Huntington Hills Center for Health and Rehabilitat

Inspectors wroteBased on record review and interviews during the Recertification Survey and Abbreviated Survey (Complaint # NY 00356442 ) initiated on 11/6/2024 and completed on 11/15/2024, the facility did not ensure sufficient nursing staff were available to provide nursing services to attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident. This was identified for eight of eight nursing units during the Sufficient Staffing Task. Specifically, 1) a review of the Payroll-Based Journal (PBJ) Staffing Data Report Quarter three, 2024 (April 1st- June 30th) and the weekend of 11/9/2024 to 11/10/2024 indicated excessively low weekend staffing; 2) a review of the daily staffing sheets revealed the facility did not provide sufficient number of Licensed Nurses as indicated in the Facility Assessment; [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey and Abbreviated Survey (Complaint # NY 00356442 ) initiated on 11/6/2024 and completed on 11/15/2024, the facility was not administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Specifically, the facility was not effectively administered to ensure sufficient staffing was provided to promote the highest practicable physical mental, and psychosocial well-being of each resident. The Facility Assessment did not include the overall number of facility staff needed to ensure that each resident's needs were being met. Additionally, the Administrator did not monitor and enhance the quality of care and services by repeating the same deficiencies: [...]

Inspectors wroteBased on record review and staff interviews during the Recertification Survey initiated on 11/6/2024 and completed on 11/15/2024, the facility did not ensure its Facility Assessment considered specific staffing needs for each shift and each resident unit (first floor and second floor) in the facility. Specifically, the Facility Assessment, last updated in February 2024, did not include a breakdown of staffing needs for each of the facility's eight units for each shift. Cross Reference: F 725 Sufficient Nursing Staff F 835 Administration The finding is: [...]

Inspectors wroteBased on record review and interviews during the Recertification Survey and Abbreviated Survey (NY 00331241) initiated on 11/06/2024 and completed on 11/15/2024 the facility did not ensure that all alleged violations, including injuries of unknown source, were reported not later than 24 hours if the events that cause the allegation do not include abuse or do not result in a serious bodily injury, to the New York State Department of Health. This was identified for one (Resident #54) of five residents reviewed for Abuse. Specifically, Resident #54 reported that a nurse erroneously administered an injectable medication to the resident's abdominal area. Upon assessment, the resident had a bruise on the lower left side of the abdomen. [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey initiated on 11/6/2024 and completed on 11/15/2023, the facility did not ensure that Residents who needed respiratory care were provided such care consistent with professional standards of practice. This was identified for one (Resident #236 ) of two residents reviewed for Respiratory care. Specifically, Resident #236 had a physician's order to receive 4 liters per minute of supplemental oxygen. The resident was observed receiving oxygen at a liter flow less than the current physician's order. The finding is: The facility's policy for Oxygen, revised on 2/2022, documented that oxygen is administered by licensed staff under a physician's order to oxygenate and provide comfort to residents' acute or chronic respiratory difficulties. [...]

Inspectors wroteBased on interviews and record review conducted during a Recertification Survey and Abbreviated Survey (NY 00350913) initiated on 11/6/2024 and completed on 11/15/2024, the facility did not ensure the Physician reviewed the resident's total program of care at each visit. This was identified for one (Resident #187) of two residents reviewed for Mood and Behavior. Specifically, Resident #187 with a diagnosis of Dementia but no prior history of physical aggression, punched another resident on 5/15/2024 and was ordered for psychiatric evaluation on 5/15/2024. The psychiatric consult was never completed. There is no documented evidence that the Physician followed up on the resident's psychiatric evaluation during their monthly visit in June 2024 and July 2024. Resident #187 subsequently bit another resident on 8/9/2024. [...]

Inspectors wroteBased on interviews, observations, and record review conducted during a Recertification Survey and Abbreviated Survey (NY 00350913) initiated on 11/6/2024 and completed on 11/15/2024, the facility did not ensure that timely arrangements were made for outside services that met professional standards. This was identified for one (Resident #187) of two residents reviewed for Mood and Behavior. Specifically, Resident #187 with a diagnosis of Dementia but no prior history of physical aggression, punched another resident on 5/15/2024 and was ordered for psychiatric evaluation on 5/15/2024. There is no documented evidence that the psychiatric consult was completed until 8/20/2024 after Resident #187 bit another resident on 8/9/2024. The finding is: The facility did not develop policy and procedures related to outside consultant. [...]

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey initiated on 11/6/2024 and completed on 11/15/2024, the facility did not establish and maintain an infection prevention and control program designed to prevent the development and transmission of communicable diseases and infections. This was identified for two (Resident #627 and Resident #625) of three residents reviewed for Transmission Based Precautions. Specifically, during observation of Resident #627 and Resident #625's shared room, an Isolation Droplet/Contact Precaution sign was observed outside the door for positive COVID-19 (Coronavirus-2019) infection. The precaution signage included instructions for the use of Personal Protective Equipment (PPE) including N95 respirator mask, gloves, a gown, and eye protection (face shield or goggles). [...]

Inspectors wroteBased on record review and staff interviews during the Recertification Survey initiated on 6/4/2023 and completed on 6/9/2023, the facility did not ensure that a comprehensive person-centered care plan that includes measurable objectives and timeframes to meet a resident's medical and nursing needs that are identified in the comprehensive assessment was implemented for each resident. This was identified for one (Resident #64) of two residents reviewed for Limited Range of Motion. Specifically, Resident #64 was observed on three separate occasions to not have bilateral hand rolls applied as ordered by a Physician. The finding is: The facility's policy titled Physician Orders dated 10/2015 documented that when a Medical Doctor (MD) / Nurse Practitioner (NP) order is obtained, the Nurse is responsible to pick up the order. [...]

Inspectors wroteBased on record review and staff interviews during the Recertification Survey and Abbreviated Survey (Complaint # NY 00310491) initiated on 6/4/2023 and completed on 6/9/2023, the facility did not ensure that a Comprehensive Care Plan (CCP) was prepared by an interdisciplinary team that includes but is not limited to the participation of the resident and the resident's representative and is reviewed and revised by the interdisciplinary team after each assessment, including both the comprehensive and quarterly review assessments. This was identified for one (Resident #64) of two residents reviewed for Limited Range of Motion and one of 39 residents reviewed for care planning. Specifically, 1) Resident # 64's Comprehensive Care Plan (CCP) was not reviewed and revised to reflect the resident's current condition following a hospitalization. [...]

Inspectors wroteBased on observation, record review and interviews during the Recertification Survey initiated on 6/4/2023 and completed on 6/9/2023, the facility did not ensure that a resident who needs respiratory care is provided such care, consistent with professional standards of practice, and the comprehensive person-centered care plan. This was identified for two (Resident #68 and #454) of two residents reviewed for Oxygen use. Specifically, 1) Resident #68 had a Physician's order for continuous oxygen via nasal cannula at 2 liters per minute on all shifts and on four separate occasions the resident was observed not receiving oxygen as per the Physician's orders. 2) Resident #454 was receiving oxygen therapy without a Physician's order.

Inspectors wroteBased on observations, record review and staff interviews during the Recertification Survey and Abbreviated Survey (Complaint # NY 00310491) initiated on 6/4/2023 and completed on 6/9/2023, the facility did not ensure sufficient nursing staff were available to provide nursing services to attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident. This was identified on one of eight nursing units during the Sufficient Staffing Task and a review of the Payroll Based Journal (PBJ) Staffing Data Report. Specifically, on four weekend days in May 2023: 5/7/2023, 5/14/2023, 5/21/2023 and 5/28/2023, there were three Certified Nursing Assistants (CNA) rather than four CNAs on unit 2C for the 2:30 PM to 10:30 PM evening shift. The finding is: The Facility Staffing policy updated 2/2023 documented Staff assignments will be adjusted accordingly. [...]

Inspectors wroteBased on record review and interview during the Recertification Survey initiated on 6/4/2023 and completed on 6/9/2023 the facility did not ensure that a facility-wide assessment included what resources are necessary to care for the facility's residents competently during both day-to-day operations and emergencies. Specifically, the Facility Assessment did not include the overall number of facility staff needed, including Registered Nurses, Licensed Practical Nurses, and Certified Nursing Assistants to ensure that a sufficient number of qualified staff were available to meet each resident's need during both day-to-day operations and emergencies. Additionally, the facility Assessment did not consider a review of individual staff assignments and systems for coordination and continuity of care for residents within and across these staff assignments. The finding is: [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey completed on 10/28/2021 the facility did not ensure that each resident was treated with respect and dignity and received care in a manner that promotes maintenance or enhancement of his or her quality of life and recognizes each resident's individuality for two (Resident #14 and #150) of two residents reviewed for Dignity. Specifically, 1) Certified Nursing Assistant (CNA) #3 was observed with Resident #14 in the resident's room after the resident's lunch and instructed the resident in a loud tone to wipe their (Resident #14) mouth and then abruptly placed a napkin on the resident's mouth; 2) CNA #3 was observed standing over and feeding Resident #150 while the resident was sitting in their (Resident #150) wheelchair in the hallway. [...]

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey completed on 10/28/2021, the facility did not ensure that each resident had the right to choose activities, schedules, and health care consistent with his or her interests, assessments, and plan of care for one (Resident #85) of five residents reviewed for Choices. Specifically, Resident #85 requested a change of shower days; however, the facility did not accommodate the resident's request. The finding is: The facility's policy titled admission of a Resident, dated 5/2014, documented based on room assignment, shower or tub bath to be scheduled 1-2 times a week and when needed, or based on patient preference. [...]

Inspectors wroteBased on observations, record review and interviews conducted during the Recertification Survey completed on 10/28/2021, the facility did not ensure that residents received proper assistive devices to maintain hearing for one (Resident #112) of two residents reviewed for Communication. Specifically, Resident #112, who has severe hearing impairment, was not provided services to maintain functional hearing. The finding is: The facility's Hearing Aid Policy dated 10/2020 documented to care for the hearing aid and to maintain the hearing aid in good working condition. The policy documented that if a hearing aid malfunctioned, the unit clerk would arrange for a service appointment. Resident #112 was admitted with diagnoses of Alzheimer's Disease and Type 2 Diabetes Mellitus. [...]