Little Neck Care Center

Inspectors wroteBased on record review and interview, the facility did not ensure the Binding Arbitration Agreement provides for the selection of a neutral arbitrator agreed upon by both parties and the agreement provides for the selection of a venue that is convenient to both parties. This was evident in three (3) (Residents #17, #57, and #117) of 28 total sampled residents. Specifically, the Binding Arbitration Agreement signed by Residents #17, #57, and #117 had no documented evidence the agreement addresses the selection of a neutral arbitrator agreed upon by both parties and the selection of a venue that is convenient to both parties.

Inspectors wroteBased on observation, record review, and interviews, the facility did not ensure that food was stored, prepared, distributed and served in accordance with professional standards for food service safety. This was evident during the kitchen and food service observations. Specifically, 19 vanilla puddings and 21 chocolate puddings in 4-ounce containers dated 05/22/2026 were stored in the kitchen refrigerator and ready to be served that were dated passed 72 hours from the time they were prepared.

Inspectors wroteBased on observation, record review, and interview, the facility failed to maintain the residents' rights to a safe, comfortable, and homelike environment. This was evident in Unit Three (3). Specifically, residents' rooms were observed with missing and/or peeling wallpaper, missing baseboards, and missing wood on closet door.

Inspectors wroteBased on interviews and record review, the facility did not ensure all alleged violations involving abuse were reported immediately to the New York State Department of Health no later than 2 hours after the alleged occurrence. This was evident for 1 (Resident # 9) of 3 residents reviewed for Abuse out of 28 total sampled residents. Specifically, Resident # 9 had an allegation of injury of unknown origin that was not reported in a timely manner.

Inspectors wroteBased on interviews and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident. This was evident for one (1) of one (1) resident investigated for Anticoagulant out of a total of 28 sampled residents. Specifically, Resident #67 did not a comprehensive care plan for anticoagulant therapy.

Inspectors wroteBased on interviews and record review, the facility failed to ensure that the physician reviews the resident's total program of care, including medications and treatments, at each visit. This was evident for one (1) of two (2) residents investigated for Antibiotic Use out of a total of 28 sampled residents. Specifically, physician progress notes for Resident #59 failed to reflect a review of the resident's total program of care and current condition and the physician's decision about the continued appropriateness of the resident's medical regimen, specifically the rationale for continued use of an antibiotic, Ceftriaxone.

Inspectors wroteBased on interviews and record review, the facility failed to ensure that the resident's drug regimen was free from unnecessary drugs. This was evident for one (1) of two (2) residents investigated for Antibiotic Use out of a total of 28 sampled residents. Specifically, the facility failed to adequately review whether the infection had resolved, and there was no documented evidence of rationale for continued use, leading to a duration of ceftriaxone therapy of 67 days.

Inspectors wroteBased on observation, records review, and interviews, the facility did not ensure a quality assurance and performance improvement (QAPI) program that put forth good faith attempts to identify and correct quality deficiencies were in place. Specifically, the facility had repeat deficiencies from the previous recertification surveys (from August 21/2024 to August/28/ 2024) in the areas of infection control prevention (F880), reporting of unwitnessed fall on time (F609) and posted nurse staffing information not in an accessible area for visitors to see (F732). There was no evidence there was a QAPI plan in place to meet the specific needs of the facility.

Inspectors wroteBased on observation and staff interviews, the facility did not ensure that it established and maintained an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. This was identified specifically, when Licensed Practical Nurse #1 did not follow the manufacturer's instructions and did not use the appropriate Environmental Protection Agency (EPA) approved disinfectant to clean and disinfect the shared blood glucose meter.

Inspectors wroteBased on observations and interviews, the facility failed to provide a safe, functional, sanitary and comfortable environment for residents, staff and the public. This was evident for one unit (Unit 3) of three units observed during the Environmental Task.

Inspectors wroteBased on observations, interviews, and record review, the facility did not ensure that results of the most recent recertification survey, as well as any complaint investigations from the preceding three years, were available and accessible to all residents and visitors. Specifically, upon review of the Department of Health survey binder located at the front desk, it did not contain the recertification survey result from 2024 and any complaint investigations since the last complaint investigation found in the binder dated 07/11/2023.

Inspectors wroteBased on observations, interviews, and record review, the facility did not ensure that Nurse Staffing Information was posted in a prominent place readily accessible to residents and visitors. Specifically, the staffing information was posted on the glass window of nursing office located on the main floor, not in a prominent area, readily accessible to all residents and visitors. Additionally, the staffing information did not indicate the actual hours worked by staff.

Inspectors wroteBased on observation, record review, and interviews conducted during survey, the facility failed to ensure residents' safety after an allegation of abuse was made and the facility failed to complete a thorough investigation of the alleged violation. This was evident for one of five residents (Resident #1) reviewed and sampled for risk of abuse. Specifically, on 05/02/2026 between 5:30 AM to 5:45 AM, Certified Nursing Assistant #1 reported to Licensed Practical Nurse #1 that in the presence of Certified Nursing Assistant #2, Resident #1 assaulted them during care. Licensed Practical Nurse #1 went to Resident #1's room and Resident #1 told Licensed Practical Nurse #1 they were beaten up. [...]

Inspectors wroteBased on observation and staff interviews conducted during the Recertification Survey from 8/21/24 to 8/28/24, the facility did not ensure that a resident was cared for in a manner that maintained or enhanced dignity. This was evident for 1 (Resident #3) of 4 residents reviewed for Catheter out of a sample of 25 residents. Specifically, Resident #3's Foley catheter bag and tubing were not covered with a privacy bag.

Inspectors wroteBased on record review and staff interviews conducted during the Recertification Survey from 08/21/2024 to 08/28/2024, the facility did not ensure that the resident and their representative were provided with a summary of the baseline care plan. This was evident for 1 (Resident #78) of 2 residents reviewed for Care Planning out of 25 total sampled residents. Specifically, Resident #78 was not provided a written summary of their baseline care plan.

Inspectors wroteBased on observations, record review and interviews conducted during the Recertification survey from 08/21/2024 to 08/28/2024, the facility did not ensure that a person-centered Comprehensive Care Plan was developed and implemented to meet the resident's goal, and address the resident's medical, physical, mental, and psychosocial needs. This is evident for 1 (Resident #75) of 2 residents reviewed for Urinary Catheter out of 25 sampled residents. Specifically, Resident #75 was receiving Oxygen therapy, and a comprehensive care plan was not created.

Inspectors wroteBased on observation, record review, and interview conducted during the Recertification survey from 08/21/2024 to 08/28/2024, the facility did not ensure that a resident with limited range of motion received appropriate treatment and services to prevent further decrease in range of motion. This was evident for 1 (Resident # 3) of 4 residents reviewed for Urinary Catheter from a sample of 25 residents. Specifically, Resident #3, a resident with left hand weakness and left wrist drop was observed on more than one occasion without a left-hand splint in place as ordered.

Inspectors wroteBased on observation, record review and interviews conducted during the Recertification survey between 08/21/2024 and 08/28/2024, the facility did not ensure that Nurse Staffing Information was posted in a prominent place readily accessible to residents and visitors. Specifically, the posting of staffing did not indicate the actual hours worked by staff or the resident census and was posted by the employee time clock, located in a corner at the entrance to the kitchen, that was not readily accessible to all residents and visitors.

Inspectors wroteBased on observations, record review, and staff interviews conducted during the Recertification survey between 08/21/2024 and 08/28/2024, the facility did not ensure infection control practices and procedures were maintained to provide a safe and sanitary environment to help prevent the development and transmission of communicable diseases and infections. Specifically, resident's oxygen tubing was not changed and dated as per protocol. This was evident for 2 (Residents #9 and #29) of 2 residents reviewed for Respiratory Therapy out of 25 sampled residents.

Inspectors wroteBased on record review and staff interview during the Recertification/Complaint survey (NY00324573) conducted between 08/21/2024 and 08/28/2024, the facility did not ensure that all alleged violations involving abuse were reported immediately to the New York State Department of Health, but not later than 2 hours after the allegation was made. This was evident for 1 (Resident #83) of 2 residents reviewed for Abuse out of 25 sampled residents. Specifically, the facility did not report 1). an allegation of Abuse, and 2). an injury of unknown origin for Resident #83 to the New York State Department of Health within 2 hours.

Inspectors wroteBased on observations, record review, and interviews conducted during the Recertification survey from 10/12/2022 to 10/18/2022, the facility did not ensure safe food storage was practiced. This was evident during the kitchen observation. Specifically, expired liquid nutritional supplements, expired thickened juice and expired thickened water were observed in the kitchen's Emergency Food Storage Room (EMSR).

Inspectors wroteBased on observations, record review, and interviews conducted during the Recertification Survey from 10/12/22 to 10/18/22, the facility did not ensure a resident remained free from physical restraints. This was evident for 1 (Resident # 25) out of 2 residents reviewed for Restraints. Specifically, Resident # 25 was observed on several occasions lying in bed with 2 pillows placed underneath the fitted sheet on each side of the resident, bordering the length of the body to prevent Resident # 25 from getting out bed.

Inspectors wroteBased on observation, record review and interviews conducted during the Recertification and Complaint survey (NY00292535), the facility did not ensure the Minimum Data Set (MDS) 3.0 assessment accurately reflected the resident's status. This was evident for 2 of 28 sampled residents (Resident #29 and Resident #305). Specifically, 1) Resident #29's use of anticoagulant and antidepressant medication were not documented on the MDS. 2) Resident #305's insulin injections were not documented on the MDS.

Inspectors wroteBased on record review and staff interviews conducted during a Recertification/Complaint Survey from 10/12/2022 to 10/18/2022, the facility did not ensure that the resident and their representative were provided with a written summary of the baseline care plan. This was evident for 1 (Resident #203) of 3 residents reviewed for Care Plan out of 28 sampled residents.

Inspectors wroteBased on record review and interview conducted during the recertification survey from 10/12/22 to 10/18/22, the facility did not ensure a resident was offered the opportunity to participate in the development of their comprehensive care plan (CCP). This was evident for 1 (Resident #20) of 2 residents reviewed for care plan meeting (CPM). Specifically, Resident #20 was not invited to participate in quarterly CPMs.

Inspectors wroteBased on observation, record review, and staff interview conducted during the Recertification and Complaint survey (NY00292455) from 10/12/22 to 10/18/22, the facility did not ensure that residents are provided pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident. This was evident for 1 (Unit 3) of the 3 units medication storage rooms and 1 (Resident #257) of 1 resident(s) reviewed for pain management out of 28 sampled residents. Specifically, 1) the facility did not ensure that expired medications were removed and discarded according to the manufacturer's recommendation, and 2) the facility did not ensure Trulance and Clozapine were dispensed to Resident #257 as ordered upon admission.