Royal Spring Valley Center

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Royal Spring Valley 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 Royal Spring Valley Center

Royal Spring Valley Center is a for profit, 82-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of Leicester, Holden, Shrewsbury, Millbury,  Spencer, Grafton, Sutton, Northborough, Westborough, and the other towns in and surrounding Worcester County, Massachusetts.

Royal Spring Valley Center
81 Chatham St
Worcester, MA 01609

Phone: (508) 754-3276

 

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 2018, Royal Spring Valley Center in Worcester, Massachusetts received the following ratings:

Performance Area Rating
Overall Rating Rating Not Displayed
State Health Inspections 3 out of 5 (Average)
Staffing Rating Not Displayed
Quality Measures 5 out of 5 (Much Above Average)

Fines Against Royal Spring Valley Center

The Federal Government fined Royal Spring Valley Center $59,890 on 09/01/2016 September 1st, 2016 in for health and safety violations.

Fines and Penalties

Our Nursing Home Accident Lawyers inspected government records and discovered Royal Spring Valley Center committed the following offenses:

Failed to provide housekeeping and maintenance services.

Based on observation and interview, the facility staff failed to maintain a clean and sanitary environment relative to resident bathrooms.

Findings include:

During the Quality of Life Group Interview on 11/2/17 at 1:00 P.M., a complaint was raised about the cleanliness of the resident bathrooms. Particularly in bathrooms shared by eight residents. During inspection of the environment on 11/4/17 at 1:15 P.M. the surveyor observed the bathroom between rooms 341 and 343, used by eight residents. Feces was observed on the raised toilet seat and dirty linen was observed on the floor. The bathroom in room 305, used by 4 residents, had urine splashed on the toilet seat. Housekeeping staff were observed in the hallway at this time. Housekeeper #1 said she cleaned the bathrooms every morning and as needed.

On 11/4/17 at 2:15 P.M. the surveyor returned to room 341/343 to inspect the bathroom. It was unchanged since the previous observation. Feces was still on the raised toilet seat and the dirty linen was still on the floor. A resident was observed leaving this bathroom and said he/she couldn’t use the bathroom because it was dirty. Non-sampled (NS) Resident #1, who resides in this room, told the surveyor the bathroom was always dirty and that housekeeping only came once a day to clean it. Resident #1 continued to say if you said anything to the nurses they would say it wasn’t their job.

On 11/4/17 at 2:30 P.M. the surveyor returned to room 305. It too was unchanged since the previous observation. Urine was still observed on the toilet seat. NS #2, who resided in that room, said the bathroom was often dirty. NS #3, a roommate, said he/she usually has to wipe the seat with tissue before he/she uses the toilet. Housekeeping was not in the hallway during these last two observations of the bathrooms.

On 11/2/17 at 2:45 P.M. the surveyor, accompanied by Nurse #3, observed the bathrooms in rooms 305 and 341. The condition of the bathroom remained unchanged. He said they had to be cleaned right away. During an interview with the Housekeeping Supervisor on 11/2/17 at 3:00 P.M., he said he would re-do the cleaning schedule to address the problem.

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 interview and record review the facility staff failed to complete a Significant Change Status Assessment (SCSA) for 1 resident (#4) when the resident had a decline in a total sample of 15 residents.

Findings include:

For Resident #4, the facility failed to complete a SCSA when the resident had a significant decline in activities of daily living (ADLs). Resident #4 was admitted to the facility in 7/2002 with [DIAGNOSES REDACTED]. Review of the Annual Minimum Data Set (MDS) Assessment, dated 1/25/17, indicated the resident had severe cognitive impairment as evidenced by a Brief Interview of Mental Status (BIMS) score of 5 of 15, was independent with bed mobility and transfers, and required supervision with ambulation. The resident weighed 185 pounds. Review of the Quarterly MDS Assessment, dated 4/18/17, indicated the resident’s BIMS score was 3/15, he/she was independent with bed mobility and required extensive assistance of one for transfers and for ambulation in his/her room. The resident weighed 188 pounds. Review of the Quarterly MDS Assessment, dated 7/19/17, indicated the resident had severe cognitive impairment as evidenced by a score of 4 of 15 on the BIMS, required extensive assistance for bed mobility, transfers and ambulation in his/her room, and had only ambulated once or twice with extensive assistance in the corridor. The resident weighed 171 pounds.

Review of the Quarterly MDS Assessment, dated 10/18/17, indicated the resident was unable to complete the BIMS, but had severe cognitive impairment as evidence by the staff assessment, required extensive assistance with bed mobility, transfers and ambulation in his/her room. The resident had not ambulated in the corridor. The resident weighed 174 pounds.

During an interview with Certified Nurses’ Aide (CNA) #1 on 11/3/17 at 8:45 A.M., she said she knew Resident #4 very well and that he/she had declined in ADLs and needed more help. During an interview with the MDS Nurse on 11/3/17 at 11:00 A.M., she said she had reviewed the past MDS assessments and a SCSA should have been done.

Failed to make sure that residents receive treatment/services to not only continue, but improve the ability to care for themselves.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility staff failed to provide appropriate care and services to prevent a decline in activities of daily living (ADLs) for 1 resident (#4) in a total sample of 15 residents.

Findings include:

For Resident #4, the facility failed to provide rehabilitation services when the resident experienced a decline in his/her ability with bed mobility, ambulation and transfers. The facility was unable to provide a policy and/or procedure relative to decline in ADLs. Resident #4 was admitted to the facility in 7/2002 with [DIAGNOSES REDACTED]. Review of the Annual Minimum Data Set (MDS) Assessment, dated 1/25/17, indicated the resident had severe cognitive impairment as evidenced by a Brief Interview of Mental Status (BIMS) score of 5 of 15, was independent with bed mobility and transfers, and required supervision with ambulation. The resident was incontinent of bladder and continent of bowel.

Review of the ADL Flow Sheets for 1/2017 and 2/2017 indicated the resident was independent for bed mobility and transfers, and independent/continual supervision with ambulation in both room and corridor. Review of the 3/2017 ADL Flow Sheets indicated the resident was independent with bed mobility, required limited assistance for transfers and supervision to extensive assistance with ambulation in both room and corridor. Review of the Quarterly MDS Assessment, dated 4/18/17, indicated the resident’s BIMS score was 3/15, he/she was independent with bed mobility, required extensive assistance of one for transfers and ambulation in his/her room, and was incontinent of both bowel and bladder.

Review of the 4/2017 ADL Flow Sheets indicated the resident was independent with bed mobility and required supervision to extensive assistance with transfers and ambulation in his/her room. Review of the 5/2017 ADL Flow Sheets indicated the resident now required extensive assistance on 8 occasions for bed mobility and extensive assistance with transfers and ambulation in his/her room. The resident did not ambulate in the corridor.

Review of the 6/2017 ADL Flow Sheets indicated the resident was independent for bed mobility and required limited to extensive assistance for ambulation in his/her room, and supervision in the corridor. Review of the Quarterly MDS Assessment, dated 7/19/17, indicated the resident had severe cognitive impairment as evidenced by a score of 4 of 15 on the BIMS, required extensive assistance for bed mobility, transfers and ambulation in his/her room, and had only ambulated once or twice with extensive assistance in the corridor.

Review of the clinical record indicated the resident was hospitalized from [DATE] to 7/14/17 for a testicular hydrocele (fluid in the scrotum). Review of the 7/2017 ADL Flow Sheets indicated that starting 7/15/17, the resident required extensive assistance for bed mobility, transfers and ambulation in his/her room. The resident did not ambulate in the corridor.

Review of the 8/2017 ADL Flow Sheets indicated the resident required extensive assistance for bed mobility and transfers. The resident required extensive assistance with ambulation in his/her room on the 7:00 A.M. to 3:00 P.M. shift but did not ambulate in his/her room on the 3:00 P.M. to 11:00 P.M. shift, and did not ambulate at all in the corridor.

Review of the 9/2017 ADL Flow Sheets indicated essentially the same thing as 8/2017 Review of the Quarterly MDS Assessment, dated 10/18/17, indicated the resident was unable to complete the BIMS, but had severe cognitive impairment as evidence by the staff assessment, required extensive assistance with bed mobility, transfers and ambulation in his/her room. The resident had not ambulated in the corridor.

Review of the 10/2017 ADL Flow Sheets indicated the resident continued to require extensive assistance with bed mobility and transfers, had only ambulated on the 11:00 P.M. to 7:00 A.M. shift in his/her room with extensive assistance but not during the day or evening shifts, and did not ambulate in the corridor.

Review of the clinical record did not indicate any physician’s orders [REDACTED]. During an interview with Certified Nurses’ Aide (CAN) #1 on 11/3/17 at 8:45 A.M., she said she knew Resident #4 very well and that he/she had declined in ADLs and needed more help. She said she could not remember getting any education/training from the rehabilitation staff regarding the resident’s decline. Nurse #1, at this same time, said she could not ever recall seeing Resident #4 ambulate in the 6 weeks she had been working there. During an interview with the MDS Nurse on 11/3/17 at 11:00 A.M., she said there was no evidence in the clinical record that the resident was ever screened or evaluated by the rehabilitation staff for a decline in ADL status.

During an interview on 11/3/17 at with the Director of Nurses (DON) and Administrator at 11:30 A.M., they said a new rehabilitation company was starting, but they would try and reach the previous company to see if the resident had been seen for a decline in functioning.

On 11/7/17 at 9:15 A.M. during survey, the Rehabilitation Area Manager told the surveyor she was doing an evaluation for Resident #4 today. He/she would be picked up for services, probably three times a week because she felt he/she could benefit. She said Resident #4 was able to transfer and ambulate a couple of steps with assistance. On 11/7/17 at 9:35 A.M. the DON told the surveyor she had not been able to find any instance where the resident was evaluated or treated by the rehabilitation staff.

Failed to give the right treatment and services to residents who have mental or psychosocial problems adjusting.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility staff failed to provide appropriate care and service to promote mental and psychosocial functioning to attain the highest practical level of well being for 2 (#6 and #10) residents in a total sample of 15 residents.

Findings include:

1. For Resident #10, the facility failed to consult with appropriate psychiatric and counseling services for a resident with mental illness and a history of polysubstance abuse. Review of the facility policy for Behavioral Health Referrals, revised 9/17/2016, indicated that referrals will be initiated for new or current residents with psychosocial needs outside the services of the facility offered services. This may occur as a result of significant psychosocial history, recent psychosocial events, medication reviews, or emergencies.

Resident #10 was admitted to the facility in 8/2017 with [DIAGNOSES REDACTED]. Review of the resident’s care plan, implemented 8/18/17, indicated the resident was a new admission and at risk for a mood decline, had episodes of anxiety secondary to nursing home placement and was at risk for complications related to [MEDICAL CONDITION] medication use.

Review of the Initial Social Service History, dated 8/16/17, indicated the resident had 15 psychiatric hospitalization s. Review of the nurses’ notes indicated the following:

-On 8/17/17 the resident was very agitated, used foul language when things did not go her way. He/she called the police because medications were not given on time.
-On 9/14/17 the resident came to the nurse’s station demanding medication. He/she was verbally abusive and made false accusations, saying the nurse was holding his/her medications.
-On 9/25/17 the resident became agitated and accusatory because he/she felt he/she was getting incorrect medications. He/she was verbally abusive to the staff and called 911 to report he/she hadn’t received medications. Redirected with poor effect. Threatened to have the nurse fired. The note said the staff would continue to monitor and redirect.
-On 10/30/17 the resident was confrontational and argumentative with a nurse. He/she said she knew the nurse wrote something about him/her.

Review of the clinical record did not indicate the resident had been referred to Psychiatric services for her [MEDICAL CONDITION], anxiety and use of [MEDICAL CONDITION] medications, nor had she been referred for services relative to her history of polysubstance abuse.

During an interview with Unit Manager #1 on 11/2/17 at 11:00 A.M., she said the resident had not received any psychiatric services. During an interview with Resident #10 on 11/2/17 at 11:10 A.M., he/she said everything was fine. He/she was very focused on the cleanliness of the bathroom and the cleanliness of the facility in general. He/she was not easily redirected from this topic.

During an interview with the Director of Social Services on 11/2/17 at 11:30 A.M., he said he thought the resident was receiving psychiatric services. He was not aware the resident was not receiving services for her mental health issues or polysubstance abuse history. His expectation was that the resident would have been referred. He said he would look into this right away.

2. For Resident #6, the facility staff failed to ensure the resident received continued mental health service as recommended.

Resident #6 was admitted to the facility in 6/2015 with [DIAGNOSES REDACTED]. Review of the 10/2017 Physician’s Orders indicated the following orders;

-[MEDICATION NAME] (antidepressant) 20 milligrams (mg.) by mouth one time a day,
-[MEDICATION NAME] (antidepressant) 15 mg. by mouth at bedtime. Review of a Physician’s note, dated 10/3/17, indicated a [DIAGNOSES REDACTED].

Review of the clinical record indicated a Counseling Progress note, (dated 2/16/17), indicated chief complaint as Dementia with behaviors and depression. The note indicated the resident could benefit from psychiatric medications and behavior modification, and follow-up in 3 months and as needed.

Further review of the clinical record indicated no additional psychiatric services had been provided.

During an interview on 11/3/17 at 9:15 A.M., Unit Manager #1 said she was unsure why the resident had not received further psychiatric services as previously recommended. She said the resident should have had the follow up visit. She said she would call and request follow-up psychiatric services for the resident.

Failed to safely provide drugs and other similar products available, which are needed every day and in emergencies, by a licensed pharmacist

Based on observations and interviews, the facility staff failed to ensure that routine and emergency drugs and biologicals were of current date on 2 of 2 units observed.

Findings include:

Review of the facility Storage of Medications Policy, (with a revised date of April 2007) indicated that the facility shall not use discontinued, outdated, or deteriorated drugs or biologicals. All such drugs shall be returned to the dispensing pharmacy or destroyed.

1 a. During an inspection of the Second Floor Unit Storage Room on 11/2/17 at 1:00 P.M., three Pharmacy House Stock Emergency Kits (Numbered #16, #20 and #24) were found. Each kit was labeled with an expiration date of 10/2017.

b. During an inspection of the Second Floor Unit Storage Room medication refrigerator on 11/2/17 at 1:10 P.M., one Pharmacy Emergency Kit containing 2 vials of Ativan (medication used to treat anxiety) was found with an expiration date of 5/2017. During an interview on 11/2/17 at 1:25 P.M., Nurse #4 said the three Pharmacy House Stock Emergency Kits and the Emergency Kit containing Ativan were all expired and he said he would reorder new kits from the pharmacy.

2. During an inspection of the Third Floor Unit Storage Room on 11/2/17 at 1:35 P.M., the Pharmacy Anaphylactic Kit containing one Epinephrine Auto Injector (used to treat an allergic emergency) was found with an expiration date of 10/2017. During an interview on 11/2/17 at 1:40 P.M., Unit Manager #2 said the Epinephrine Auto Injector was expired and she removed it. She said she would reorder a new kit from the pharmacy.

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

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility staff failed to ensure that medications were of current date to provide reliability of strength and accuracy of dosage on 1 of 2 units observed.

Findings include:

Review of the facility Storage of Medications Policy, (with a revised date of April 2007) indicated that the facility shall not use discontinued, outdated, or deteriorated drugs or biologicals.

During an inspection of the Second Floor Unit medication room on 11/2/17 at 1:00 P.M., the following expired medications were found:

– One opened vial of Aplisol (a screening test for [DIAGNOSES REDACTED], an infection of the lungs) with no open date documented (vial must be discarded within 30 days of opening as per manufacturer’s instruction).
-One bottle of Saline Nasal Spray with an expiration date of 9/2017.
-2 boxes of Carbamide Peroxide (ear wax removal solution) with an expiration date of 10/2017.
-1 bottle of Biotene Dry Mouth Oral Rinse (used to help relieve and soothe dry mouth) with an expiration date of 2/2016.

During an interview on 11/2/17 at 1:25 P.M., Nurse #4 said the vial of Aplisol, Saline Nasal Spray, 2 boxes of Carbamide Peroxide, one bottle of Biotene Dry Mouth Oral Rinse were all expired and he removed them.

Royal Spring Valley 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 – Royal Spring Valley Center

Inspection Report for Royal Spring Valley Center – 11/07/2017

Page Last Updated: April 4, 2018

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