Articles Posted in Medication Errors

Rosewood Rehabilitation and Nursing Center has received a total of 77 citations for being in violation of public health code since 2018 and may even be placed on a Special Focus Facilities list for failing to properly care for its residents.

Rosewood Rehabilitation and Nursing Center has received 77 citations for violations of public health code between 2018 and 2021, according to New York State Department of Health records accessed on January 29, 2022. The facility has also been named a candidate for the Center for Medicare and Medicaid Services’ list of Special Focus Facilities, nursing homes with a history of quality issues. The Rensselaer nursing home’s citations resulted from a total of 12 surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not implement adequate measures to prevent infections. Section 483.80 of the Federal Code stipulates that nursing homes must establish and maintain an effective infection prevention and control program. A December 2021 citation found that Rosewood Rehabilitation and Nursing Center failed to ensure such. The citation states specifically that the nursing home “did not ensure facility staff cleansed scissors after using them to remove a contaminated dressing and prior to using the scissors to cut a wound packing, and did not place a contaminated item in a multi-resident use treatment cart.” It goes on to describe an instance in which a staff member did not undertake hand hygiene procedures between taking off soiled gloves and putting on clean gloves. In an interview, the facility’s Director of Nursing said that “hand hygiene should be performed before and after providing resident care, after each glove removal and between each area when providing wound care.” A plan of correction undertaken by the facility included the re-education of relevant staff. 

Throgs Neck Rehabilitation and Nursing Center in the Bronx has received 22 citations in the last four years after surveys by state inspectors and has been fined $2,000 for violating health codes.

Throgs Neck Rehabilitation & Nursing Center has received 22 citations for violations of public health code between 2017 and 2021, according to records accessed on December 17, 2021. It also received a $2,000 fine in 2021 over findings it violated health code provisions. The Bronx nursing home facility’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 adequately prevent medication errors. Section 483.45 of the Federal Code stipulates that medication error rates at nursing homes must not be “5 percent or greater.” A September 10, 2021 citation found that Throgs Neck Rehabilitation & Nursing Center failed to ensure such. The citation states specifically that one resident “was not administered with six (6) of the prescribed medications due” during an observation. The citation states further that the Licensed Practical Nurse administering the resident’s medications did “not inform the resident that some medications were not being administered at that time.” In an interview, the LPN told a state health inspector that “the missed medications were not available in the medication cart and they should have informed the resident.” The LN added that they planned to search for the medications or contact the facility’s pharmacy to confirm when the medications were re-ordered, or to re-order them if necessary. In an interview, the facility’s Director of Nursing stated “that the nurses are supposed to follow up and get medication before they are exhausted, and they did not know why the staff are not doing that.” A plan of correction undertaken by the facility included the ed-education and in-servicing of relevant staff.