Premier Nursing and Rehab Center of Far Rockaway

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey conducted from 03/02/2025 to 03/07/2025, the facility failed to maintain each resident's right to a safe, clean, comfortable, and homelike environment. This was evident in 3 (Units 2, 3, and 4) of 4 units observed. Specifically, resident's room, bathroom, and medical equipment were observed with dirt and rust, wheelchairs were soiled, peeled paints, and window treatments were not in good condition.

Inspectors wroteBased on observation, record review, and interview during the Recertification Survey from 03/02/2025 to 03/07/2025, the facility did not ensure residents' right to personal privacy and confidentiality of medical records were maintained. This was evident in 2 (Units 2 and 3) of 4 units observed. Specifically, licensed nurses left computer screens unlocked and unattended exposing private medical information during medication administration.

Inspectors wroteBased on observation, record review, and interview during the Recertification Survey conducted from 03/02/2025 to 03/07/2025, the facility did not ensure that a comprehensive person-centered care plan for each resident was developed and implemented, that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs. This was evident in 1 (Resident #95) of 4 residents reviewed for care planning out of 37 total sampled residents. Specifically, Resident #95 had no comprehensive care plan developed to address comfort/palliative care.

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey conducted from 03/02/2025 to 03/07/2025, the facility did not ensure appropriate services, care, and equipment are provided to assure that residents with limited range of motion and mobility maintain or improve function based on the residents' clinical condition. This was evident in 3 of 3 residents reviewed for Limited Range of Motion out of 37 total sampled residents. Specifically, 1.) Resident #22 was observed without an abductor wedge as per physician's order. 2.) Resident #92 was observed with no bilateral heel protectors and Thoracic Lumbo Sacral Orthosis as per physician's order.

Inspectors wroteBased on observation, record review, and interview during the Recertification Survey conducted from 03/02/2025 to 03/07/2025, the facility did not ensure that all medications and biologicals were stored properly. This was evident in 1 (Unit 2) of 4 units observed during Medication Administration Task. Specifically, medications were pre-poured and left unattended on the medication cart, and the medication cart was left unattended and unlocked.

Inspectors wroteBased on record review and interview during the Recertification Survey from 03/02/2025 to 03/07/2025,the facility did not ensure Minimum Data Set assessments were electronically transmitted to the Centers for Medicare and Medicaid Services Data System within 14 days after assessments were completed. This was evident in 10 out of 37 total sampled residents. Specifically, Residents #72, #161, #119, #97, #66, #60, #21, #6, #15, and #151's Minimum Data Set assessments were not transmitted within 14 days after the assessments were completed.

Inspectors wroteBased on record review and interview during the Recertification and Complaint Survey (NY00370559) conducted from 03/02/2025 to 03/07/2025, the facility did not ensure all alleged violations involving abuse were reported immediately, but not later than 2 hours after the allegations were made, to the State Survey Agency. This was evident in 1 (Resident #116) of 1 resident reviewed for Abuse out of 37 total sampled residents. Specifically, on 01/29/2025 at 05:55 AM, the Administrator was made aware that on 01/29/2025 at approximately 05:30 AM, Resident #7 was accused of hitting Resident #116 in the face with a nebulizer machine. The facility reported the abuse allegation to the New York State Department of Health on 01/29/2025 at 02:28 PM.

Inspectors wroteBased on record review and interviews conducted during the recertification survey, the facility did not ensure appropriate liability and appeal notices were provided to Medicare beneficiaries. This was evident for 3 (Resident #114, 319 and # 419) of 3 residents reviewed for Beneficiary Protection Notification Rights out of a sample size of 36 residents. Specifically, the facility did not provide residents with the Notice of Medicare Non-Coverage (NOMNC) Form CMS-10123 at the termination of their Medicare Part A benefits to Resident #114, #319, and #419 at the completion of Medicare Part A coverage.

Inspectors wroteBased on observation, record review, and interviews conducted during the recertification survey, the facility did not ensure residents were provided with a clean and homelike environment. This was observed on 3 out of 4 units (Units 2, 3, and 4). Specifically, windows were noted with missing blinds, closet doors were missing paint, radiator/ac units were rusty, dirty, and missing paint, bathrooms were missing tiles, bathroom ceilings missing parts, bathroom ceilings were noted with dried leak marks, privacy curtains were off the track, and baseboard covering missing leaving raw cement exposed.

Inspectors wroteBased on observation, record review, and interviews conducted during the recertification survey from 6/26/23 to 7/3/23, the facility did not ensure that the comprehensive care plans (CCP) were reviewed and revised after each assessment. This was evident for 3 (Resident #126, #80, and #128) of 36 total sampled residents. Specifically, The 1) CCP related to dementia care and unnecessary medication were not reviewed and revised for Resident #126, 2) multiple CCPs for Resident #80 were not reviewed and revised upon assessment, and 3) the CCP related to psychotropic medications was not reviewed and revised for Resident #128.

Inspectors wroteBased on observation, interview, and record review conducted during the recertification survey from 6/26/23 - 7/3/23, the facility did not ensure food was prepared, distributed, and served in accordance with professional standards for food service safety. This was observed during the Kitchen review. Specifically, cold sandwiches were observed being held at an unsafe temperature above 41 F.

Inspectors wroteBased on observation, interview, and record review conducted during the recertification survey from 6/26/23 - 7/3/23, the facility did not ensure garbage was disposed of and maintained to prevent potential feeding and harborage for pests. This was observed during review of the Kitchen. Specifically, the garbage compactor area, located outside, adjacent to the parking lot, was observed with a discolored liquid with a foul odor and flies on the ground next to the compactor.

Inspectors wroteCitation Text for Tag 842 Based on observation, record review, and interviews conducted during the Recertification Survey from 6/26/2023 to 7/3/2023, the facility did not ensure that the resident record were accurately documented in accordance with professional standards of practice. This was identified for one (Resident #101) of three residents reviewed for Pressure Ulcers out of 36 total sampled residents. Specifically, the Nurse Practitioner (NP) and Primary Care Physician (PCP) did not accurately document in the resident's medical record pressure ulcer on right elbow has healed. The finding is: [...]

Inspectors wroteBased on observation, interviews, and record review conducted during the Recertification Survey from 6/26/23 to 7/3/23, the facility did not ensure the resident's right to a safe, clean, comfortable, and homelike environment. This was evident in the laundry room. Specifically, the laundry room was dirty and contained an eye wash station that was dirty and not functional.

Inspectors wroteBased on interviews and record review conducted during the Life Safety Code recertification survey, the facility did not ensure all mechanical, electrical, and patient care equipment were maintained in safe operating condition. This was evident during Life Safety review. Specifically, the facility sprinklers and boilers were not inspected annually.

Inspectors wroteBased on record review and interviews conducted during the recertification survey from 6/26/23 to 7/3/23, the facility did not ensure Minimum Data Set 3.0 (MDS) assessments were electronically transmitted to the Quality Improvement Evaluation System (QIES) Assessment Submission and Processing (ASAP) system in a timely manner. This was evident for 5 (Resident #9, # 20, #45, # 63, and #101 ) of 5 residents reviewed for Resident Assessment out of a sample size of 36 residents. Specifically, the MDS assessments for Resident #9, # 20, #45, # 63, and #101 were not submitted and transmitted within 14 days of the completion date.

Inspectors wroteBased on observation, record review and staff interviews conducted during the recertification survey, the facility did not ensure that residents and/or families were informed and provided with written information concerning the right to formulate an advance directive. Specifically, advance directives were not explained to or discussed with a cognitively intact resident. This was evident for 1 of 1 resident reviewed for Advance Directives (Resident #301). The finding is: The facility policy on Advance Directives, updated 02/2018, documented the Social Worker will review Advance Directives upon admission. The initial advance directives review form will be used to document that the conversation and review of Advance Directives has taken place. [...]