Worcester Health Center

Worcester Health Center

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Worcester Health 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 Worcester Health Center

Worcester Health Center is a for profit, 160-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of Worcester, Shrewsbury, Holden, Leicester, Millbury, Grafton, Northborough, Westborough, Sutton, Spencer, Clinton, Northbridge, Oxford, Marlborough, Hudson, and the other towns in and surrounding Worcester County, Massachusetts.

Worcester Health Center
25 Oriol Dr,
Worcester, MA 01605

Phone: (508) 852-3330
Website: http://worcesterhc.com

CMS Star Quality Rating

Worcester Health CenterThe 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, Worcester Health Center in 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 Against Worcester Health Center

The Federal Government fined Worcester Health Center $3,941 on 10/19/2016 and $54,846 on 08/01/2017 for health and safety violations.

Fines and Penalties

Our Nursing Home Accident Lawyers inspected government records and discovered Worcester Health Center committed the following offenses:

 

Failed to Let the resident refuse treatment or refuse to take part in an experiment and formulate advance directives.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility staff failed to implement the Advanced Directives for 1 Resident (#9) out of a total sample of 24 residents.

Findings include:

Resident #9 was admitted to the facility in 4/2017 with a [DIAGNOSES REDACTED]. Review of the Massachusetts Medical Orders for Life-Sustaining Treatment (MOLST) form, dated 4/25/17, indicated the resident wanted to be resuscitated and intubated (breathing tube) in the event of a cardiac or respiratory arrest.

Review of the admission Minimum Data Set assessment, dated 4/28/17, indicated the resident was cognitively intact with a Brief Interview for Mental Status score of 14 out of 15. Review of the 5/2017 physician’s orders [REDACTED].

During an interview on 6/1/17 at 1:20 P.M., Unit Manager (UM) #2 said the MOLST and the physician’s orders [REDACTED]. During an interview on 6/1/17 at 1:50 P.M., UM #2 said she talked to the resident and the resident wanted to be a full code, she said the order would be clarified.

Failed to provide care by qualified persons according to each resident's written plan of care.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility staff failed to follow the plan of care and/or Physician orders [REDACTED].#8 and #11) out of a total sample of 24 residents.

Findings include:

1. For Resident #11, the facility staff failed to follow the plan of care for a positioning device and failed to follow the physician’s orders [REDACTED]. Resident #11 was admitted to the facility in 6/2016 with [DIAGNOSES REDACTED]. A. Review of an Occupational Therapy (OT) evaluation and plan of treatment, dated 10/12/16, indicated Resident #11 was seen by OT to improve his/her eating skills. Review of a Functional Maintenance Program (FMP), dated 12/15/16, indicated the resident needed a neck pillow during meal time. The roll part of the pillow should be placed behind his/her neck. The instructions indicated to position the resident upright with the neck support pillow when feeding.

Review of the Annual Minimum Data Set (MDS) Assessment, dated 5/22/17, indicated the resident had severe cognitive loss as evidenced by a score of 3 out of 15 on the Brief Interview of Mental Status (BIMS) and was dependent for all activities of daily living. On 6/1/17 at 9:15 A.M. the surveyor observed Resident #11 in bed, being fed breakfast by Certified Nurses Aide (CNA) #1. The head of the bed was elevated but there was no neck pillow behind the resident’s neck. The surveyor observed the neck pillow was located on top of the resident’s bureau.

On 6/1/17 at 12:50 P.M. the surveyor observed Resident #11 in the day room seated in a recliner being fed lunch by CNA #2. The recliner was in an upright position but there was no neck pillow behind the resident’s neck. On 6/1/17 at 12:52 P.M. during an interview the surveyor asked CNA #2 if the resident used any special positioning devices while being fed. He said, No. The surveyor then asked if he knew anything about a neck pillow that Resident #11 should be using while eating and again he said he was not aware of any pillow.

On 6/1/17 at 1:00 P.M. during interview with Unit Manger (UM) #3, she said the resident should use the neck pillow whenever he/she eats. The surveyor then asked how the CNAs were made aware of special devices the resident required. UM #3 said after the FMP was set up by therapy, all staff were supposed to sign the FMP education form. The information was to be transferred to the CNA Kardex and care plan. UM #3 said the information was never transferred to the Kardex or care plan.

B. For Resident #11, the facility staff failed to follow the physician’s orders [REDACTED]. Review of the physician’s orders [REDACTED]. Review of the Treatment Administration Record (TAR), dated 5/2017, indicated that nurses initialed the TAR every shift for the entire month which indicated they checked that the air mattress was in place and functioned. On 6/1/17 at 1:15 P.M. during an observation and interview with Unit UM #3 she observed the resident’s bed and said that there was no air mattress in place. UM #3 then looked at the resident’s TAR, dated 5/2017, and saw that the nurses initialed the TAR the entire month which indicated the air mattress was in place and functioned. She said that it was a big problem that the nurses signed off the TAR when the mattress was not in place.

2. For Resident #8, the facility staff failed to follow the physician’s orders [REDACTED]. Resident #8 was admitted to the facility in 9/2014 with [DIAGNOSES REDACTED]. Review of the quarterly MDS Assessment, dated 5/1/17, indicated the resident’s weight was 123 pounds. Review of the user manual for the alternating pressure and low air mattress system indicated the settings on the dial corresponded to the weight of the resident and static or alternating pressure modes. Further review of the manual indicated the low pressure light warns when the mattress pressure is below the user defined level. Review of the physician’s orders [REDACTED]. During an observation on 6/1/17 at 3:15 P.M., the air mattress was set at 320 pounds (referring to resident weight) and locked on static with the low pressure indicator light illuminated. The resident was in the bed. During an observation on 6/2/17 at 9:00 A.M., the air mattress was set at 320 pounds and locked on static with the low pressure indicator light illuminated. The resident was in the bed.

During an interview on 6/2/17 at 1:44 P.M., UM #1 changed the air mattress setting from 320 pounds to a setting between 120 and 150 pounds. She said it should have been set according to the resident’s weight, and his/her weight was around 127 pounds. She said the settings also indicated the mattress was locked on static and the low pressure indicator light was on. When UM #1 reviewed the physician’s orders [REDACTED]. She said the mmHg range specified in the order was not an available setting on the mattress control box. She said a special formula would need to be calculated to determine the weight equivalent of 10-15 mmHg.

Failed to provide necessary care and services to maintain the highest well being of each resident.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility staff failed to ensure that 1 Resident (#14) out of a total sample of 24 residents, received [MEDICAL TREATMENT] services consistent with professional standards of practice.

Findings include:

Resident #14 was admitted to the facility in 4/2015 with a [DIAGNOSES REDACTED]. Review of the facility’s policy for Care of a Resident with [MEDICAL CONDITION], with a revision date of 9/2010, indicated the following:

-Residents with [MEDICAL CONDITION] will be cared for according to currently recognized standards of care.

-Education and training of staff includes, specifically: .timing and administration of medications, particularly those before and after [MEDICAL TREATMENT].

Review of the quarterly Minimum Data Set assessment, dated 5/8/17, indicated the resident was cognitively intact with a Brief Interview for Mental Status score of 15 out of 15.

During initial tour of the unit on 5/31/17 with Unit Manager #2, she said Resident #14 goes out to [MEDICAL TREATMENT] three times a week and gets picked up between 5:30 and 6:00 A.M. Review of the 5/2017 signed Physician’s orders indicated the following:

-[MEDICATION NAME] ([MEDICAL CONDITION]) 500 milligrams (mg) every day at 8:00 A.M.
-Carvedilol (blood pressure) 3.125 mg twice a day at 9:00 A.M. and 9:00 P.M., hold for systolic blood pressure less than 90 and or heart rate less than 50.
-Calcium Acetate 1334 mg twice a day at 8:00 A.M. and 5:00 P.M.
-Artificial Tears one drop to both eyes twice a day at 9:00 A.M. and 9:00 P.M.
-Finger Stick Blood Sugar three times daily with Humalog insulin sliding scale coverage as indicated. -Resident attends [MEDICAL TREATMENT] on Tuesday, Thursday, and Saturday (time was not specified).

Further review indicated there was no Physician’s order for the resident to take the medications with him/her to [MEDICAL TREATMENT], nor was there an order to give the scheduled morning medications at a different time on [MEDICAL TREATMENT] days. Review of the 5/2017 Medication Administration Record [REDACTED]. During an interview on 6/1/17 at 1:20 P.M., Nurse #1 said that within the last 3 weeks the resident had been getting picked up at 5:30 A.M. to go to [MEDICAL TREATMENT]. He said the 8:00 A.M. and 9:00 A.M. medications were signed off by the 11:00 P.M.-7:00 A.M. shift nurse and given to the resident to take at [MEDICAL TREATMENT].

During an interview on 6/1/17 at 1:30 P.M., Resident #14 said he/she took the morning medications to [MEDICAL TREATMENT] because he/she was unable to take them on an empty stomach. The Resident took his breakfast to the [MEDICAL TREATMENT] Center to eat before he took his morning medications. The resident said the nursing staff at the facility checked his/her fingerstick blood sugar before getting picked up for [MEDICAL TREATMENT] and the Humalog sliding scale insulin was administered at that time, without food (the sliding scale insulin coverage was ordered for 7:30 A.M.). Humalog is a rapid acting insulin which must be administered within 15 minutes of a meal or immediately after a meal. (Nursing (YEAR) Drug Handbook). During an interview on 6/2/17 at 9:10 A.M., the Director of Nurses said she was aware the resident brought his/her medications to [MEDICAL TREATMENT]. She said there should have been a Physician’s order to do so.

Failed to make sure that each residents' abilities in activities of daily living do not decline, unless unavoidable.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility staff failed to ensure 1 Resident (#6) out of a total sample of 24 residents ability to ambulate did not diminish.

Findings include:

For Resident #6, the facility staff failed to follow a Functional Maintenance Program (FMP).

Resident #6 was admitted to the facility in 11/2016 with [DIAGNOSES REDACTED]. Review of the Quarterly Minimum Data Set (MDS) Assessment, dated 2/13/17, indicated the resident had severe cognitive loss as evidenced by a score of 3 out of 15 on the Brief Interview of Mental Status (BIMS) and was an extensive assist of 2 people for transfers and ambulation.

Review of the care plan for Activities of Daily Living, dated 2/16/17, indicated the resident was a limited assist of 1 or 2 for ambulation. Review of the FMP, dated 3/21/17, indicated the resident was to ambulate 100 feet daily, utilize a rolling walker, gait belt and wheelchair to follow. Review of the Physical Therapy (PT) discharge summary, dated 3/28/17, indicated Resident #6 needed supervision of 1 person for transfers and ambulated 150 feet with a rolling walker. The recommendation from PT was for the resident to follow the FMP to prevent a decline. Review of the undated Certified Nurses Aide (CNA) Kardex, did not indicate any FMP for ambulation. On 5/31/17 at 7:40 A.M. the surveyor observed Resident #6 in the day room, seated in a wheelchair.

During an interview on 6/1/17 at 8:10 A.M., the Director of Rehabilitation (Rehab) said the resident was a hand held assist with ambulation. She said the FMP was always started before a resident was discharged from therapy so rehab can monitor how the resident was doing. She said after the nurses had been educated on the FMP it was their responsibility to update the CNA Kardex and the care plan so staff would know how to take care of the resident. The Director of Rehab said there was no way to assess how the resident ambulated because the distance was not documented. During an interview on 6/1/17 at 8:35 A.M. CNA #3 said she took care of Resident #6 and said the resident used to walk a little but did not walk anymore. CNA #3 said he/she was always in a wheelchair.

On 6/1/17 at 8:45 A.M. during interview with Unit Manager (UM) #3 she said that after a FMP was developed the CNA Kardex and care plans were supposed to be updated. She said that neither Resident #6’s Kardex nor care plan was updated. UM #3 said that she did see the resident walk at times but could not say if it was daily or the distance the resident walked. On 6/2/17 at 9:00 A.M. during an interview with the Director of Nurses (DON) she said there was no way to assess the FMP because it was not documented anywhere.

Failed to make sure that residents with reduced range of motion get propertreatment and services to increase range of motion.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility staff failed to provide appropriate treatment and services to increase range of motion and/or prevent further decrease in range of motion for 1 Resident (#11) out of a total sample of 24 residents. Specifically, the facility staff failed to follow a Functional Maintenance Program (FMP) for range of motion (ROM).

Findings include:

Resident #11 was admitted to the facility in 6/2016 with [DIAGNOSES REDACTED]. Review of the Physical Therapy (PT) discharge summary, dated 12/12/16, indicated the resident was discharged to the nursing team and a FMP was set up so Resident #11 would maintain his/her current level of performance and prevent decline. The discharge summary also included that FMP instructions had been completed with the interdisciplinary team. Review of the Annual Minimum Data Set (MDS) Assessment, dated 5/22/17, indicated the resident had severe cognitive loss as evidenced by a score of 3 out of 15 on the Brief Interview of Mental Status (BIMS), was dependent for care, did not ambulate, and had limited ROM that interfered with daily functions to both lower extremities. On 6/1/17 at 7:10 A.M. the surveyor observed the resident in bed. The resident was laying on his/her left side with his/her legs severely contracted and tucked up with heels almost touching buttocks.

On 6/1/17 at 1:05 P.M. during an interview with the Director of Rehabilitation (Rehab), she said when the resident was discharged from rehab services on 12/12/16 he/she was put onto a FMP program for passive ROM (PROM). She said that she was unable to find the instructions and/or FMP program that was developed for Resident #11. The discharge summary also indicated that nursing was aware of the PROM program. The Director of Rehab was unable to show the surveyor where the PROM program was documented. The surveyor asked the Director of Rehab how she or anyone else knew that the resident received the PROM. She said that she just assumed the resident received it but could not tell for sure. On 6/2/17 at 8:45 A.M. during interview with the Director of Nurses (DON), she said that she did not know what the PROM program was. The DON said that all FMP needed to be educated and the Kardex and care plan needed to be updated to reflect the resident’s needs. She said that Resident #11’s Kardex nor care plan was updated. The DON said that it was a problem that the Kardex and care plan was not updated because the Certified Nurses Aide (CNA) did not know how to care for the resident. The DON could not show the surveyor if the FMP program was done.

Failed to make sure that the nursing home area is free from accident hazards and risks and provides supervision to prevent avoidable accidents.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility staff failed to provide a secure environment to prevent elopement through exit doors for 1 Resident (#5) out of a sample of 24 residents.

Findings include:

Resident #5 was admitted to the facility in 2/2013 with [DIAGNOSES REDACTED]. Review of the Quarterly Minimum Data Set (MDS) Assessment, dated 6/27/16 indicated the resident had impaired short and long term memory and impaired decision. The resident was supervised for ambulation and mobility in his/her wheelchair. The resident did not have any behaviors based on the MDS Assessment.

Review of a facility Unusual Event Report, dated 7/19/16, indicated Resident #5 eloped from the facility. The report indicated facility staff received a call from the Police around 2:30 A.M. saying they had found Resident #5 on a main road in his/her wheelchair (.25 miles from the facility per MapQuest).

Review of an Incident Report Form, submitted to the Department of Public Health (DPH) on 7/25/16, indicated a WanderGuard sensor (a signaling device that triggers an alarm, alerting staff that a resident wearing the device is near an exit) was on the wheelchair frame at the time of the incident. The facility’s internal investigation concluded the WanderGuard bracelet could have malfunctioned because staff never heard the alarm sound. Further review of the investigation indicated the last time staff could account for the resident was at 10:45 P.M Based on the report, the resident could not be accounted for between 10:45 P.M. on 7/18/16 and 2:30 A.M. on 7/19/16 (approximately 3.75 hours). Review of the manufacturer guidelines for the WanderGuard Departure Alert System indicated a warning against placing the signaling device/bracelet on or next to metal, such as a wheelchair frame, because metal can interfere with the signal sent to door modules. During an interview on 6/6/17 at 8:50 A.M. the Director of Nursing (DON) said the WanderGuard alarms were located at the front entrance and on the elevator serving units 1 and 2. She said the WanderGuard alarm could only be silenced with a key and staff didn’t hear an alarm the night of the incident. The DON said she could not verify if the alarm sounded on the resident’s return to the facility on [DATE]. She said the facility staff ruled out the possibility of elopement from exits other than the main door, because the other exits were via stairwell and the resident was found in his/her wheelchair. When the surveyor asked if the WanderGuard bracelet was in place at the time of the elopement, the DON said it was on the frame of the wheelchair. When the Surveyor reviewed the manufacturer warnings with the DON, she said she was aware of the warning against putting the bracelet on the wheelchair frame, but the resident had a history of [REDACTED]. When the surveyor asked if the DON called the manufacturer of the WanderGuard system for suggested alternatives, she said she did not. The DON was unable to provide documentation of the decision to proceed with the bracelet on the wheelchair frame despite warning from the manufacturer. She said education was provided to the health care proxy (HCP) on the recommendation to change the resident’s room to a secure unit in the facility. She said the risks and benefits of using the WanderGuard alert bracelet against manufacturer guidelines were not discussed with the HCP.

During an interview on 6/6/17 at 9:40 A.M. with the maintenance director, he said he did not recall the specific incident, but said if they needed the system to be tested , he was the person they would call. He said when he tested the WanderGuard system at the door and elevator, he used a testing device provided by the manufacturer. He said the nursing staff checked the battery life of the bracelet sensors every day. He told the surveyor he had never done a simulation or tested if Resident #5’s WanderGuard that was attached to the wheelchair frame sounded the alarm when it is passed through.

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 record review and interview the facility staff failed to maintain a medical record that was accurately documented for 1 Resident (#11) out of a total sample of 24 residents.

Findings include:

For Resident #11, the facility staff failed to document the resident’s Treatment Administration Record (TAR) accurately.

Resident #11 was admitted to the facility in 6/2016 with [DIAGNOSES REDACTED]. Review of the physician’s orders [REDACTED]. Review of the Treatment Administration Record (TAR), dated 5/2017, indicated that nurses initialed the TAR every shift for the entire month which indicated they checked that the air mattress was in place and functioned.

On 6/1/17 at 1:15 P.M. during an observation and interview with Unit Manager (UM) #3 she observed the resident’s bed and said that there was no air mattress in place. UM #3 then looked at the resident’s TAR, dated 5/2017, and saw that the nurses initialed the TAR the entire month which indicated the air mattress was in place and functioned. She said that it was a big problem that they signed off the TAR when the mattress was not in place.

Worcester Health 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:

Medicare Nursing Home Profiles and Reports – Worcester Health Center

Inspection Report for Worcester Health Center – 06/06/2017

Page Last Updated: August 14, 2018

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