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Home  /  Medication Errors  /  Concord Nursing and Rehabilitation Center Cited for Elopement Risk

Concord Nursing and Rehabilitation Center Cited for Elopement Risk

by Law Offices of Thomas L. Gallivan, PLLC 03 Sep2020

Concord Nursing and Rehabilitation Center received 44 citations for violations of public health code between 2015 and 2019, according to New York State Department of Health records accessed on January 16, 2020. The facility also received a 2016 fine of $14,000 in connection to findings it violated health code provisions regarding administration and respiratory care. The Brooklyn nursing home’s citations resulted from a total of five surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not provide adequate supervision to

. Section 483.25 of the Federal Code requires nursing homes to provide residents with “adequate supervision and assistance devices to prevent accidents.” An August 2018 citation found that Concord Nursing and Rehabilitation Care did not adequately supervise residents who had been identified as at risk for elopement. The citation specifically found that a resident “was not provided with [a] wander guard” as per a physician’s order, and further that no documentation in the resident’s records indicated they were being supervised “to prevent unsafe wandering and/or elopement.” Although the resident had a physician order specifying for a wander guard on their left hand, according to the citation, when an inspector asked a Certified Nursing Assistant if the resident had one, none was found. The CNA stated in an interview that “the resident is confused and sometimes removes the wander guard,” and further that “there is no daily record monitoring the use of wander guard.”

2. The nursing home did not maintain adequately low medication error rates. Section 483.45 of the Federal Code stipulates that nursing home medication error rates must not exceed “5 percent or greater.” According to an August 2018 citation, facility staff did not ensure an error rate below five percent. The citation states specifically that “residents did not receive their prescribed medications because those medications were not available, resulting in medication error rate of 7.4 % out of 27 opportunities.” In an interview, one of the facility’s Licensed Practical Nurses informed an inspector that “running out of medications is a common problem” at the nursing home and that “she always notifies the Nurse supervisor.” The facility’s Registered Nurse supervisor stated in an interview, however, “that she was unaware that medications were missing.”

3. The nursing home did not adequately protect residents from physical restraints. Under Sections 483.10 and 483.12 of the Federal Code, nursing home residents have the right to be “free from physical or chemical restraints imposed for purposes of discipline or convenience and that are not required to treat the resident’s medical symptoms.” An August 2018 citation found that Concord Nursing and Rehabilitation Care did not identify the use of side rails for three residents as potential restraints, consequently resulting in the use of restraints for three residents without justification. The citation goes on to state that in an interview, the facility’s Registered Nurse Supervisor said that “resident should be using full side rails unless the interdisciplinary team determined that they should be used,” and that she was unaware side rails were in use for the residents in question. The citation describes this deficiency as having the “potential to cause more than minimal harm.”

The attorneys at the Law Offices of Thomas L. Gallivan, PLLC work diligently to protect the rights of nursing home residents.  Please contact us to discuss in the event you have a potential case involving neglect or abuse.

Posted in: Medication Errors, Neglect, Nursing Home Abuse, Nursing Home Violations

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