Articles Posted in Nursing Home Violations

Clove Lakes Health Care and Rehabilitation Center experienced 15 deaths from Covid-19 as of June 8, 2020, per state records. The nursing home also received 24 citations for violations of public health code between 2016 and 2020, including one for infection prevention and control procedures, according to health records accessed on June 9, 2020. The Staten Island nursing home’s citations resulted from a total of three surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not adequately maintain infection prevention and control policies. Section 483.80 of the Federal Code requires nursing homes to establish and maintain an infection control program “designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.” A January 2020 citation found that Clove Lakes Health Care and Rehabilitation Center did not ensure such. The citation states specifically that oxygen tubing connected to residents’ nares was in several instances observed touching the facility’s floor. The citation goes on to state that “this was evident” for three residents. It notes that facility policy provided for the changing of oxygen tubing found on the floor. In an interview, a Certified Nursing Assistant said that “oxygen tubing should not be on the floor.” A plan of correction undertaken by the facility included the changing of two residents’ tubing two a shorter length.

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Quantum Rehabilitation and Nursing received 29 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 9, 2020. The facility has also received two fines: one 2019 fine of $10,000 in connection to findings in a 2019 inspection that it violated unspecified health code provisions; and one 2016 fine of $8,000 in connection to findings in a 2014 inspection that it violated health code provisions regarding investigations, accidents, and administration. The Middle Island 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 provide adequate pressure ulcer treatment. Section 483.25 of the Federal Code requires nursing homes to ensure residents with pressure ulcers receive “necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.” An April 2019 citation found that Quantum Rehabilitation and Nursing did not ensure such for one resident. The citation states specifically that the resident’s “skin integrity deteriorated over a five-day period resulting in open areas, pain and crying,” but that these changes were neither promptly reported to nor assessed by health professionals, and “appropriate treatment was not implemented” until seven days after the changes were initially noted. The citation states that this deficiency resulted in “actual harm.”

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Ten Broeck Center for Rehabilitation & Nursing suffered 32 deaths from Covid-19 as of June 16, 2020, per state records. The nursing home also received 31 citations for violations of public health code between 2016 and 2020, according to health records accessed on June 16, 2020. One of those citations found a violation in the nursing home’s infection control practices. The Lake Katrine nursing home’s citations resulted from a total of 3 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not take adequate measures to prevent infection. Section 483.80 of the Federal Code stipulates that nursing homes must establish and maintain an infection prevention and control program designed to provide a safe and comfortable environment for residents. A February 2018 citation found that Ten Broeck Center for Rehabilitation & Nursing did not ensure such. The citation states specifically that three of the facility’s Licensed Practical Nurses did not perform proper hand hygiene to prevent cross contamination while they were conducting a medication pass. One of the LPNs was observed placing her finger inside a medication cup before giving it to the resident, and opening a medication package without wearing gloves. Another was observed placing two medication cups atop a medication cart without cleaning the top of the cart, filling each cup with a medication tablet, and lifting one of the cups and stacking it in the other, potentially contaminating the latter cup; this LPN was also observed putting her finger inside the medication cups before giving them to a resident. And a third LPN was observed putting her finger inside a medication cup, potentially contaminating the resident; when she gave the medication to the resident, one of the pills fill from the resident’s hand onto the resident’s bed, and the LPN was observed picking the pill up “with her bare hand” and returning it to the resident. A plan of correction undertaken by the facility included the counseling and education of the LPNs in question.

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A new report by the Washington Post suggests that “thousands of nursing homes” across the United States were ill prepared for the novel coronavirus pandemic. Federal guidance as well as advice from researchers and medical experts encouraged a policy of treating patients in place, the article notes, believing that hospitals “are not friendly environments for the frail and elderly.” But, the Post suggests, nursing homes “neglected” the fact that treating patients in place “requires having effective means of treatment, staff who know how to deploy that treatment and procedures to stop the spread of infection.” The result was that even though nursing homes “did not swamp hospitals” with coronavirus patients, they also did not prevent “the deaths of more than 30,000 of their residents, or, in many cases, even provide decent palliative care.”

The Post discusses one nursing home in upstate New York, Absolut Care Care of Aurora Park in East Aurora. Public records indicated that 153 residents at the nursing home were infected, with 61 deaths by May 31, 2020. This figure “includes deaths on site and among those taken to hospitals,” the Post says, and is disputed by the facility’s owners, though they “did not provide their own tally.” A nurse who quit working at the facility in early May told the Post that “Once it was there it just spread like wildfire… It was very hectic, chaotic.”

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Glens Falls Center for Rehabilitation and Nursing suffered 15 deaths from Covid-19 as of June 16, 2020, per state records. The nursing home also received 41 citations for violations of public health code between 2016 and 2020, according to health records accessed on June 16, 2020. Multiple citations concerned deficient infection prevention practices. The Glens Falls nursing home’s citations resulted from a total of 7 surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not take adequate measures to prevent the spread of infection. Section 483.80 of the Federal Code requires nursing home facilities to “establish and maintain an infection prevention and control program designed to… help prevent the development and transmission of communicable diseases.” An April 2020 citation found that Glens Falls Center for Rehabilitation and Nursing did not ensure such. The citation states specifically that staffers did not provide for the handling and delivery of laundry “in a manner to prevent the spread of COVID-19 infection.” It goes on to state that staff delivering laundry entered a resident’s room wearing personal protective equipment, as required by directions on the door, and then exited the room without removing the PPE or performing hand hygiene before they entered the room of a resident who did not have PPE precautions posted on their door. A plan of correction undertaken by the facility included the removal of a laundry aide from the assignment and the removal and re-laundering of personal items in affected rooms.

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Members of the House Select Subcommittee on the Coronavirus Crisis have requested documents and a briefing from New York Governor Andrew Cuomo concerning his March 25, 2020 order that New York nursing homes must admit patients discharged from hospitals even if those patients had been treated for COVID-19. According to a report in the New York Post, those congressmen said the order “likely contributed” to the high COVID-19 death toll in nursing homes.

According to the Post, five Republican members of the subcommittee have requested “six categories of documents and information, including the daily number of coronavirus deaths of a ‘registered nursing home patient at a hospital.'”

The report notes that the New York State Department of Health “stopped listing on that figure on its website” at the beginning of May. The committee members have also requested a briefing of their staff, and have sent similar requests to the governors of Michigan, California, New Jersey, and Pennsylvania.

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A new investigation by ProPublica examines the effects of New York Governor Andrew Cuomo’s March 25, 2020 order that nursing homes must admit medically stable patients discharged from hospitals that determined they required nursing home care, even if those patients had been treated for COVID-19. The order also prevented nursing homes from testing such prospective residents to determine whether they had either become newly infected with COVID-19 or remained contagious from an earlier infection. According to ProPublica, the disease “tore through New York state’s nursing facilities, killing more than 6,000 people” in the weeks after the order was implemented. Those deaths comprised roughly 6% of the 100,000+ nursing home residents in the state. 

ProPublica notes that states with comparable orders suffered comparable outcomes: Michigan, for instance, suffered a death rate of about 5% of its 38,000 nursing home residents, while New Jersey suffered a rate of 12% of its 43,000+ residents. Meanwhile in Florida, which prevented such transfers from hospitals to nursing homes, 1.6% of the state’s 73,000 died as a result of COVID-19. And in California, which “quickly revised” a policy comparable to New York’s, 2% of the state’s 103,000 nursing home residents died.

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A June 12 report by the Centers for Medicare and Medicaid Service disclosed that 31,782 nursing home residents died as a result of COVID-19 as of May 31, 2020. This accounts for about one-third of the known COVID-19 deaths in the United States, according to a column in Forbes, with “the highest number of deaths” occurring in the states of New York, New Jersey, and Connecticut. The column notes that these states “were among the first to grant civil immunity to nursing homes,” a grant that “effectively eliminates civil legal redress for and on behalf of nursing home residents who died due of COVID-19 due to negligence and abuse.”

According to the Forbes columnist, the granting of immunity to nursing homes that may not have established “reasonable protections for vulnerable residents” in the face of the coronavirus pandemic is “an appalling abuse of the law.” Such grants have occurred in roughly 20 states, with Congress preparing to take comparable federal action—even though, the columnist notes, no serious inquiry has been held into nursing homes’ handling of the coronavirus pandemic. Broad immunity for nursing homes would impede the ability of victims’ family members to uncover what happened to their loved ones “who died during a lockdown, alone and behind closed doors.” It also removes the broader public’s ability to hold “bad nursing homes operators accountable for patient abuse and neglect.

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Ross Center for Nursing and Rehabilitation received 31 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 9, 2020. The facility has also received a 2011 fine of $10,000 in connection to findings in a 2010 inspection that it violated health code provisions regarding accidents and supervision. The Brentwood 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 provide adequate bedsore / pressure ulcer treatment and care. Section 483.25 of the Federal Code requires nursing homes to ensure that residents with pressure ulcers are provided with treatment and services necessary “to promote healing, prevent infection and prevent new ulcers from developing.” A July 2017 citation found that Ross Center for Nursing and Rehabilitation did not ensure such for one resident. The citation states specifically that the nursing home “did not effectively evaluate factors that could be removed or modified to stabilize, reduce, or remove risk factors which contributed to the development and deterioration” of the resident’s pressure ulcer. According to the citation, the resident was given a concave mattress placed atop a pressure relieving mattress. In interviews, facility staff suggested that the concave mattress “impeded staff from properly turning and positioning” the resident, and further that the mattress “did not provide optimum level of pressure reduction for wound healing.” As such, according to the citation, the resident “developed a stage 2 pressure ulcer which then deteriorated to a stage 3.” A plan of correction undertaken by the facility included the educational counseling of its Unit Manager.

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St. Catherine of Siena Nursing and Rehabilitation Care Center received 12 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on April 11, 2020. The Smithtown nursing home’s citations resulted from a total of four surveys by state inspectors. The deficiencies they describe include the following:

1. 1. The nursing home did not implement adequate measures to mitigate medication errors. Section 483.45 of the Federal Code requires nursing homes to ensure that “residents are free of any significant medication errors.” A January 2019 citation found that St. Catherine of Siena Nursing and Rehabilitation Care Center did not ensure such for one resident. The citation states specifically that while the resident’s primary care physician had ordered the resident to receive an anticonvulsant medication twice a day, “the resident did not receive five consecutive doses of the prescribed anticonvulsant medication.” In interviews, facility staffers including the Registered Nurse Supervisor stated that they were not aware the medication in question had been unavailable on multiple days.

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