The New York State Department of Health (DOH) has cited Elant at Newburgh in Orange County, NY of numerous violations of the state’s Public Health Laws. Graphic at times, the report chronicles the deficient care that several residents received throughout their stay at Elant.
As this blog has noted several times in the past, Public Health Laws regarding the prevention and treatment of pressure ulcers articulate very specific standards of care that facilities must maintain with respect to their patients. The extensive document that the DOH recently released to the public details a number of incidents at Elant during which these standards of care were neglected, unknown, or seemingly ignored. In certain cases, the development of pressure ulcers in elderly residents of nursing homes is an unfortunate, yet unavoidable, occurrence. The facility’s duty is to ensure that safeguards are in place to prevent avoidable sores. The practices at Elant depicted in the DOH report not only seem to disregard this duty, but also to quicken the development of pressure ulcers in already debilitated patients.
Residents suffering from incontinence are particularly susceptible to pressure ulcers. Title 10 Section 415.12(d) of the New York Administrative Code states that: “Based on the resident’s comprehensive assessment, the facility shall ensure that: (1) a resident who is incontinent of bladder receives the appropriate treatment and services to…restore as much normal bladder function as possible.” Yet, at Elant, a tour of the facility revealed that, among other deviations from standard care, 8 of 8 Certified Nursing Assistants (CNA’s) interviewed were unaware of the facility’s toileting program, and 7 of 8 CNA’s demonstrated poor infection control techniques during perineal care. Section 415.12(c) of the Code mandates that the facility ensure that “(2) a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.” Again, the CNA’s at Elant failed in this charge, with 5 of 8 interviewed stating that they would not report open skin areas to the charge nurse. On one occasion the Director of Nursing was intervewed following a comment by a Licensed Practical Nurse who posited that a pressure ulcer with a scab was “healed.” The Director’s response: “No, by no means. I’m so embarassed.”
The work of Nursing Home facilities is difficult and intense. This does not excuse a lack of proper care and knowledge by the staffs of such facilities. Based upon the DOH report, it seems that Elant has significant work to do to ensure that it brings its staff members up to date on current acceptable practices for elder care.
Website Resource: New York State DOH