New York State DOH Continues Years-Long Investigation and Issuance of Violations to Rehabilitation and Nursing Center
In August 2019 a New York Rehabilitation and Nursing Center was issued 11 new citations by the New York Department of Health (NYDOH). The citations followed an unannounced inspection in March, and brought the total number of citations issued over the last four years regarding health and safety concerns to 101.
Recently, after yet another inspection, the NYDOH issued citations for 9 more violations. The records of this inspection highlighted several concerns by the inspectors regarding the quality of care the facility provides to its residents, the diet that residents are receiving, and whether the facility is taking adequate precautions to protect residents from infections.
A former resident told a news reporter, “It’s understaffed, the few that are there that care really care, and the ones that don’t care, you can tell they really don’t care.”
A family member of a resident who was hospitalized in 2018 for bedsores said this about her family member, “I’m here eight hours at a time. No one comes in and puts pillows under the man, turns him, does anything. I push the button, and for 35 minutes I sit there, and finally go to the desk and find no one.”
The administrator of the facility issued this statement in response to the NYDOH’s recently cited violations:
“Again, we are very proud of the services provided to residents here (name of facility). All of our employees have worked hard to ensure that fully appropriate care is furnished to all. Not only is there no ‘IJ’ (immediate jeopardy), but the cited deficiencies are not ‘serious’ in the context you have set forth. The State issued a letter dated August 30th noting that our plan of correction was accepted, a re-visit was conducted resulting in notification to CMS (the Federal oversight agency for SNFs) that ‘the facility is in substantial compliance with Federal and State requirements’ governing nursing homes. I am not sure if you are aware of the ongoing survey process, however, level D deficiencies and life-safety deficiencies may be routinely found and then subject to correction for all nursing homes across the nation….”
Compliance Perspective
Continued failure by a facility to implement policies and procedures that address and correct continuing systemic problems preventing the facility from providing the ongoing quality of care needed by the residents, and that specifically includes adequate staffing, the provision of proper food and nutrition, and effective infection and prevention control, may be considered provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures to determine how to address and correct systemic and widespread issues that are affecting the facility’s ability to provide the quality of care it is required to provide for the residents admitted to the facility.
- Train all staff regarding policies and procedures, with particular emphasis on providing adequate food and nutrition, following effective infection prevention protocols, and providing the individual care, e.g., frequent re-positioning of residents to prevent pressure sores. The facility should consider exploring ways to improve the attitudes of caregivers who may be conveying a “don’t really care” posture to the residents.
- Periodically audit to determine if the food being provided meets a high quality standard, if residents susceptible to developing pressure sores are being repositioned regularly on all shifts, and if staff are carefully observing infection prevention and control protocols.
