Last week New York Governor Kathy Hochul met with the children of nursing home residents who died during the Covid-19 pandemic and apologized for the state’s handling of the crisis, according to reports by local news outlets. In a press conference the next day, she reportedly said, “I apologized for the pain that those poor families had to endure.” Continue reading
A report released last year by New York Assemblyman Ron Kim examined the thousands of deaths from Covid-19 in the state’s nursing homes in an attempt to identify underlying problems that caused the raft of fatalities and what can be done to address those problems. The report, published by Kim’s office in July 2020, is available here.
The Citadel Rehab and Nursing Center at Kingsbridge has received eight citations for violations of public health laws between 2017 and 2021, according to New York State Department of Health records accessed on June 18, 2021. Those citations include a finding of systemic accident hazards in the facility, which also received a $10,000 fine in 2016. The Bronx nursing home’s citations resulted from a total of five inspections by state authorities. The violations they describe include the following:
1. The nursing home did not take adequate steps to prevent accidents such as elopement. Section 483.25 of the Federal Code stipulates that nursing homes must keep their facilities “as free of accident hazards as is possible” and provide residents with adequate supervision to prevent accidents. A February 2021 citation found that The Citadel Rehab and Nursing Center failed to ensure such for one resident. The citation states specifically that after new windows were installed in the resident’s rom, the nursing home “failed to ensure the window’s safety latch was in place to prevent the window from tilting into the room and fully opening.” The resident had been identified as at risk for elopement, and had been observed exhibiting increased “exit-seeking behaviors” that were not reported to the physician. At a redacted date, surveillance video showed, the resident opened the window in their room, “threw tied sheets out, and climbed out the window.” They then fell to the ground and were found by staff several hours later, after which they were “transferred to the hospital and expired.” A plan of correction undertaken by the facility included the termination of two Certified Nursing Assistants and a Licensed Practical Nurse.
2. The nursing home did not take adequate steps to prevent physical abuse. Section 483.12 of the Federal Code ensures nursing home residents “the right to be free from abuse.” A January 2021 citation found that The Citadel Rehab and Nursing Center failed to ensure such for one resident. The citation states specifically that during an incident in which a resident slapped a Certified Nursing Assistant, the Certified Nursing Assistant “retaliated and slapped” the resident’s left cheek, causing the resident’s eyeglasses to fall to the floor. The citation states that the incident was witnessed by a housekeeper and another Certified Nursing Assistant. A plan of correction undertaken by the facility included the suspension and then the termination of the Certified Nursing Assistant.
A recent report by the New York State Bar Association’s Long-Term Care Task Force found that a 2020 health order by New York Governor Andrew Cuomo caused deaths in the state’s nursing homes from Covid-19. According to the Times-Union, the new report pushes back on earlier findings by the Department of Health, which concluded that the order did not cause Covid-19 deaths, attributing them to “the unwitting infection of asymptomatic nursing staff members.”
The Five Towns Premier Rehabilitation & Nursing Center received 28 citations for violations of public health code between 2016 and 2020, according to New York State Department of Health records accessed on March 17, 2020. The facility has also received five fines between 2013 and 2019, totaling $58,000, for findings that it violated health code provisions concerning accidents, administration, quality of care, and more. The Woodmere 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 provide adequate treatment and care for residents with pressure ulcers. Section 483.25 of the Federal Code requires nursing homes to provide residents without pressure ulcers necessary care to prevent pressure ulcers from developing unless unavoidable, and residents with pressure ulcers the necessary care to promote healing, prevent infection, and prevent the development of new ulcers. An October 2018 citation found that The Five Towns Premier Rehabilitation & Nursing Center did not provide such for two residents. The citation states specifically that a resident who was at moderate risk of developing a pressure ulcer developed two ulcers after admission, and that their wounds “were not promptly identified, reported, assessed and monitored, and treatments were not implemented as per the physician’s orders.” As for the other resident, the citation states that they had a stage 4 pressure ulcer, but a physician’s recommendation that they be hospitalized for debridement of the wound was not addressed, resulting in harm to the resident.
2. The nursing home did not ensure residents were protected from significant medication errors. Section 483.45 of the Federal Code requires nursing homes to ensure residents’ are kept “free of any significant medication errors.” An October 2018 citation found that The Five Towns Premier Rehabilitation & Nursing Center did not ensure such for one resident. The citation found specifically that a Licensed Practical Nurse administered an ear medication to the resident’s eye. Later, the resident “complained of mild irritation to the eyes” and “was noted with redness to the eyes.” In an interview, the LPN said that while administering the drug she was “distracted because she was conversing with the [resident’s] family member.” A plan of correction undertaken by the facility included the educational counseling of the LPN.
Townhouse Center for Rehabilitation & 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 March 20, 2020. The facility has also received four fines: a 2019 fine of $10,000 in connection to findings in a 2019 inspection that it violated unspecified health code provisions; a 2018 fine of $16,000 in connection to findings in a 2018 inspection that it violated unspecified health code provisions; a 2017 fine of $2,000 in connection to findings in a 2017 inspection that it violated health code provisions regarding the use of physical restraints; and a 2017 fine of $4,000 in connection to findings in a 2016 inspection that it violated health code provisions regarding quality of care and administrative practices. The Uniondale nursing home’s citations resulted from a total of ten surveys by state inspectors. The deficiencies they describe include the following:
1. The nursing home did not ensure residents were protected from neglect. Section 483.12 of the Federal Code guarantees nursing home residents the right to “be free from… neglect.” An August 2018 citation found that Townhouse Center for Rehabilitation & Nursing did not ensure such for one resident. The citation describes specifically an instance in which the facility’s security guard on duty “left his post unattended,” after which a resident eloped. The resident was later found a block away from the nursing home and returned to it ‘without any injury.” A plan of correction undertaken by the facility included the termination of the security guard in question.
The federal government unveiled a new tool last month for families to see if a nursing home facility was recently accused of abuse. The government-run Nursing Home Compare website, which aggregates nursing home safety information from across the country, will now flag nursing homes which have credible allegations of abuse reported to authorities in the last 12 months. A “small icon” of a “red circle with a white hand inside” will show up next to the name of the nursing home facility whenever it is searched for on the government website.
Nursing home advocates say the change is minor but long overdue. Studies show that as many as one in 20 nursing home patients are abused and the problem is rarely reported. Already, more than 5 percent of the nursing homes have been branded with the icon warning of abuse allegations, representing facilities with 1.4 million residents. Families who want more information on the allegations of nursing home abuse can look at the entries on inspection reports. The Wall Street Journal details one example where two wheelchair-bound residents with dementia got into a fight and staffers at the Pennsylvania nursing home chose not to intervene. The fight ended when a 95-year-old man died. Another example reported by the national newspaper involves a Maryland nursing home where health inspectors found maggots in the face wound of a dying cancer patient. Both facilities will now have red warning icons next to their name on the government website.
New York nursing homes breathed a sigh of relief last week when a New York Supreme Court judge stopped the state from cutting Medicaid reimbursement funds to facilities across the state. Speaking on behalf of the nursing home industry, Ami Schnauber of LeadingAge New York told McKnight’s Long-Term Care News that the ruling is a “big relief” for its members across the state. The ruling comes after the New York Department of Health revamped its formula for determining Medicaid reimbursement rates. According to state officials, the new rates create a “more fair and accurate picture of [the needs of] nursing home patients.”
The nursing home industry disagrees and says the state is trying to plug an unrelated budget shortfall by cutting necessary funding to the 80,000 New Yorkers who rely on Medicaid to pay for their nursing homes. While the health department says it does “not expect this change to result in any disruption to nursing home residents and the care they receive,” the nursing home industry disagreed and sued the state. In their arguments before Supreme Court Justice Kimberly O’Connor, the nursing homes said the $246 million cuts would cause “irreparable harm” to nursing home patients and force short-staffed nursing homes to lay off even more workers.
Fieldston Lodge Care Center received 38 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 14, 2019. That figure is six greater than the statewide average of 32 citations. The Bronx nursing home’s citations resulted from a total of five inspections by state authorities. The violations they describe include the following:
1. The nursing home did not take adequate measures to prevent and control infection. Section 483.80 of the Federal Code stipulates that nursing home facilities “must establish and maintain an infection prevention and control program… to help prevent the development and transmission of communicable diseases and infections.” A July 2019 citation found that Fieldston Lodge Care Center failed to properly implement its disease prevention guidelines by neglecting to properly clean poles for hanging gastrostomy tube feeding, and by allowing oxygen tubing to run along the floor in spite of protocol requiring that it be maintained off the floor. A state inspector found that this lapse had the “potential to cause more than minimal harm.”