Queens Boulevard Extended Care Facility

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that food was served at an appetizing temperature during meal service. This was evident for 2 (5th and 6th floor) of 2 units observed during dining observation. Specifically, food served during lunch meal service were not maintained at palatable and appetizing temperatures. The findings are: The facility's policy titled Communal Dining with a revision date of 04/10/2024 documented the purpose of the policy was to enhance the quality of life through the provision of nourishing, palatable, attractive meals that meet the residents' daily nutritional needs in a communal dining experience. The policy documented that the dietary department would bring meals to the floors via food trucks as quickly as possible to maintain temperatures, where nursing staff will be ready to receive and distribute meals. Temperatures for hot meals must be maintained at 140 degree…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and staff interview conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that a resident was assessed using the quarterly review instrument specified by the State and approved by the Centers for Medicare and Medicaid Services not less frequently than once every 3 months. This was evident for 1 (Resident #107) of 2 residents reviewed for Resident Assessment out of 38 total sampled residents. Specifically, Resident #107's quarterly assessment was not completed. The findings are: The Centers for Medicare and Medicaid Services Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual Version 1.18.11 October 2023 documented that the Federal requirement mandates facilities to encode and electronically transmit Minimum Data Set 3.0 data. The Manual also stated that Assessment Completion refers to the date that all information needed has been collected and recorded for a particular assessment type and staff have signed and dated that the assessment is complete. The undated facility policy titled Minimum…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interviews conducted during the Recertification Survey from 06/13/2024 to 06/21/2024, the facility did not ensure that services provided or arranged by the facility met professional standards of quality. This was evident for 2 (Resident #85 and #20) of 38 total sampled residents. Specifically, 1.) Resident #85 was observed with oxygen via nasal cannula with no physician's order. 2.) Resident #20 had physician's order to notify the physician when Resident's finger stick blood sugar (method of drawing drops of blood from the finger for testing the blood glucose level) result is less than 70 milligrams per deciliter or more than 400 milligrams per deciliter. The licensed nurse failed to notify the physician when Resident #20's finger stick blood sugar was higher than 400 milligrams per deciliter on 7 occasions from 06/09/2024 through 06/18/2024. In addition, Resident #20 was administered 7 units of Novolin R insulin (a short acting insulin that lowers blood sugar) on 5…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interviews conducted during the Recertification and Abbreviated Survey (NY00340566) from 06/13/2024 to 06/21/2024, the facility did not ensure that all allegations of abuse were thoroughly investigated. This was evident for 1 (Resident #164) of 2 residents reviewed for abuse out of 38 total sampled residents. Specifically, there was no documented evidence that an investigation was conducted for Resident #164, who complained of being roughly handled by a Certified Nursing Assistant during care. The findings are: The facility's policy and procedure titled Abuse, Neglect, Mistreatment and Misappropriation of Resident Property with a last reviewed date of 10/31/2023 documented that residents will be protected from abuse, neglect, and harm while residing at the facility. No abuse or harm of any type will be tolerated, and residents and staff will be monitored for protection. It is the policy of the facility that reports of abuse are promptly and thoroughly investigated. The investigation is…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interviews and record review conducted during the Recertification survey from 05/18/22 to 05/25/22, the facility did not ensure a resident was provided information to formulate advanced directives (AD). This was evident for 1 (Resident #417) of 1 resident reviewed for ADs out of a sample of 37 resident reviewed. Specifically, there was no documented evidence Resident #417 received education and formulated ADs. The findings are: The facility policy titled Advance Directives dated October 21, 2008, documented the Social Worker (SW) will discuss and distribute to all new resident and/or Designated Representatives, information about Advance directives; and document that information was given. Resident #417 was admitted to the facility 05/17/2022 with diagnoses of diabetes mellitus and chronic obstructive pulmonary disease. On 05/23/22 at 12:27 PM, Resident #417 was interviewed and stated they were admitted to the facility approximately one week ago and no one has educated them regarding ADs. On 05/23/22 at 12:56 PM, the Registered Nurse (RN) # 1 was interviewed and stated…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview conducted during the Recertification Survey from 5/18/22 to 5/25/22, the facility did not ensure the Minimum Data Set 3.0 (MDS) assessment accurately reflected the resident's status. This was evident for 1 (Resident #65) of 5 residents reviewed for Unnecessary Medications. Specifically, the MDS did not document Resident #65's evaluation for Gradual Dose Reduction (GDR) of psychotropic drugs. The findings are: The facility undated policy titled MDS 3.0 documented the facility will ensure MDS Coordinators work with floor Nurses to ensure accurate documentation. Resident #65 had diagnoses of non-Alzheimer's dementia, depression, and psychotic disorder. The MDS dated [DATE] and 02/09/2022 documented Resident #65 was severely cognitively impaired, received antipsychotic and antidepressant medication within 7 days prior to the MDS date, and a GDR had not been attempted or documented physician (MD) as clinically contraindicated. Psychiatric Evaluation Progress note…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review conducted during the Recertification Survey from 05/18/2022 to 05/25/2022, the facility did not ensure the development of a comprehensive, person-centered care plan (CCP) consistent with the resident's medical, nursing and mental and psychosocial needs. This was evident in 1 (Resident #264) of 1 resident reviewed for constipation. Specifically, Resident #264 was receiving psychotropic and constipation medication, and related CCPs were not developed. The findings are: The undated facility policy titled Care Planning - Interdisciplinary documented the comprehensive care plan will facilitate the inclusion of the resident and/or RR and will include an assessment of the resident's strengths and needs. Resident #264 had diagnoses of constipation and anxiety Disorder. The Minimum Data Set (MDS) dated [DATE] documented Resident #264 was cognitively intact. The Physician Order as of 5/23/2022 documented Resident #264 received Celexa 40 mg once daily for anxiety. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews and record reviews conducted during a Recertification and Complaint (NY00294185) Survey from 05/18/2022 to 05/25/2022, the facility did not ensure that a resident's representative (RR) was involved in revision of a resident's person-centered plan of care (CCP) with the interdisciplinary team (IDT). This was evident in 1 (Resident #48) of 35 residents reviewed. Specifically, the facility did not involve Resident #48's RR in revision of the resident's CCP to address Resident #48's ongoing refusal to be transferred out of bed and to receive showers. The findings are: The undated facility policy titled Care Planning - Interdisciplinary documented the comprehensive care plan will facilitate the inclusion of the resident and/or RR and will include an assessment of the resident's strengths and needs. Resident #48 had diagnoses of cerebral infarction and non-Alzheimer's dementia. The Minimum Data Set 3.0 (MDS) dated [DATE] documented the Resident #48 was severely cognitively impaired, was totally…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interviews, and record review conducted during the Recertification survey from 5/18/22 to 5/25/22, the facility did not ensure a residents environment remained free of hazards. This was evident for 1 (#516) of 4 residents reviewed for respiratory care. Specifically, a large Oxygen Cylinder (OC) at Resident #516's bedside was not properly secured. The finding includes: The facility policy titled Oxygen Administration/Therapy dated 07/20/2021 documented when using oxygen cylinders, secure oxygen cylinders at the bedside by using a tank holder/chain. Tighten around the cylinder's base or placing the cylinder carrier vertically, making sure the cylinder is strapped or chained to the carrier and the wheels on a carrier are folded flat against the cylinder. On 05/18/2022 at 11:59 AM, 05/19/2022 at 10:10 AM, and 05/20/2022 at 9:58 AM, a large OC was observed on the right side of Resident #516's bed. The large OC was not secured in a carrier or chained to the wall. Resident # 516 was admitted on…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interviews conducted during the Recertification survey from 05/18/2022 to 05/25/2022, the facility did not ensure residents with respiratory care were provided such care consistent with professional standards of practice. This was evident for 1 (Resident #516) of 4 residents reviewed for respiratory care. Specifically, Resident #516 was observed several times being administered oxygen therapy via nasal cannula (NC) without a Medical Doctor Order (MDO). The findings are: The facility policy titled Care of Oxygen Equipment dated 07/15/2020 documented the licensed nurse implements oxygen delivery orders per MDO and according to the plan of care. Resident # 516 was admitted on [DATE] and had diagnoses asthma and acute embolism/thrombus. On 05/18/2022 at 11:59 AM, 05/20/2022 at 9:58 AM, and 05/20/2022 at 9:58 AM, Resident # 516 was observed with oxygen 2 liters per minute (lpm) via NC running from a concentrator to the resident's nose. On 05/20/2022 at 1:55 PM, Resident # 516…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interviews conducted during the Recertification Survey from 5/18/2022 to 5/25/2022, the facility did not ensure a resident was adequately equipped to call for assistance through a communication system. This was evident for 1 (Resident #29) of 35 residents reviewed. Specifically, there were multiple observations of Resident #29 without an operating Call Bell (CB) next to their bed. The findings are: The facility's policy titled Call Lights/Bells dated 9/2005 documented the CB system is the primary means of communication between residents and nursing staff. CBs will be operable, accessible, and within resident's reach. Resident #29 had diagnoses of heart failure, blindness of the right eye, and hearing loss. The Minimum Data Set 3.0 (MDS) assessment dated [DATE] documented Resident #29 had mild cognitive impairment, required extensive assistance of one person for bed mobility, transfers and personal hygiene, and required limited assistance of one person for dressing and…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and staff interviews during the re-certification survey, the facility did not ensure a resident received the necessary treatment and services, consistent with professional standards of practice, to promote healing of ulcers. Specifically, pressure relieving devices were not put in place for a resident with bilateral heel wounds. This was evident for one (1) of four (4) residents investigated for Pressure Ulcer Care Area (Resident #344) out of a final sample of 35 residents. The finding is: The facility's policy and procedure titled, Pressure Relief Assistive Devices, (Dated 10/17), documented, If problems are identified that warrant pressure relief, appropriate pressure relief interventions are initiated. Examples of pressure relief interventions include but are not limited to the following: Lower extremity devices such as multipodus boots, heel lifts and heel pads, off loading shoes, abductor rolls. Resident #344 was initially admitted on [DATE] with diagnosis include but…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.