New York Nursing Home The Willows at Ramapo Cited for Inadequate Infection Control & Elopement

The Willows at Ramapo Rehabilitation and Nursing Center received 23 citations for violations of public health code between 2018 and 2022, according to New York State Department of Health records accessed on April 7, 2022. The Haverstraw nursing home’s citations resulted from a total of four surveys by state inspectors. The deficiencies they describe include the following:

1. The nursing home did not provide adequate supervision to prevent elopement. Section 483.25 of the Federal Code stipulates that nursing homes must provide residents with a level of supervision necessary to prevent accidents. A September 2021 citation found that The Willows at Ramapo failed to ensure such. The citation specifically describes an incident in which the facility’s receptionist “left the front desk without coverage, leaving the front desk unattended,” after which a resident with severe cognitive impairment “was able to exit the facility undetected by staff.” The resident was later discovered in the parking lot by facility staff. A plan of correction undertaken by the facility included an audit of residents at risk of elopement to ensure the proper placement and functioning of their wander guard devices.

2. The nursing home did not adequately prevent the use of psychotropic medications. Section 483.45 of the Federal Code requires nursing homes to ensure residents’ drug regimens are free from unnecessary medications, including unnecessary psychotropic medications. An April 2019 citation found that The Willows at Ramapo failed to ensure such. The citation specifically describes an instance in which a psychiatrist’s recommendation to discontinue a resident’s antidepressant medication “was not communicated to the resident’s primary medical doctor concurrent with a new order for a different antidepressant.” As a result, the resident was administered “duplicate medication therapies” for 12 days. A plan of correction undertaken by the facility included the re-education of the registered nurse manager “responsible for this deficiency.”

3. The nursing home did not undertake adequate infection-control interventions. Section 483.80 of the Federal Code stipulates that nursing homes must create and maintain a program designed to prevent the development and spread of transmissible diseases and infections. An April 2019 citation found that The Willows at Ramapo failed to ensure such. The The citation specifically describes the facility’s failure to ensure staff “followed proper hand hygiene, gloving, and proper cleansing of a blood glucose monitoring device to prevent the spread of infection.” It goes on to describe an instance in which a Licensed Practical Nurse displayed various procedural failures, including the placement of a device on an over-bed table without first cleansing the table or applying a protective barrier, and the return of the device to its pouch after use without first cleansing it “according to manufacture specifications, or with a facility recommended solution.” A plan of correction undertaken by the facility included the re-education of the LPN.

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