statement, “Over the last three weeks, the weekly positive testing rate has declined from 3%, to less than 1% for the most recent week for which we have test results… For facilities in regions that have entered Phase 2, just 0.76% of test results this past week have come back positive, mirroring the tremendous progress New Yorkers have made to control COVID-19 spread… Based on the testing results to date, I have recommended to Governor Cuomo that moving forward, New York State follow CDC guidance in requiring nursing home staff to be tested once a week, and implement this for regions that have met the criteria to enter Phase 2 of New York’s reopening, and continue twice weekly testing in facilities that are still located in Phase 1 regions.”