Fairview Nursing Care Center Inc.

Inspectors wroteNumber of residents sampled:Number of residents cited:Based on observation, record review, and interviews, the facility failed to maintain each resident's right to a safe, clean, comfortable, and homelike environment. This was evident in 3 of 5 units (Unit 1, Unit 4, and Unit 3.) observed. Specifically, resident's rooms were noted with torn window screen, ceiling tiles not firmly affixed to ceiling, paint plastered on wall, dining room furniture in disrepair, shower room with stains and shower curtains that were soiled and in disrepair.

Inspectors wroteNumber of residents sampled:37Number of residents cited:4 Based on observations, record review and interviews, the facility failed to ensure medical records were complete and accurately documented in accordance with accepted professional standards and practices. This was evident for one (1) resident (Resident #86) of three (3) residents reviewed for Activities of Daily Living out of a sample of 38 residents. Specifically, 1). Resident #86 was not assisted out of bed, but documentation reflected that resident was taken out of bed, 2). Requested documents for Residents #79, Resident #221 and Resident #220 and access to the facility electronic medical record were not provided in a timely manner.

Inspectors wroteNumber of residents sampled:Number of residents cited:Based on observations and staff interviews, the facility did not ensure that it provided a safe, functional, sanitary, and comfortable environment for residents, staff and the public. This was evidenced by multiple observations of the staff bathrooms, elevators, lobby area and nursing stations. This was evident in the Lobby Area including on one (1) of five (5) units. Unit 4.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure residents remained free from chemical restraints. This was evident for one (1) of five (5) residents (Resident #162) reviewed for Unnecessary Medication out of a sample of 38 residents. Specifically, the facility did not rule out underlying medical conditions prior to initiating and increasing a dose of an antianxiety medication. In addition, there was no evidence the continued need for the medication was evaluated after Resident #162 was treated for a urinary tract infection and no longer displayed behaviors that were present when the medication was initiated.

Inspectors wroteNumber of residents sampled: 35Number of residents cited:1Based on observation, staff interview and record review, the facility failed to ensure needed care and services that are resident centered, in accordance with the professional standards of practice that will meet resident's physical, mental, and psychosocial needs are provided to a resident. This was evident for one (1) of two (2) residents (Resident #79) reviewed for Tube Feeding out of 38 sampled residents. Specifically, 1). functioning of a gastrostomy tube was not checked prior to the administration of medications, and 2). Multiple medications were crushed and administered together.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure that residents who are unable to carry out activities of daily living receive the necessary services and assistance to maintain grooming, and personal hygiene. This was evident for one (1) of three (3) residents (Resident #86) reviewed for Activities of Daily Living out of a sample of 38 residents. Specifically, Resident #86 was not assisted out of bed as per physician's order and their plan of care.

Inspectors wroteBased on observation, staff interview and record review conducted during the Recertification survey, the facility failed to ensure that a resident fed by enteral means receives the appropriate treatment to prevent complications of enteral feeding. This was evident for one (1) of two (2) residents (Resident #79) reviewed for Tube Feeding out of a 38 sampled residents. Specifically, 1). The functioning of a gastrostomy tube was not checked prior to the administration of medications, and 2). Multiple medications were crushed and administered together.

Inspectors wroteNumber of residents sampled:Number of residents cited:Based on observation and staff interviews, the facility failed to ensure infection control prevention practices and procedures were maintained to provide a safe and sanitary environment, and to help prevent the development and transmission of communicable diseases and infections. This was evident during the Infection Control Task. Specifically, Resident #3 was observed with an open right shoulder wound and was not maintained on Enhanced Barrier Precautions.

Inspectors wroteBased on observations and staff interviews conducted during the recertification survey on 11/08/23 - 11/15/23 the facility did not ensure that pertinent State Agency information was posted as is required. Specifically, the New York Department of Health Complaint Hotline number and related information were observed not posted on any resident units. This was evident for 5 of 5 resident units. The finding is: The undated facility policy & procedure titled Residents' Rights documented that any written information required to be posted shall be posted conspicuously in a public place in the facility that is frequented by residents and visitors, posted at wheelchair level. [...]

Inspectors wroteBased on observations, record review, and interviews conducted during the Recertification survey (17LT11) from 11/08/2023 to 11/15/2023 the facility did not ensure safe food storage and infection control was practiced. Specifically, two five- pound cottage cheese tubs with a use by date of 10/19/2023 was noted with broken plastic seal and green colored discoloration on top of one container top. This was evident during the Kitchen Observation Task.

Inspectors wroteBased on interviews and record review conducted during the Recertification survey from 11/8/23 to 11/15/23, the facility did not ensure a resident received appropriate notice before the resident's room in the facility was changed. This was evident for 1 of 4 residents reviewed for Choices out of a sample of 38 residents. Specifically, Resident #115 was not given the opportunity to view the new room, meet roommates and ask questions before the room was changed.

Inspectors wroteBased on staff interviews and record review conducted during the Recertification survey from 11/08/23-11/15/23, the facility did not ensure that all alleged violations including injuries of unknown origin were reported immediately but not later than two hours to the New York State Department of Health (NYSDOH). This was evident for 1 of 5 residents reviewed for Accidents out of 38 total sampled residents. Specifically, Resident #54 had an unwitnessed event which resulted in the fracture of the left hip. The finding is: The facility's Abuse, Prevention, Prohibition & Reporting, policy, revised date 04/21/2023, documented, that staff development provides and orientation program which includes reporting abuse including injuries of unknown origin, and to whom and when staff and others must report their knowledge. [...]

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification survey from 11/08/2023 to 11/15/2023, the facility did not ensure that menus were followed. This was evident for 1 of 5 residents reviewed for Food out of 38 total sampled residents. Specifically, Resident # 18 received items that were listed on the allergies/preferences section of their tray ticket during mealtimes.

Inspectors wroteBased on observations, record review, and interviews during the Recertification survey conducted from 11/08/2023 to 11/15/2023, the facility did not ensure that infection control practices were maintained. Specifically, (1) a Registered Nurse (RN #3) was observed using a blood pressure cuff (BPC), and pulse oximeter on multiple residents without sanitizing the BPC between residents and not performing consistent hand hygiene between residents (Resident # 282, Resident # 18, Resident #336, and Resident #337), and (2) the Wound Care Nurse was did not practice appropriate hand hygiene while performing a wound care treatment.

Inspectors wroteBased on observation, record review and interview conducted during the recertification and abbreviation survey (NY00271315) , the facility failed to maintain an infection prevention and control program to prevent the development and transmission of COVID-19. Specifically, the facility did not take additional measures and precautions, per NYS Epidemiology and Centers for Disease Control and Prevention (CDC) recommendations, to prevent ongoing transmission of COVID-19 during a facility outbreak with uncontrolled transmission of COVID-19. There were 66 COVID-19 cases identified in the facility from 9/18/21 to 10/21/21 on all units. The facility did not cease indoor visitation when the outbreak spread to more than one unit per NYS guidance. Residents residing on units with positive cases were not put on transmission-based precautions to prevent further spread. [...]

Inspectors wroteBased on observation, record review, and staff interview during the recertification survey, the facility did not maintain an effective pest control program so that the facility is free of pests. Specifically, multiple flies were observed in resident rooms and the hallway area. This was evident for 42 residents on 1 of 5 units observed for the Environment (Unit 5). The finding is: The undated facility policy, titled pest control program, documented that the facility will maintain an effective pest control to eradicate and contain common household pests and rodents (for example: bed bugs, lice, roaches, ants, mosquitoes and rats). The policy also documented that the facility will provide comprehensive pest control services on a regular and scheduled basis. Observations were made on 10/18/21 on Unit 5 between the hours of 10:00 AM and 2:30 PM,. [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification and Abbreviated survey (NY00281452), the facility did not ensure housekeeping and maintenance services necessary to maintain a sanitary, orderly,and comfortable interior were provided. Specifically, a resident's chest of drawers was in disrepair with rot and holes. This was evident for 1 of 5 units observed for the environment (Units 3).

Inspectors wroteBased on observation, record review, and interview conducted during the Recertification survey, the facility failed to ensure that a resident with limited range of motion received appropriate treatment and services to prevent further decrease in range of motion. Specifically, a resident with hand contractures, was not wearing splint devices as ordered. This was evident for 1 of 1resident reviewed for Limited Range of Motion (Resident #1). The finding is: Resident #1 was was admitted with diagnoses which include Seizure Disorder, Vitamin Deficiency, and Subarachnoid Hemorrhage. The Quarterly Minimum Data Set 3.0 (MDS) assessment dated [DATE]documented the resident had severely impaired cognition. The resident required extensive assist of 2 for bed mobility, total assist of 2 for transfer and extensive assist of one for dressing and personal hygiene. [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification and Abbreviated survey (NY00278100), the facility did not ensure the resident environment remained as free of accident hazards as possible. Specifically, the Licensed Practical Nurse (LPN) left controlled subtances unlocked and unattended on the medication cart in the hallway, leaving them accessible to residents. A resident took two narcotic blister packs from the medication cart narcotic box. (Percocet 10/325mg tablets -16 tablets and Oxycodone 5mg tablets -16 tablets) and ingested some of the medication. This was evident for 1 out of 35 sampled residents (Resident #484).

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification survey, the facility did not ensure residents with respiratory care were provided such care consistent with professional standards of practice. Specifically, residents were receiving oxygen therapy without physician's orders and a comprehensive care plan in place for oxygen therapy. This was evident for 2 out of 2 residents reviewed for quality of care out of a total investigation sample of 35 residents (Resident #142 and #486).

Inspectors wroteBased on record review and interviews conducted during the Recertification and Abbreviated survey (NY00278100), the facility did not ensure that Schedule II Controlled Substances were locked in compartments permitting only authorized personnel to have access. Specifically, on 06/20/2021, the Licensed Practical Nurse (LPN) left the medication cart unattended during medication administration. A resident took two narcotic blister packs from the medication cart narcotic box. (Percocet 10/325mg tablets -16 tablets and Oxycodone 5mg tablets -16 tablets). This was evident for 1 out of 35 sampled residents (Resident #484) on 1 of 5 units (Unit 5) reviewed for Medication Storage.

Inspectors wroteBased on observation, record review and interviews, conducted during the Recertification survey, the facility did not ensure that a resident was adequately equipped to call for assistance through a communication system that relays the call directly to a staff member or a centralized staff work area. Specifically, a resident was observed on multiple occasions without an operating call bell in place. This was evident for 1 of 1 resident reviewed for Physical Environment out of 35 residents reviewed. (Resident #38).