In a February 21, 2012 Certification Survey, the Department of Health found a Westchester nursing home deficient in several areas, including that a resident’s care must be supervised by a physician.
CFR 483.40(a) states that residents must remain under the care and supervision of a physician from admittance and throughout their stays. There must also be a secondary physician available to supervise the care of the residents if the primary physician is unavailable. At Bethel in Croton, a resident known to be a risk for dehydration was placed on interventions addressing this issue. When notified that the resident was exhibiting signs of lack of sufficient fluids, the physician stated that he would evaluate the resident, however there is no documentation that this was done. When interviewed by the DOH, the physician stated that he did not, in fact, address the hydration issue, and that he expected that the nursing staff would have initiated hydrating when these signs presented themselves. This does not constitute supervision by a physician under the applicable regulations.
The facility was also cited for failing to ensure that the resident’s environment remained as free of accident hazards as possible; and for failing to ensure that each resident received adequate supervision and assistance devices to prevent accidents.
For the full DOH findings with respect to Bethel Nursing and Rehabilitation Center, go to the DOH website here.