Queens Boulevard Extended Care Facility

Inspectors wroteBased on observation, interview, and record review conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that food was served at an appetizing temperature during meal service. This was evident for 2 (5th and 6th floor) of 2 units observed during dining observation. Specifically, food served during lunch meal service were not maintained at palatable and appetizing temperatures.

Inspectors wroteBased on record review and staff interview conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that a resident was assessed using the quarterly review instrument specified by the State and approved by the Centers for Medicare and Medicaid Services not less frequently than once every 3 months. This was evident for 1 (Resident #107) of 2 residents reviewed for Resident Assessment out of 38 total sampled residents. Specifically, Resident #107's quarterly assessment was not completed.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that services provided or arranged by the facility met professional standards of quality. This was evident for 2 (Resident #85 and #20) of 38 total sampled residents. Specifically, 1.) Resident #85 was observed with oxygen via nasal cannula with no physician's order. 2.) Resident #20 had physician's order to notify the physician when Resident's finger stick blood sugar (method of drawing drops of blood from the finger for testing the blood glucose level) result is less than 70 milligrams per deciliter or more than 400 milligrams per deciliter. The licensed nurse failed to notify the physician when Resident #20's finger stick blood sugar was higher than 400 milligrams per deciliter on 7 occasions from 06/09/2024 through 06/18/2024. [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification and Abbreviated Survey (NY00340566) from 06/13/2024 to 06/21/2024, the facility did not ensure that all allegations of abuse were thoroughly investigated. This was evident for 1 (Resident #164) of 2 residents reviewed for abuse out of 38 total sampled residents. Specifically, there was no documented evidence that an investigation was conducted for Resident #164, who complained of being roughly handled by a Certified Nursing Assistant during care.

Inspectors wroteBased on interviews and record review conducted during the Recertification survey from 05/18/22 to 05/25/22, the facility did not ensure a resident was provided information to formulate advanced directives (AD). This was evident for 1 (Resident #417) of 1 resident reviewed for ADs out of a sample of 37 resident reviewed. Specifically, there was no documented evidence Resident #417 received education and formulated ADs.

Inspectors wroteBased on observation, record review, and interview conducted during the Recertification Survey from 5/18/22 to 5/25/22, the facility did not ensure the Minimum Data Set 3.0 (MDS) assessment accurately reflected the resident's status. This was evident for 1 (Resident #65) of 5 residents reviewed for Unnecessary Medications. Specifically, the MDS did not document Resident #65's evaluation for Gradual Dose Reduction (GDR) of psychotropic drugs.

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey from 05/18/2022 to 05/25/2022, the facility did not ensure the development of a comprehensive, person-centered care plan (CCP) consistent with the resident's medical, nursing and mental and psychosocial needs. This was evident in 1 (Resident #264) of 1 resident reviewed for constipation. Specifically, Resident #264 was receiving psychotropic and constipation medication, and related CCPs were not developed.

Inspectors wroteBased on interviews and record reviews conducted during a Recertification and Complaint (NY00294185) Survey from 05/18/2022 to 05/25/2022, the facility did not ensure that a resident's representative (RR) was involved in revision of a resident's person-centered plan of care (CCP) with the interdisciplinary team (IDT). This was evident in 1 (Resident #48) of 35 residents reviewed. Specifically, the facility did not involve Resident #48's RR in revision of the resident's CCP to address Resident #48's ongoing refusal to be transferred out of bed and to receive showers.

Inspectors wroteBased on observation, interviews, and record review conducted during the Recertification survey from 5/18/22 to 5/25/22, the facility did not ensure a residents environment remained free of hazards. This was evident for 1 (#516) of 4 residents reviewed for respiratory care. Specifically, a large Oxygen Cylinder (OC) at Resident #516's bedside was not properly secured.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification survey from 05/18/2022 to 05/25/2022, the facility did not ensure residents with respiratory care were provided such care consistent with professional standards of practice. This was evident for 1 (Resident #516) of 4 residents reviewed for respiratory care. Specifically, Resident #516 was observed several times being administered oxygen therapy via nasal cannula (NC) without a Medical Doctor Order (MDO).

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification Survey from 5/18/2022 to 5/25/2022, the facility did not ensure a resident was adequately equipped to call for assistance through a communication system. This was evident for 1 (Resident #29) of 35 residents reviewed. Specifically, there were multiple observations of Resident #29 without an operating Call Bell (CB) next to their bed.

Inspectors wroteBased on observation, record review, and staff interviews during the re-certification survey, the facility did not ensure a resident received the necessary treatment and services, consistent with professional standards of practice, to promote healing of ulcers. Specifically, pressure relieving devices were not put in place for a resident with bilateral heel wounds. This was evident for one (1) of four (4) residents investigated for Pressure Ulcer Care Area (Resident #344) out of a final sample of 35 residents. The finding is: The facility's policy and procedure titled, Pressure Relief Assistive Devices, (Dated 10/17), documented, If problems are identified that warrant pressure relief, appropriate pressure relief interventions are initiated. Examples of pressure relief interventions include but are not limited to the following: [...]