Medford Rehabilitation and Nursing Center

Medford Rehabilitation and Nursing Center

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Medford Rehabilitation and Nursing 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 Medford Rehabilitation and Nursing Center

Medford Rehabilitation and Nursing CenterMedford Rehabilitation and Nursing Center is a for profit, 142-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of  Arlington, Everett, Winchester, Cambridge, and the other towns in and surrounding Middlesex County, Massachusetts.

Medford Rehabilitation and Nursing Center focuses on 24 hour care, respite care, hospice care and rehabilitation services.

Medford Rehabilitation and Nursing Center
300 Winthrop St,
Medford, MA 02155

Phone: (781) 396-4400
Website: http://medfordrnc.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, The Medford Rehabilitation and Nursing Center in Massachusetts received a rating of 2 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 Medford Rehabilitation and Nursing Center

The Federal Government fined Medford Rehabilitation and Nursing Center $177,600 on June 8th, 2016 for health and safety violations.

Fines and Penalties

Our Nursing Home Accident Lawyers inspected government records and discovered Medford Rehabilitation and Nursing 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 failed to obtain expanded authority for the resident’s court appointed Guardian and subsequently a Roger’s Treatment Plan for 1 resident, (#1 ), in a total sample of 24 residents.

Findings include:

For Resident #1, the court appointed Guardian did not have the Rogers Guardianship (authority to consent for treatment with an antipsychotic medication) prior to the administration of this medication.

On 4/18/17 and 4/19/16 Resident #1’s clinical record was reviewed. The resident was admitted to the facility in 7/2010 with [DIAGNOSES REDACTED].

Review of the most recent comprehensive Minimum Data Set (MDS) assessment dated [DATE], and the most recent quarterly MDS dated [DATE], identified the resident as having a Brief Interview of Mental Status (BIMS) score of 15 (cognitively intact). Further review of the Quarterly MDS indicated the Resident had received an antipsychotic medication for the entire 7 days of the evaluation period.

Review of the physician’s orders [REDACTED]. On 2/6/17, the doctor’s order changed to [MEDICATION NAME] 0.25 mgs in the A.M. and [MEDICATION NAME] 0.5 mgs at 9:00 P.M. Review of the resident’s court appointed Guardianship documents, evidenced the resident had a court appointed Guardian for health care decisions. Further, the documents included a revocation, by the court, of the expanded authority to administer antipsychotic medication dated 6/29/16.

Review of the Medication Administration Records, dated 9/2016, 10/2016, 11/2016, 12/2016, 1/2017, 2/2017, and 3/2017 indicated the resident received the [MEDICATION NAME] as ordered for a total of 362 doses.

During interview with Director of Nursing on 4/19/17 at 10:05 A.M., the facility was unable to provide evidence that the court appointed Guardian had the authority to consent to Antipsychotic medication use. She said that she had discovered the Resident was on the antipsychotic without a Rogers in place on 3/1/17, and at that time immediately inserviced staff about the need for a valid Rogers Guardianship from the court before administering an antipsychotic medication. However, further review of the clinical record indicated that the Resident continued to be administered the medication until 3/13/17, for a total of 24 more doses.

Failed to provide care for residents in a way that keeps or builds each resident's dignity and respect of individuality.

Based on observation, the facility staff failed to provide a privacy bag for 1 Non-sampled Residents (NS #4) in a total sample of 24 sampled residents and 5 non-sampled residents.

Findings include:

For NS #4 the facility failed to cover a urinary catheter collection bag. NS #4 was admitted to the facility in 4/2015. During observations on 4/18/17, at 6:30 A.M. and 4/20/17, at 7:36 A.M., the Resident was lying in bed and had a Foley catheter (tube inserted into the bladder for urine collection) bag and tubing hanging from the bed frame. The Foley bag was not in a privacy bag. The Foley catheter bag was filled with urine and visible from the hallway.

Failed to ensure the activities program is directed by a qualified professional.

Based on review of the documents of the person directing the activity program, and interviews with the Administer and Activities Director the facility failed to provide a qualified Activities Director.

Findings include:

1. Review of the job application of the Activities Director for employment indicated she held the following positions:

a. A substance abuse screener

b. Substance abuse clinician providing individual and group therapy

c. emergency room clinician providing crisis assessment

d. Child protection investigator

e. Fraud investigator for employee fraud

f. Youth counselor supervisor supervised employees

2. Review of her education file indicated:

a. She had an undergraduate degree in History

b. She had a graduate degree in Mental Health Counseling Both the Administrator and the Activities Director, were interviewed. When asked if they had any other information pertaining to the Activities Director qualifications, they said they did not.

The person acting in the role of Activities Director was not qualified as per regulation.

Failed to review or revise the resident's care plan after any major change in a resident's physical or mental health.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to complete a significant change assessment for 2 residents (#15) and (#3) out of a total sample of 24 sampled residents.

Findings include:

1. For Resident #15, the facility failed to complete a significant change assessment after the resident had an overall change in functional status.

Resident #15 was admitted to the facility in 9/2016 with [DIAGNOSES REDACTED].

Review of Resident #15’s quarterly Minimum Data Set, (MDS), dated [DATE], indicated that he/she required the following:

extensive assist for hygiene

extensive assist for bathing

Review of Resident #15’s quarterly MDS dated [DATE], indicated that he/she now required the following:

independent for hygiene

independent for bathing

During interview with the MDS Coordinator on 4/25/17, at 1:45 P.M., she said that she would modify the Resident’s MDS.

2. For Resident #3 the facility failed to complete a Significant Change Assessment after the resident had an overall decline in functional status.

Resident #3 was admitted to the facility in 4/2012 with [DIAGNOSES REDACTED]. Review of Resident #3’s annual Minimum Data Set ((MDS) dated [DATE] indicated functional ability as: Independent transfer ability with set up help only. Independent ability for ambulation without any assistance from staff. Limited assistance for toileting needs with one person assistance. Review of Resident #3’s quarterly MDS dated [DATE] indicated functional ability as: Extensive assist of one person for transfers. Extensive assist of one person for ambulation. Extensive assist of one person for toileting needs.

MDS nurse #2 said during interview that the resident had a decrease in functional ability secondary to a predictable cyclical pattern related to his/her [MEDICAL CONDITION] disease therefore a significant change assessment was not required. There was no cyclical pattern identified in previous MDS assessments.

Failed to make sure each resident receives an accurate assessment by a qualified health professional.

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

Based on record review and interviews, the facility failed to accurately code assessments for 2 residents (#15,#17), out of a total sample of 24 residents.

Findings include:

1. For Resident #15, the Facility failed to accurately code his/her weight. Resident #15 was admitted to the Facility in 9/2016 with [DIAGNOSES REDACTED]. Review of Resident #15’s initial MDS dated [DATE], indicated that the Resident’s weight was recorded as 199 pounds.

Review of the Resident’s weight record dated 9/24/2016, indicated that the Resident’s weight upon admission was 189 pounds.

Review of Resident #15’s quarterly MDS dated [DATE], indicated that the Resident’s weight was recorded as 216 pounds.

Review of the Resident’s weight record dated 3/01/2017, indicated that the Resident’s weight was 210 pounds.

2. For resident #17, the Facility failed to accurately code his/her use of an antidepressant medication.

Resident #17 was admitted to the Facility in 3/2016 with [DIAGNOSES REDACTED]. Review of Resident #17’s initial comprehensive MDS dated [DATE], indicated that section NO410, item C. (number of days an antidepressant was used) was blank. Review of Resident #17’s doctor’s orders dated 3/16/2017, indicated an order for [REDACTED].

Review of Resident #17’s Medication Administration Record [REDACTED]. On 4/24/2017, at 1:45 P.M. the MDS coordinator said she would modify the MDS to accurately reflect the medications the Resident was receiving.

Failed to develop a complete care plan that meets all of a 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 and interview the facility failed to develop a comprehensive care plan for discharge planning for 5 Residents (#4, #9, #15, #16, #17) in a sample of 24 Residents.

Findings include:

1. Resident #4 was admitted to the facility in 11/2016 with [DIAGNOSES REDACTED]. The Minimum Data Set (MDS) assessments dated 11/19/16 and 2/17/17, indicated that Resident #4 does not require any physical assist with any of his/her activities of daily living. Review of the MDS’s dated 11/19/16 and 2/17/17, indicated a Brief Interview for Mental Status (BIMS) score of 14 out of 15 (cognitively intact).

Review of the Resident’s Care Plan indicated no plan to address the Resident’s request to be discharged to the community. Review of an email from elder services (ES) ( a program that helps financially disadvantaged people find housing) to the Facility

Social Service (SS) Director and dated 2/7/2017, indicated that although the Resident had been supplied with a list of appropriate housing opportunities by ES and given directions on how to fix his/her criminal background check (CORI), Resident #4 had not made any phone calls to assist with his/her discharge from the Facility.

On 4/19/17, at 2:15 P.M., during an interview Resident #4 said he/she wants to be discharged to the community. On 4/29/17, at 2:20 P.M., the Social Service Director said she had not helped the Resident call any of the housing opportunities nor had she helped him/her with the issues with his/her CORI that were an obstacle to obtaining housing.

2. Resident #9 was admitted to the facility in 9/2016 with [DIAGNOSES REDACTED]. The Minimum Data Set (MDS) assessments dated 12/2/16 and 3/10/17, indicated that Resident #9 requires physical assistance with his/her activities of daily living. Review of the MDS’s dated 12/2/16 and 3/10/17, indicated a Brief Interview for Mental Status (BIMS) score of 15 and 14 respectively(cognitively intact).

Review of the facility document titled Social History and Initial Assessment and dated 10/7/2016, indicated that the Resident will need extensive services and a safe environment to return home and that the team is to assess safety needs for discharge planning. Further review of the clinical record did not indicate the home environment was assessed for needs for a safe discharge.

Review of the MDSs dated 12/2/16 and 3/10/17, indicated in section Q0400, a discharge plan was in place, however section Q0600 indicated that no referrals to any agencies to assist with housing or care were indicated.

Review of the Resident’s Care Plan indicated no plan to address the Resident’s potential to be discharged to the community.

3. Resident #15 was admitted to the facility in 9/2016 with [DIAGNOSES REDACTED]. Review of the MDS dated [DATE], indicated a Brief Interview for Mental Status (BIMS) score of 14 out of 15 (cognitively intact).

The Minimum Data Set (MDS) assessments dated 3/24/17, indicated that Resident #15 does not require any physical assist with any of his/her activities of daily living. Review of the clinical record on 4/20/17, indicated no comprehensive discharge plan to assist the Resident with finding a safe discharge location.

Review of the facility document titled Social Service Progress note and dated 3/29/17, indicated that the Resident will work with SS on finding a place. Further review of the clinical record indicated no evidence that SS had worked with the Resident to obtain a safe discharge.

On 4/24/17, at 11:48 A.M., the Discharge Planner said she didn’t know what the plan for the Resident’s discharge was and she would have to ask a co-worker. She also said that they had tried a few things but could not say what those things were or what the end results were.

On 4/24/17, at 12:56 P.M., during an interview with the SS Director, when Surveyor #2 pointed out that there was no discharge care plan in the clinical record the SS Director said she was not working here when the Resident was admitted . The SS Director said she doesn’t update the Care Plans but writes a progress note instead so she was not aware there was no discharge care plan for the Resident.

4. Resident #16 was admitted to the facility in 2/2016 with [DIAGNOSES REDACTED]. Review of the MDS dated [DATE], indicated a Brief Interview for Mental Status (BIMS) score of 15 out of 15 (cognitively intact).

The Minimum Data Set (MDS) assessments dated 3/3/17, indicated that Resident #16 does not require any physical assist with any of his/her activities of daily living.

Review of the clinical record indicated a care plan dated 3/15/17, with a problem statement that the Resident will be able to find housing at the time of discharge over the next 90 days. The goal of the care plan states the Resident will have ongoing needs met at time of discharge. Further review of the care plan indicates no interventions for the facility to attempt to facilitate an appropriate discharge.

5. Resident #17 was admitted to the facility in 2/2016 with [DIAGNOSES REDACTED]. Review of the MDS dated [DATE], indicated a Brief Interview for Mental Status (BIMS) score of 15 out of 15 (cognitively intact).

The Minimum Data Set (MDS) assessments dated 3/23/17, indicated that Resident #17 requires physical assistance to transfer and walk however, Surveyor #2 observed the Resident on 4/18/17 at 7:55 A.M., on 4/20/17 at 2:46 P.M., on 4/24/2017 at 11:20 A.M., and throughout the survey, to transfer in and out of bed independently and to ambulate in his/her room and throughout the facility independently in front of staff and without intervention from staff.

Review of the clinical record on 4/23/17, indicated no comprehensive discharge plan to assist the Resident with finding a safe discharge location.

Review of the Facility document titled IDT Care Plan Meeting and dated 4/14/17, indicated that there was a tentative discharge date of [DATE]. On 4/24/17, at 12:56 P.M., the SS Director said that she didn’t know what the plan for discharge was because the Resident’s mother said she knew nothing of her son’s plans and nobody had contacted her to ask if she was okay with her son moving in with her and it is not okay.

Failed to maintain 15 months of resident assessments in the resident's active clinical record.

Based on record review and facility staff interview, the facility failed to maintain the required 15 months of Minimum Data Set (MDS) Assessments in the active clinical record, that is accessible to all professional staff members, who need to review the information.

Findings include:

During an interview with the Director of Nurses Services (DNS), on 4/18/17 at 3:41 P.M., surveyors inquired about the medical record system in use by the facility, to gain access to the necessary documents needed for review during survey. The DNS said that the facility maintains a paper medical record for all residents with the exception of the MDS Assessments. She further said that they are not in the printed medical record. She informed the surveyors that they would need to ask the DON or MDS Director to print the MDS Assessments they needed to review.

During an interview with the MDS Director, on 4/19/17, she said that she completes the MDS Assessments in the computer except for the sections completed by the Social worker, Activities Director and the Dietician. She further said that only the current MDS would be in the medical record. She further said that the nurses on the resident units could ask the MDS nurses to print an MDS if they needed it. When asked about 24 hour access the MDS coordinator did not respond.

Failed to encode and automate the resident's assessment data.

Based on record review, the facility failed to electronically transmit encoded, accurate and complete Minimum Data Set(MDS) data to the CMS System for 2 sampled residents (#18 and #21) and 16 non-sampled residents( NS #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, #17, #18, #19, #20, #21 and #22) for a total of 18 residents.

Findings include:

A CASPER Report dated 5/5/2017 indicated the following residents currently residing in the facility, had required OBRA Assessments missing.

The last MDS transmitted to CMS for sampled Resident #18 was 1/30/16.
The last MDS transmitted to CMS for sampled Resident #21 was 9/28/15.
The last MDS transmitted to CMS for NS #7 was 10/9/15.
The last MDS transmitted to CMS for NS #8 was 7/24/15.
The last MDS transmitted to CMS for NS #9 was 8/29/15.
The last MDS transmitted to CMS for NS #10 was 10/23/15.
The last MDS transmitted to CMS for NS #11 was 8/2/16.
The last MDS transmitted to CMS for NS #12 was 10/23/16.
The last MDS transmitted to CMS for NS #13 was 8/12/16.
The last MDS transmitted to CMS for NS #14 was 1/30/16.
The last MDS transmitted to CMS for NS #15 was 11/13/15.
The last MDS transmitted to CMS for NS #16 was 2/19/16.
The last MDS transmitted to CMS for NS #17 was 8/7/15.
The last MDS transmitted to CMS for NS #18 was 6/19/15.
The last MDS transmitted to CMS for NS #19 was 10/4/16.
The last MDS transmitted to CMS for NS #20 was 8/2/16.
The last MDS transmitted to CMS for NS # 21 was 12/22/15.
The last MDS transmitted to CMS for NS #22 was 10/14/16.
The Facility failed to transmit MDS data from assessments as required.

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

Based on observations and staff interviews, the facility staff failed to ensure that medications and biologicals were of current date to provide reliability of strength and accuracy, on 3 of 3 units observed.

Findings include:

1. During an inspection of the Winthrop Unit medication room on 4/18/17 at 9:15 A.M., the following was observed:

A. 1 bottle of ear drops with an expiration date of 2/2017.
B. 2 bottles of pneumonia vaccination with an expiration date of 3/24/17. During an interview on 4/18/17, at 9:15 A.M., the Unit Manager said she would dispose of the expired medication.

2. During an inspection of the Mystic Unit medication room on 4/18/17, at 9:30 A.M. the following was observed:

A. 1 bottle of flu vaccination open and without a date.
B. 1 bottle of tuberculin purified protein derivative open and without a date.

3. During an inspection of the Pleasant View Unit medication room on 4/18/17, at 9:45 A.M. the following was observed:
A. 1 bottle of Psyllium with an expiration date of 3/2017.
B. 1 bottle of C-Omeprazole with an expiration date of 4/1/17.
C. 1 bottle of flu vaccination open and without a date.
D. a tool box with the following medications inside:
a. Asamanex 220 micrograms (mcg) inhaler with an expiration date of 11/2016.
b. Omeprazole 20 milligrams (mg) with an expiration date of 12/2016.
c. Risperidone 3 mg with an expiration date of 3/6/16.
d. Trazodone 100 mg with an expiration date of 12/10/16.
e. Trazodone 1 mg with an expiration date of 3/13/17.
f. Seroquel 100 mg with an expiration date of 2/10/17.
g. Naltrexone 50 mg with an expiration date of 3/6/17.
h. Simvastatin 20 mg with an expiration date of 3/13/17.
i. Omeprazole 20 mg with an expiration date of 9/24/16.
j. Omeprazole 20 mg with an expiration date of 1/27/17.
k. Proair inhaler with an expiration date of 1/8/16.
l. Proventil inhaler 90 mcg with an expiration date of 11/2016.

During an interview, on 4/18/17 at 9:50 A.M., the the unit manager said there should be no expired medications or supplies in the medication rooms. He also said that someone must have put the box of medications in the medication room and forgot about them. Review of the facility policy titled 4-1 Medication Storage, indicated that the facility should not use outdated, contaminated, or deteriorated medications. They should be removed from stock and disposed of according to procedure for medication destruction.

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 observation, the facility failed to follow standard infection control practices for the prevention and spread of infection for 5 non-sampled (NS) Residents ( #1, #2, #4, #5 and #6) relative to medical equipment used to deliver oxygen and aerosolized medications in a total sample of 24 residents and 5 non-sampled residents.

Findings include:

Findings include: 1. For NS #1 the facility staff failed to maintain proper infection control practices to prevent the spread of infection relative to medical equipment used to deliver aerosolized medications.

Resident #1 was admitted in 11/2016. On 4/18/17, at 6:30 A.M. and on 4/20/17, at 4:50 P.M., Surveyor #2 observed Resident #1 in her/his room with nebulizer tubing lying on top of her/his dresser without a protective covering.

2. For NS #2 the facility staff failed to maintain proper infection control practices to prevent the spread of infection relative to medical equipment used to deliver oxygen. NS #2 was admitted to the facility in 2/2017. On 4/18/17, at 6:30 A.M., Surveyor #2 observed NS #2 in her/his room with the nasal cannula and oxygen tubing on the floor.

3. For NS #4 the facility staff failed to maintain proper infection control practices to prevent the spread of infection relative to medical equipment used to deliver oxygen and aerosolized medications. NS#4 was admitted to the Facility in 4/2015. On 4/18/17, at 6:38 A.M. with oxygen tubing draped over her/his side rail without a protective cover. On 4/20/17, at 4:36 P.M., Surveyor #2 observed NS #4 in her/his room with oxygen tubing draped lying in her/his bed without a protective cover.

4. For NS #5 the facility staff failed to maintain proper infection control practices to prevent the spread of infection relative to medical equipment used to deliver oxygen and aerosolized medications. NS #5 was admitted in 9/2016.

On 4/18/2017, at 7:13 A.M., Surveyor #2 observed NS #5 oxygen tubing coiled and inserted into the handle of the oxygen concentrator without a protective cover and Nebulizer tubing on the top of her/his dresser without a protective cover.

During an interview with the Director of Nursing on 4/20/17, she said that she did not have a policy for oxygen or nebulizers regarding the storage of the tubing and masks to prevent infection. She said that their practice was to store them in a plastic bag when not in use to keep them clean.

5. For NS #6 the facility failed to maintain proper infection control practices to prevent the spread of infection relative to medical equipment used to deliver aerosolized medications. NS # 6 was admitted to the facility in 8/2016 with [DIAGNOSES REDACTED]. On 4/19/17 Surveyor #1 observed Resident #6 lying in bed with oxygen being delivered from an oxygen concentrator through a nasal cannula. Beside her bed was a nebulizer unit to deliver respiratory medication that was not dated.

Medford Rehabilitation and Nursing 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 – Medford Rehabilitation and Nursing Center

Nursing Home Inspection, Safety and Deficiency Report  Medford Rehabilitation and Nursing Center – 04/25/2017

Page Last Updated: December 10th, 2017

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