Articles Posted in Infection

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

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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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

New York Attorney General Letitia James has called for state lawmakers to lift the partial immunity from civil lawsuits it gave to nursing home facilities early in the Covid-19 pandemic, according to a report by NBC New York. The immunity shield, granted in the spring of 2020, gave nursing homes as well as hospitals and other healthcare providers protection from civil suits as well as criminal prosecution.

Lobbyists behind the legislation described it as a means of protecting overextended healthcare providers, like nursing homes, from lawsuits that might cripple them for trying their best to care for patients during the pandemic. Over the summer, state legislators lifted some of the immunity provisions, specifically those regarding patients who didn’t have Covid-19. According to NBC News, “It has never applied to instances of gross negligence, intentional criminal or reckless misconduct.” Still, nursing home and other healthcare providers remained shielded from lawsuits or prosecutions over their Covid-19. Continue reading

A new report by New York Attorney General Letitia James found that the state may have undercounted nursing home Covid-19 fatalities by as much as 50%, and that nursing homes may be responsible for “nearly one in every three coronavirus fatalities in the state.” The report, released last week, found a litany of failures by nursing homes to implement infection prevention and control procedures, from failing to isolate nursing home residents infected with Covid-19 to failing to test staffers for the novel coronavirus.

According to the New York Post, Attorney General James said in a statement that “As the pandemic and our investigations continue, it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate… While we cannot bring back the individuals we lost to this crisis, this report seeks to offer transparency that the public deserves and to spur increased action to protect our most vulnerable residents.”

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Elderwood at Cheektowaga suffered 18 confirmed COVID-19 deaths as of January 23, 2021, according to state records. The facility has also received 27 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on January 23, 2020. The Cheektowaga 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 adequately prevent and control infection. Under Section 483.80 of the Federal Code, nursing homes are required to create and maintain an infection control program “designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.” A November 2019 citation found that Elderwood at Cheektowaga failed to ensure such. The citation states specifically that in one resident unit, dirty bed linens “were placed directly on the floor without a protective barrier,” and that in another unit, oxygen tubing “was observed directly on the floor during multiple observations,” all in contravention of facility policy. A plan of correction undertaken by the facility included the discarding of the tubing and the re-education of the staff member who placed dirty linens on the floor.

2. The nursing home did not sufficiently prevent medication errors. Under Section 483.25 of the Federal Code, nursing homes must keep their residents “free of any significant medication errors.” A January 2019 citation found that Elderwood at Cheektowaga failed to ensure such. The citation states specifically that one resident’s medications “were not ordered in accordance with discharge medications specified on the hospital discharge summary.” The resident according received incorrect dosages of certain medications, and didn’t receive other medications at all. A plan of correction undertaken by the facility included an audit and reconciliation of the medical records.

Elderwood at Hamburg suffered 26 confirmed COVID-19 deaths as of January 17, 2021, according to state records. The facility has also received 36 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on January 17, 2020. The Hamburg 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 employ adequate measures to prevent and control infection. Section 483.80 of the Federal Code stipulates that nursing homes must create and maintain an infection prevention and control program “designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.” A September 2020 citation found that Elderwood at Hamburg failed to ensure such. The citation states specifically  that the facility failed to maintain a program “to ensure the health and safety of residents to help prevent the transmission of COVID-19.” It goes on to state that the nursing home failed to maintain social distancing on two resident care units. A surveyor observed residents “sitting side by side in wheelchairs less than 6 feet apart across from the Unit 2 Nurses Station,” with face masks hanging on the back of their wheelchairs. When a Registered Nurse walked past the residents, the citation states, she “made no attempt to socially distance the residents six feet apart.” A plan of correction undertaken by the facility included Covid-19 testing for the residents in question, who were found to be negative.

2. The nursing home did not protect residents from accidents. Section 483.25 of the Federal Code requires nursing homes to provide residents with adequate supervision to prevent accidents. An October 2019 citation found that Elderwood at Hamburg failed to ensure such. The citation states specifically that the facility “did not provide fluid in the consistency ordered by the Physician” for two residents. It goes on to state that they were served soup at an incorrect consistency. A plan of correction undertaken by the facility included the placement of one of the residents on aspiration precautions and the re-education of relevant staff.

The New York State Health Department has told the Empire Center for Public Policy, a watchdog group, that it requires three more months to respond to a records request for an accounting of Covid-19 deaths in nursing homes, “because the records potentially responsive to your request are currently being reviewed for applicable exemptions, legal privileges and responsiveness.”

According to a report in the New York Post, the Empire Center submitted a Freedom Of Information Law request in early August, asking for “the total number of COVID-19 nursing home fatalities,” including those who died in nursing homes and those who died after being sent to hospitals. As things stand, the Health Department’s accounting only includes residents “physically died in nursing homes.” Continue reading

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