A rehabilitation and nursing center received three times the average number of citations over the last four years for violations. These violations involve Quality of Care, Resident’s Rights, Abuse, Neglect, Exploitation and Insufficient Staffing and may be considered fraud waste and abuse in violation of the False Claims Act when billing to Medicare or Medicaid is for substandard care or worthless services.
Compliance Perspective – Care of Residents:
The Compliance Officer will review with the Administrator, DON, Dietary Manager and Housekeeping Manager the facility’s policies and procedures regarding Residents’ Rights, Freedom from Abuse, Neglect and Exploitation, Quality of Care, and Nursing Services. Staff from Nursing, Dietary and Housekeeping will receive education and training identified with the areas where they work, e.g., Nursing staff—F600-Free from Abuse and Neglect, F602-Free from Misappropriation/Exploitation, F684-Quality of Care, F687-Foot Care, F725-Sufficient Nursing Staff; Dietary staff—F692-Nutrition/Hydration Status Maintenance; Housekeeping staff—F584 Safe/Clean/Comfortable/Homelike Environment. The Compliance Officer will request that the DON, Dietary and Housekeeping Managers develop and implement appropriate audits to assess their areas of responsibility. The DON will survey residents and family members to identify any incidents where care has not been provided by nursing staff (bathing, grooming, footcare) or personal items are missing, and audit nursing staff schedules for all shifts compared with actual staff reporting for work on those shifts for the previous six months. Dietary will audit to determine the level of satisfaction with food being served to residents. Housekeeping will audit to determine the status of residents’ rooms and the regularity with which rooms are thoroughly cleaned and linens are being changed and laundered. Completed audits will be summarized and submitted to QAPI for review and recommendations to the Compliance Committee.
The families of numerous residents in a New York rehabilitation and nursing center are speaking out to news media to raise public awareness about the “imminent danger” status they believe their loved ones are experiencing. The facility has received three times the number of health and safety violations than the state average.
One resident’s daughter expressed concern over the lack of care regarding her mother’s hygiene. She provided pictures of her mother’s long curving toenails—so long they overlapped her toes. The daughter said that she is the person who regularly bathes her mother. She also said that on multiple occasions she brought fresh clothes and supplies for her mother, and within a period of 48 hours they are missing or were being worn by another resident. The most upsetting thing reported by the daughter was coming to visit her mother after having to be away for two weeks and finding her mother laying in a coffee and urine stained bed with crusted food on the bed and on the floor.
Dozens of family members have expressed concerns to the news media. These concerns include a son who came to visit his father and found him dead in his bed. He had been deceased for over three hours.
A resident’s husband was concerned about the food his wife was being fed—she had lost between 30 and 40 pounds and was very distressed.
Data from the New York State Department of Health’s website revealed that over the last four years the facility has been cited 68 times for health violations compared to the state average of 20 and received 22 citations for life safety violations compared to the state average of 13. Although the rehabilitation and nursing center received three times more citations than other nursing homes, it has never been fined.
A family member spoke with the facility’s administrator and was told that many of the issues were due to a staffing shortage and burn-out.
