Seneca Nursing & Rehabilitation Center, LLC

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey and complaint investigation (NY00371778) from 06/23/2025 to 06/27/2025, for six (6) (Residents #1, #2, #27, #35, #37 and #46) of 20 residents reviewed, the facility did not promote and treat each resident with respect and dignity in a manner and an environment that promotes maintenance or enhancement of their quality of life. Specifically, for Residents #2, #35, and #46 staff were observed assisting residents during meals in an undignified manner. Residents #1, #27, #37 and #46 were observed eating with their hands/fingers while dropping food debris on themselves and no staff assist observed.

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey from 06/23/2025 to 06/27/2025, for 5 (Residents #1, #26, #27, #37, and #46) of 18 residents reviewed, the facility did not provide the residents who were unable to carry out activities of daily living, the necessary services to maintain good nutrition, grooming, and personal and oral hygiene. Specifically, the residents did not receive the necessary assistance with eating they required and were care planned for.

Inspectors wroteBased on observations and interviews conducted during the Recertification Survey from 06/23/2025 to 06/27/2025, for two (2) (B and C-units) of three (3) resident units, the facility did not provide housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. Specifically, hand washing sink plumbing fixtures were not working properly to supply hot water.

Inspectors wroteBased on observations, interviews, and record review conducted during a Recertification Survey from 06/23/2025 to 06/27/2025, for one (1) (Resident #43) of two (2) residents reviewed, the facility did not develop and implement a comprehensive person-centered care plan that included measurable objectives and timeframes to meet the resident's medical, nursing, mental and psychosocial needs including resident goals, desired outcomes, and preferences. Specifically, Resident #43 was care planned to be at risk for developing pressure ulcers but was not documented as having an active pressure ulcer as indicated on their Minimum Data Set (a resident assessment tool) upon their admission to the facility. This is evidenced by the following: [...]

Inspectors wroteBased on observations, interviews, and record review conducted during a Recertification Survey from 06/23/2025 to 06/27/2025, the facility did not ensure each resident received adequate supervision and assistive devices to prevent accidents for one (1) (Resident #23) of five (5) residents reviewed. Specifically, Resident #23, who had a history of dysphagia (difficulty swallowing foods or liquids) was observed eating in their room without adequate supervision as recommended. This is evidenced by the following: The facility policy Assistance with Meals, revised March 2022, included all residents would be encouraged to eat in the dining room. Resident #23 had diagnoses including dysphagia (difficulty swallowing), adult failure to thrive, and muscle weakness. [...]

Inspectors wroteBased on interviews and record review conducted during the Recertification Survey from 06/23/2025 to 06/27/2025, for one (1) (Resident #31) of three (3) residents reviewed, the facility did not provide the appropriate liability notice to a Medicare beneficiary at the termination of their Medicare Part A coverage. Specifically, the facility did not provide the resident or their representative with an Advance Beneficiary Notice informing them of their appeal rights and/or liability for services at the termination of their Medicare Part A benefits with benefit days remaining. The finding is: Resident #31 was admitted to the facility on [DATE] under Medicare Part A benefits and discharged from Medicare Part A benefits on 05/17/2025. The resident remained in the facility with Medicare A days remaining. [...]

Inspectors wroteBased on observations, interviews and record reviews conducted during the Recertification Survey 6/22/23 to 6/28/23, it was determined that for one (Resident #40) of three residents reviewed for activities of daily living (ADLs), the facility did not ensure the residents received the necessary services to maintain good grooming and personal hygiene. Specifically, Resident #40 was observed with dirty and long nails over several days. This is evidenced by the following: The facility policy Care of Fingernails/Toenails, dated September 2011, included that the purpose of the procedure is to keep nails trimmed and cleaned, and to prevent infections. The policy included that nail care includes cleaning and trimming. [...]

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey 6/22/23-6/28/23, it was determined that for one (Resident #33 of three residents reviewed for activities, the facility did not provide an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of the resident. Specifically, the resident was observed on multiple occasions sitting alone, not invited to participate in current activities and not provided with sunglasses as requested due to vision concerns. This is evidenced by the following: Resident #33 had diagnoses of dementia with severe agitation, glaucoma and hearing loss. [...]

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey 6/22/23 to 6/28/23, it was determined that for one (Resident #40) of two residents reviewed for respiratory care, the facility did not provide specialized care needs for the provision of respiratory care in accordance with professional standard of practice, and the resident's care plan, goals, and preferences. Specifically, Resident #40 did not receive oxygen (O2) as ordered. This is evidenced by the following: Review of the undated facility policy Respiratory Therapy - Prevention of Infection Procedure, included that distilled water is to be used for humidification, and that the refillable humidifier unit water levels are to be checked daily. The humidifier container is to be changed at least weekly. [...]

Inspectors wroteBased on interview and record reviews conducted during a Recertification Survey completed on 9/10/21, it was determined that the facility did not implement written policies and procedures to prevent abuse, neglect, exploitation and misappropriation of resident property related to screening prospective employees. Specifically, a nurse aide registry abuse screening was not completed prior to hire for three (Employees #3, #5, and #6) of six employee files reviewed.

Inspectors wroteBased on observations, interviews and record reviews conducted during the Recertification Survey, completed on 9/10/21, for 1 (Resident #56) of 20 residents reviewed, the facility did not ensure the resident's care plan was implemented regarding leg splints. Specifically, therapy recommendations on the use of bilateral leg splints daily following a hospital stay were not implemented as recommended with no explanation. This is evidenced by the following: Resident #56 had diagnoses including severe intellectual disabilities, adult failure to thrive and contractures of the right and left knees. The Minimum Data Set Assessment, dated 8/23/21, revealed the resident was severely impaired cognitively, had functional limitation in range of motion (ROM) of both lower extremities (hip, knee, ankle, foot), required extensive assistance of two staff for dressing and did not ambulate. [...]

Inspectors wroteBased on interviews and record reviews conducted during the Recertification Survey, completed on 9/10/21, it was determined for one (Resident #28) of six residents reviewed, the facility did not ensure the medical team provided a rationale for action taken or not taken regarding a pharmacy recommendation for a medication dose reduction. Specifically, there was no documented evidence that the physician addressed a pharmacy recommendation to decrease a cholesterol medication from daily to every other day for over four months. This is evidenced by the following: Resident #28 had diagnoses including hyperlipidemia, hypertension and type 2 diabetes. A Minimum Data Set Assessment, dated 7/22/21, revealed modified independence in decision making skills. Review of current physician orders revealed atorvastatin (used to treat high cholesterol) 20 milligrams (mgs) daily was initiated on 2/1/21. [...]

Inspectors wroteBased on interviews and record review conducted during the Recertification Survey, completed 9/10/21, it was determined that for one of seven residents reviewed, the facility did not ensure that medical orders for psychotropic medications, which were not antipsychotic medications, were limited to 14 days, unless the attending physician/prescribing practitioner documented a rationale to extend the medication. Specifically, Resident #61 had an order for lorazepam (an antianxiety psychotropic medication) ordered as needed (PRN) for an extended use of time without a duration for use or a rationale to extend the medication. This is evidenced by the following: Resident #61 had diagnoses including epilepsy, dementia with behavioral disturbance and recent right hip fracture. The Minimum Data Set Assessment, dated 8/17/21, revealed the resident was severely impaired cognitively. [...]

Inspectors wroteBased on interview and record reviews conducted during the Recertification Survey and complaint investigation (#NY00266031) completed on 9/10/21, it was determined that for two (Resident #38 and #3) of three residents reviewed for abuse, the facility did not report an incident of resident-to-resident sexual abuse to the New York State Department of Health (NYSDOH) per the regulation. This is evidenced by the following: Review of the policy and procedure, Abuse, Neglect, and Exploitation, Prohibition, Training, Investigation, and Reporting dated December 2016, revealed that alleged violations involving sexual abuse, neglect, exploitation, or mistreatment are reported immediately to the Facility Administrator and to other officials, including the New York State Department of Health, within five working days of the incident. [...]

Inspectors wroteBased on observations, interviews, and record reviews conducted during a Recertification Survey completed on 9/10/21, it was determined that for one of one main kitchen, one (B-unit) of two nourishment refrigerators, and one (B-unit) of two ice dispensing machines, the facility did not store, prepare, distribute and serve food in accordance with professional standards for food service safety. Specifically, an ice machine was dirty, walls and ceilings were in disrepair, and a refrigerator was not maintained to keep 'temperature controlled for safety' (TCS) foods at or below 45 degrees (°) Fahrenheit (F).