Silvercrest

Inspectors wroteBased on observations, record reviews, and staff interviews conducted during an Abbreviated Survey (NY00371678), the facility failed to ensure that a resident's Advance Directives were followed. This was evident for one (1) out of five (5) residents (Resident #1) sampled. Specifically, Resident #1, who was ventilator dependent, had a Medical Order for Life Sustaining Treatment indicating Do Not Resuscitate. Resident #1 was found without a pulse on 02/08/2025 and staff performed Cardiopulmonary Resuscitation that resulted in the return of spontaneous circulation. The resident was transferred to the hospital and remains there at this time. Based on several staff interviews, the resident received cardiopulmonary resuscitation efforts until staff members learned the resident was a Do Not Resuscitate. The resident was assessed after efforts were stopped and was found to have a pulse. [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification Survey and Complaint Survey (NY00361139, NY00361002, NY00353498, NY00348185 and NY00340617) from 12/12/2024 to 12/19/2024, the facility did not ensure sufficient nursing staff were available to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Specifically, 1). par levels documented in the Facility Assessment did not reflect actual weekend staffing levels. 2). interviews with members of the Resident Council, reflected ongoing concern about staffing levels at the facility, 3). five of eleven complaints investigated during the survey involved staffing concerns, and 4). interviews with other residents and staff reflected stafffing concerns. [...]

Inspectors wroteBased on observation, record review and interviews conducted during the recertification survey from 12/12/2024 to 12/19/2024, the facility did not ensure that an appropriate surety bond was purchased, or otherwise assurance satisfactory to the Secretary was provided, to assure the security of all personal funds of residents deposited with the facility. Specifically, there is no surety bond was provided to assure the residents fund against loss. This was evident for 138 residents who maintained personal funds accounts with the facility.

Inspectors wroteBased on observation, record review and interviews conducted during the recertification survey from 12/12/2024 to 12/19/2024, the facility did not ensure residents' rights to send and receive mail. Specifically, residents did not have mail delivered to them in the facility on the weekend.

Inspectors wroteBased on observation, record review and interviews conducted during the Recertification and Complaint survey (NY00340617) survey from 12/12/2024 to 12/19/2024, the facility did not ensure that adequate clean linen was provided to facilitate timely care of residents. Specifically, there were multiple complaints of insufficient linen from residents and staff.

Inspectors wroteBased on interview and record review conducted during the Recertification and Complaint survey (NY00325467) from 12/12/2024 to 12/19/2024, the facility did not ensure that it promoted and facilitated resident self-determination through the support of resident choice. This was evident for 1 (Resident #103) of 5 residents reviewed for Choices. Specifically, bathing preference was not obtained and not provided in accordance with Resident #103's wishes.

Inspectors wroteBased on observation, record review and interviews conducted during the recertification survey from 12/12/2024 to 12/19/2024, the facility did not ensure individual resident financial records were made available to resident or their representative through quarterly statements. This was evident for 1 (Residents #36) of 2 residents reviewed for Personal Funds out of a sample of 38 residents. Specifically, there was no documented evidence that Resident #36, or their representative had been provided with quarterly statements in writing within 30 days after the end of the quarter.

Inspectors wroteBased on observations and interviews conducted during the Recertification Survey from 12/12/2024 to 12/19/204, the facility did not ensure that the Nurse Staffing Information was posted appropriately. Specifically, the posting of daily nurse staffing information was not posted in a prominent area which was readily accessible to residents, families, and visitors. The finding is: The facility did not provide a policy and procedure regarding posting of the Daily Nurse Staffing Information . During observations conducted on 12/13/2024, 12/16/2024 and 12/17/2024, the State Surveyor located the postings of the Daily Nurse staffing levels for each shift at the side of the vestibule in the Information Lobby and was not readily visible or accessible to visitors, families, or residents. [...]

Inspectors wroteBased on observation, interview, and record review conducted during the Recertification and Complaint survey (NY00325467) from 12/12/2024 to 12/19/2024, the facility did not ensure that resident menus and dietary preferences were followed. This was evident for 1 (Resident #103) of 8 residents reviewed for Food out of 38 total sampled residents. Specifically, portion sizes were not consistently followed, and were not provided to Resident #130.

Inspectors wroteBased on observation, interview, and record review conducted during the Recertification and Complaint survey (NY00325467) from 12/12/2024 to 12/19/2024, the facility did not ensure that food was served at an appetizing temperature during meal service. This was evident for 1 (Resident #103) of 8 residents reviewed for Food out of 38 total sampled residents. Specifically, food served during lunch meal service was not maintained at palatable and appetizing temperatures.

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification and Abbreviated (NY00350202) survey from 12/12/2024 to 12/19/2024, the facility did not ensure a resident was free from physical abuse. This was evident for 1 (Resident #173) of 3 residents reviewed for Abuse out of 38 total sampled residents. Specifically, Resident #173 reported that on 08/03/2024, at approximately 04:00 AM, Certified Nurse Aide #1 was rough with them while providing care, and Certified Nurse Aide #1 did not stop their actions, continued with the task while Resident #173 continued to express their discomfort, and then Certified Nurse Aide #1 yelled at Resident #173. The finding is: [...]

Inspectors wroteBased on observation, record reviews, and interviews, conducted during an abbreviated survey NY00334448), the facility failed to ensure that a resident right to be informed, in advance, of changes to their plan of care. This was evident for 1 out of 6 residents (Resident #2) sampled. Specifically, a Nursing Progress Note dated 05/19/2024 at 9:16pm documented Resident #2 was an elopement risk, and a wander-guard (elopement prevention system transmitter) was placed on the left side of Resident #2's motorized wheelchair. During an interview on 08/01/2024 at 2:30pm, Resident #2 stated that they were not aware that the facility had placed a wander-guard device on their motorized wheelchair until 06/07/2024 when they attempted to exit the main entrance door in the lobby. [...]

Inspectors wroteBased on record review and staff interview conducted during the Recertification survey from 11/28/2022 to 12/06/2022, the facility did not ensure a resident's Comprehensive Care Plan (CCP) was reviewed and revised to reflect the resident's changing needs. This was evident in 1 (Resident #243) of 5 residents reviewed for Activities of Daily Living of 38 total sampled residents. Specifically, Resident #243's CCP related to cardiovascular condition was not reviewed and revised to reflect a Physician Order (PO) for a Sequential Compression Device (SCD).

Inspectors wroteBased on observation, record review, and interviews conducted during the Recertification Survey, the facility did not ensure that residents receive treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan and the resident's choices. This was evident in 1 (Resident #243) of 5 residents reviewed for Activities of Daily Living out 38 total sampled residents. Specifically, Resident #243 did not a Sequential Compression Device (SCD) applied as ordered.

Inspectors wroteBased on observations, record review, and interviews conducted during the Recertification survey, the facility did not ensure food was prepared and served in accordance with professional standards for food service safety to prevent foodborne illness. This was evident during Dining Observation on the 3 South Unit. Specifically, a Certified Nursing Assistant (CNA) was observed serving breakfast trays without performing hand hygiene in between residents.

Inspectors wroteBased on observation, record review, and staff interviews conducted during the recertification survey, the facility did not maintain infection control practices to prevent the development and transmission of communicable diseases and infections. Specifically, oxygen tubing with a flexible tube (a piece used to connect the oxygen to a tracheostomy) was observed resting on the floor, and the flexible tube was touching the wall inside the resident's room. This was evident for 1 of 6 residents reviewed for Respiratory Care out of a total sample of 38 residents (Resident #139). The finding is: The facility policy and procedure titled Oxygen Therapy dated 12/13/19 documented oxygen tubing should be replaced when it becomes contaminated, e.g., if it touches the ground. [...]