The Chateau at Brooklyn Rehabilitation and Nursing

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 resident right to manage his or her financial affairs was maintained. This was evident for 1 (Resident #9) of 1 resident reviewed for Personal Funds. Specifically, the facility did not provide Resident #9 with quarterly statements advising of the balance in their personal fund account. The finding is: The facility policy and procedure titled Residents Funds with revision date of 06/18/2024 states that the facility manages the personal funds of residents who request the facility to do so. [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification Survey from 6/13/2024 to 6/21/2024, the facility did not ensure a person-centered comprehensive care plan was developed and implemented to meet a resident's needs. This was evident for 1 (Resident #6) of 6 residents reviewed for Pain Management and 1 (Resident #22) of 2 residents reviewed for Respiratory Care out of 38 total sampled residents. Specifically, 1). a comprehensive care plan related to pain was not developed to address Resident #6 chronic pain and 2). there was no care plan created for a resident receiving Oxygen therapy.

Inspectors wroteBased on record review and interviews conducted during the Recertification and Complaint (NY00337375) survey from 06/13/2024 to 06/21/2024, the facility did not ensure that residents were free from misappropriation of property. This was evident for 2 (Resident #232 and #334) of 2 residents reviewed for Abuse out of 38 total sampled residents. Specifically, Licensed Practical Nurse #3 diverted narcotic medication ordered and delivered for use with two residents. Licensed Practical Nurse #3 hid the medication in their personal bag and removed it from the facility.

Inspectors wroteBased on record review and interviews conducted during the Recertification and Complaint (NY00337275) survey from 06/13/2024 to 06/21/2024, the facility did not ensure that misappropriation of property was reported to the Department of Health. This was evident for 1 (Resident # 334) of 2 residents reviewed for abuse out of 38 total investigated sampled residents. Specifically, during another investigation a Licensed Practical Nurse was found to have diverted narcotic medication for Resident #334 and this was not reported to the Department of Health.

Inspectors wroteBased on record review and interviews conducted during the Recertification and Abbreviated (NY00337375) survey from 6/13/2024 to 6/21/2024, the facility did not ensure services provided met professional standards. This was evident for 2 (Resident #232 and #334) of 2 residents reviewed for Abuse out of 38 total sampled residents. Specifically, Licensed Practical Nurse #3 diverted narcotics intended for use with two residents. Licensed Practical Nurse #3 documented on 3/24/2024 that 30 Percocet 5/325 mg tablets were received instead of 60 Percocet 5/325 mg tablets for Resident #232 and that 30 Oxycodone 10 mg tablets were received instead of 60 Oxycodone 10 mg tablets for Resident #334. [...]

Inspectors wroteBased on record reviews and interviews conducted during the Recertification and Abbreviated (NY00337375) Survey from 6/13/2024 to 6/21/2024, the facility did not ensure pharmaceutical services was provided to including procedures that assure accurate, receiving of narcotics, establish a system of records of receipt and disposition of all controlled drugs in sufficient detail to enable an accurate reconciliation; and determine that drug records are in order; and that an account of all controlled drugs is maintained. Specifically, Licensed Practical Nurse #3 diverted narcotics delivered for two residents. Licensed Practical Nurse #3 documented on 3/24/2024 that they received 30 Percocet 5/325 mg tablets instead of 60 Percocet 5/325 mg tablets and 30 Oxycodone 10 mg tablets instead of 60 Oxycodone10 mg tablets. [...]

Inspectors wroteBased on observations, record review, and interviews conducted during the Recertification survey from 5/18/2022 to 5/25/2022, the facility did not ensure safe food handling and storage were practiced to prevent food-borne illness. This was evident during observation of the facility Kitchen. Specifically, several expired food items were observed in the Kitchen refrigerators.

Inspectors wroteBased on record review, observation, and interview the facility did not ensure a comprehensive person-centered care plan that includes measurable objectives and timeframes to meet a resident's medical, nursing, mental, and psychosocial needs and includes the resident's goals, desired outcomes, and preferences was developed. Specifically, a comprehensive care plan was not developed for a resident with a diagnosis of diabetes mellitus. This was evident for 1 of 5 residents reviewed for Unnecessary Medications out of a sample of 35 residents. (Resident #77)

Inspectors wroteBased on observation, record review, and interview during the Recertification Survey, the facility did not ensure that a resident was cared for in a manner that maintained or enhanced his or her dignity. Specifically, residents with a catheter were observed in common areas with visible urine-filled catheter tubing. This was evident for 2 of 2 residents reviewed for Catheter Care (Residents #162 and #165).

Inspectors wroteBased on observation, record review, and interview during the Recertification Survey, the facility did not ensure that residents' privacy and confidenciality were maintained. Specifically, residents with a catheter were observed in common areas with visible urine-filled catheter tubing. This was evident for 2 of 2 residents reviewed for Catheter Care (Residents #162 and #165).

Inspectors wroteBased on observation and interview during the Recertification survey, the facility did not ensure that housekeeping and maintenance services were maintained. Specifically: 1.) chairs in resident room and in dining room were soiled, faded, tattered and torn, with duck tape to armrests. 2.) hole in wall, peeling plaster, soiled dusty curtains hanging off their hooks. 3) Dining room windows missing vertical blind slats. 4.) the 4th floor nurse station counter top with its edges with exposed inner wood material and missing pieces of the Formica covering. 5) Hoyer lift with accumulation of dirt and dust. This was evident for two (2) of (5) five resident units. (units 4 and 5).

Inspectors wroteBased on observation record review and interview during the Recertification Survey, the facility did not ensure that a person-centered care plan with measurable goals and time frames and interventions was developed to address a resident's medical needs identified in the comprehensive assessment. Specifically, there was no documented evidence that the comprehensive care plan included measurable goals, objectives and interventions to address for a resident with a Urinary Catheter. This was evident for one (1) of two (2) Residents investigated for Catheter Care. (Resident # 165). The finding is: Resident # 165 is a [AGE] year old admitted on [DATE] with diagnosis that included 'Retention of Urine. The Annual MDS ARD of 05/26/19 documented the resident has being able to be understood and understands, with moderate to severe cognition. [...]

Inspectors wroteBased on observation record review and interview the facility did not ensure that infection control practices were maintained. Specifically, a resident who has an physician order to be on contact precautions did not have clear signage to the resident's room either identifying the category of transmission-based precautions, instructions for use of Personal Protective Equipment (PPE), and/or instructions to see the nurse before entering. This was evident for one (1) resident investigated for Infection. (Resident # 65). The finding is: Review of the facility policy and procedure for, Infection Control, dated 03/28/19 documented that, When Transmission Based Precautions are implemented, the designee shall, Post the appropriate notice on the room entrance door . Observations on 06/20/19 at 12:04 PM found a visitor in the the room of the resident who was on contact precautions. [...]