Articles Posted in Infection

Elderwood at Lockport received 31 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on January 8, 2021. The facility also received a fine of $10,000 in February 2020 in connection to violations of unspecified health code provisions. The Lockport 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 steps to prevent accidents. Section 483.25 of the Federal Code requires nursing homes to keep resident environments as free as possible of accident hazards and to provide residents with adequate supervision to prevent accidents. An October 2019 citation found that Elderwood at Lockport failed to ensure such. The citation states specifically that one resident who was documented for one-to-one supervision “was left unattended in a common area,” and subsequently sustained a fall and a redacted medical injury. In an interview, the facility’s administrator said the resident was left unattended in a chair because they were sleeping, and their wasn’t any violation of the resident’s care plan. A plan of correction undertaken by the facility included a review of guidelines for one-to-one supervision of residents.

2. The nursing home did not take proper infection prevention measures. Under Section 483.65 of the Federal Code, nursing homes must establish and maintain an infection prevention and control program that helps mitigate the transmission of disease. A November 2016 citation found that Elderwood at Lockport The citation states specifically that two units “had issues that involved the lack of proper disinfection of a blood glucose monitor between resident use,” as well as with unlabeled and improperly stored resident items, and with medication being administered after staffers handled it without wearing gloves. The citation states that these deficiencies had the “potential to cause more than minimal harm.” A plan of correction undertaken by the facility included the counseling of relevant staff.

An outbreak of the novel coronavirus has infected 137 residents and killed 24 at The Commons at St. Anthony, a nursing home in Auburn, New York. According to a report on syracuse.com, the outbreak began on December 21, 2020, “as a wave of post-Thanksgiving Covid-19 cases began hitting the county,” per an official overseeing the home’s operations. The outbreak has affected 47 employees. Of the residents who died, 21 died at the nursing home, while three died at the hospital. Prior to the first three deaths that were reported at the nursing home on December 29, 2020, “There had been no nursing home Covid-19 deaths in Cayuga County.” As of the report’s publication on January 9, there have been 2,650 confirmed cases in Cayuga county.

According to the report, the nursing home responded to the pandemic by requiring employees to wear “gowns, gloves and face shields at all times when working with residents,” and isolated positive cases on their own floors. Employees are tested weekly, while residents are tested “on a schedule established by the state Health Department.” An infection by state health authorities found no issues with the nursing home’s infection control policies and procedures.

Records maintained by the Health Department show that as of January 8, 2021, The Commons at St. Anthony had received 27 citations for violations of public health code between 2016 and 2020. The citations resulted from a total of six inspections by state surveyors. They include the following:

Corning Center for Rehabilitation and Healthcare suffered 28 confirmed COVID-19 deaths as of January 2, 2021, according to state records. The facility has also received 33 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on January 2, 2020. The Corning nursing home’s citations resulted from a total of six surveys by three inspectors. The deficiencies they describe include the following:

1. The nursing home did not adequately protect residents from accident hazards. Under Section 483.25 of the Federal Code, nursing home residents are required to be provided with an environment that is “as free of accident hazards as is possible.” A March 2018 citation found that Corning Center for Rehabilitation and Healthcare failed to ensure such when it served sliced turkey to a resident “who was on a mechanical soft diet with ground meats.” In an interview, one of the facility’s Licensed Practical Nurses stated that “according to the tray ticket, the resident should have received ground turkey, not sliced.” The facility’s Director of Food Services stated in an interview that “someone on the tray line must have made a mistake.” A plan of correction undertaken by the facility included the re-education of dietary staff.

2. The nursing home did not implement adequate measures to prevent and control infection. Under Section 483.80 of the Federal Code, nursing home facilities must “establish and maintain an infection prevention and control program designed to… help prevent the development and transmission of communicable diseases and infections.” A March 2018 citation found that Corning Center for Rehabilitation and Healthcare failed to ensure such. The citation states specifically that in connection to one resident, “there was improper incontinence care and lack of glove changing and handwashing,” and that shower stretchers used by the facility for several residents “were not clean.” A plan of correction undertaken by the facility included the cleaning of shower stretchers and the re-education of the Certified Nursing Assistant who failed to provide proper incontinent care.

A new analysis by City and State asks whether New York’s nursing home facilities are prepared for another wave of the Covid-19 pandemic. Noting that while long-term care facilities have so far accounted for about 8% of Covid-19 cases, they have comprised about 40% of US fatalities from the disease. In New York especially, there have been 27,307 total Covid-19 deaths, of which 6,967 confirmed or presumed Covid-19 fatalities took place in nursing home facilities, a number that excludes residents who died outside of the facility. While nursing homes have improved their policies and procedures when it comes to Covid-19 since the virus initially struck, City and State argues, “there are still vulnerabilities that could leave nursing-home residents and staff at risk again.”

On the positive side, nursing homes are more likely to have more consistent access to tests and personal protective equipment, the analysis suggests. Nursing homes have already been conducting regular testing of all employees, and are required to have a 60-day supply of PPE. Additionally, a state rule has been reversed that in the spring led to nursing homes accepting Covid-19 patients from hospitals, spreading the virus throughout facilities.

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Harlem Center for Nursing and Rehabilitation suffered 3 confirmed and 29 presumed COVID-19 deaths as of December 4, 2020, according to state records. The nursing home has also received 33 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on December 4, 2020. In May 2020, it received a fine of $24,000 in connection to unspecified findings of “multiple” health code violations. The Harlem 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 establish and implement infection-control measures. Under Section 483.80 of the Federal Code, nursing homes must develop a program to prevent and control infection in a manner that provides residents a comfortable and sanitary environment. A May 2020 citation found that Harlem Center for Nursing and Rehabilitation failed to do so. The citation states specifically that facility staff were observed “not doffing Personal Protective Equipment (PPE) appropriately as they left resident rooms”; that a resident admitted with a recommendation that they be placed on contact isolation with put in a room with a resident who was not on contact isolation; that residents were seen gathering in the facility’s common areas, where staff did not encourage them to socially distance; and that a resident who had been placed on contact isolation and droplet precautions was seen “eating lunch with other residents in the dayroom without maintaining social distance.” A plan of correction undertaken by the facility included the in-servicing of relevant staff.

2. The nursing home did not provide an environment adequately free of accident hazards. Under Section 483.25 of the Federal Code, nursing home facilities must ensure their residents’ right to an environment as free as possible from accident hazards, and in which every resident receives supervision and assistive devices adequate to prevent accidents. A February 2020 citation found that Harlem Center for Nursing and Rehabilitation failed to ensure such. The citation states specifically that “an oversized television was positioned on a slant, on top of a smaller dresser in a resident’s room,” and that after another resident sustained a fall, the incident was not assessed “to determine if updates were needed to the plan of care to prevent further falls.” A plan of correction taken by the facility included the mounting of the TV to the wall, and the review of the fall and updating of the resident’s plan of care.

Coler Rehabilitation and Nursing Care Center suffered 13 confirmed and 1 presumed COVID-19 deaths as of December 4, 2020, according to state records. The nursing home has also received 31 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on December 2, 2020. In July 2020, it received a fine of $30,000 in connection to unspecified findings of health code violations. The Brooklyn 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 implement policies and procedures to prevent and control infection. Section 483.80 of the Federal Code stipulates that nursing home facilities must establish and maintain “an infection prevention and control program designed to provide a safe, sanitary and comfortable environment.” A May 2020 citation found that Coler Rehabilitation and Nursing Care Center failed to do so. The citation states specifically that did not follow “cohorting requirements’ laid out in state guidance related to the prevention and control of Covid-19. The guidance in question required nursing homes to maintain “protocols to separate residents into cohorts of positive, negative, and unknown as well as separate staffing teams to deal with COVID-positive residents and non-positive residents,” and to transfer residents wither within the facility or to another facility if they cannot separate patients in their own facility. The citation goes on to state that residents who tested negative for Covid-19 were not moved out of their rooms when their roommates tested positive. A plan of correction undertaken by the facility included the movement of affected residents and the re-education of staff regarding Covid-19 policies.

2. The nursing home did not adequately control pests. Section 483.90 of the Federal Code stipulates that nursing homes must “Maintain an effective pest control program so that the facility is free of pests and rodents.” A May 2020 citation found that Coler Rehabilitation and Nursing Care Center failed to ensure such. The citation states specifically that “filth flies and fruit flies were observed flying around a 4-bed occupancy room and crawling on the surface of a resident’s personal belonging that had been removed from the room,” and that a mouse was observed in a resident’s room, running across the floor. The flies in question were observed around a pile of “soiled crumpled napkins, 3 browned bananas, an orange, and used soda cups” on the floor of a resident’s room. I nan interview, a housekeeper said it’s “difficult” for housekeepers to clean the room in question because the roommate gets agitated “and may even become physical.” In another interview, the resident’s roommate said the resident has a hoarding problem, the facility rarely cleans the room, and “There are flies everywhere and she often sees roaches in the room.” A plan of correction undertaken by the facility included the cleaning of the room and the re-education of both the resident and housekeeping staff.

Pennsylvania Governor Tom Wolf has vetoed a hotly debated new piece of legislation that would protect nursing homes from coronavirus-related lawsuits, according to recent news reports.

The bill in question passed both houses of Pennsylvania’s state legislature, though Law360 notes it passed in the General Assembly “by narrow margins.”

Governor Wolf said in a statement about the veto that the bill extended too much protection to nursing homes, schools, hospitals, and various other businesses. “This legislation provides broad, overreaching immunity from civil liability during the current pandemic,” he said. “Shielding entities from liability in such a broad fashion as provided under this bill invites the potential for carelessness and a disregard for public safety.”

Over three months ago the Commissioner of the New York State Department of Health, Howard Zucker, pledged to disclose the number of nursing home residents who died in a hospital during the Covid-19 pandemic. As Greg Floyd of CBS 6 Albany pointed out in a recent report, Zucker has yet to follow through on that promise. To this day, the true extent of the Covid-19 pandemic in New York remains unknown.

Thats why the Empire Center for Public Policy has filed a lawsuit to obtain the information from the state, while CBS 6 is seeking the data through a Freedom of Information Act request. Floyd notes that Commissioner Zucker “has a huge team to gather and tabulate and re-tabulate numbers” of nursing home resident deaths, and nursing home themselves use an official reporting system called the Health Emergency Response Data System, but nonetheless state authorities have delayed the information’s release by citing that it’s taking time to produce accurate figures. Floyd took it upon himself to see just how difficult it is to gather those numbers—by calling and asking health facilities themselves. Continue reading

A new report by the Associated Press illustrates the devastating toll of the Covid-19 pandemic on nursing home residents across the country. The tragedy is not limited to Covid-19 deaths themselves, but also to deaths from other causes that ballooned as staff dealt with Covid-19 patients. One expert cited in the report estimated that “for every two COVID-19 victims in long-term care, there is another who died prematurely of other causes.” Ultimately, they concluded, there may have been more than 40,000 more “excess deaths” in nursing homes since March, compared to the same period in previous years.

The expert, professor Stephen Kaye at the University of California, San Francisco, attributes the spike in excess deaths to staffing issues at nursing homes. By comparing death rates at nursing homes that experienced outbreaks to nursing homes that didn’t, he found that “the more the virus spread through a home, the greater the number of deaths recorded for other reasons,” which suggests that healthcare workers were “consumed” caring for Covid-19 patients—and/or contracted the illness themselves—and therefore unable to devote adequate care to residents without Covid-19. Kaye suggests this effect was compounded by longstanding staffing issues at nursing homes: “In 20 states where virus cases are now surging,” the report observes, “federal data shows nearly 1 in 4 nursing homes report staff shortages.” Continue reading

Baptist Health Nursing and Rehabilitation Center has received 34 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on August 28, 2020. The facility has also received two fines totaling $12,000 in connection to findings that it violated health code provisions, among others, regarding quality of care.. The Scotia 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 properly implement infection-control measures. Under Section 483.80 of the Federal Code, nursing homes are required to take steps to prevent and control infection via the maintenance of an infection control program that ensures residents a comfortable and sanitary environment. An August 2017 citation found that Baptist Health Nursing and Rehabilitation Center failed to ensure such. The citation states specifically that staff did not properly wear personal protective equipment when necessary, glucometers were not disinfected after use, and employees “did not observe Contact Precautions during Foley catheter care and when providing housekeeping services to 2 residents.” A plan of correction undertaken by the facility included the education of nurses on glucometer cleaning, the education of a certified nursing assistant on proper foley catheter emptying, the education of a housekeeper and CNA on contact precautions, and the education of nursing staff on wound care techniques.

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