Unity Living Center

Inspectors wroteBased on interviews and record reviews conducted during an Abbreviated Survey (NY00352620), the facility did not ensure resident records were complete, accurately documented, accessible, and systematically organized in accordance with professional standards of practice for three (3) (Residents #1, #2 and #4) of three (3) residents reviewed. Specifically, the facility could not provide documented evidence that wound treatments were administered as ordered, and documentation did not include who provided the treatments or when the treatments were completed.

Inspectors wroteBased on observations, interviews, and record reviews conducted during the Recertification Survey from 7/19/24-7/25/24, the facility did not ensure they established and maintained an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for six (Residents #6, #26, #66, #87, #92, and #100) of seven residents reviewed for infection control on the facility's ventilator unit. Specifically, the facility failed to ensure a blood glucose monitoring device (a device used to obtain a blood sample to check blood sugar levels) was cleaned and disinfected between each use for Residents #6, #26, and #87. Additionally, staff did not wear the posted and required personal protective equipment for Residents #6, #26, #66, #92, and #100. [...]

Inspectors wroteBased on interviews, observations, and record reviews conducted during a Recertification Survey from 7/19/24-7/25/24, for two (Residents #20 and #93) of three residents reviewed for medication administration, the facility did not ensure that each resident was free from significant medication errors. Specifically, several significant medications were not administered to both Resident #20 and Resident #93 due to not being available. This is evidenced by the following: The facility's policy Medication Administration dated August 2021, documented the facility shall properly administer and store all medications. Medications are administered following a valid order entered in the Electronic Medical Record which links to the Medication Administration Record. 1. [...]

Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey from 7/19/24-7/25/24, for one of four residential units (3300 unit), the facility did not provide for safe and secured medications in accordance with currently accepted professional standards. Specially, there were multiple loose unpackaged and unlabeled pills and expired medications observed in two medication carts on the 3300 Unit. The Medication Administration Policy, dated February 2020, included that the facility shall properly store all medications. All medications must remain in secure storage until administered to the patient. During an observation and interview on 7/22/24 at 12:22 PM on the 3300 resident care unit, the team one hall medication cart contained 25 loose unlabeled pills (different shapes and colors) in the medication drawers. [...]

Inspectors wroteBased on observations, interviews and record review conducted during a Recertification Survey, completed on 9/9/22, it was determined that for 3 of 29 residents reviewed for care planning, the facility did not develop and implement a comprehensive person- centered care plan that included measurable objectives to meet all the resident's medical, nursing, mental and psychological needs as identified in their comprehensive assessments. Specifically, Resident #18's Comprehensive Care Plan (CCP) did not include goals, interventions and desired outcomes related to dementia with behaviors, depression or that the resident had a seizure disorder. [...]

Inspectors wroteBased on observations, interviews and record reviews conducting during the Recertification Survey from 8/31/22 to 9/9/22, it was determined that for one (Resident #81) of five residents reviewed for nutrition, the facility did not ensure that the resident's daily fluid intake met their needs as ordered by the physician. Specifically, the physician ordered fluid restriction was not being consistently monitored or documented. This is evidenced by the following: The facility policy, Encouraging or Restricting Fluids, dated 10/28/19, instructed staff to verify if there was a physician's order for this and to review the resident's care plan and/or the daily assignment sheet to assess for any special needs. The General Guidelines included: To follow specific instructions concerning fluid intake or restrictions concerning fluid intake. Record fluid intake accurately. [...]

Inspectors wroteBased on observations, interviews and record review conducted during the Recertification Survey, completed 9/9/22 it was determined that for one (Resident #13) of three residents observed during medication pass, the facility did not ensure that it was free of medication error rate of 5 percent (%) or greater. There were 4 medication errors for 28 opportunities resulting in a 14.3 % medication error rate. The issue involved administering three medications at the wrong time and not administering one medication that the nurse signed out as administered. This is evidenced by the following: Resident #13 had diagnoses including type 2 diabetes, hypertension, and gastric ulcer. The Minimum Data Set Assessment, dated 5/16/22, documented that the resident had moderate impairment of cognitive function. Current physician orders included but not limited to, the following medications: a. [...]

Inspectors wroteBased on observation, interviews and record review conducted during the Recertification Survey from [DATE] to [DATE], it was determined that for one (Resident #94) of 29 residents reviewed the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable disease and infections. Specifically, the facility did not ensure that visitors of a resident on transmission-based precautions, due to multiple communicable (contagious) infections, practiced appropriate infection control prevention. This was evidenced by the following: The current Centers for Disease Control (CDC) guidelines for Transmission-Based Guidelines includes under Contact Precautions: [...]

Inspectors wroteBased on interviews and record review conducted during the Recertification Survey completed on 9/9/22, it was determined that for two (Resident #38 and #58) of two residents reviewed for hospitalizations, the facility did not ensure a written notification, which specifies the duration of the bed-hold policy, was provided to the resident and/or the resident representative at the time of transfer to the hospital. Specifically, Resident #38 and Resident #58 were transferred to the hospital and the facility could not provide evidence that a written notice of information regarding the facility's bed-hold policy was provided to the residents' or the resident's representatives at the time of transfer or soon after per the regulation. This was evidenced by the following: [...]

Inspectors wroteBased on interviews and record reviews conducted during the Recertification Survey, it was determined that for one (Resident # 93) of one resident reviewed for grievances, the facility did not make prompt efforts to resolve a grievance. Specifically, the resident's Health Care Proxy voiced concerns about staff members that were not investigated in a timely manner. This is evidenced by the following: Resident #93 has diagnosis including anoxic brain injury, heart failure, and has a tracheotomy. The Minimum Data Set Assessment, dated 1/21/20, revealed that the resident's cognitive skills for daily decision making were severely impaired, the resident was non-verbal (absence of spoken words), and dependent on staff for all activities of daily living. [...]

Inspectors wroteBased on interviews and record reviews conducted during the Recertification Survey, it was determined that for 4 (Residents #11, #33, #72 and #115) of 14 residents reviewed for Baseline Care Plans, the facility did not have documented evidence that a Baseline Care Plan was developed within 48 hours of admission. This is evidenced by, but not limited, to the following: The facility policy and procedure, Baseline Care Plan Policy for Long Term Care, effective January 2018, revealed that upon admission, the facility will begin the process of developing a Baseline Care Plan which will be completed within 48 hours. 1. Resident #11 was admitted to the facility on [DATE] with diagnoses including Parkinson's disease, osteoarthritis, and neurogenic bladder. [...]