Articles Posted in Falls & Fractures

The Grove at Valhalla Rehabilitation and Nursing Center received 27 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 29, 2019. The Valhalla nursing home’s citations resulted from a total of four inspections by state surveyors. The deficiencies they describe include the following:

1. The nursing home did not adequately implement an infection prevent and control system. Under Section 483.80 of the Federal Code, nursing home facilities must create and maintain infection prevention and control protocols that are “designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.” An August 2018 citation found that the facility did not properly ensure its staff undertook adequate hand hygiene measures “to prevent cross contamination and the spread of infection” in connection to one resident. The citation states specifically that during a wound observation of the resident, who was at risk of developing a pressure ulcer, an inspector observed a Licensed Practical Nurse “his bare hands to reposition the resident in bed, in addition to pulling the bedside curtain to maintain privacy.” Then, without sanitizing his hands, the nurse in question put on a pair of of gloves with which he opened a saline solution bottle, poured the solution on gauze pads, and cleaned the resident’s wound. According to the citation, the nurse continued wearing “the soiled gloves” as he went on to perform several other activities that included touching the wound. The citation states that this conduct had the “potential to cause more than minimal harm.”

2. The nursing home did not properly implement its abuse and neglect investigation and reporting policies. Section 483.12 of the Federal Code requires nursing homes to develop and implement policies and procedures that prohibit and prevent abuse and neglect, and that provide for the investigation of abuse and neglect allegations. A November 2018 citation found that the nursing home failed to thoroughly investigate a resident’s unwitnessed fall, and to timely report the incident to state authorities in order to rule out the possibility of abuse, neglect, or mistreatment. The citation states further that the nursing home failed to report and investigate a second fall sustained by the resident. In response to the citation, the nursing home initiated an investigation into one of the incidents, and stated its intention to report the incident and the investigation’s results to state health authorities.

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The Citadel Rehab and Nursing Center at Kingsbridge received 19 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 14, 2019. Those citations include two that were found to cause immediate jeopardy to resident health, and one that authorities say reflected “a severe, systemic deficiency.” The Bronx nursing home’s citations resulted from a total of five inspections by state authorities. The violations they describe include the following:

1. The nursing home did not ensure it provided an environment free of accident hazards. Under Section 483.25 of the Federal Code, nursing home facilities are required to provide residents with an environment as free as possible from accident hazards, and with proper supervision and assistive devices to prevent accidents. An August 2016 citation states that an inspector observed more than 50 beds with siderails whose measurements “exceeded the FDA recommendation that spaces between the bed siderail bars should be no larger than 4 3/4 inches.” While the Department of Health inspector found that this deficiency had so far not resulted in actual harm, it had “the potential for more than minimal harm that was immediate jeopardy and substandard quality of care.”

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Jeanne Jugan Residence received 19 citations for violations of public health laws between 2015 and 2019, according to records provided by the New York State Department of Health and accessed on November 14, 2019. The Bronx nursing home also received a Federal Civil Money Penalty of $8,518.25 for citations found on a March 9, 2018 survey, according to the Long Term Care Community Coalition. Federal Civil Money Penalties are one of several remedies state and federal authorities are empowered to assess when nursing home facilities are found to fall short of minimum health and safety standards. Jeanne Jugan Residence’s 19 citations result from three inspections by state inspectors. The violations they describe include the following:

1. The facility did not ensure an environment free of accident hazards. Under Section 483.25 of the Federal Code, nursing home facilities must provide an environment as free as possible from accident hazards, and with adequate supervision and assistive devices to ensure that residents do not sustain accidents. A March 9, 2018 inspection found that Jeanne Jugan Residence’s staff failed to adequately train and supervise a Certified Nursing Assistant to ensure that a resident’s care plan was implemented in such a manner that would prevent them from sustaining an injury. The resident specifically required the assistant of two persons “when applying a sling for stand up lift while sitting in bed, and floor mats were to be at bedside to prevent injury from falls.” The inspection found that the CNA tried to assist the resident without a second staffer’s assistance, and apparently without floor mats in place. As a consequence of this lapse, the resident fell from their bed and sustained harm to their clavicle.

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Senators released a list of 400 nursing homes with a ‘persistent record of poor care,’ according to the federal legislators. These nursing homes are not included in the federal government’s “special focus facilities” a list of nursing homes released by the government each year indicating poor care and unsafe conditions. According to the Senators, the list of 400 facilities is “virtually indistinguishable” from special focus facilities and the elder care facilities are not all lumped together only because a 2014 law imposed a cap on the number of so-called special focus facilities. Consequently, this left 400 facilities subject to heightened government scrutiny without public knowledge.

According to the Centers for Disease Control and Prevention, approximately 1.3 million Americans are nursing home residents at 15,600 facilities across the country. The federal government identified 3 percent of these nursing homes as problematic in April. In New York, these nursing homes include New Roc Nursing and Rehabilitation Center in Rochester, The Knolls in Valhalla, and Cayuga Ridge Extended Care in Ithaca, according to LoHud.com. In addition to these nursing homes, fourteen other New York long-term care facilities were included in the list of 400 released by the Senate.

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More senior citizens are dying from falls each year, a problem that is only expected to get worse as the country’s population continues to age. According to a report by the Centers for Disease Control and Prevention, almost 30,000 Americans over the age of 65 died as the result of a fall. To put that into perspective, falls killed 61 out of every 100,000 senior citizens in 2016, the year with the most recent data available. In 2007, only 47 out of every 100,000 deaths were caused by a fall. This means fall-related deaths have increased 37 percent in less than a decade.

About one in every four elderly Americans has a serious fall each year, according to experts. These falls typically result in broken bones or traumatic brain injuries. The risk of death caused by a serious fall increases with age. Americans between 65 and 74 only have 15 fatal falls for every 100,000. For those that are over the age of 75, that statistic increases to 248 per 100,000, according to the data released by the CDC. Women are at a higher risk than men of both falling and dying from a fall. If the fall-related mortality rate continues at the same pace then 59,000 senior citizens will die from a fall in 2030, according to The Los Angeles Times.

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The government recently adopted a more accurate measurement for determining when a nursing home has sufficient staffing levels and the results show a glaring problem across the nursing home industry. According to Kaiser Health News, the new method of recording hospital staffing shows a 12 percent decrease in hospital staffs. Further, there seems to be a severe fluctuation at many nursing homes which have sufficient nurses during the week but insufficient staff on the weekends. The new evidence shows that despite the minimal Medicaid requirements on the nursing staff levels at nursing homes, many nursing homes are still failing.

Under the previous method for calculating nursing staff, nursing homes would be required to provide all payroll information for the previous two weeks and government regulators would tally and report on the number of nurses employed during that time period. Because nursing homes sometimes knew when an inspection would occur ahead of time, this method was not generally considered accurate. Under the new method for calculating nursing staff, which Medicare began in April of this year, nursing homes must provide a report to Medicaid on staffing throughout the entire year.

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State investigators in Raleigh, North Carolina have captured several nurses cruelly abuse an elderly man at a retirement home on a hidden camera. The hidden camera was set up after an elderly man told his daughter that the orderlies had been “tormenting and neglecting him,” according to WRAL. In response to the incident, state investigators are investigating the nursing home.

According to the news station, the video shows Richard Johnson, 68 years old and recovering from a stroke, fall out of his bed. After crying out for help, several orderlies pass by and ignore the elderly man for over an hour. When staff members finally arrive they immediately begin berating and cruelly taunting the senior citizen, asking “What are you doing there? Why are you on the floor?” Another nurse joined in on bashing the vulnerable man, stating “You had to do something very wrong with your life. What did you do? You’re suffering so bad, so you’ve done something wrong. Yes, you did.”

According to Richard Johnson’s daughter, Johnson even went to the bathroom while on the floor waiting for help. This unfortunate incident prompted a third member of the nursing staff to scold him, saying “How old are you? One? You’re supposed to be enjoying your retirement. Instead, look what you are doing, pooping on yourself. Shame on you.”

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Mirroring national trends, elderly Americans are beginning to use more addictive prescription drugs. In a report by the New York Times, the number of prescriptions for benzodiazepines, a class of anxiety drugs which includes Xanax and opioids have markedly increased in the last couple decades. Not only do these addictive drugs have serious side effects, they can be deadly to the user, sometimes even when taken as prescribed.

According to the newspaper, the number of benzodiazepine prescriptions for Americans over the age of 65 increased 8.7 percent between 2003 and 2010, the year with the most recent data available. A 2008 study indicated that about 9 percent of adults between 65 and 80 took one of these anti-anxiety drugs. The Centers for Disease Control (CDC) paints an even more ominous picture of the problem – the number of deaths caused by benzodiazepines in Americans over the age of 65 rose from 63 deaths in 1999 to 431 in 2015. In 1999, opioids were a contributing cause of 29 percent of these deaths. A mere fifteen years later, opioid drugs now contribute to two-thirds of deaths caused by benzodiazepines.

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gavel-bed-300x199The Martine Center for Rehabilitation and Nursing, previously the Schnurmacher Center, in White Plains, New York received 60 complaints and 15 citations for violating New York and federal law, according to the New York State Department of Health. The Department of Health inspects each nursing home facility in the state every 9 to 15 months and publishes the results of these inspections. According to the state health care agency, the nursing home violated the following state or federal regulations on nursing home safety:

1. The nursing home did not perform criminal background checks on all of its employees. Under Section 402.6(b) of the New York Code, nursing homes must run a criminal history background check on all of its employees who come in contact with its residents. This includes completing a form and submitting two sets of the employee’s fingerprints to the Department of Health. The health inspector found that the nursing home violated this provision by forgoing a criminal background check on an employee who had direct contact with nursing home residents. Continue reading

resident-left-in-empty-hallOver the previous four years, the United Hebrew Geriatric Center in Westchester County received 22 citations for violating New York law on nursing home safety. The violations were all categorized as “moderately severe”, according to the New York Department of Health.

While the quality of care received by patients at the facility was higher in some areas of treatment compared to the rest of New York state, the facility scored below the state average in the number of residents who experienced a major fall (2.3 percent) and the percent of residents whose ability to move independently worsened during their long-term stay (14.4 percent). Further, according to the New York State Department of Health, 2.1 percent of nursing home residents received a diagnosis of pressure ulcers, or bed sores – a largely preventable type of harm.

According to the state’s inspectors, the following laws and regulations were violated by the United Hebrew Geriatric Center in the last several years: Continue reading

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