Information & Ratings on Cambridge House, Bristol, Tennessee
Do you suspect that your loved one living in a nursing facility is receiving substandard care in an unsafe environment? If so, the Tennessee Nursing Home Law Center Attorneys can provide immediate legal intervention to remove them from the dangerous situation.
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This Medicare/Medicaid nursing facility is a "for profit" home providing services to residents of Bristol and Sullivan County, Tennessee. The 130-certified bed long-term care center is located at:
250 Bellebrook Rd
Bristol, Tennessee, 37620
Tennessee and federal investigators have the legal authority to penalize any nursing home that has been cited for a serious violation that harmed or could have harmed a nursing home resident. Typically, these penalties include imposed monetary fines and denial of payment for Medicare services. Within the last three years, state and federal nursing home regulatory agencies imposed a massive fine against Cambridge House for $211,798 on March 2, 2017.
Over the last thirty-six months, Medicare denied two payments for services on May 16, 2018, and March 2, 2017, due to substandard care. The facility also received six formally filed complaints and self-reported three serious issues that all resulted in citations. Additional documentation about fines and penalties can be found on the Tennessee Department of Health Nursing Home Reporting Website concerning this nursing facility.Bristol Tennessee Nursing Home Safety Concerns
Families can download statistics from Medicare.gov and the Tennessee Department of Public Health online site. These sites detail a comprehensive historical list of all incident inquiries, dangerous hazards, filed complaints, health violations, safety concerns, and opened investigations of every facility statewide. The information can be used to determine the level of health, and hygiene care each community long-term care facility provides its patients.
According to Medicare, this facility maintains an overall rating of one out of five stars, including one out of five stars concerning health inspections, four out of five stars for staffing issues and one out of five stars for quality measures. The Sullivan County neglect attorneys at Nursing Home Law Center have found serious deficiencies and safety concerns at Cambridge House that include:
- Failure to Provide an Environment Free of Unnecessary Physical Restraints
- Failure to Provide Every Resident an Environment Free of Accident Hazards and Provide Adequate Supervision to Prevent Avoidable Accidents
- Failure to Provide and Implement an Infection Protection and Control Program
In a summary statement of deficiencies dated May 16, 2018, the state investigators noted that the facility had failed to “assess one resident [before] the use of a physical restraint and failed to assess [another resident] for restraint reduction.” The investigators reviewed the facility’s policy titled: Use of Restraints revised in 2007 that reads in part:
“Prior to placing a resident in restraints, there shall be a pre-restraining assessment and review to determine the need for restraints. Restrainedindividual shall be reviewed regularly to determine whether they are candidates for restraint reduction, less restrictive methods of restraint, or total restraint elimination.”
The survey team reviewed a resident’s medical records that “revealed no documentation of a restraint assessment had been completed [before] the use of bilateral three/fourth length side rails.” The surveyors observed the resident on the morning of May 14, 2018, in their room while “lying in bed with both 3/4 side rails in the up position." At noon on the same day, the resident was observed in their room “lying in bed with the 3/4 length side rails in the up position.
The surveyor’s interviewed a Registered Nurse (RN) Unit Manager the following afternoon in the resident’s room. The RN “revealed the facility does not code side rails as a restraint.” The RN also said that the resident “was able to change positions from lying to sitting with no assistance” and the “rails were put in place to keep the resident in bed to prevent falls.”
As a part of the investigation, the investigators interviewed the Director of Nursing who “confirmed the side rails were used as a restraint and a restraint assessment had not been completed.” The Director stated that “she was unaware that 3/4 side rails were being used in the facility."
In a separate case, the investigators reviewed another resident’s Physical Restraint Elimination Assessment that revealed that the resident “was a good candidate for a restraint/reduction/elimination.” The assessment dated May 15, 2018, revealed that the nursing staff had continued to use a lap buddy (a soft, cushion height type device that fits over the lap and may be secured in different ways depending on the manufacturer) due to decreased safety awareness.” The resident has “extremely decreased safety awareness – tolerating a lap buddy well.”
Documentation shows that the resident has a “history of dementia, depression, mood disorder” and that the “resident was a good candidate for restraint reduction or elimination.” The surveyors reviewed the resident’s Care Plan dated November 10, 2017, that was updated on January 31, 2018, and April 20, 2018, that revealed that the “resident was to use a lap buddy while up in a wheelchair to stop unassisted ambulation.
The Care Plan stated ‘reassess for the elimination of restraint or change to a less restrictive option routinely. The plan stated the resident needed the lap buddy restraint due to poor safety awareness.”
The investigators observed the resident on numerous occasions between 10:00 AM until 4:00 PM on May 14, 2018, when the resident “was up in the hallways and day room with the lap buddy in place.” The following day, the investigators observed the resident between 7:30 AM and 4:15 PM with a lap buddy in place while the resident was in the day room and the hallways.
The surveyors interviewed the Director of Nursing who “confirmed no interventions to reduce the resident’s use of a restraint had been attempted in quite a while.”
In a summary statement of deficiencies dated May 16, 2018, the state surveyors documented that the facility had failed to “implement interventions for safe transfers with an assistive device to prevent accidents.” The deficient practice by the nursing staff involved one of three residents reviewed for accidents. “The facility’s failure resulted in actual harm for [a resident].”
The investigators reviewed the facility’s policy titled: Safe Lifting and Movement of Residents that reads in part:
“In order to protect the safety and well-being of residents, this facility uses appropriate techniques and devices to lift and move residents.”
“Resident safety will be incorporated into goals and decisions regarding the safe lifting and moving of residents. Nursing staff shall assess individual residents’ needs for transfer on an ongoing basis.”
The investigative team reviewed a resident’s Annual MDS (Minimum Data Set), and Brief Interview for Mental Status that revealed the resident “was cognitively intact” and “totally dependent on ‘two or more’ person physical assist for bed mobility, and transfers, and had impaired mobility in the upper and lower extremities.”
A review of the resident’s medical records and Comprehensive Care Plan dated February 20, 2018, shows that the resident had a “potential for falls related to dependent on staff for transfers via mechanical lift and for person assist.”
The resident’s Nurse’s Notes dated May 2, 2018, at 5:00 AM revealed that a Certified Nursing Assistant (CNA) called the nursing staff to the resident’s room after finding the resident on the floor with supposedly no injuries. The documentation shows that the CNA had lowered the resident to the floor and then assisted the resident back to bed.”
The resident’s medical records revealed a Nurse’s Notes at 11:30 AM where the Nurse Practitioner had seen the resident due to complaints of increasing pain.” The Nurse Practitioner wrote a new order for a right ankle x-ray. The radiation interpretation from that day showed an “acute bony avulsion (when a tendon or ligament comes away from the bone, often pulling a small piece of bone with it) to the medial malleolus (a round bony prominence on the inner side of the ankle joint).”
The nurses placed a call to the Nurse Practitioner who initiated new physician’s telephoned orders dated that afternoon to send the resident to the local emergency room for evaluation and treatment of their right ankle injury. The hospital records show that the non-ambulatory patient “had a fall while being transferred at the nursing home. The patient has swelling noted to her foot, diffused dorsal tenderness,” tenderness and other injuries to the ankle including a “definitive acute fracture.”
The hospital placed the resident’s ankle in a boot and provided instructions for their Primary Care Physician before being discharged with “strict return precautions for worsening symptoms or other concerns.”
The investigative team interviewed the facility Director of Nursing concerning the resident’s Care Plan that indicated that the resident “required the assistance of four staff for transfers with a mechanical lift.” The Director confirmed that “at the time of the fall on May 2, 2018, the facility failed to follow [the resident’s] Care Plan for transferring the resident using the mechanical lift and assist of four persons.”
During an interview with the facility Medical Director it was “confirmed that his expectation was for staff to follow the plan of care while providing care to all residents, and the facility’s failure to follow the plan of care while transferring [the resident] with a mechanical lift resulted in an ankle fracture (actual physical harm).”
The survey team interviewed a Certified Nursing Assistant (CNA) on May 15, 2018, who confirmed that “she was aware that the resident required four staff for transfers but stated the rest of the staff was really busy.” During the interview, it was confirmed that “she knew now not to transfer her alone and received training following the accident.” The CNA also confirmed that “she had not completed competency with return demonstration [training] on the proper use of transferring residents with a mechanical lift.”
In a summary statement of deficiencies dated May 16, 2018, a state investigator noted the nursing home's failure to “ensure staff adhere to appropriate infection control isolation practices and appropriate hand hygiene practice.” The deficient practice by the nursing staff involved one of five residents “reviewed on isolation precautions.”
The investigators also documented that the nursing home had “failed to use appropriate infection control hand hygiene practice during medication administration in one of three medication administration observations.” The survey team reviewed the CDC (Centers for Disease Control and Prevention) Frequently Asked Questions concerning infection control and contact precautions that involved isolating patients with contagious diseases from non-infected patients and performing hand hygiene after removing gloves.
The survey team reviewed a resident’s hospital laboratory results that showed that the resident had an infectious bacterium found in their stool culture “that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.”
The resident’s medical records show that they required “assistance of one person for bathing, dressing, ambulation, transfers, repositioning and bed mobility.” The resident was “incontinent of bowel and bladder and was on a check and change incontinence management program.” The patient had been placed in contact isolation to ensure the contagious infection was not transferred to other residents, visitors, family members, and employees.
The investigative team observed the resident’s door and room that showed that PPE (Personal Protective Equipment) including gowns, gloves, and masks were “located on the cart outside of the resident’s door.” The investigators also observed, “signage outside the resident’s room on the door instructing visitors to please check in at the nursing station before entering the resident’s room.”
However, the surveyors observed the resident with a Licensed Practical Nurse (LPN) on May 14, 2018, just before lunchtime “in the common lounge area, near the 200 Hall nursing station” while “seated in a lounge area with seven other residents seated at various tables and in wheelchairs.” During an interview with the LPN, it was confirmed that the resident “was on contact isolation” for a highly contagious disease “and should not have been in the lounge area with other peers.”
If you suspect caregivers, visitors, employees or other residents victimized your loved one while living at Cambridge House, call Tennessee nursing home abuse lawyers at Nursing Home Law Center at (800) 926-7565 today. Our law firm fights aggressively on behalf of Sullivan County victims of mistreatment living in long-term facilities including nursing homes in Bristol.
Contact us now to schedule a free case review to discuss how to obtain justice and resolve a financial compensation claim. We can begin working on your case today to ensure your rights are protected.
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