Nassau County nursing home White Oaks Rehabilitation and Nursing Center was cited in a February Department of Health deficiency report for several health violations. Among these was failure to provide proper treatment to prevent or heal pressure sores. In short, the facility did not ensure that a resident who entered without a pressure ulcer did not develop one during her stay at White Oaks.
Upon admission to White Oaks, the resident did not have a pressure ulcer. According to her Braden Scale assessment, a test used by nursing homes to determine an individual’s risk for the development of pressure sores, the resident was a mild risk. Approximately five months after admission, the resident developed a Stage II pressure ulcer to the lower back. Two weeks later, the ulcer had deteriorated to the point that it was now unstageable. Although the treatment given to the resident in the two weeks following the discovery of the sore did not assist in healing, the care plan for this resident went unchanged for the next five months. In an interview with the physician in February of this year (five months after the ulcer had developed and subsequently deteriorated), he stated that there was no evidence that the ulcer was unavoidable.
Cases such as the one documented above exhibit clear signs of negligence and violations of state and federal regulations applicable to nursing homes. The regulation takes into account that at times pressure ulcers are unavoidable for elderly residents of nursing homes. In this instance, the physician himself states that there was no documented evidence that the pressure ulcer was unavoidable. Additionally, the initial treatment clearly did not help the resident to heal. On the contrary, the condition of the wound deteriorated in the two weeks following its discovery. Despite this, there is no documentation of the care plan being changed for a full five months after the sore became unstageable. It appears from the Department of Health report that White Oaks failed both to prevent the development of pressure sores where avoidable, and also to provide proper treatment to promote the healing of wounds that do develop.
The Department of Health report, including other violations found in the February 2013 inspection, can be found on the DOH website here.