Articles Posted in Infection

Surge Rehabilitation and Nursing received 30 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 15, 2020. The Middle Island 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 accident-prevention measures. Section 483.25 of the Federal Code stipulates that nursing homes must ensure residents receive adequate supervision and assistance devices to prevent accidents. A July 2018 citation found that Surge Rehabilitation and Nursing did not ensure such for one resident. The citation states specifically that the facility did not follow the resident’s dentist’s recommendations regarding the safe use of a denture. In an inspection, according to the citation, the resident was talking to a nursing assistant, and as they spoke, “the upper denture appeared loose and moved with her lip and tongue movement.” The citation goes on to describe a nurse stating that although the resident’s dentures “are supposed to come out at night and [be] replaced in the morning,” the resident does not always allow staff to remove them; another staffer stated that “sometimes the resident has the denture in from the previous night and refuses to use adhesives for dentures.” In an interview, the resident’s dentist stated that “removing the denture at night is a standard precaution,” and that the resident’s smaller-than-conventional denture may pose a remote risk of aspiration.

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An April 16, 2020 report by the New York Times raised questions about whether Sapphire Center for Rehabilitation and Nursing in Queens, New York was accurately the number of residents who died during the coronavirus outbreak. Although the facility’s administration informed Queens state representative Ronald Kim that a total of 29 residents died, according to the report, Kim said “the numbers given by the home… did not match what he was hearing from workers there.”

The Times report stated additionally that two workers at 227-bed nursing home said “the actual death toll was considerably higher” than the 29 figure, and may have reached as high as 60 residents. One unnamed staffer at the facility told the Times, “You come to your shift and this person’s gone, this person’s gone…We were losing five or six residents a week, then four or five a day. Last week on my shift it was about eight of them passed away.” Information about resident deaths was reportedly not shared with residents’ families. One resident’s son told the newspaper that over the course of regular video chats with his mother—arranged after the facility suspended family visits—he became concerned about her development of a fever, cough, and loss of appetite. He was reportedly told by a nurse that she had pneumonia; when he asked if it was COVID-19, the nurse said the facility did not know, because patients were not able to get tests. The report continues:

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A new report by the Long Term Community Care Coalition asks the question: “Can animals in a zoo or kennel expect better treatment and conditions than that which many human nursing home residents actually receive?” Noting that its goal is not to trivialize the experiences of nursing home residents or animals, the report seeks to demonstrate how nursing homes are subject to systemic accountability failures, resulting in rampant abuse and neglect that “not only fall below the federal nursing home standards of care, but also below accepted standards for the humane treatment of animals.”

The report compares conditions in eleven key areas of interest: freedom from abuse and neglect; general care and treatment; sufficient staffing with appropriate skills and competencies; nutrition and hydration; safe food handling; medical supervision; simulating and safe environment; freedom from restraints; treatment of injuries; appropriate medications; and infection control and prevention. Below is what the LTCCC found in each of those categories.

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A report by the State of New York found that New Franklin Center for Rehabilitation and Nursing in Flushing, Queens, was the home of about one-fifth of the 200 COVID-19-related deaths in Queens. As of April 17, 2020, that nursing home had suffered 44 deaths related to the disease, according to the Queens Daily Eagle.

The total number of COVID-19-related deaths in New York nursing homes and long-term care facilities was 3,505 as of mid-April, according to the Wall Street Journal. An April 22 report by the New York Post describe the coronavirus’s impact on New York nursing homes as “hellish.” Ronald Kim, a state assemblyman representing Queens, told the Post that death tallies in nursing homes were undercounted, and that the conditions in nursing homes are “scandalous.” Kim and another assemblyman are reportedly considering convening hearings about possible negligence in nursing home facilities that led to such a deadly impact by the coronavirus.

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New York Governor Andrew Cuomo announced last week that the state’s Department of Health would partner with its Attorney General, Letitia James, to probe nursing home facilities in the state that violate executive orders requiring them to release data about COVID-19 test results and fatalities to the families of their residents.

According to a press release, the governor also ordered nursing homes “to immediately report to DOH the actions they have taken to comply with all DOH and CDC laws, regulations, directives and guidance.” The governor warned that the DOH would perform inspections of facilities noncompliant with these orders, including those that concern “separation and isolation policies, staffing policies and inadequate personal protective equipment.” Facilities found to be in noncompliance will be ordered to submit plans of correction, and may be subject to fines of $10,000 per violation or the revocation of their operating licenses.

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Healthcare workers at Fairview Rehab & Nursing Home recently described what they called “crazy” conditions at the Queens facility, according to an April 20, 2020 report by Gothamist. One of the staff members said she showed up for a job interview and was “whisked” through a training session and hired immediately, with the nurse leading the training session explaining that many of the facility’s staff and managers were “out sick with COVID-19.” This nurse explained that the facility had a nurse-to-resident ratio of 40:1, and then asked the prospective job applicants who “could begin a double shift immediately.”

Conditions inside the nursing home are so severe, according to the report, that most of the facility’s 200 residents have “acute pressure ulcers,” meaning it has been days since they were turned over by nurses. “They’re slumped over in bed, just laying there rotting,” one nurse told Gothamist. The report also describes shortages of infection control supplies like gloves, hand sanitizers, and even medication. Staff were reportedly instructed not to record missing medication as out of stock, but instead to “note that a resident refused it.” Inexperienced staff are in some instances “given high-level tasks,” workers said, including one instance when a nursing assistant inserted a resident’s nasal cannula “upside down,” a “potentially deadly error” that resulted in a “gasping fit” before it was caught.

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Suffolk Center for Rehabilitation and Nursing received 51 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 15, 2020. The facility has also received two fines: one 2017 fine of $10,000 in connection to findings in a 2016 inspection that it violated health code provisions regarding quality of care; and one 2016 fine of $10,000 in connection to findings in a 2013 inspection that it violated health code provisions regarding quality of care. The Patchogue nursing home’s citations resulted from a total of eight surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not maintain low enough medication error rates. Section 483.45 of the Federal Code requires nursing home facilities to ensure medication error rates below five percent. A December 2018 citation found that Suffolk Center for Rehabilitation and Nursing did not ensure a low enough rate. The citation states specifically that an inspector observed two errors out of 27 opportunities in a medication pass, leading to an error rate of 7.4 percent. The citation goes on to state that a Licensed Practical Nurse crushed a resident’s medication tablets whose blister packets stated “Do Not Crush.” In an interview, the LPN stated that she had not read the instructions. The facility’s consultant pharmacist stated in an interview that when crushed, one of the medications causes a bitter taste and may cause diarrhea, while the other would be more difficult to swallow. A plan of correction undertaken by the facility included the in-servicing of the facility’s medication nurses.

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Woodhaven Nursing Home received 46 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 24, 2020. The facility has also received two fines: one 2017 fine of $2,000 in connection to findings in an inspection that it violated health code provisions regarding unnecessary; and one 2016 fine of $12,000 in connection to findings in a 2013 inspection that it violated health code provisions regarding accidents and administration. The Port Jefferson Station 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 prevent abuse. Section 483.12 of the Federal Code states that nursing home residents have the right to be free from abuse. A November 2019 citation found that Woodhaven Nursing Home did not ensure that right for one resident. The citation states specifically that the resident was repeatedly hit by another resident “with a wheelchair with the leg rest in place,” suffering a “laceration with severe bleeding to the right leg” and requiring transfer to the hospital. A plan of correction undertaken by the facility included the transfer of the resident to a “safe location” and the transfer of the aggressive resident to a hospital for psychiatric evaluation.

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The Osborn received 16 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 24, 2020. The facility has also received a 2016 fine of $10,000 in connection to findings in a 2014 inspection that it violated health code provisions regarding facility administration and resident rights. The Rye nursing home’s citations resulted from a total of four inspections by state surveyors. The violations they describe include the following:

1. The nursing home did not employ adequate measures to prevent infection. Section 483.80 of the Federal Code states that nursing home facilities must create and uphold an infection prevention and control program designed with an aim “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 The Osborn did not adequately ensure staff followed proper hand hygiene and gloving technique so as to mitigate the risk of cross-contamination and the spread of infectious pathogens. The citation states specifically that an inspector involved a pressure ulcer wound care procedure in which a registered nurse did not wash her hands after discarding a soiled wound dressing and pair of gloves, and before donning a new pair of gloves. The nurse was then observed pouring sterile water on cleanser until gauze sponges and cleaning the resident’s wound without having sanitized her hands. In an interview after the procedure, the nurse “confirmed that she did not practice appropriate hand hygiene.”

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East Neck Nursing & Rehabilitation Center received 29 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on March 28, 2020. The West Babylon 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 prevent residents from being administered unnecessary drugs. Section 483.25 of the Federal Code requires nursing homes to keep “each resident’s drug regimen… free from unnecessary drugs.” A May 2016 citation found that East Neck Nursing & Rehabilitation Center did not ensure such for one resident. The citation states specifically that there was an increase in the resident’s antidepressant medication without any “documented evidence as to why the medication was increased.” In an interview, the facility’s neurologist was asked where the documentation for the dosage increase was, he said that he “will write it next time.” A plan of correction undertaken by the facility included an updating of the resident’s medical record and re-education of nursing staff regarding unnecessary medications.

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