The Onondaga Center for Rehabilitation and Nursing located on 215 East Ave. in Minoa was fined $22,000 by the state last February for patient care violations. (photo by Lauren Young)
A Minoa nursing home has been fined $22,000 by the state for patient care violations, ranging from leaving residents in soiled clothing to missed meals and medications.
Onondaga Center for Rehabilitation and Nursing, located on 215 East Ave. in Minoa, received the fine after the finding of numerous violations during a February 9 inspection of the facility by the New York State Department of Health.
Inspectors observed multiple residents left in soiled clothing, suffering from bed sores, having missed showers and medication doses, according to the state health department website. The facility was ordered to pay $22,000 within 30 days.
“We have surrounded the Onondaga administrator with an extremely strong support team in order to correct the issues that were noted in our February survey. Our two strongest regional team leaders, in administration and clinical services, are helping to oversee the on-site leadership team and both have made a significant impact operationally and in terms of clinical care delivery that we are confident will be evident in our next survey,” stated the facility. “Health care staffing is a crisis issue everywhere in New York State. There are simply not enough qualified care-givers to meet the rising level of need.”
Formerly known as the Crossings, this 82-bed home was bought last year by Centers Health Care, a Bronx-based health care chain that owns 53 nursing homes in New York, New Jersey and Rhode Island.
According to the inspection report, there were multiple deficiencies identified on the recertification survey, including repeat deficiencies in the areas of abuse, activities of daily living, pressure ulcers, bowel/bladder, staffing, medication storage and prompt notification of lab results.
When inspectors visited the home in February, it was being run by an out-of-state administrator who was unavailable on weekends, according to the inspection.
The facility was fined for 24 deficiencies, many of which were repeat deficiencies, according to the report.
Observations from the report include:
According to staff at the facility, short staffing is largely to blame for these patient care violations.
On January 24, the company’s corporate director of nursing was interviewed, where she stated there were “staffing challenges.” She said the evening shifts were the most challenging, as there was often one certified nursing assistant (CAN) for 40 people. According to the report, she said “I think they do what they can with what they have.”
During an interview with a CNA on January 24, she said she typically works with three other CNAs for 35 to 40 residents on day shifts and typically only one to two CNAs for the evening shift. She added that the center is “always short staffed,” and once worked an entire shift by herself, struggling to provide fluids to residents as she spent most of her day getting residents up.
During an interview with a registered nurse (RN) on January 25, some treatments could not be completed on multiple occasions as there was only one nurse passing medications to 40 residents.
On January 27, a licensed practical nurse (LPN) stated she worked every weekend and frequently worked with just herself passing medications to 40 residents. Sometimes there was no time to get treatments done as she was busy getting all the medications passed.
On February 6, an LPN said it was “difficult to get everything done when she was the only nurse on the floor,” stating that she tried to prioritize and pass medications first, but was also responsible for calling physicians, answering phones, doing treatments and she also had one resident discharged and another on the way for re-admission. She stated no other nurses came to help her the entire day.
On February 7 an RN was interviewed, stating that it was “physically impossible” to pass medications to 40 residents by herself and complete all the treatments as well.
During an interview with the NP that same day, she stated medications were not given to residents as ordered because there was either a shortage of nurses or the nurses on the unit were not familiar with the residents and their needs. She also stated that her orders “were not being carried out” — an “ongoing issue” at the facility.
During a telephone interview with an RN on February 8, she stated she worked as an evening supervisor from 3 p.m. to 11 p.m. and could not perform her duties as a supervisor if she was also responsible for passing medications. Some of her duties included assessing falls, starting and monitoring IVs, pronouncing death and communication with the medical staff when there were changes in condition and staff oversight. She stated staffing was “not good on evenings” and she was “fearful.”
In a statement from the Centers Health Care and Onondaga Center, it was stated that the administrator initially hired is a traveling administer, licensed in New York, who they “rely on from time to time for temporary duty while [they] conduct a thorough search for a qualified, local candidate.”
The company has since hired an interim administrator, to which they stated that during that entire period, the Director of Nursing (DON) “was a local resident and was available 24/7.”
That DON has since been replaced by “a very capable nurse who is also local and available 24/7.”
The current administrator is Bonnie Shippee, a native New Yorker from the Central New York region.
The facility’s staffing, the company said, is becoming “one of the emerging strengths of Onondaga Center,” earning a 4-Star staffing rating on the Centers for Medicare & Medicaid Services (CMS) website.
In March/April, the state Department of Health re-surveyed the facility and found that leadership had “corrected the underlying issues” and that “sufficient staffing levels were being maintained.”
The facility additionally noted that its number of employees was “misleading,” as “every shift requires varying staffing levels, and their 4-Star rating “attests to the fact that we are over performing relative to state and national levels 24/7.”
The facility said, upon taking over the nursing and rehabilitation center, they have “put a number of initiatives in place, including a fluid distribution program to ensure proper hydration with fluid checks performed multiple times each day.”
Additionally, the facility acknowledged issues with pressure ulcers by bringing in Wound Care Solutions, an independent wound care physician’s group, and have established a rounding schedule and increased in-service training supported by “[an] aggressive follow-up to make certain that our residents are wound free.”
The facility said it is “confident” that their next survey will prove the efficacy of their efforts, which they said is “ongoing.”
Jason Emerson is editor of the Cazenovia Republican and Eagle Bulletin newspapers.