Schulman and Schachne Institute for Nursing and Re

Inspectors wroteBased on observation, record review, and interviews during an Abbreviated Survey (NY00364046), complaint investigation concluded the facility failed to ensure a resident was treated with respect and dignity including the right to be free from physical or chemical restraints imposed for the purposes of discipline or convenience and that are not required to treat the resident's medical symptoms. This was evident for 1 out of 39 residents (Resident #1). Specifically, on several occasions Resident #1's wrists were tied with bed sheets to the bed rails. Certified Nursing Assistant #6 admitted to placing Resident #1 in these restraints and intentionally not removing them to prevent Resident #1 from removing their brief and smearing feces. Resident #1 was restrained for the purposes of discipline or convenience. [...]

Inspectors wroteBased on observation, record review and interviews conducted during an Abbreviated Survey (NY00364046), the facility did not ensure that an alleged violation involving abuse, neglect, mistreatment, are reported immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, to the administrator of the facility. This was evident in 1 out of 39 residents (Residents #1) sampled. Specifically, on 10/14/2024, 10/15/2024, and 11/15/2024 Certified Nursing Assistants #2 and #5 observed Resident #1's wrists tied with bed sheets to the bed rails and reported it to Licensed Practical Nurse #1 and #2. [...]

Inspectors wroteBased on observation, record review, and interviews conducted during an abbreviated survey (NY00364046), the facility did not ensure that a resident received the necessary care and treatment in timely manner and accordance with professional standards of practices. This was evident in 1 out of 39 residents (Residents #1) sampled. Specifically, a Rewrite Orders Cover Sheet dated 12/05/2024, signed by Licensed Practical Nurse #1 on 12/05/2024, documented x-ray of the left forearm to rule out fracture. A Nursing Progress note dated 12/07/2024 at 3:15 PM documented x-ray was done and result pending. A Nursing Progress note dated 12/09/2024 at 10:40 PM documented x-ray result showed fracture of the midshaft and ulna. Resident #1 to be transferred to the hospital. The x-ray was not done timely, and the results were not obtained in a timely manner.

Inspectors wroteBased on observation, record review, and interviews during the Recertification survey from 06/26/2024 to 07/03/2024, the facility did not ensure that food was stored, prepared, distributed, and served in accordance with professional standards for food service safety. This was identified during the Dining and Kitchen Tasks. Specifically, 1) During the initial tour of the kitchen, opened and undated package of food were observed in the walk-in freezer. 2) the walk-in refrigerator was noted with juice spills, and 3) the walk-in refrigerator had food on the shelf past the best buy date.

Inspectors wroteBased on observation and interviews conducted during the Recertification Survey from 06/26/2024 to 07/03/2024, the facility did not ensure that garbage and refuse were disposed of properly. Specifically, garbage was not properly contained outside of the facility. The blue trash compactor/dumpster was not covered and there were various types of garbage lying on the ground. There was an overflow of various metal objects from the open dumpster.

Inspectors wroteBased on record review and interview conducted during the Recertification Survey from 06/26/2024 to 07/03/2024, the facility failed to develop and implement an effective discharge planning process that focuses on the resident's discharge goals. This was evident for 3 (Residents #136, #44, and #291) of 35 total sampled residents. Specifically, an individualized discharge care plan was not developed for Residents #136, #44, and #291.

Inspectors wroteBased on observation, interview, and record review conducted during the Recertification and Complaint (NY00311959) Survey from 06/26/2024 to 07/03/2024, the facility did not ensure that food were served at an appetizing temperature during meal service. This was evident for 2 units observed during dining observation. Specifically, food served during lunch meal service were not maintained at palatable and appetizing temperatures.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification Survey from 06/26/2024 to 07/03/2024, the facility did not provide an ongoing program to support residents in their choice of activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident. This was evident for 1 (Resident #365) out of 38 total sampled residents. Specifically, Resident #365 was not provided with a television or other device to watch their preferred programs.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification Survey from 06/26/2024 to 07/03/2024, the facility did not ensure 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 # 69) of 1 resident reviewed for position/mobility. Specifically, there were multiple observations of Resident #60 without the left-hand carrot in place as per Occupational Therapy and physician orders.

Inspectors wroteBased on observation, interviews, and record review conducted during the Recertification and Complaint (NY00340955) Survey from 06/26/2024 to 07/03/2024, the facility did not ensure that a resident who is unable to carry out activities of daily living received the necessary services to maintain grooming and personal hygiene. This was evident for 1 (Resident # 69) of 35 total sampled residents. Specifically, Resident #69 did not receive staff assistance for nail trimming and was observed with thick, long, discolored fingernails.

Inspectors wroteBased on observation, record review, and interview conducted during the Recertification and Complaint Survey (NY00341538), the facility did not ensure that the resident environment remains as free of accident hazards as is possible; and received adequate supervision to prevent accidents. This was evident for 1 (Resident #237) of 5 residents investigated for Accidents, out of 38 total sampled residents. Specifically, on 05/07/2024, Resident #237 sustained a fall when Certified Nursing Assistant #11 transferred Resident #237 using a mechanical lift without assistance from another staff.

Inspectors wroteBased on observation, interviews, and record review during an abbreviated survey (Case #NY00332762, NY00332416) the facility did not ensure that the resident's representative was notified of changes to a resident skin. This was evidenced in one of three residents sampled (Resident #1). Specifically, on 01/29/2024, Resident #1' s designated family member was visiting Resident #1 and saw healing abrasions to the front of the legs below the knees (shins). The family member was not aware of the skin changes.

Inspectors wroteBased on observations, interviews, and record review conducted during the recertification survey, the facility did not ensure an effective pest control program was maintained. This was evident for 1 (6th floor) of 7 residential floors in 1 of 2 facility buildings. Specifically, there were multiple observations of roaches infestation in resident rooms on the facility's 6th floor.

Inspectors wroteFACILITY Resident Assessment Based on staff interview and record review conducted during a recertification and abbreviated survey, the facility did not ensure that each portion of the Minimum Data Set (MDS) assessment accurately reflect the resident's status. This was evident for 2 residents out of 38 sampled residents. (Resident # 11, Resident #207). Specifically, Resident #11's Annual MDS assessment inaccurately documented that Resident #11 received Insulin for seven days while in the facility. Resident #207's Annual MDS assessment did not accurately document that the resident received dialysis three times weekly while a resident.

Inspectors wroteBased on observation, record review, and interview conducted during the recertification survey, the facility did not ensure a comprehensive care plan (CCP) was developed to meet a resident's medical, nursing, mental, and psychosocial needs. This was evident for 2 (Resident #27, Resident #67) of 38 sampled residents. Specifically, 1) Resident #27 was observed with hoarding behavior and documented refusals of medications without a developed CCP to address the behaviors; and 2) there was no documented evidence a CCP related to Psychotropic Drug Use was developed for Resident #67 who receives antipsychotic and anti-depressant medication.

Inspectors wroteBased on record review and interviews conducted during the Recertification and Complaint survey from 6/13/2022 to 6/21/2022, the facility did not ensure, to the extent practicable, that residents were involved in developing the comprehensive care plan and making decisions about their care. Specifically, the facility did not ensure that residents were afforded the opportunity to participate in the Comprehensive Care Plan (CCP) meeting. This was evident for 1 of 3 residents reviewed for Participation in Care Planning out of a sample of 38 residents (Resident # 319).

Inspectors wroteBased on interviews and record review conducted during the recertification survey, the facility did not ensure a resident diagnosed with dementia, received the appropriate treatment and services to attain or maintain their highest practicable physical, mental, and psychosocial well-being. This was evident for 1 (Resident #67) of 3 residents reviewed for Dementia Care. Specifically, the facility did not develop a comprehensive care plan (CCP) related to dementia for Resident #67 who was diagnosed with dementia.

Inspectors wroteBased on record review and staff interviews conducted during the recertification survey, the facility did not ensure assessment accurately reflected the resident status. Specifically, the Minimum Data Set (MDS) assessment did not document that a resident was receiving dialysis services. This was evident of 1 out 2 one resident reviewed for Dialysis out of a sample of 38 residents. (Resident #379).