East Haven nursing home among 7 fined after lapses in care

Conn. Health I-Team

Conn. Health I-Team

Seven Connecticut nursing homes have been fined by the state Department of Public Health for violations that endangered or injured residents.

Talmadge Park Healthcare in East Haven was fined $1,635 after a resident fell from a wheelchair, suffering a broken hip and other injuries. The resident required two-staff assistance with transfers. But on Dec. 26, 2016, a nurse aide was changing the resident when the fall occurred. The resident was taken to a hospital and found to have a broken left hip and six skin tears on the left arm. The nurse aide no longer works at the facility.

Officials at the facility didn’t return a call seeking comment.

Hewitt Health & Rehabilitation Center in Shelton was fined $1,530 after a student nurse witnessed a nurse aide calling a resident an expletive on Feb. 23, 2017. According to DPH, an investigation substantiated the student nurse’s claim that the aide became frustrated and used the expletive while trying to move the resident out of bed, violating the facility’s abuse policy.

Officials at the facility didn’t return a call seeking comment.

Harbor Village North Health and Rehabilitation Center in New London was fined $3,000 for four violations.

On Aug. 1, 2017, a resident with pulmonary heart disease was hospitalized with low blood pressure and incontinence after a registered nurse administered medication intended for another resident, according to DPH. On that same date, a second resident was mistakenly given long-acting insulin instead of fast-acting insulin by a licensed practical nurse.

On June 15, 2017, a resident with schizophrenia was seen opening a bottle of Tylenol that an LPN had left on top of a medication cart. The resident had 10 tablets in hand and was unable to state if any had been ingested, according to the citation, which said the medication cart should have been locked.

In October 2017, a resident with schizo-affective disorder and major depressive disorder went 21 days without receiving a medication. A physician’s note directed staff to decrease the resident’s dose beginning Sept. 29, 2017, but staff stopped administering the medication altogether on Oct. 2, according to DPH.

An official at the facility declined to comment.

Bridgeport Health Care Center was fined $3,000 after a resident with alcohol-induced dementia, cerebral vascular disease and other diagnoses left the facility from 10:45 a.m. until 3:47 p.m. Aug. 16, 2017, despite wearing a WanderGuard sensor.

According to DPH, the sensor was operable, but no staff recalled it setting off any alarms when the resident left. Doors that lead to an elevator and exterior patio should have been locked but weren’t that day due to an inoperable fire alarm system. With the doors unlocked, staff was directed to guard the exists, but no one observed the resident leaving, the citation said.

The resident was found exiting Bridgeport Manor, a neighboring facility owned by the same company, and taken to an emergency department before returning to Bridgeport Health Care Center.

The facility completed a corrective action plan by Aug. 19, including updates to its fire watch policy, regular WanderGuard audits, testing of all door locks and other precautions, according to DPH.

Officials at the facility didn’t return a call seeking comment.

Bridgeport Manor was fined $1,950 after a resident was hurt falling from a lift. On Aug. 24, 2017, the resident, who required the use of a Hoyer lift by two staff members for transfers, fell when one of the lift’s straps came unhooked, according to DPH.

At a hospital, the resident was treated for several fractures in the pelvic area. An investigation found staff didn’t ensure hooks were properly placed in the loops of the Hoyer lift pad, the citation said.

Facility official didn’t return a call seeking comment.

Bloomfield Center for Nursing and Rehabilitation was fined $1,740 after a resident was given the wrong medication, which resulted in a delay in a procedure.

The resident was scheduled to have a biliary (bile duct) stent changed during an outpatient procedure on July 19, 2017, and a physician’s note directed staff to give the resident nothing by mouth after the midnight prior and to skip the resident’s doses of an anticoagulant medication for two days prior to the procedure, according to DPH.

Staff did, however, administer a dose of Novolog insulin the morning of the scheduled appointment. The resident, while at the facility for the procedure, became lethargic and had “an unresponsive episode,” the citation said. The resident was hospitalized for three days and discharged back to the Bloomfield Center with diagnoses of hypoglycemia and biliary stent obstruction.

“Bloomfield Center for Nursing and Rehabilitation takes the care of its patients and residents very seriously and has a zero-tolerance policy in regards to any lapse of care,” said spokesman Tim Brown. “We are confident that the issues raised in the report were isolated and not consistent with the care and customer service at our center. We have retrained the staff involved in policies, procedures and expectations for our care.”

Regal Care at Greenwich was fined $330 after several bathroom sinks were tested during inspections and had excessively high hot water temperatures on Aug. 19 and Sept. 18, 2017. According to DPH, a maintenance assistant told investigators the water temperatures were checked daily but the assistant didn’t know what the temperatures should be.

Officials at the facility didn’t return a call seeking comment.

Cara Rosner is a Connecticut Health I-Team writer. This story was reported under a partnership with the CHI (c-hit.org).