Articles Posted in Physical Abuse

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The nursing home in Syracuse, New York was cited for findings of improper PPE use during the Covid-19 pandemic.

Bishop Rehabilitation and Nursing Center has received 75 citations for violations of public health code between 2017 and 2021, according to health records accessed on April 16, 2021. The Syracuse nursing home’s citations resulted from a total of 15 inspections by state surveyors. The violations they describe include the following:

1. The nursing home did not take adequate steps to prevent infection. Section 483.80 of the Federal Code requires nursing homes to create and maintain an infection control program designed to prevent infection. A September 2020 citation found that Bishop Rehabilitation and Nursing Center failed to ensure such. The citation states specifically that the nursing home two registered nurses and a licensed practical nurse “were observed wearing face masks below their noses” while treating a resident, and that a unit aide was observed “wearing a face mask below her nose and mouth while sitting with 2 residents and speaking with another staff member,” in contravention of the facility’s guidelines concerning the use of personal protective equipment. A plan of correction undertaken by the facility included the re-education of relevant staff.

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A nursing home based in Syracuse, New York has received 57 health citations since 2017.

Van Duyn Center for Rehabilitation and Nursing has received 57 citations for violations of public health code between 2017 and 2021, according to New York State Department of Health records accessed on April 8, 2021. The facility has additionally received seven fines totaling $90,000 since 2008. The Syracuse nursing home’s citations resulted from a total of 15 surveys by state inspectors. The deficiencies they describe include the following: Continue reading

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A health inspector found that one resident of the New York nursing home kept his smoking paraphernalia when outside the designated smoking area and outside of designated smoking times.

The Eleanor Nursing Care Center has received received 48 citations for violations of public health code between 2017 and 2021, according to health records accessed on March 12, 2021, as well as two fines totaling $12,000 between 2016 and 2017. The Hyde Park 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 implement adequate measures to prevent accidents. Under Section 483.25 of the Federal Code, nursing homes are required to provide residents with environments as free as possible of accident hazards. A September 2019 citation found that The Eleanor Nursing Care Center failed to ensure such. The citation state specifically that “no ashtrays were observed in the designated smoking area” on several occasions, that eleven residents were observed “flicking cigarette ashes to the ground,” and that one resident “maintained possession of his personal smoking paraphernalia when not in the designated smoking area at scheduled smoking times,” in contravention of facility policy. A plan of correction undertaken by the facility included the purchase of non-combustible ashtrays and the education of staff on “the importance of safe disposal of ashes in the ashtrays.”

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An investigation found that nursing homes with five-star ratings often received citations for abuse and neglect.

A new investigation by the New York Times examines how nursing homes use the star rating system to “mislead the public.” As the article explains, the nursing home star rating system, in which one star is the lowest rating and five star is the highest ratings, has been “a popular way for consumers to educate themselves and for nursing homes to attract new customers.”

However, the report suggests, the system in fact offers “a distorted picture of the quality of care” at nursing homes, with many facilities manipulating the rating system to conceal failings that led to disproportionate nursing home resident deaths during the Covid-19 pandemic. The Times ultimately found that residents “at five-star facilities were roughly as likely to die of the disease as those at one-star homes.” Continue reading

Ira Davenport Memorial Hospital suffered 28 confirmed and 1 presumed COVID-19 deaths as of January 2, 2021, according to state records. The nursing home has 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 January 2, 2020. The Bath 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 adequately protect residents from accident hazards. Section 483.25 of the Federal Code requires nursing homes to ensure that resident environments are kept “as free of accident hazards as is possible” and that staff provide residents with “adequate supervision… to prevent accidents.” An April 2019 citation found that Ira Davenport Memorial Hospital failed to ensure such. The citation states specifically that one resident was not provided with sufficient protection from accidents and subsequently suffered a fall with injury. It a section describing the incident in question, the citation states that “the resident was walking in the hall, lost her balance, and fell to the floor hitting her head and sustaining a goose egg to her left forehead.” The registered nurse who documented the fall wrote that there were no fall protections in place for the resident. A plan of correction undertaken by the facility included the revision of her care plan “include the presence of safety devices, ambulation changed to assist of one due to presence of illness and 15 min checks instituted.”

2. The nursing home did not adequately protect residents from abuse. Under Section 483.12 of the Federal Code, nursing home residents are guaranteed the right “to be free from abuse, neglect, misappropriation of resident property, and exploitation.” A May 2018 citation found that Ira Davenport Memorial Hospital did not ensure such for one resident. The citation states specifically that a Certified Nursing Assistant hit a resident on the resident’s left thigh after the resident grabbed the CNA’s hair. According to the citation, the facility’s policies forbade abuse, and the CNA had received abuse training. A plan of correction undertaken by the facility included the termination of the CNA.

The Riverside suffered 48 confirmed and 17 presumed COVID-19 deaths as of December 26, 2020, according to state records. The nursing home has also received 53 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on December 26, 2020. The New York 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 protect residents from abuse. Under Section 483.12 of the Federal Code, nursing home residents have a right to freedom from abuse and neglect. A June 2020 citation found that The Riverside failed to ensure such. The citation states specifically that a resident who had “dementia and a history of physical aggression” participated in four altercations with other residents after the facility transferred her to a new unit. According to the citation, the facility did not put interventions in place to address this resident’s behavior and to protect other residents in the unit. It goes on to state that one altercation resulted in a laceration to the crown of another resident’s head; a subsequent altercation resulted in the aggressor’s transfer to the hospital for evaluation. A plan of correction undertaken by the facility included the review and revision of her care plan.

2. The nursing home did not provide adequate treatment for dementia. Section 483.40 of the Federal Code requires that nursing homes provide residents suffering from dementia with “appropriate treatment and services to attain or maintain his or her highest practicable physical, mental, and psychosocial well-being.” A June 2020 citation found that The Riverside failed to provide such. The citation states specifically that the facility did not take individualized interventions in response to a resident’s “increasing dementia-related behaviors that occurred after a room change,” specifically, the resident’s instigation of physical altercations with other residents, including hitting one over the head with a footrest. A plan of correction undertaken by the facility included the creation of a person-centered care plan for the resident.

Steuben Center for Rehabilitation and Healthcare has received 38 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on August 19, 2020. The facility has also received a 2018 fine of $10,000 in connection to findings in a 2017 inspection that it violated unspecified health code provisions. The Bath 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 protect residents from abuse. Section 483.12 of the Federal Code grants nursing home residents “the right to be free from abuse.” A January 2018 citation found that Steuben Center for Rehabilitation and Healthcare did not ensure such for one resident. The citation states specifically that a Licensed Practical Nurse was witnessed undressing and washing the resident after the resident told the LPN to stop, then pushing the resident onto the toilet when the resident attempted to stand up. The citation also states that the LPN told another nurse at the facility “that she wanted to use the biggest needle she could find on the resident.” A plan of correction undertaken by the facility included the suspension and subsequent termination of the LPN.

2. The nursing home did not properly prevent infection. Section 483.80 of the Federal Code stipulates that nursing homes must maintain a program to prevent and control infection. A July 2018 citation found that Steuben Center for Rehabilitation and Healthcare did not ensure such for two residents. The citation states specifically that a nurse “did not properly disinfect the blood glucose testing machine (glucometer) before or after resident use.” In an interview, the nurse said “she should have wiped the glucometer down between residents” and that “she usually cleans the glucometer with bleach wipes that are located at the nurses’ station.” The facility’s Assistant Director of Nursing said in another interview that “she would expect the nurse to clean the glucometer in between residents using the approved bleach wipes.”

Washington Center for Rehabilitation and Healthcare has received 49 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on August 14, 2020. The facility has also received a total of $74,000 in fines in connection to findings that it violated health code provisions concerning infection control, accidents, medication errors, resident behavior, hydration, administration, and more. The Warsaw 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 protect residents from physical abuse. Section 483.12 of the Federal Code grants nursing home residents “the right to be free from abuse, neglect, misappropriation of resident property, and exploitation.” A January 2020 citation found that Washington Center for Rehabilitation and Healthcare failed to ensure this right for two residents. The citation specifically states that it did not ensure the two residents “were free from physical abuse related to a resident to resident altercation.” It describes an incident in which one resident attempted to pull another resident’s wheelchair “and was swinging a fist at the resident,” who in response “used his reacher and struck” the resident “twice in the face,: at which point a staffer separated the residents. A plan of correction undertaken by the facility included a rooming change for the residents, who were roommates.

2. A November 2019 citation also found that Washington Center for Rehabilitation and Healthcare did not protect residents from abuse. The citation specifically describes a Registered Nurse Supervisor assaulting a resident. According to the citation, the RNS instructed two other staffers to to hold the resident’s hands while the RNS placed medication crushed into pudding into the resident’s mouth. Per a written statement, one of those staffers said “that RNS #1 had instructed LPN #1 and CNA #1 to hold Resident #1’s hands, then put medication into his/her mouth. When RNS #1 put the medication in Resident #1’s mouth, she tipped his/her head back and put her hand in front of his/her mouth.” A plan of correction undertaken by the facility included the suspension, investigation, and termination of the RNS.

Staten Island Care Center received 23 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on July 22, 2020. The Staten Island nursing home’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 effectively ensure the prevention and control of infection. Under Section 483.80 of the Federal Code, nursing home facilities must create and uphold a program designed to prevent and control the development and transmission of disease and infection. A June 2019 citation found that Staten Island Care Center failed to ensure such. The citation specifically describes a housekeeper who was observed exiting the room of a resident on contact precautions without wearing personal protective equipment. The housekeeper, who was “mopping the floor” of that resident’s room, was observed using the same mop to clean another resident’s room. The citation states that this deficiency had the “potential to cause more than minimal harm.” A plan of correction undertaken by the facility included the in-servicing of the housekeeper on the cleaning of isolation rooms and use of PPE.

2. The nursing home did not protect residents from physical abuse. Section 483.12 of the Federal Code provides nursing home residents with “the right to be free from abuse.” A May 2018 citation found that Staten Island Care Center did not ensure such for one resident. The citation specifically states that facility surveillance camera footage showed the resident sitting in a wheelchair a Certified Nursing Assistant “pulled the resident’s shirt from the back of the neck.” According to the citation, the resident said in an interview that they had also been struck by a staff member. While the footage did not show the resident being hit, according to the citation, a Certified Nursing Assistant said in an interview that she witnessed another CNA striking the resident in his face “but did not report it.” A plan of correction undertaken by the facility included the initiation of an abuse prevention plan.

Elderwood at Waverly suffered 19 fatalities from Covid-19 as of July 18, 2020, per state records. The nursing home also received 17 citations finding it violated public health code between 2016 and 2020, according to health records accessed on July 20, 2020. It was additionally the recipient of a 2019 fine in connection to findings in a 2018 survey that it violated unspecified health code provisions. The Waverly nursing home’s citations resulted from a total of six surveys by state inspectors. The violations they describe include the following:

1. The nursing home did not properly supervise residents to prevent accidents. Section 483.25 of the Federal Code requires nursing homes to ensure resident environments are kept as free as possible of accident hazards, and that residents received “adequate supervision and assistance devices to prevent accidents.” A January 2019 citation found that Elderwood at Waverly failed to ensure residents received an adequate level of supervision with the use of assistance devices. The citation specifically describes a resident with “moderate cognitive impairment” who required the assistance for transfers and walking. “The resident utilized a wheelchair and walker, was not steady when moving fro a seated to standing position and for surface to surface transfers,” according to the citation, which goes on to describe an instance in which the resident was observed “self-propelling from the dining room to her room using doorways and handrails to assist” and with her feet under her wheelchair’s leg rest foot plates; it also describes another instance in which she stood from her wheelchair to move to the other side of a table in the dining room, and another in which she self-propelled with her feet under her wheelchair’s leg rests. In an interview, the facility’s Director of Therapy stated that “any resident who self-propelled in a wheelchair with their legs and feet should not have leg rests on the chair due to the risk to fall and impeding mobility.” A plan of correction undertaken by the facility included a revision of the resident’s care plan concerning the use of leg rests.

2. The nursing home did not protect residents from abuse. Section 483.12 of the Federal Code requires nursing homes to protect each resident’s right “to be free from abuse, neglect, misappropriation of resident property, and exploitation.” An October 2018 citation found that Elderwood at Waverly failed to ensure such. The citation specifically describes a resident who “was observed on video being hit by facility staff.” According to the citation, a Registered Nurse “bent to kiss the resident on her forehead” after administering medication, at which point the resident struck theRN in the face, and the RN “responded by grabbing and slapping the resident’s left arm.” A plan of correction undertaken by the facility included the termination of the RN.

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