Smithtown Center for Rehabilitation and Nursing Care, located in Suffolk County, received sub-standard ratings from a Department of Health Certification Survey Dated November 2, 2011. Among the several deficiencies noted by the DOH were frequency of meals and providing/obtaining radiology services.
Section 483.35(f) of the CFR dictates that the facility provide three daily meals to residents, with no more than fourteen hours between dinner and breakfast the next day, unless a snack is provided at bedtime, in which case the interval may increase to sixteen hours. One logical reason for this rule is that the facility provides these meals, so the residents eating habits are subject to the staff providing them. Also, as it is the duty of the home to prevent the development of bedsores and infections, a consistent nutritional allowance is a necessity. Hunger can lead to distraction and accidents, which the facility is bound by law to make provisions to avoid. In this instance, residents reported that snacks were not provided on a regular basis by the staff, although these residents claimed feelings of hunger and that they would have readily accepted offered snacks.
For an elderly person, a fracture can have serious, and potentially life threatening, consequences. When a fall with a possible fracture occurs, it is essential to diagnose the results as quickly as possible to ensure that the correct treatment is given and the resident can begin to recover. For this reason, CFR 483.75(k)(1) provides that the facility must obtain radiology and diagnostics for its residents, and that the facility is responsible for the timeliness of obtaining these. In one instance noted in the report, a resident suffered a fall and complained of hip pain. Although an x-ray was ordered immediately, the results of this x-ray were not reported until almost sixteen hours later. As such, the injury, which was an acute right hip fracture, went undiagnosed during this interval. As evidenced by the DOH deficiency report, this lag is unacceptable.
A full list of deficiencies noted by the DOH with reference to Smithtown Center for Rehabilitation and Nursing can be located here.