Northern Riverview Health Care Center, a Rockland County nursing home, was deficient in providing adequate care to residents according to an April, 2012 certification survey from the Department of Health. Among the numerous violations documented by the Department was a failure to provide proper treatment to prevent or promote the healing of pressure sores.
We have written many times about the dangers of pressure ulcers for elderly nursing home patients. Aside from tremendous pain and discomfort, pressure sores can lead to infection, surgeries, and death. Because of these extreme side effects, federal regulations state that the facility must ensure that residents entering a nursing home without pressure sores remain free of them unless unavoidable despite using all reasonable means; and that residents with pressure sores receive treatment necessary to promote healing, prevent infection, and prevent new sores from developing. For the purposes of this case at Northern Riverview, we focus on the second half of the regulation.
The resident chronicled in the Department’s report was readmitted to the facility following a hospital stay. Upon this readmission, pressure sores were present on her heels. However, the staff failed to “stage” the ulcers upon re-admission. Interventions noted in the care plan called for heel booties to be worn at all times, except during hygienic periods, such as cleaning the patient. In contravention of this care plan, the patient was observed on numerous occasions lying in bed without heel boots or protectors, often with the effected areas in direct contact with the bedclothes or other parts of the body. As is common knowledge in the medical community, pressure ulcers are caused by unrelieved pressure against the skin. Allowing a known trouble area of the body to go without protective measures to prevent pressure ulcers creates a substantial risk that pressure ulcers will develop, or existing ulcers will worsen. In this case, the pressure sore of the right heel advanced to a Stage III, one level below the most serious Stage IV ulcer.
For a full recap of all violations by Northern Riverview, the Department of Health report can be viewed here.