Bronxcare Special Care Center

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure that the resident's representative was notified of a change in resident's condition. This was evident in 1 (one) (Resident #143) of 1 resident reviewed out of 35 total sampled residents. Specifically, the facility did not inform Resident #143's family representative that the resident's fourth fingernail on the right hand was detached.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to report all alleged violations involving neglect, abuse, and/or including injuries of unknown source to the State Survey Agency. This was evident for one (1) (Resident #143) of six (6) residents reviewed for abuse out of 35 total sampled residents. Specifically, on 05/23/2025, Resident #143's fourth finger on the right hand was bleeding and was subsequently noted with a detached fingernail on 05/24/2025. The resident was cognitively impaired and could not explain how the injury had occurred This incident was not reported to the New York State Department of Health. Cross Reference:

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice. This was evident in one (1) (Resident #238) of one (1) resident reviewed out of 35 total sampled residents. Specifically, on 05/16/2025, Resident #238 was observed with thick, brownish, foul smelling penile discharge. The attending physician was not appropriately notified of Resident #238's change in condition resulting to a delay in medical intervention.

Inspectors wroteBased on observation, record review, and interviews during the Recertification and Complaint (#668295) Survey, the facility failed to ensure that food was served at an appetizing temperature during meals. This was evident in one (1) (Unit 4) of five (5) units. Specifically, food served during meal service were not maintained at palatable and appetizing temperatures.

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey, the facility failed to ensure residents, or their designated representatives, were provided appropriate notification at the termination of Medicare Part A benefits. This was evident in three (3) (Residents #187, #212, and #222) of three (3) residents reviewed for Beneficiary Notification out of 35 total sampled residents. Specifically, the facility did not provide residents with Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN- form CMS-10055) at the termination of their Medicare Part A benefits. The residents remained in the facility.

Inspectors wroteBased on record review and staff interviews during the Recertification and Complaint survey, the facility did not ensure that a surety bond or similar protection with the amount equal to at least the current total amount of resident's funds. Specifically, the surety bond held by the facility did not cover the total amount of resident personal funds deposited with the facility. This was evident for 111 residents with personal funds out of 238 residents in the facility.

Inspectors wroteBased on observation, record reviews, and staff interviews conducted during the Recertification survey from 6/1/23 through 6/8/23, the facility did not ensure that Gradual Dose Reduction (GDR) was attempted for a prescribed psychotropic medication. This was evident in 2 (Resident #113 and #82) of 5 residents reviewed for Unnecessary Medication out of a sample of 38 residents. Specifically, 1) Resident #113 had a diagnosis of dementia and was prescribed and administered Risperidone for agitation with no GDR attempted, and 2) Resident # 82 had a diagnosis of dementia and was prescribed Divalproex and Citalopram without a GDR attempt.

Inspectors wroteBased on record review and interviews conducted during the Recertification survey from 6/1/23 through 6/8/23, the facility did not ensure that each resident or resident representative was offered the opportunity to participate in the review of their Comprehensive Care Plan s (CCP). This was evident for 2 out of 4 residents reviewed for care planning out of a sample of 38 residents. (Resident #54 and Resident #444). Specifically, Resident #54 and Resident # 444 were not invited to participate in their care plan meeting.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification and Complaint survey, the facility did not ensure that residents are informed and provided written information concerning their right to accept or refuse medical or surgical treatment and, at the resident's option, formulate an advance directive. This includes a written description of the facility's policies to implement advance directives and applicable State law. This was evident for 3 of 3 residents reviewed for Advance directive out of 35 sample residents (Residents #23, #121, and #229). Specifically, the facility failed to discuss and provide information concerning the resident's right and option to formulate an advance directive for newly admitted resident.

Inspectors wroteBased on record review and staff interview conducted during the Recertification/Complaint survey from 6/1/23 to 6/8/23, the facility did not ensure that the resident and their representatives were provided with a written summary of the baseline care plan. This was evident for 1 of 3 residents reviewed for Advance Directive out of a sample of 35 residents. (Resident #229). The finding is: The facility policy and procedure titled Comprehensive Care Planning - Baseline Care Plans dated September 2022 documented: .The facility must provide the resident and their representative with a summary of the baseline care plan that includes but not limited to: The initial goals of the resident; A summary of the resident's medication and dietary instructions; Any services and treatments to be administered by the facility and personnel acting on behalf of the facility; [...]

Inspectors wroteBased on observation, interview, and record review conducted during the Recertification Survey from 6/1/23 to 6/8/23, the facility did not ensure a comprehensive care plan (CCP) was reviewed and revised to reflect changes in the resident's care. This was evident for 1 (Resident #444) of 2 residents reviewed for Respiratory out of 38 total sampled residents. Specifically, Resident #444's CCP was not reviewed and revised to reflect that Resident #444 was receiving oxygen therapy.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification survey from 6/1/23 through 6/8/23, the facility did not ensure a resident with an indwelling Foley catheter was provided care consistent with professional standards of practice. Specifically, a resident was observed several times with an indwelling Foley catheter without a Medical Doctor's Order (MDO). This was evident in 1 of the 1 residents reviewed for urinary catheter out of 38 sample residents. (Residents # 105).

Inspectors wroteBased on record review and staff interviews conducted during re-certification survey, the facility did not report an alleged incident of resident-to-resident sexual abuse was reported to the New York State Department of Health (NYSDOH) within 2 hours. Specifically, the Certified Nursing Assistant (CNA #1) reported that she observed Resident #23 and Resident #38 (a cognitively impaired resident) engaged in inappropriate sexual behavior in the dining room. The facility did not report this allegation of resident-to-resident abuse to NYSDOH. This was evident for 2 of 3 residents sampled for abuse (Resident #23 and Resident # 38).

Inspectors wroteBased on record review and staff interviews conducted during a recertification survey, the facility did not ensure that an allegations of abuse were thoroughly investigated and corrective actions were implemented. Specifically, (1) an allegation of potential resident-to-resident sexual abuse reported by a Certified Nursing Assistant (CNA #1) who observed Resident #23 and Resident #38 (a cognitively impaired resident) engaged in sexually inappropriate behavior was not thoroughly investigated; and (2) a resident's allegations of abuse and neglect were not thoroughly investigated, and the corrective action of having male CNA's assigned was not implemented (Resident #63). This was evident for 3 of 3 residents reviewed for Abuse (Resident #s 23, 38, and 63) for 2 abuse allegations reviewed.