Buffalo nursing home hit with biggest state fine from Covid-19 violations

Sep. 23--A Buffalo nursing home has been hit with a $50,000 fine, the biggest imposed by the state Health Department following a blitz of Covid-19 inspections earlier this year when the virus began its devastating march through long-term care facilities.

Twenty-three nursing homes statewide, including five in Western New York, have been fined a total of $328,000 for infection control violations or other missteps related to the coronavirus that has killed more than 6,000 New York nursing home residents, the Health Department told The Buffalo News.

The $50,000 fine on Humboldt House Rehabilitation and Nursing Center stemmed, according to state records, from an April visit in which inspectors observed:

--Some Covid-19 positive residents rooming with residents who were not infected.

--Failure to practice social distancing among residents and workers and instances of residents and staff either not wearing masks or wearing them improperly.

--Workers tending to Covid-19 positive residents and then caring for uninfected residents without changing into fresh personal protective gear or washing their hands.

Meanwhile, the Buffalo Center for Rehabilitation and Nursing was fined $22,000 for multiple deficiencies found in an April inspection, the records show, and Comprehensive Rehab and Nursing Center of Williamsville was fined $14,000 after inspectors in May found multiple violations.

The Villages of Orleans Health and Rehab Center in Albion was cited in May for multiple deficiencies and fined $20,000.

Cuba Memorial Hospital Inc. SNF (Skilled Nursing Facility) was fined $2,000 for multiple violations.

Officials at Humboldt House and Buffalo Center for Rehabilitation said they quickly corrected the violations after being cited by the state. Humboldt House passed subsequent infection control inspections, an administrator said. Buffalo Center retrained its workers, a spokesman said.

The three other nursing homes in Western New York did not respond Tuesday to requests for comment from The News.

The Villages of Orleans nursing home has had 23 of its residents die from Covid-19 at the facility, according to the State Health Department. Fourteen residents died at Buffalo Center from confirmed or suspected Covid-19. Humboldt House had six Covid-19 deaths.

All but one of the five nursing homes have the lowest one-star overall rating from the U.S. Centers for Medicare and Medicaid Services. The Cuba nursing home has an overall rating of three stars, or "average."

More fines coming

Since March 1, the month confirmed infections from the virus hit New York, the state Health Department has conducted 1,845 infection control inspections and issued 95 citations at 77 of the more than 600 nursing homes in the state.

In addition to the fines already issued, more are on the way, according to Health Department spokeswoman Jill Montag.

The $328,000 in penalties, she said, "only represents a portion of the total number of cases for which we are actively pursuing fines."

Montag added, "The Department will continue to hold providers who violate regulations accountable for their actions."

Richard J. Mollot, a national advocate for residents in long-term care facilities, pointed out that the federal government required all states to conduct the infection control inspections for Covid-19 or face cuts in federal funding.

"I'm glad the state is imposing penalties for violations. It is literally a matter of life and death for residents. The issue of proper infection control and prevention has been a persistent and widespread issue in nursing homes," said Mollot, executive director of the Long Term Care Community Coalition in New York City.

Much of the proper infection control procedures, he said, "come down to hand washing and changing personal protective gear. It is not brain surgery."

Humboldt House violations

Reports written by state health inspectors who conducted the Covid-19 reviews provide a window into lax infection control practices at some nursing homes last spring .

These facilities, the state determined, "did not establish and maintain an infection control program to ensure the health and safety of residents to help prevent the transmission of Covid-19."

At Humboldt House, certified nursing assistants were observed not removing their gowns or gloves after caring for residents who were classified as under "contact and droplet precautions" to prevent the spread of the virus, according to an inspection report.

They also failed to practice proper hand cleansing and some "CNAs were unable to identify residents that were on contact and droplet precautions for COVID-19," the inspection report stated.

On social distancing, the inspectors, also known as "surveyors," stated: "During an observation on 4/23/20 at 12:30 p.m., there were six residents in a lounge area across from the nurses' station on the fourth floor. They were not maintaining their face masks or social distancing.

"Staff members [activities/nursing] were present in the area but did not redirect the residents to replace their masks or to social distance, until the surveyors intervened. The licensed practical nurse [LPN] #1 stated there were both Covid-19 positive and negative residents in the lounge area at this time."

Dementia patients on the fourth floor were able to "independently move and wander throughout the entire fourth floor" where there was a mix of Covid-19 positive residents and virus-free residents, the inspection stated.

On April 25, a housekeeper told an inspector she changed her gloves after entering residents' rooms but not her gown. She said, "We only get one gown per shift because there aren't enough gowns to go around."

Humboldt House Administrator Michelle Hardy said in a statement that all state and federal guidelines were followed there.

"In the midst of this pandemic, a new on-site survey was developed for nursing homes for authorities to review infection control procedures dealing with Covid-19.

"This was not an effort to assist the nursing homes in this new situation but an effort to once again put regulatory ramifications and fines to the nursing home industry.

"Despite all good effort, ongoing staff education in infection control and endless hours of work by all staff, the results of the survey were not favorable," Hardy wrote in an email to The Buffalo News.

Humboldt House immediately corrected "all issues raised by the Department of Health ... and the facility was placed back in compliance within 3 days," the statement continued and pointed out that the nursing home has remained "Covid free for 100-plus days and has had 3 additional infection control surveys by the DOH with no issues found."

Buffalo Center violations

At the Buffalo Center for Rehabilitation and Nursing, the state cited failures to discard and change into fresh personal protective equipment in situations where workers cared for Covid-19 positive residents, according to an inspection report.

"CNA #1, wearing a disposable gown, held Resident #1's hand and walked the resident to their bed and assisted them into the bed. While wearing the same disposable gown, CNA #1 exited the room, walked down the hallway and entered the room of non-Covid-19 Resident #2.

"As CNA #1 assisted the non-Covid-19 Resident #2 with adjusting their under clothing, Resident 2 supported themselves by placing their hand on the arm and shoulder of CNA #1, touching the CNA's gown," according to the inspection report from April 30.

Jeff Jacomowitz, a Buffalo Center spokesman, said the nursing home addressed the violations by conducting extensive retraining of workers.

"All clinical staff, from the CNA level to upper clinical management, were given a re-education about the best ways to stop the spread of the virus within the facility," Jacomowitz said.

Retraining included competency in how to use personal protective equipment, "donning and doffing" it and minimizing and preventing cross-contamination, he said.

Other nursing homes cited

At Comprehensive Rehab, inspectors cited a lack of social distancing among residents and improper hand washing among some workers.

"Specifically, the facility did not practice social distancing on two (Unit 5 and Unit 6) of 4 units, residents were not assessed for signs and symptoms of Covid-19 and there was a lack of proper hand hygiene," the inspection report stated.

At the Villages of Orleans Health and Rehab Center, inspectors observed some certified nurse assistants and licensed practical nurses failing to take proper precautions in serving food and in other circumstances.

"Facility staff ... entered and exited the room of a resident diagnosed with [redacted]. The same staff then entered the rooms of residents without Covid-19, passed breakfast trays, assisted with the resident's meal and provided hands-on care without wearing PPE and completing proper hand hygiene. Staff on Covid19 Units, Covid-19 rooms, and Covid-19 presumed rooms were not wearing proper PPE," the inspection report stated.

Inspectors cited Cuba Memorial Hospital's nursing home for not isolating infected residents and failing to report infection information to the state.

All of the facilities fined in this region agreed to implement plans of corrections, according to state Health Department documents.

The News asked the state Health Department if any of the citations it issued across the state involved violations related to the death of residents from Covid-19.

Montag, the spokeswoman, issued this response: "Nursing homes are required to have infection control measures in place to protect residents from Covid-19, and when they fail to do so, Public Health Law empowers the Department to assess fines against facilities for violating federal and state regulations pertaining to Covid-19."

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