Articles Posted in Nursing Home Violations

A new column the New York Post describes the “horrors” suffered by New York nursing home residents during the Covid-19 pandemic. The disease “has killed at least 11,000 to 12,000” such residents in New York, which the Post says is “nearly double what the state admits…”

The state’s health commissioner “began fudging the statistics” as the crisis spread, according to the author, a former New York lieutenant governor, who says the commissioner switched in late April from reporting all nursing home resident deaths to reporting only deaths that occurred in nursing homes, excluding those who died after hospitalizations. “That reduced the number to 6,602,” the Post said, when in fact “at least another 17,000 elder-care patients with COVID-19 were sent to hospitals, and an estimated 5,000 to 7,000 of them have died.” The Post attributes its figures to the Journal of the American Medical Association.

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A new poll shows that New Yorkers disapprove of Governor Andrew Cuomo’s “handling of nursing homes amid the coronavirus pandemic,” according to a May 27 report by the New York Post. The poll reportedly shows that the governor’s numbers fell from 71% approval a month ago to 63%, “with the majority disapproving of how he dealt with the elder care facilities.” The poll was conducted by Siena College, whose pollster, Steven Greenberg, said in a statement: “When it comes to addressing the needs of nursing homes, only 44 percent give him positive marks, compared to a plurality, 48 percent, who rate him negatively,”

According to the Post, Governor Cuomo has “backtracked” on a “controversial mandate” that nursing homes had to readmit from hospitals residents who tested positive for the virus, though he “twice blamed federal guidance” for the policy. The state has since ordered that hospitals “cannot send COVID-positive people back into homes,” and that nursing homes test staff members for coronavirus twice each week. Meanwhile, state legislators have issued calls for independent probes of the state’s role in New York’s “hellish nursing home death tolls.

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San Simeon by the Sound Center for Nursing & Rehabilitation received 25 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 10, 2020. The Greenport 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 provide adequate  bedsores / pressure ulcer care. Section 483.25 of the Federal Code stipulates that nursing homes must ensure residents with pressure ulcers receive “necessary treatment and services, consistent with professional standards of practice.” An October 2017 citation found that San Simeon by the Sound Center for Nursing & Rehabilitation did not ensure such for one resident. The citation states specifically that the facility “did not compete thorough assessments nor provide adequate treatment” of a resident assessed upon admission as at risk of pressure ulcers. A plan of correction undertaken by the facility included the review of the charts of all residents with stage 2 or greater pressure wounds.

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Some New York nursing homes’ internal coronavirus death counts far exceed the official state figures, according to a new report by the New York Post. Staff members at several nursing homes told the paper that a widespread lack of coronavirus testing has resulted in institutions’ inability to attribute deaths to the virus with certainty, leading to confusion about the true number of coronavirus deaths. One nursing home resident advocate suggested that some facilities may have “taken advantage” of the confusion to be less than transparent about fatalities.

The Post report cites a few nursing homes in which internal documents reflect a higher death count than figures released by the state. Cypress Garden Center for Nursing and Rehabilitation in Flushing, Queens sustained 76 deaths between March 1 and May 2, whereas the state described seven deaths. Seagate Rehabilitation and Nursing Center in Coney Island suffered 74 deaths through May 1, whereas the state described 25. And Cold Spring Hills Center for Nursing and Rehabilitation in Woodbury suffered 115 deaths through May 8, whereas the state described 23.

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Van Duyn Center for Rehabilitation and Nursing suffered 13 coronavirus deaths as of May 17, 2020, per state records. The nursing home also received 78 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on May 18, 2020. The facility has additionally received seven enforcement actions, including: a 2019 fine of $2,000 in connection to findings in a 2015 inspection that it violated unspecified health code provisions; a 2018 fine of $10,000 in connection to findings in a 2015 inspection that it violated unspecified health code provisions; and a 2016 fine of $40,000 in connection to findings that it violated health code provisions regarding transfer and discharge requirements, discharge, quality of care, and staff treatment of residents. The Syracuse nursing home’s citations resulted from a total of 14 surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not take adequate measures to prevent infection. Section 483.80 of the Federal Code requires nursing homes to maintain an infection control program that ensures residents a sanitary environment. A January 2017 citation found that Van Duyn Center for Rehabilitation and Nursing did not ensure such. The citation states specifically that two employees “did not receive the flu vaccine, did not sign a declination of influenza vaccination, and were observed wearing their flu masks incorrectly.” The citation goes on to state that eight other employees wore their flu masks incorrectly, “potentially exposing residents and staff to influenza.” The citation states that this deficiency had the “potential to cause more than minimal harm.”

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The Grand Rehabilitation and Nursing at Rome suffered 8 coronavirus deaths as of May 17, 2020, per state records. The nursing home 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 May 18, 2020. The facility has additionally received one enforcement action: a 2019 fine of $10,000 in connection to findings in a 2019 inspection that it violated unspecified health code provisions. The Rome nursing home’s citations resulted from a total of seven surveys by state inspectors. The deficiencies they describe include three alleged violations of Section 483.80 of the Federal Code, which requires nursing homes to maintain an infection prevention and control program that helps mitigate the development and transmission of communicable diseases and infections. Those three citations include:

1. A January 2020 citation states that an inspector observed that a resident’s IV access had no cap placed on its port, and that staff were touching the end of the access with ungloved hands. The inspector also observed a treatment in which a resident “did not have a barrier placed between bare feet and the floor and clean supplies and a soiled dressing were placed on the resident’s bed.” A plan of correction undertaken by the facility included the reeducation of relevant staff members on proper infection control technique, including the capping of IV tubing and the need for a barrier between residents’ feet and the bare floor during treatment.

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Bishop Rehabilitation and Nursing Center suffered nine coronavirus deaths as of May 17, 2020, per state records. The nursing home also received 109 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on May 18, 2020. The facility has additionally received eight enforcement actions, including: a 2018 fine of $24,000 in connection to findings it violated unspecified health code provisions; a 2016 fine of $10,000 in connection to findings in a 2016 inspection that it violated health code provisions regarding pressure sores; and a 2016 fine of $10,000 in connection to findings in a 2016 inspection that it violated health code provisions regarding accidents. The Syracuse nursing home’s citations resulted from a total of 15 surveys by state inspectors. These citations include several for alleged violations of Section 483.80 of the Federal Code, which requires nursing homes establish and implement infection control practices. Those three citations include:

1. An August 2019 citation found that the nursing home did not ensure proper hand hygiene was performed during the administration of medication. An inspector specifically observed a Licensed Practical Nurse prepare medications for a resident without performing hand hygiene. The LPN was observed removing blister packs from her cart while touching her computer and mouse, then helping the resident back into his wheelchair after he fell, obtaining his vital signs, returning to her cart, removing pills from blister packs, placing them in a cup, and giving them to the resident, all without performing hand hygiene. The LPN was then observed pushing the cart to another resident’s doorway, removing blister packs from the cart, popping pills into a cup, touching her computer mouse, pouring water into a up, moving the resident’s overbed table, and handing him the pills and some water, then returning to her cart without performing hand hygiene. A plan of correction undertaken by the facility included educating the LPN on proper hand washing technique.

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Union Plaza Care Center suffered 20 coronavirus deaths as of May 17, 2020, per state records. The nursing home also received nine citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on May 18, 2020. The facility has additionally received one enforcement action: a 2010 fine of $2,000 in connection to findings in a 2009 inspection that it violated health code provisions regarding accidents and supervision. The Flushing nursing home’s citations resulted from a total of seven surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not ensure the establishment and maintenance of its infection prevention and control program. Section 483.80 of the Federal Code stipulates that nursing home facilities must create and maintain infection control programs that help prevent disease and infection. A March 2020 citation found that Union Plaza Care Center did not ensure such. The citation states specifically that a resident’s Bi-pap machine oxygen tubing “was observed touching the floor,” and that a resident’s nasal cannula was observed “attached to a portable oxygen tank uncovered and touching the floor.” The citation states that these deficiencies had the “potential to cause more than minimal harm.”

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An investigation by USA Today found that of 88 New York nursing homes with reported COVID-19 deaths (as of May 1), 51 had previously received citations from health inspectors for violations of infection control regulations. A few days after this investigation, New York officials released findings that 353 nursing homes in the state had reported 4,813 confirmed or presumed deaths from COVID-19, comprising about one-fourth of the state’s COVID-related fatalities. This aligns with national figures, according to USA Today, which found that “COVID-19-related illnesses in nursing homes account for about a quarter of deaths in the US.”

Many nursing homes have long suffered from infection control issues, with state and federal inspectors identifying violations at homes across the state. USA Today describes a 2017 inspection of Carillon Nursing and Rehabilitation Center, in Long Island, which found that the nursing home failed to ensure that “an incidence of a communicable disease was reported to the state Department of Health” as required. In that incidence, five residents suffered from scabies, but the facility’s director of nursing did not report the disease. “Now,” USA Today states, “it has reported 30 deaths from COVID-19.”

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Hebrew Home for the Aged at Riverdale received 38 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on May 11, 2020. The Riverdale 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 employ adequate infection control practices. Section 483.80 of the Federal Code requires nursing homes to establish and maintain an infection prevention and control program designed to mitigate the spread of communicable diseases and infections. An August 2019 citation found that Hebrew Home did not ensure its infection control practices were properly maintained. An inspector specifically observed two residents who receive oxygen through nasal cannula with their oxygen tubing lying on the floor, in contravention of policies and procedures. The citation goes on to state that this inspector also observed residents’ rooms in which various equipment—oxygen cannulas, nebulizers, and more—were “stored without being covered,” as well as a nurse who did not conduct proper hand hygiene while caring for a resident’s room. The citation states that these deficiencies had “potential to cause more than minimal harm.”

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