Brush Hill Care Center

Brush Hill Care Center

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Brush Hill Care Center? 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 Brush Hill Care Center

Brush Hill Care Center Brush Hill Care Center is a for profit, 160-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of Milton, Quincy, Braintree, Dedham, Randolph, Canton, Brookline,  Holbrook, Norwood, Weymouth, Westwood, Stoughton, Boston, Needham, Cambridge, , and the other towns in and surrounding Norfolk County, Massachusetts.

Brush Hill Care Center focuses on 24 hour care, respite care, hospice care and rehabilitation services.

Brush Hill Care Center
1200 Brush Hill Rd,
Milton, MA 02186

Phone: (617) 333-0600
Website: http://brushhillcarecenter.com/

CMS Star Quality Rating

The 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 2017, Brush Hill Care Center in Milton, Massachusetts received a rating of 1 out of 5 stars.

Performance Area Rating
Overall Rating 1 out of 5 (Much below average)
State Health Inspections 1 out of 5 (Much below average)
Staffing 3 out of 5 (Average)
Quality Measures 4 out of 5 (Above average)

Fines and Penalties

Our Nursing Home Abuse Lawyers inspected government records and discovered Brush Hill Care Center committed the following offenses:

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 staff failed to ensure that the rights of the Resident were exercised by the court appointed guardian for 1 Resident (#17) of 24 sampled residents.

Findings include:

Resident #17 was admitted to the Facility with [DIAGNOSES REDACTED]. Resident #17 had a court appointed guardian with a Roger’s monitor in place. Clinical record review on 2/14/17 indicated that Resident #17 had a physician’s orders [REDACTED]. There was no documented evidence in the clinical record that consent for the administration of this antipsychotic medication had been obtained from the Resident’s legal guardian.

On 2/14/17 at 1:45 P.M. the Director of Nursing was informed by the Surveyor that there was no consent available in the clinical record for the antipsychotic medication [MEDICATION NAME]. At 4:00 P.M. the DON informed the Surveyor she was unable to find a consent from the guardian for this medication.

Failed to tell the resident completely about his or her health status, care and treatments.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on record review, staff interview and observation, the facility failed to ensure that 4 residents, (#3, #10, #11, and #12) of 24 sampled residents, were informed in advance of changes to the medical plan of care.

Findings include:

Resident #3 had [DIAGNOSES REDACTED]. According to the quarterly minimum data set (MDS) with a reference date of 11/4/16 this resident was alert and oriented requiring extensive assistance for hygiene, bathing and dressing. This resident was receiving the antidepressant, [MEDICATION NAME] 40 milligrams (mg) daily. The psychiatric service nurse practitioner (NP) visited the resident on 10/19/15. Documentation from that visit indicated that the resident was to be trialed on [MEDICATION NAME] 20 mg at HS (hour of sleep) for [MEDICAL CONDITION] and to assist with mild OCD ([MEDICAL CONDITION]) symptoms which included scratching. A physician’s orders [REDACTED]. There was no consent form signed by the resident and no documentation in the clinical record to indicate this new medication was discussed with the resident.

Resident #11 was admitted to the facility status [REDACTED]. The admission Minimum Data Set was in process. The Resident is documented as being alert and oriented. Review of the clinical record on 2/7/17 indicated the Resident had a physician’s orders [REDACTED]. There was no documented evidence in the clinical record that Resident #11 had given consent to receive [MEDICATION NAME]. The DON was informed at 4:00 P.M. on 2/14/17 that there was no signed consent from the Resident to receive [MEDICATION NAME].

Resident #10 was admitted to the facility in 8/2016 with [DIAGNOSES REDACTED]. The Quarterly Minimum Data Set, signed as completed on 11/18/16, documents the Resident as scoring a 12 out of 15 on the Brief Interview of Mental Status (BIMS) indicating mild cognitive deficit. Review of Resident #10’s clinical record indicated that the Resident had an order for [REDACTED]. Review of Resident #10’s clinical record indicated that there was no documented evidence that Resident #10 had given consent to receive the [MEDICATION NAME] or [MEDICATION NAME].

Resident #12 was admitted to the facility in 4/2016 with [DIAGNOSES REDACTED]. Review of the Quarterly Minimum Data Set, dated dated [DATE] documented that the Resident scored an 11 out of 15 on the BIMS, indicating mild cognitive deficit. The Resident is documented as being his/her own decision maker. Review of Resident #12’s clinical record indicated that the Resident had a physician’s orders [REDACTED]. The [MEDICATION NAME] and [MEDICATION NAME] orders were dated as written by the physician on 4/5/16. Review of Resident #12’s clinical record indicated that there was no documented evidence that Resident #12 had given consent to receive either the [MEDICATION NAME] or [MEDICATION NAME].

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

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on interviews and record review the Facility staff failed to notify the physician of a recommendation from the consultant pharmacist for 1 Resident (#14) of a total sample of 24 Residents.

Findings include:

Resident #14 was a admitted to the Facility for short term rehabilitation in 1/2017 with [DIAGNOSES REDACTED].>A review of the physician orders [REDACTED].#14 included the following medications: [REDACTED] -[MEDICATION NAME]-[MEDICATION NAME] Aerosol Solution 20-100 mcg (microgram)/act: 1 puff inhale orally every 6 hours as needed

  • -Atorvastatin Calcium tablet 20 mg (milligrams): give one tablet daily
  • -[MEDICATION NAME] ([MEDICATION NAME]) tablet 10 mg: give 1 tablet by mouth daily
  • -[MEDICATION NAME] ([MEDICATION NAME]) capsule 100 mg: give 1 capsule by mouth two times per day

A review of the medical record indicated a recommendation was written by the consultant pharmacist on 1/30/17 with a note indicating medications were listed twice in the electronic Medication Administration Record (eMAR), the detailed recommendation was not found in the medical record. On 2/08/17 at 12:00 P.M., Nurse #1 was unable to locate the recommendation and contacted the Assistant Director of Nursing (ADON).

A copy of the pharmacist recommendation was obtained; which stated The following general observations were made from my review and recommendations for improvement: Atorvastatin appears twice on the eMAR; [MEDICATION NAME] and [MEDICATION NAME] are on the eMAR; [MEDICATION NAME] and [MEDICATION NAME] are on the eMAR; PRN [MEDICATION NAME] appear twice on the eMAR.

During an interview with the ADON on 2/08/17 at 1:00 P.M. he stated he had not previously seen or reviewed the recommendation from the pharmacy consultant until it was requested by the Surveyor. He confirmed there were duplicate orders on the eMAR and was unable to determine that duplicate medications were not given to Resident #14. He confirmed the physician had not been notified of the recommendation.

Failed to allow residents to easily view the results of the nursing home's most recent survey.

Based on observation and staff interviews, the Facility staff failed to ensure the results of the Facility’s most recent survey and any complaint investigation survey results conducted by Federal or State Surveyors and any plan of corrections in effect were readily available and accessible for examination in a readable format.

Findings include:

For all days of survey 2/7/14 to 2/14/17, the survey results were not available for examination and there was no posting stating how one could access the survey results for examination as required.

Observations included the following: Tour of all four nursing units and the facility entrance lobby failed to indicate survey results were available or postings of how to access the survey results. The Surveyor interviewed the facility receptionist and Human Resource Director at 3:00 P.M. on 2/14/17. The facility receptionist and Human Resource Director said the survey results and sign were not located where they should be in the facility lobby. The Surveyor interviewed the Administrator at 3:15 P.M. on 2/14/17. The Administrator said the survey results were not posted where they should be in the lobby.

The Facility failed to post a notice where to locate the survey inspection report results for examination survey results were not accessible without having to ask a staff member to see the survey inspection reports. During an interview with the Administrator on 02/14/17 at 4:00 P.M., the Administrator stated he was unaware of the update to the regulation in 11/2016 for the Facility to provide access and post how to obtain access for 3 years of survey results.

Failed to provide housekeeping and maintenance services.

Based on observation and staff interview, the facility failed to provide housekeeping and maintenance services to maintain a sanitary and orderly environment.

Findings include:

The following were observed through out the survey dates from 2/7/17 through 2/14/17: -Room 310 was observed to have two windows, one window had a pull shade that was falling and was halfway down the window.

Room 204 was observed with two overbed tables that had gouges around the edges and the vinyl surrounding each table top was missing exposing the particle board. The top of the table was warped and appeared rippled leaving it uneven. The floor near the bottom of the first bed had multiple small holes in 10 of the approximate 10 inch squares. The four drawer dresser had two handles broken and one missing. The closet door was off the track on the floor allowing it to be easily pushed in. The wall across from the first bed had gouges several feet long at approximately 3.5 feet high.

The television room on the unit 3A had two windows, one window did not have a pull shade.

The dining room on unit 2B had water marks that went from the ceiling (approximately 10 feet tall) to the chair rail (approximately 2.5 feet from the floor) on one wall. The water marks smudged the paint on the wall.

The pub lounge on the 1st floor had four tables, each table had bubbling on the top, making the surface of the table warped.

Provide doctors orders for the resident's immediate care, at the time the resident was admitted.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on interview and record review the Facility staff failed to obtain accurate physician orders [REDACTED].#22) out of a sample of 24 Residents.

Findings include:

Review of the closed medical record indicated Resident #22 was discharged to the hospital from the Facility on 2/04/17, upon his/her request. Review of the hospital History and Physical (H&P) dated 1/28/17, six days prior to admission, indicated the Resident had a suprapubic catheter and a [MEDICAL CONDITION]. The medical record indicated the hospital H&P was utilized for review of the Residents’ medications and treatments upon admission to the Facility as check marks were observed on the H&P next to each medication. The H&P indicated the Resident was to start on an IV (intravenous) antibiotic ([MEDICATION NAME] 4.5 grams) every eight hours. There was no hospital discharge summary available at the time of record review on 2/14/17. There was no indication of when the Resident last received medication doses or care and treatment of [REDACTED].

A record review included the Admission/Readmission Data Collection completed upon admission to the facility by a nurse. Section M of the Data Collection indicated Resident #22 had a Peripherally Inserted Central Catheter (PICC) line in his/her left arm. Review of the paper MAR for 2/2017 had no documentation regarding physician’s orders [REDACTED]. The Nurse wrote that all orders were verified by the nursing supervisor, transcribed and faxed to the pharmacy. There was no documentation that the physician was notified and reconciled the medications.

An interview was conducted with the ADON on 2/14/17 at 2:50 P.M. The ADON reviewed the medical record for Resident #22 and stated there should have been documentation in regards to the PICC including but not limited to placement, orders to flush the line, orders to administer antibiotic medication through the PICC. The ADON confirmed a Discharge Summary from South Shore Hospital was not included in the medical record and confirmed that the Facility staff should have contacted the hospital to obtain the Discharge Summary.

Failed make sure services provided by the nursing facility meet professional standards of quality.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on record review and staff interviews, the Facility staff failed to ensure services were provided that met professional standards of quality for administration of medications and treatments for 18 Residents (#1, #2, #3, #6, #7, #8, #9, #10, #12, #13, #14, #15, #16, #17, #18, #19, #20 and #21) out of 24 sampled Residents.

Findings include:

Standard reference: Standard of Practice Reference: Pursuant to Massachusetts General Law (M.G.L.), chapter 112, individuals are given the designation of registered nurse and practical nurse which includes the responsibility to provide nursing care. Pursuant to the Code of Massachusetts Regulation (CMR) 244, Rules and Regulations 3.02 and 3.04 define the responsibilities and functions of a registered nurse and Practical nurse respectively. The regulations stipulate that both the registered nurse and practical nurse bear full responsibility for systematically assessing health status and recording the related health data. They also stipulate that both the registered nurse and practical nurse incorporate into the plan of care, and implement prescribed medical regimens. The rules and regulations 9.03 define standards of Conduct for Nurses where it is stipulated that a nurse licensed by the Board shall engage in the practice of nursing in accordance with accepted standards of practice. A review of medication and treatment administration records (MAR and TAR) for 16 Residents in a total sample of 24 Residents (#2, #3, #6, #7, #8, #9, #10, #12, #13, #14, #16, #17, #18, #19, #20 and #21) revealed there was no documentation of administration of medications or treatments from 1/01/17 through 1/15/17.

Failed to give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on observation, record review, and staff interviews, the Facility staff failed to ensure proper care and appropriate treatment and services were provided for enteral feeding with a gastrostomy tube (tube inserted through the abdomen that delivers nutrition directly to the stomach: G- tube), for 3 Residents (#2, #13 and #16) out of a total sample of 24 Residents.

Findings include:

Review of the facility policy, Confirming Placement of Feeding Tubes, dated September 2003, indicated that 1) verify that there is a physician’s order for the procedure, 2) review the resident’s care plan and provide for any special needs of the resident, 3) assemble equipment and supplies, 4) attach fifty to sixty cubic centimeter (cc) syringe with ten cc of air to the end of the tube, 5) place stethoscope 2 to 3 inches below the xyphoid (lower part of the sternum) process, 6) forcefully inject ten cc of air into tube while listening to the abdomen with stethoscope for whooshing sound, verification of placement of tube is complete when whooshing sound is heard.

The facility policy indicated that the person performing this procedure should record the following information in the Resident’s medical record: 1) the date and time the procedure was performed 2) the name and title of the individual who performed the procedure 3) all assessment data obtained during the procedure 4) how the Resident tolerated the procedure 5) if the Resident refused the procedure, the reason why and the intervention taken 6) the signature and title of the person recording the data.

Failed to properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on record review and staff interviews, the Facility staff failed to ensure the proper care and treatment of [REDACTED].#2 and #22) out of a total sample of 24 residents.

Findings include:

Resident #2 was admitted to the Facility in 11/2016 with [DIAGNOSES REDACTED]. Resident #2 was admitted to the hospital in 1/2017 and 2/2017. Review of Resident #2’s clinical record indicated that the Resident was transferred to the hospital on [DATE] and admitted to the intensive care unit. Review of the hospital discharge summary dated 2/2/17, indicated that the Resident was to be discharged to the facility with a PICC line to complete his/her course of IV (intravenous) antibiotics.

Review of Resident #2’s nurse’s note dated 2/3/17 indicated that the Resident was readmitted to the facility and all medications were verified and approved (the note did not say with whom the orders were confirmed) including an order for [REDACTED]. Review of Resident #2’s nurse’s note dated 2/3/17 did not include documentation regarding baseline information pertaining to the PICC line. There was no documentation indicating the date the PICC was inserted, the location of the PICC, the total internal/external catheter length, arm circumstance, base measurement of the catheter, or physician’s orders [REDACTED].

Resident #22 was admitted to the Facility in 2/2017 with a [DIAGNOSES REDACTED]. Review of the medical record indicated Resident #22 was discharged from the Facility on 2/04/17, upon his/her request. The medical record indicated a hospital History and Physical was utilized for review of the Residents’ medications and treatments upon admission to the Facility. There was no hospital discharge summary available at the time of record review on 2/14/17. The History and Physical was written by the physician at South Shore Hospital six days prior to the admission of Resident #22 to the Facility. The History and Physical indicated the Resident was to start on an IV antibiotic ([MEDICATION NAME] 4.5 grams) every eight hours.

A record review included the Admission/Readmission Data Collection completed upon admission to the facility by a nurse. Section M of the Data Collection indicated Resident #22 had a PICC line in his/her left arm. Review of the paper MAR for 2/2017 had no documentation regarding physician’s orders [REDACTED].

Failed to prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.

Based on interviews, observations and test tray results, the Facility staff failed to ensure that food was palatable and at appetizing temperatures for two of three test trays.

Findings include:

A group interview was conducted with residents on 2/08/17 at 2:00 P.M. The residents complained that the food was always late and cold. Breakfast was consistently served late.

Failed to make sure that special or therapeutic diets are ordered by the attending doctor.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on observations, interviews and record review the Facility staff failed to ensure 2 Residents (#14 and #19) out of a total sample of 24 Residents received a therapeutic, physicians ordered diet.

Findings include:

Resident #14 was admitted to the Facility in 1/2017 with [DIAGNOSES REDACTED]. A review of the medical record, conducted on 2/08/17, indicated Resident #14 was admitted on a ground diet with thin liquids and weighed 86 lbs (pounds). The Registered Dietician completed an Initial Nutrition Evaluation on 1/20/17 with recommendations to add super cereal at breakfast and super pudding at lunch and dinner. A Dietician Recommendation form was written and signed by a Nurse. An additional Dietician Recommendation written on 1/31/17 indicated the Resident requested large portions and was signed by a nurse. The physicians order for diet was reviewed on 2/08/17, which indicated Resident #14 was to receive ground meats, thin liquids and double portions. There was no indication the super cereal or super pudding had been added to the physicians order. The Nutrition Care Plan written on 1/20/17 indicated goals of consuming 75% of each meal and minimizing weight loss through interventions of monitoring nutrition intake.

Resident #19 was a long term care resident admitted in 11/2008 with [DIAGNOSES REDACTED]. A review of the medical record, conducted on 2/10/17, indicated Resident #19 was on a regular diet. A Nutrition Review by the Registered Dietician was completed on 11/1/16 which indicated Resident #19 had a weight loss of 9% over six months and a recommendation was made for magic cup (high caloric ice cream) at lunch and dinner and to change the daily nutritional supplement from ensure twice per day to mighty shake three times per day. The Registered Dietician wrote an interim progress note on 1/10/17 indicating the Resident currently had low weight and to add double portions to increase intake and that the Resident was in agreement. An additional Nutritional Review was conducted on 1/26/17 with a recommendation to add a nutritional supplement (medpass) twice per day. The physicians order for diet was reviewed on 2/10/17, which indicated Resident #19 was to receive a regular diet, there was no indication for double/large portions or magic cup at lunch and dinner. An interim physicians order written on 11/08/16 indicated that the ensure was to be discontinued and the mighty shake was to be started three times per day. The paper MAR for the month of December indicated that the ensure had been discontinued as ordered, but the mighty shake had not been ordered. The Nutrition Care Plan updated 11/01/16 indicated goals of consuming 75% of each meal and will have no further weight loss through interventions of monitoring nutrition intake and magic cup at lunch and dinner.

Failed to maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards.

Based on document review and staff interview the Facility staff failed to ensure the safe and secure storage of medications, failed to maintain an accurate record of receipt of controlled drugs, and failed to maintain medical equipment in accordance with manufacturer’s guidelines.

Findings include:

On 2/14/17 at 2:50 P.M. an inspection of the Unit 1 A medication room was conducted with Nurse #1. As part of the inspection, the facility emergency narcotic kit and documentation was reviewed. The emergency narcotic kit for the facility was kept in the locked narcotic drawer in a medication cart on Unit 1. Review of the controlled substance log indicated that the emergency narcotic kit had not been logged in. There was no documentation of the date the narcotic kit was received or the names of nursing staff that received the kit. Nurse #1 was unable to explain why the narcotic kit had not been logged into the controlled substance log. The Director of Nursing (DON) was called to the unit and also was unable to explain why the emergency narcotic kit had not been signed into the controlled substance log. The DON said it was Facility policy for the emergency narcotic kit to be signed in by two nurses.

Failed to give or get quality lab services/tests in a timely manner to meet the needs of residents.

Based on record review, staff interview and observation, the Facility staff failed to ensure the for 1 Resident (#18) of 24 sampled residents, laboratory services were provided as ordered by the physician.

Findings include:

Resident #18 had [DIAGNOSES REDACTED]. According to the quarterly minimum data set (MDS)with a reference date of 1/4/17, this resident was alert and oriented requiring assistance for bathing, grooming and dressing.

Failed to keep accurate, complete and organized clinical records on each resident that meet professional standards

Based on interviews the Facility staff failed to maintain clinical records that were complete and readily accessible, for all Residents in the Facility who were admitted prior to 7/01/16.

Findings include:

The Administrator and Director of Nursing were interviewed on 2/14/17 at 12:00 P.M. The Director of Nursing stated the previous electronic medication administration system was discontinued as the Facility’s application as of 6/30/16. The Director of Nursing stated that the company previously used, discontinued access for the Facility staff and they were unable to retrieve any electronic Medication Administration Records or electronic Treatment Administration Records for all Residents who were admitted prior to that date.

Failure to tell the resident completely about his or her health status, care and treatments.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on records reviewed and interviews, for 2 of 3 sampled residents (Resident #1 and Resident #3), the Facility failed to obtain consent for the provision of behavioral health services.

Findings include:

The Facility’s Psych Services Policy indicated that: For residents who are appropriate and require Psych services a written consent will be obtained by Psych service from the resident or the responsible party. A verbal consent can be obtained for services to initiate treatment and prevent a delay of (sic) needed treatment for [REDACTED].

The Tracking Sheet for the Facility’s behavioral health provider indicated that Resident #1 was first seen for service on 04/11/16, and had been seen a total of 10 times between that date and the date of survey. The sheet did not indicate that a signed consent form for services was in place.

The Tracking Sheet for the Facility’s behavioral health provider indicated that Resident #3 was first seen for service in September 2015, and had been seen a total of 7 times between that date and the date of survey. The sheet indicated that a signed consent form was in place.

Maintain 15 months of resident assessments in the resident's active clinical record.

Based on records reviewed and interviews, for 3 of 3 sampled residents (Resident #1, Resident #2 and Resident #3), the Facility failed to ensure that the most recent Minimum Data Sets (MDSs) were available in the residents’ clinical records.

Findings include:

The Surveyor interviewed the Administrator at multiple times on 09/09/16. The Administrator said the Facility did not use either full or partial electronic medical records, that residents’ clinical records remained on paper.

Resident #1 was admitted in April 2016. Resident #1’s clinical record did not include any completed MDSs.

Resident #2 was admitted in July 2015. Resident #2’s clinical record did not include the MDS completed on 08/10/16.

Resident #3 was admitted in September 2013. Resident #3’s clinical record did not include the MDS completed on 08/05/16.

The Surveyor interviewed the MDS Coordinator at 1:29 P.M. on 09/09/16. The MDS Coordinator said MDSs were not kept in the the residents’ clinical records, that she would need to access the computerized MDS system to print out any assessments the Surveyor wanted to review.

Failed to make sure that doctors visit residents regularly, as required.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on records reviewed and interviews, for one of 3 sampled residents (Resident #1), the Facility failed to ensure that Resident #1 received physician visits at least once every 30 days for the first 90 days after his/her admission, and at least once every 60 days thereafter. The Facility also failed, for 1 of 3 sampled residents (Resident #1), to ensure that the physician completed an initial history and physical (H&P) assessment in a timely manner

Findings include:

Review of Resident #1’s Physician’s Progress Notes indicated that his/her first physician visit at the Facility occurred on 04/12/16, 11 days after admission. The progress notes indicated that the next physician visit occurred on 08/27/16, 107 days after Resident #1’s admission to the Facility.

Failed to make sure that all needed doctor visits are made personally by a doctor, as required.

After initial doctor visit, care may be alternated by a physician assistant (PA) or nurse practitioner (NP).

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on records reviewed and interviews, for one of 3 sampled residents (Resident #1), the Facility failed to ensure that alternating required visits were made by the physician.

Findings include:

The Assistant Director of Nurses (ADON) provided the Surveyor with copies of physician and nurse practitioner (NP) notes for Resident #1 that were faxed to the Facility from the physician’s office. Review of the physician and NP notes provided by the ADON indicated that the physician’s initial visit for Resident #1 was on 04/12/16, 11 days after his/her admission to the Facility, and the next physician visit occurred on 08/27/16, 107 days after his/her admission to the Facility. The notes indicated that the NP visited Resident #1 a total of 6 times between those two physician visits. The Surveyor interviewed the ADON at multiple times on 09/09/16. The ADON said the physician’s office faxed over all of the notes they said they had regarding Resident #1. There was no documentation that the physician alternated visits to Resident #1 with the NP.

Failed to keep accurate, complete and organized clinical records on each resident that meet professional standards.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on records reviewed and interviews, for one of 3 sampled residents (Resident #3), the Facility failed to ensure the accuracy of nursing assessments. The Facility also failed, for one of 3 sampled residents (Resident #1), to ensure that Resident #1’s clinical record included documentation of the most recent physician and/or nurse practitioner (NP) visits.

Findings include:

Resident #3’s clinical record indicated that the Health Care Proxy was invoked in September 2013 due to dementia, and that his/her [DIAGNOSES REDACTED]. – The Quarterly Minimum Data Set (MDS), dated [DATE], indicated that Resident #3 was always incontinent of bowel and bladder (having little or no control over bowel movements or urination).

Brush Hill Care Center, 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:

Page Last Updated: November 18, 2017

Call Now Button