Brandon Woods of Dartmouth

Brandon Woods of Dartmouth

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Brandon Woods of Dartmouth? Our lawyers can help.

Abuse of the elderly is not acceptable and we fight hard in these types of cases. If you suspect a nursing home or caregiver has caused harm to your loved one in someone elses’ care, contact our law firm today for a free legal consultation.

Talking to us does not obligate you to anything, but we may be able to tell you if you have a claim and the value of your case. If we accept your case, you pay no fee unless we recover for you.

About Brandon Woods of Dartmouth

Brandon Woods of Dartmouth is a for profit, 118-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of New Bedford, Fairhaven, Acushnet, Fall River, Tiverton Rhode Island, Somerset, Portsmouth Rhode Island, Wareham,  Swansea, Falmouth, and the other towns in and surrounding Bristol County, Massachusetts.

Brandon Woods of Dartmouth
567 Dartmouth Street,
South Dartmouth, MA 02748

Phone: (508) 997-7787
Website: http://www.elderservices.com/brandon-woods-of-dartmouth

CMS Star Quality Rating

Brandon Woods of DartmouthThe Centers for Medicare and Medicaid (CMS) rates all nursing homes that accept medicare or medicaid benefits. CMS created a 5 Star Quality Rating System—1 star is the lowest rating and 5 stars is the highest—that look at three areas.

As of 2018, Brandon Woods of Dartmouth in Massachusetts received a rating of 5 out of 5 stars.

Performance Area Rating
Overall Rating 5 out of 5 (Much Above Average)
State Health Inspections 5 out of 5 (Much Above Average)
Staffing 4 out of 5 (Above Average)
Quality Measures 4 out of 5 (Above Average)

Fines and Penalties

Our Nursing Home Accident Lawyers inspected government records and discovered Brandon Woods of Dartmouth committed the following offenses:

Failed to have a program that investigates, controls and keeps infection from spreading.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and observation, the Facility failed to ensure that contact precautions were maintained for 1 Non Sampled resident out of a total sample of 23 residents (Non Sampled Resident #1) during medication administration on 8/10/16.

Findings include:

Review of the Facility policy for Clostridium Difficile (C-diff), dated August, 2012, indicated the following:

– Preventative measures will be taken to prevent the spread of infection with[DIAGNOSES REDACTED] which included vigilant handwashing with soap and water rather than alcohol based rubs

– Residents with[DIAGNOSES REDACTED] will be placed on contact precautions for the duration of the illness

– Healthcare workers and visitors will don gloves and gowns when entering the room of the[DIAGNOSES REDACTED] resident Review of the handwashing policy,dated August, 2012, indicated that

– Hand hygiene products and supplies (sinks, soaps, towels )shall be readily accessible and convenient for staff to use

– Employees must wash their hands for at least 15 seconds using an anti microbial soap and water under the following conditions: before and after entering the precaution room, and after contact with a resident with infectious diarrhea including C-dif.

Non Sampled Resident #1 was admitted to the Facility in 7/2016, and his/her [DIAGNOSES REDACTED].

The Surveyor observed the medication pass on 8/10/16 at 9:50 A.M. The Surveyor observed that the Medication Nurse donned gloves and a gown when she entered Non Sampled Resident #1’s room to administer the medications. The Surveyor observed the Medication Nurse come out of Non Sampled Resident #1’s room, remove the protective gown and gloves and place them into the medication cart’s trash. The Surveyor asked the Medication Nurse about handwashing and removal of the isolation gown inside the isolation room, and the Medication Nurse was unable to respond as to why she failed to follow contact precautions.

During the observation of the medication pass, the Laboratory Technician entered Non Sampled Resident #1’s room without any protective gear, and placed two of her work bags on the bed. The Surveyor asked the Medication Nurse about the lack of precautions and the Medication Nurse directed the Laboratory Technician to don a gown and gloves. The Surveyor observed the Laboratory Technician come to the door of Non sampled Resident #1’s room and use words to the effect, there is no soap in the bathroom . The Surveyor observed Certified Nurse Aide (CNA) #1 enter the precaution room, don a gown and gloves, move about the room and then remove her gown and gloves at the door and leave the precaution room without hand hygiene.

The Surveyor spoke with the Director of Nurses (DON) on 8/10/16 about the lack of infection control protocol observed by the Surveyor. The DON said she would follow up with facility staff and the Laboratory Staff about the lack of infection control practices observed by the Surveyor.

Failed to give the resident's representative the ability to exercise the resident's rights.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to ensure the individual exercising the Residents’ rights had the authority to do so for one Resident (#8) in a total sample of 23.

Findings include:

For Resident #8 the facility failed to ensure the daughter had authority to exercise the Resident’s rights.

Resident #8 was admitted to the facility in 5/2017 with [DIAGNOSES REDACTED]. The Resident had a health care proxy authorizing the daughter to make health care decisions if the Resident became unable to do so.

Clinical record review indicated that the Residents’ physician had not invoked/activated the Health care proxy, deeming the Resident unable to make health care decisions. The daughter had signed the admission documents, the MOLST (Medical Order for Life Sustaining Treatment), informed consents for psychoactive medications and the documents that pertain to the Residents health care decisions.

Although the daughter was making all of the Resident’s health care decisions, the health care proxy had not been activated/invoked by the primary care physician. On 12/7/17 at 10:05 A.M. Licensed Social Worker #2 confirmed that the facility failed to obtain a physician’s orders [REDACTED].

Failed to honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, observations, staff interview and Resident interviews, the facility failed to ensure that one Resident (#85) had the right to share a room with his or her roommate of choice in a total sample of 23.

Findings include:

For Resident #85 the facility failed to ensure that the right to share a room with his/her roommate of choice had been honored. Resident #85 was admitted to the facility in 3/2017 with [DIAGNOSES REDACTED]. The Minimum Data Set (MDS) completed on 11/1/17, indicated that the Brief Interview for Mental Status Score (BIMS) was a 15 out of 15 indicating cognition was intact.

On 12/06/17 at 8:33 A.M. Surveyor observed that the Resident was visibly upset and Resident #85 told the Surveyor that being upset was in regards to a request that was made about sharing a room with her significant other. The Resident was interviewed and he/she had asked her roommate a couple of weeks ago if he/she would be willing to switch rooms and the roommate agreed. However, this morning, his/her roommate stated that he/she would not move. The Resident also told the surveyor that he/she was going to get married next Tuesday and that he/she didn’t understand why the process to change rooms had not been initiated when requested to staff a couple weeks prior. Clinical record review indicated that in the paper chart and in the Electronic Medical Record (EMR) there were no Social Service entries or care plans addressing the room change or the marriage that was to take place on Tuesday, 12/12/17.

On 12/6/17 at approximately 11:00 A.M. Social Worker #1 said that she has been advocating for the Resident and her significant other by spending several hours a day addressing the wedding and room change. There was no documentation within the clinical record/EMR or a care plan addressing the concerns voiced by the Resident and his/her Significant Other. Social Worker #1 further said that any documentation she had regarding these issues were kept in a notebook which had handwritten entries and was kept in her office. The notebook, with hand written entries, are not considered to be part of the clinical record especially if no staff could access to the notebook.

Review of the notebook indicated a few entries regarding their up coming marriage and it was indicated that on 11/15/17, Resident #85 had requested the room change for his/her significant other. Social Worker #1 stated she tried calling Residents families and was unsure why the request to move was still in process after two weeks. On 12/6/17 at 2:00 P.M. Social Worker #1 said that the facility failed to have any documentation in the clinical record regarding the Residents desire to cohabitate with his/her significant other.

Failed to immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the Facility staff failed to immediately notify the physician of a change in the skin condition for 1 Resident (#75) in a total sample of 23 Residents.

Findings include:

Resident #75 was admitted to the Facility in 09/2017 with [DIAGNOSES REDACTED]. Review of the nursing progress notes indicated that on 11/16/17 at 12:34 A.M. the nurse documented that Resident #75 had multiple decubitus on buttocks areas. A late entry written on 11/16/17 at 3:40 P.M. for 11/15/17 at 11:00 A.M. indicated the Resident had 3 open pressure ulcer areas (two stage 2 and one stage 1.) An additional progress note from 11/17/17 indicated the Resident had three open areas with scant drainage.

Review of the Treatment Administration Record (TAR) for 11/2017 indicated the following new orders were implemented on 11/17/17 (2 days after the new open areas were identified): proximal coccyx cleanse with normal saline, pat dry, apply Santyl, follow with dry protective dressing; right coccyx cleanse with normal saline, pat dry, apply Hydrogel and cover with dry protective dressing; and left coccyx cleanse with normal saline, pat dry, apply Hydrogel and cover with dry protective dressing. There was no nursing progress note to correspond with the order.

Unit Manager (UM) #2 was interviewed on 12/06/17 09:46 AM. She said Nurse #1, who identified additional skin areas, should have notified Director of Nurses and the physician on 11/15/17. UM #2 was unsure if the physician was notified on 11/15 as there was no documentation to indicate the physician was notified. UM #2 said she obtained a change in orders from the physician on 11/17/17, when she became aware of the new areas. The Surveyor reviewed the weekly skin care committee meeting minutes. The form indicated a meeting was held on 11/17/17. The form indicated one pressure area for Resident #75 was reviewed.

The Director of Nurses was interviewed on 12/6/17 at 2:45 PM. The DON said she was not notified by Nurse #1 of additional areas on the Resident’s buttocks on 11/15/17.

Failed to develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interviews, and observations, the Facility staff failed to develop and implement an individualized care plan for 1 Resident (#90) out of 23 sampled Residents.

Findings include:

The Facility’s Care Plan Policy, revised 05/2017, indicated that the Facility’s Care Planning/Interdisciplinary Team was responsible for the review and updating of care plans:

a. When there has been a significant change in the resident’s condition
b. When the desired outcome is not met
c. When the resident has been readmitted to the facility from a hospital stay
d. At least quarterly

1. Review of Resident #90’s clinical record indicated he/she was admitted to the Facility in 10/2016 with diagnoses that included recurrent depression for more than [AGE] years, anxiety disorder, and [MEDICAL CONDITION]. Resident #90’s clinical record indicated the Resident had a [DIAGNOSES REDACTED]. Resident #90’s Quarterly Minimum Data Set (MDS) assessment, dated 6/3/17, indicated Resident #90 scored a 6 out of 15 on the Brief Interview for Mental Status (BIMS), which indicated severe cognitive impairment. The MDS Assessment indicated that Resident #90 had a [DIAGNOSES REDACTED].

The Social Services Note, dated 8/22/17, indicated Resident #90 was transferred to the hospital at 9:05 P.M. on 8/22/17 due to the resident-to-resident altercation for a Geri-Psych (Geriatric Psychiatric) evaluation, via a Section 12 order (an emergency restraint and hospitalization of person posing a risk of serious harm by reason of mental illness).

Review of Resident #90’s Client [DIAGNOSES REDACTED].#90 had a [DIAGNOSES REDACTED]. The Hospital Discharge Summary, dated 8/26/17, indicated Resident #90 had a Geri-Psych hospitalized from [DATE] – 8/26/17, he/she presented with aggressive behavior and assault of another resident, and he/she had [MEDICAL CONDITION]. The Nurses’ Progress Note, dated 8/29/17, indicated the Quarterly Interdisciplinary Team (IDT) met on 8/29/17 and reviewed his/her care plans and to continue current prescribed treatment.

Resident #90’s Annual Minimum Data Set (MDS) assessment, dated 8/31/17, indicated Resident #90 scored a 6 out of 15 on the Brief Interview for Mental Status (BIMS), which indicated he/she had severe cognitive impairment. The MDS assessment indicated that Resident #90 exhibited verbal behavioral symptoms directed toward others that occurred 1 to 3 days during the reference period. The MDS Assessment indicated that there was no change in Resident #90’s behavior since the last assessment, and that Resident #90 had a [DIAGNOSES REDACTED].

Review of Resident #90’s Care Plans indicated there was no Care Plan identified that addressed the resident-to-resident altercation on 8/22/17, where Resident #90 hit another resident, who was in Resident #90’s bedroom, on the forehead.

Review of Resident #90’s Care Plans indicated there was no Care Plan identified to address his/her alteration in cognition or cognitive decline or recent dementia diagnosis. Resident #90 had a Geri-Psych admission on 8/22/17, 6 days after he/she had a new [DIAGNOSES REDACTED].

The Surveyor observed Resident #90 at 10:00 A.M. on 11/29/17 and at 2:00 P.M. on 12/7/17, in his/her bedroom, laying on his/her bed, with the Stop Sign dangling on the left side of the door way to Resident #90’s bedroom. The Surveyor observed that the stop sign was not attached to Resident #90’s door, allowing any wandering residents to come into his/her room unsupervised.

The Surveyor interviewed Nurse #2 at 2:00 P.M. on 12/7/17. Nurse #2 said Resident #90 should have the stop sign up across the entrance to his/her room at all times. The Surveyor interviewed the Director of Nurses (DON) at 1:40 P.M. and at 4:25 P.M. on 12/5/17. The DON said Resident #90’s care plan was not in the electronic medical record to address the resident-to-resident altercation. The DON said that there was an intervention for Resident #90 to have a stop sign attached to the entrance of his/her bedroom in order to discourage any wandering residents from entering Resident #90’s bedroom. The DON showed the Surveyor the list of Care Plans for Resident #90 and said that this list was all that she had for care plans for Resident #90. Review of the Resident #90’s care plans that the DON provided the Surveyor indicated there were no care plans to address any interventions for an individualized approach related to Resident #90’s specific behavior of resident-to-resident altercation, his/her alteration in cognition and recent [DIAGNOSES REDACTED].

As of 12/7/17, there were no Care Plans provided to the Surveyor that addressed Resident #90’s alteration in cognition, diagnoses of [MEDICAL CONDITION] disorder with psychotic features and dementia with behavioral disturbance, or Resident #90’s resident-to-resident altercation or his/her subsequent Geri-Psych hospitalization . This was not consistent with the Facility’s Care Plan Policy.

Failed to develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to review and revise the comprehensive care plans for 5 Residents (#2, #8, #15, #36 and #68 ) in a total sample of 23.

Findings include:

The Facility’s Care Plan Policy, revised 05/2017, indicated that the Facility’s Care Planning/Interdisciplinary Team was responsible for the review and updating of care plans:

a. When there has been a significant change in the resident’s condition
b. When the desired outcome is not met
c. When the resident has been readmitted to the facility from a hospital stay
d. At least quarterly

1. For Resident #2 the facility failed to have the Interdisciplinary Discipline Team (IDT) review and revise the comprehensive care plans for this Resident. Resident #2 was admitted to the facility in 4/2017 with [DIAGNOSES REDACTED]. Review of the electronic medical record (EMR) and the paper clinical record indicated that on 5/30/17 the Social Worker met with the Residents Health care Proxy and completed an IDT meeting of the Initial care plans.

Further review indicated that there were no entries within the EMR and clinical paper record indicating that the next review/revise of the care plans or that an IDT meeting had taken place (Usually occurs every 90 days).

2. For Resident #8 the facility failed to have the Interdisciplinary Discipline Team (IDT) review and revise the comprehensive care plans for this Resident. Resident #8 was admitted to the facility in 5/2017 with [DIAGNOSES REDACTED]. Review of the electronic medical record (EMR) and the paper clinical record indicated that on 8/22/17 the Social Worker had an IDT meeting for review of the care plans. Further review indicated that there were no entries within the EMR and clinical paper record indicating that the next review/revise of the care plans or that an IDT meeting had taken place.(Usually occurs every 90 days).

3. For Resident #68 the facility failed to have the Interdisciplinary Discipline Team (IDT) review and revise the comprehensive care plans for this Resident. Resident #68 was admitted to the facility in 10/2014 with [DIAGNOSES REDACTED]. Review of the electronic medical record (EMR) and the paper clinical record indicated that on 8/18/17 the Social Worker met with the Residents Health care Proxy and completed an IDT meeting of the Initial care plans. Further review indicated that there were no entries within the EMR and clinical paper record indicating that the next review/revise of the care plans or that an IDT meeting had taken place.(Usually occurs every 90 days).

4. For Resident #15 the facility failed to have the Interdisciplinary Discipline Team (IDT) review and revise the comprehensive care plans for this Resident. Resident #15 was admitted to the facility in 4/2016 with [DIAGNOSES REDACTED]. Review of the electronic medical record (EMR) and the paper clinical record indicated that for approximately 1 year the care plans or the IDT had not met to review and revise the Residents careplans.

5. Resident #36 was admitted to the Facility in 01/2013 with [DIAGNOSES REDACTED]. Review of the electronic medical record on 12/05/17 at 2:30 PM indicated there was an interdisciplinary team (IDT) care plan meeting held for Resident #36 on 7/13/17. A review of the care plans for the Resident revealed there was a not a date to indicate when each care plan was last reviewed and revised.

Social Worker #1 was interviewed on 12/05/17 at 2:30 PM. The Social Worker said the process of care plan meetings was to review each care plan through the electronic medical record. She said usually in attendance would be the nurse from the unit, social worker, resident/representative. The Social Worker said the current process was to have attendees sign in on paper, where the Social Worker would document disciplines discussed. She said, when she had time, she would enter a note in the electronic system indicating a meeting was held. Social Worker #1 said that after the documentation was put in to the electronic medical record she would shred the sign-in sheet. The Social Worker said she would have to review her paper files to determine the last IDT meeting held following the quarterly assessment on 09/17/17, for Resident #36 as there was no documentation in the electronic medical record.

Social Worker #1 was interviewed again on 12/05/17 at 2:51 PM. She said she was unable to locate documentation that an IDT meeting was held following the most recent quarterly assessment. The Social Worker was unable to provide information as to who attended or what was discussed at the most recent quarterly meeting for Resident #36. The Social Worker said she did not know where it would be documented in the electronic medical record that the care plan was revised and reviewed. Social Worker #1 and Social Worker #2 were interviewed on 12/07/17 at 10:00 A.M. They said they were unable to locate any documentation that an IDT meeting was held following the most recent quarterly assessment. The Social Workers were unable to provide information as to who attended or what was discussed at the most recent quarterly meeting for the above Residents (#2, #8, #15, #36 and #6)

Failed to provide timely, quality laboratory services/tests to meet the needs of residents.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Record review and interview, the Facility staff failed to obtain laboratory services as ordered by the physician for 1 Resident (#70) out of 23 sampled Residents.

Findings include:

Resident #70 was admitted to the Facility in 04/2016 with [DIAGNOSES REDACTED]. A review of the medical record for Resident #70 indicated a physicians telephone order was written on 11/27/17 for a urinalysis. At this time, the Surveyor was unable to locate documentation in the medical record of results of the urinalysis. Unit Manager #2 contacted the lab and said the lab did not have results on file. The Surveyor and Unit Manager #2 reviewed the Treatment Administration Record (TAR) for 11/2017 and there was no order transcribed to indicate a urine sample should be obtained for Resident #70. An interview was conducted with Unit Manager #2 on 12/5/17 at 11:00 AM. Unit Manager #2 said the original order for a urinalysis was obtained due to a change in behaviors for Resident #70. Unit Manager #2 said she spoke with the physician who indicated the urine sample should be obtained and it was obtained on 12/4/17.

Failed to safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility staff failed to maintain clinical records on each Resident in accordance with accepted professional standards that were complete and accurate for 2 sampled Residents (#12 and #75) in a total sample of 23.

Findings include:

1. For Resident #12 the facility failed to document a physician’s orders [REDACTED]. Resident #12 was admitted to the facility in 10/2016 with [DIAGNOSES REDACTED]. Clinical record review indicated the Resident was sent to the emergency roiagnom on [DATE].

Further clinical record review indicated that the nurse had not transcribed an order for [REDACTED]. On 12/6/17 at approximately 9:00 A.M. Unit Manager #1 was made aware that there had not been an order to send the Resident to the emergency room .

2. For Resident #75 the facility staff failed to document treatments of a wound in 11/2017. Resident #75 was admitted to the Facility in 09/2017 with [DIAGNOSES REDACTED]. A record review of the treatment sheets for 11/2017 indicated a treatment for [REDACTED]. The treatment order was to cleanse the coccyx area with normal saline followed by Hydrogel, cover with coversite daily and as needed. This treatment was not signed off as provided on the following dates: 11/07, 11/08, 11/09, 11/11, 11/12, 11/13, 11/14, 11/15,11/16 and 11/17/17. On 11/17/17, the order was discontinued by the physician and a new order was implemented.

Unit Manager #2 was interviewed on 12/6/17 at 9:45 A.M. The Unit Manager was unsure why the nurses providing the treatment had not documented in the medical record that the treatment was completed.

Brandon Woods of Dartmouth , Nursing Home Neglect and Elder Abuse Lawyers

If someone you love has suffered neglect or elder abuse by a senior caregiver, nursing home, or other care facility, our lawyers may be able to help. Regardless of whether or not criminal charges are filed against an alleged abuser, you may still be able to pursue compensation in a civil claim. Compensation in elder abuse cases may be awarded if someone in the care of another suffers harm due to intentional or negligent actions (including failure to take action).

Abuse of the elderly is not acceptable and we fight hard in these types of cases. If you suspect a nursing home or caregiver has caused harm to your loved one in someone elses’ care, contact our law firm today for a free legal consultation. Talking to us does not obligate you to anything, but we may be able to tell you if you have a claim and the value of your case. If we accept your case, you pay no fee unless we recover for you.

Oftentimes, victims of abuse either cannot or will not speak up for themselves out of fear. If you notice any warning signs or symptoms of neglect of abuse an an elderly person, it is important you contact an elder abuse lawyer immediately. Not only are there statute of limitations on filing a claim, but the sooner we start helping you, the easier it will be to collect evidence and talk to any witnesses before important details are lost, hidden, or forgotten.

Boston Personal Injury Lawyers for Elder Abuse Cases

We offer a free, no-obligation legal consultation to help you understand your rights and the value of your case. Our personal injury law firm takes cases involving elder abuse and neglect. We offer legal service to clients in Massachusetts, Rhode Island and New Hampshire.


Sources:

Medicare Nursing Home Profiles and Reports – Brandon Woods of Dartmouth

Inspection Report for Brandon Woods of Dartmouth –08/16/2016

Inspection Report for Brandon Woods of Dartmouth – 12/07/2017

Page Last Updated: April 17, 2018