Articles Posted in Infection

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.

Workmen’s Circle Multicare Center suffered 16 fatalities from Covid-19 as of July 12, 2020, state records report. The nursing home also received 15 citations over violations of public health code between 2016 and 2020, according to health records accessed on July 13, 2020. The Bronx nursing home’s citations resulted from a total of five surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately prevent abuse. Section 483.12 of the Federal Code stipulates that nursing homes must ensure each resident’s right to freedom “from abuse, neglect, misappropriation of resident property, and exploitation.” A September 2019 citation found that Workmen’s Circle Multicare Center did not ensure such for one resident. The citation states specifically that a Certified Nursing Assistant “acknowledged hitting” a resident “in her eye after the resident became combative during care.” The resident, according to the citation, was later “observed with her hands covered her face and crying.” In an interview, the CNA stated that the resident had become combative and was “hitting her constantly,” and that when the resident hit the CNA in the stomach, CNA “accidentally” hit the resident in the face. “It happened so fast and my hand hit her face,” the CNA stated. The citation goes on to state that the CNA said she declined to notify a nurse that she hit the resident, and a statement she gave the facility noted that she observed the resident’s “eye swollen while she was providing care.” The CNA was later arrested by the police and prosecuted by local authorities, according to the citation.

2. The nursing home did not ensure resident dignity. Section 483.10 of the Federal Code stipulates that nursing home residents have “a right to be treated with respect and dignity,” which includes a right to the use of personal possessions. A June 2018 citation found that Workmen’s Circle Multicare Center did not ensure this right for two residents. The citation specifically describes an instance in which the facility’s Administrator and Assistant Administrator went into the residents’ room and “without any explanation… opened and searched the residents’ bedside drawers” and threw out one of the resident’s unopened food items “without his permission.” In an interview, the resident’s Assistant Administrator stated that they did not throw out the resident’s food, and that they asked permission before opening the drawers.

Hill Haven Nursing Home suffered 16 fatalities from Covid-19 as of July 12, 2020, state records report. The nursing home also received 29 citations over violations of public health code between 2016 and 2020, according to health records accessed on July 13, 2020.  The Webster nursing home’s citations resulted from a total of seven surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately protect residents from neglect. Section 483.12 of the Federal Code stipulates that nursing homes must ensure residents are kept free from abuse and neglect. A November 2019 citation found that Hill Haven Nursing Home did not ensure such for one resident. The citation states specifically that the resident “did not receive incontinence care, positioning, or bedtime care for two consecutive shifts resulting in skin issues.” After a Certified Nursing Assistant reported to a Licensed Practical Nurse that it appeared the resident had not received care—that the resident “was still sitting in the chair, wearing the same clothes as the previous day, and was soaked with urine and feces through the incontinence brief and the pants”—the Registered Nurse Manager initiated an investigation and found that the resident had not received care over two shifts and “remained in the chair all nigh.” A plan of correction undertaken by the facility included the re-education and disciplining of relevant staff.

2. The nursing home did not adequately protect residents from accidents. Section 483.25 of the Federal Code stipulates that nursing homes must ensure resident environments are kept as free as possible of accident hazards, and that residents are provided with adequate supervision to prevent accidents. A July 2019 citation found that Hill Haven Nursing Home did not ensure such. The citation specifically describes a resident who “rolled out of bed and was found with his legs resting on the baseboard heater that was next to his bed” and sustained a redacted injury to hi slower extremities. A plan of correction undertaken by the facility included the relocation of the resident to another room with a bed that was further from the baseboard heater.

The Pines at Poughkeepsie Center for Nursing & Rehabilitation suffered 19 fatalities from Covid-19 as of July 12, 2020, state records report. The nursing home also received 12 citations over violations of public health code between 2016 and 2020, according to health records accessed on July 13, 2020.  One of those citations concerns findings that the facility’s infection control procedures were deficient. The Poughkeepsie 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 steps to prevent infection. Section 483.30 of the Federal Code stipulates that nursing homes must create and maintain a program designed to prevent and control infection and disease. A December 2018 citation found that Pines at Poughkeepsie Center for Nursing & Rehabilitation did not ensure such. The citation stats specifically that staff did not follow proper hand hygiene during a lunch meal observation, and further that staff did not perform proper gloving and hand hygiene during wound care treatment. During the meal observation, a staff member was observed picking up her badge from the floor after it fell and placing it back on her clothing, then reaching over and holding the resident’s arm and continuing to assist the resident with lunch meals and fluid, without first washing her hands. In the same meal observation, a Certified Nursing Assistant was observed removing the leg rests from a resident’s wheelchair, placing them on the floor, placing her hand on the resident’s arm, then leaving the resident, removing a lunch tray from a dining cart, delivering it to another resident, opening it, cutting the meat, and opening the milk container, all without being observed washing her hands. With respect to the wound observation, a Registered Nurse Manage was observed washing her hands, preparing a dressing field, donning gloves to remove the soiled dressing that had drainage on it, and cleansing the wound without removing the soiled gloves or washing her hands. A plan of correction undertaken by the facility included the in-servicing of relevant staff.

2. The nursing home did not maintain low enough medication error rates. Section 483.45 of the Federal Code requires nursing homes to ensure that “medication error rates are not 5 percent or greater.” A December 2018 citation found that The Pines at Poughkeepsie Center for Nursing & Rehabilitation did not ensure such. The citation states specifically that in one instance, a resident was incorrectly administered eyedrops; in another, a resident was not administered insulin at the proper time. A plan of correction undertaken by the facility included the in-servicing of relevant employees.

Presbyterian Home for Central New York suffered 15 fatalities from Covid-19 as of July 12, 2020, per state records. The nursing home also received 37 citations finding it violated public health code between 2016 and 2020, according to health records accessed on July 13, 2020; two such citations found deficiencies in the facility’s infection control practices. The facility has also received fines totaling $14,000 after findings that it violated health code provisions, such as those concerning quality of care and resident rights. The New Hartford nursing home’s citations resulted from a total of seven surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately implement infection control measures. Section 483.80 of the Federal Code requires nursing homes to establish procedures designed to ensure resident safety and comfort by preventing and controlling infection. A June 2019 citation found that Presbyterian Home for Central New York did not ensure such. The citation sates specifically that resident staff did not perform proper hand hygiene between residents during a medication pass, and that a glucometer “was not sanitized between resident use.” The citation goes on to state that a Licensed Practical Nurse did not perform hand hygiene before or after completing bedside glucose testing for a resident, and did not complete hand hygiene during the preparation and administration of a resident’s insulin. A plan of correction undertaken by the facility included the re-education of the nurse on proper hand-washing technique.

2. A December 2017 citations also found Presbyterian Home for Central New York did not adequately implement infection control procedures. The citation states specifically that the nursing home “did not maintain infection control protocol while providing care” for a resident on contact precautions. It goes on to state that in contravention of facility policy, a Licensed Practical Nurse entered the resident’s room without donning a gown. The citation notes that the resident’s condition “was very infectious and could be spread if not gowning.” In an interview, the facility’s Director of Nursing stated that staff were expected to wear a gown when entering the room of a resident 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.”

Meadowbrook Care Center suffered 21 fatalities from Covid-19 as of June 23, 2020, per state records. The nursing home also received 16 citations finding it violated public health code between 2016 and 2020, according to health records accessed on June 24, 2020, including one citation over its infection control procedures. The Woodbury nursing home’s citations resulted from a total of 4 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately implement infection control measures. Section 483.80 of the Federal Code requires nursing homes to provide residents with a safe and sanitary environment via the implementation of an infection prevention and control program. A January 2020 citation found that Meadowbrook Care Center failed to ensure such. The citation states specifically that a Registered Nurse was observed cleansing a resident’s pressure ulcer without changing her gloves or washing her hands afterward. It also describes a Certified Nursing Assistant who was observed “retrieving a paper napkin that fell on the floor and placing the napkin on the lunch tray” of a resident. In interviews, the RN said “she should have removed her gloves and washed her hands,” and the CNA said she “did not realize she had placed the dirty napkin back on the resident’s tray.” The citation states that these deficiencies had the “potential to cause more than minimal harm.”

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A new study in the Journal of the American Geriatrics Society concludes that nursing homes with low staffing levels, low quality scores, and high concentrations of disadvantaged residents also experience “higher rates of confirmed COVID-19 cases and deaths.”

The study’s lead author, Yue Li, a professor at the University of Rochester Medical Center Department of Public Health Sciences, said in a statement: “In nursing homes, quality and staffing are important factors, and there already exists system-wide disparities in which facilities with lower resources and higher concentrations of socio-economically disadvantaged residents have poorer health outcomes… These same institutional disparities are now playing out during the coronavirus pandemic.”

The study notes that long-term care facility residents are demonstrably vulnerable to respiratory diseases like influenza and coronaviruses, and that research suggests COVID-19 “disproportionately impacts older adults and individuals with chronic health conditions.” This makes nursing homes, which have high concentrations of elderly adults with chronic health conditions, especially vulnerable to COVID-19. Since the pandemic reached the United States, roughly 50,000 deaths related to the novel coronavirus “have been linked to nursing homes,” according to the study.

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Beechwood Homes suffered 21 fatalities from Covid-19 as of June 29, 2020, per state records. The nursing home also received 33 citations finding it violated public health code between 2016 and 2020, according to health records accessed on June 30, 2020, including one citation over findings of infection prevention measures. The Getzville nursing home’s citations resulted from a total of five surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not take adequate measures to ensure residents were protected from infection. Under Section 483.80 of the Federal Code, nursing homes must “establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment” that helps mitigate communicable diseases and infections. A May 2019 citation found Beechwood Homes failed to do so. The citation states specifically that the nursing home failed to perform “routine Legionella culture sampling and analysis at intervals” that did not exceed 90 days in its first year of testing and yearly afterward. According to the citation, the citation affected both of the nursing home’s resident use buildings. In an interview, the facility’s Director of Plant Operations said “he was not aware of the quarterly testing requirement for the buildings’ portable water supply” and that the nursing home had conducted two samplings in a redacted year. The citation states that this deficiency had the “potential to cause more than minimal harm.”

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Townhouse Center for Rehabilitation & Nursing suffered 10 fatalities from Covid-19 as of June 29, 2020, per state records. The nursing home also received 29 citations finding it violated public health code between 2016 and 2020, according to health records accessed on June 29, 2020, including one citation over its infection prevention practices. The facility has also received fines totaling $32,000 over findings that it breached provisions of the health code. The Flushing nursing home’s citations resulted from a total of 10 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not employ adequate infection prevention measures. Section 483.65 of the Federal Code requires nursing homes to maintain an infection control program that helps mitigate the spread of disease. A July 2016 citation found that Townhouse Center for Rehabilitation & Nursing failed to ensure such. The citation states specifically that a Registered Nurse did not conduct proper hand hygiene between cleaning a resident’s pressure ulcer and applying a clean dressing to the wound. According to the citation, an inspector observed the RN cleansing the wound with gauze, disposing of the gauze, removing her gloves, and putting on new gloves without first washing her hands or applying sanitizing gel. In an interview, the RN said “she realized she should have cleansed her hands after removing her gloves and prior to donning another pair of gloves.” A plan of correction undertaken by the facility included the educational counseling of relevant staff.

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