Hilaire Rehab & Nursing, a Suffolk County-based nursing home, failed to meet minimum standards of care in several areas, according to a DOH survey dated June 14, 2011. The DOH gave the facility a one star (out of five possible stars) due to the prevalence of residents with bedsores (pressure ulcers, decubitus ulcers). 21% of residents found to be at “high risk” for developing bedsores had in fact developed a bedsore (the national average in the category is 12%). Among the deficiencies noted was the failure to ensure that the facility remained free of accident hazards and failure to ensure that services are provided by qualified persons in accordance with the care plan.
Title 42 section 483.25(h) of the CFR dictates that a resident must be supervised and provided with assistance devices to prevent accidents. The DOH report details a resident with a history of wandering and barricading herself in her room. Despite this history of barricading, no intervention was in place to prevent the behavior other than 15 minute room checks. As a result, the resident successfully barricaded herself in her room on no fewer than two occasions. The resident, who had a history of dementia and psychotic disorder, also had a roommate. Because of the barricade, the room was not immediately accessible. This could have led to a serious situation/injury had the resident attempted to cause harm either to herself or her roommate. This behavior should have been noted and accounted for in the comprehensive care plan, however it was not, leading to the deficiency rating.
The second deficiency noted above is in violation of section 483.20(k)(3)(ii) of the Code. In this instance, a physician ordered an antibiotic to treat a resident’s urinary tract infection, however the medicine was not administered until three days later. The pharmacist stated that the medication was delivered to the home the day following the order. The Director of Nursing conceded that it should not have taken three days to begin administration of the prescription, but little other explanation was given for the delay. Many elderly residents at nursing homes often have numerous prescriptions to take on a daily basis. The staff must ensure that these medications are administered properly. The delay in providing this resident with his or her UTI prescription led to additional pain and discomfort for the resident, and could have resulted in sepsis.
A complete list of Hilaire’s deficiencies can be found here on the New York DOH website.