To ensure the public remains fully informed, the Centers for Medicare and Medicaid Services (CMS) and the state of California conduct routine unannounced visits, inspections, and surveys of every nursing home statewide. Their efforts help to identify serious concerns, abuse, violations, and deficiencies. When problems are found, the nursing facility is afforded the opportunity to make prompt significant improvements to the level of care they provide or face monetary consequences.
In egregious cases, nursing home regulators may designate the Home as a Special Focus Facility (SFF) and place the Center on the federal Medicare watch list. This designation alerts the facility that their unacceptable substandard of nursing care will no longer be tolerated. If improvements are not made within the appropriate timeframe, the facility may be required to sell their operation to another company in good standing or lose their contract to provide care to Medicare and Medicaid-funded patients.
In 2016, both the State of California and the CMS designated Providence Mt. Rubidoux as a Special Focus Facility and placed the nursing home on the Medicare watch list. While the nursing home has shown some improvement in the level of care they provide, they will likely remain on the watch list for many years ahead. Some details from publicly available information concerning violations and deficiencies are listed below.
This Nursing Center is a “for-profit” Facility providing services and cares to the residents of Riverside and Riverside County, California. The 143-certified bed Center is located at:
6401 33rd St.
Riverside, CA 92509
(951) 681-2200
Both the federal government and the state of California have the legal authority to issue monetary fines to nursing facilities identified with egregious deficiencies and violations. The penalties are typically issued to alert the nursing homes that serious problems that the facility must be corrected immediately.
Over the last three years, nursing home regulators have issued two monetary penalties to Providence Mt. Rubidoux. These penalties include a $50,335 fine on January 13, 2017, and a $4320 fine on December 17, 2015. Also, Medicare denied the facility a request for payment on January 13, 2017, due to substandard care.
State and federal nursing home regulatory agencies routinely update the Medicare.gov website concerning dangerous hazards, filed complaints, safety concerns, health violations, opened investigations and incident inquiries. This information is provided on every nursing facility nationwide. Also, families can use the data including the star rating summary system to determine which nursing home facilities in their community provide the best and worst care.
Currently, Providence Mt. Rubidoux maintains a below average two out of five stars overall compared to all other facilities in the US. This ranking includes one out of five stars for health inspections, four out of five stars for staffing, and two out of five stars for quality measures. Some serious problems involving deficiencies, complaints, concerns and violations at this facility are listed below.
Failure to Follow Physician’s Orders to Treat a Wound to Ensure It Heals Properly
In a summary statement of deficiencies dated August 3, 2017, the state investigator noted that the facility had failed to “ensure the pressure injury (damage to the skin or tissue) Care Plan was updated for [one resident]. This failure increased the potential for the resident to experience decreased wound healing from inconsistent nursing care.”
The investigator reviewed a resident’s Treatment Order dated July 14, 2017, to address “a Wound/Burn dressing gel (wound dressings) applied to the sacrum topically [on each] day shift for a Stage IV pressure injury for 21 days until finished. Cleanse with normal saline (pat dry, apply [the ordered medication] wound gel and cover with the calcium alginate and dry dressing) every day for 24 days then reevaluate.”
However, it was noted that the resident’s August 1, 2017, Sacrum Pressure Injury Care Plan “did not include the current treatment order for [the prescribed] wound gel.” The investigator interviewed the Licensed Vocational Nurse in Charge of providing the resident care who stated that “the Licensed Nurse receiving the treatment order should be responsible for updating the Care Plan.”
Failure to Provide Necessary Care and Services to Maintain a Resident’s Highest Well-Being
In a summary statement of deficiencies dated August 3, 2017, the surveyor noted that the facility had failed to “ensure [a resident] had a communication board [and] necessary writing supplies for nonverbal communication” and another resident “was provided a size-appropriate wheelchair from mobility.” Additional deficiencies at the facility include the failure to ensure a resident “received his blood pressure medication as ordered by the physician” and a fourth resident was provided “medication as ordered by the physician.”
Failure to Develop a Complete Care Plan That Meets All the Resident’s Needs
In a summary statement of deficiencies dated September 29, 2017, surveyors noted that the facility had “failed to ensure one [resident] had his gastronomy tube initiated a Plan of Care to ensure [a resident] would not be able to obtain and use marijuana while at the facility. This failure “had increased the risk [of the resident] being able to receive and use the substance without being noticed by the facility staff.” This failure was identified after the surveyors conducted an “unannounced visit” to investigate “a complaint related to discharge rights.”
The resident’s received a notice of “a proposed 30-days notice of discharge dated September 13, 2017, [which] indicated that the resident was being discharged due to non-payment for [their] share of costs and possession of marijuana.” An interdisciplinary team meeting was held on August 10, 2017, because marijuana was found in the resident’s room. The team informed the resident that a baggie of marijuana was found and asked if it was hers and she at first said ‘No.’” The resident “then went on to say that her roommate shared it with her and that she finally stated that it was both of theirs.”
The resident was observed “down the street on September 4, 2017”, after going “to a store on her electric wheelchairs to buy cigarettes; and on September 11, 2017”. An “interdisciplinary team meeting was held with [the resident] to address the alleged incident with another resident (resident-to-resident altercation).”
The facility’s Director Nursing stated during an interview that “there was no report regarding [the resident’s] obtaining marijuana recently [and that] resident smoking out the patio was being monitored by a Certified Nursing Assistant.” The Director also stated that “there was no specific staff monitoring [of the resident] to ensure she was not in possession are receiving marijuana in her room at that moment.”
In a separate summary statement of deficiencies dated January 25, 2015, the state surveyor noted that the facility had failed to “ensure a Plan of Care was reviewed and revised to address the current nutritional needs of [a resident]. This [deficiency] had the potential to result in further decline in the exertional status of [the resident].” The surveyor conducted an unannounced visit to the facility on January 4, 2017, to investigate a complaint related to the quality of care issues. Between November 3, 2016, and December 25, 2016, the resident’s weight gain and loss has fluctuated from 124 pounds of the 129 pounds, back down to 125 pounds and finally [back up to] 130 pounds on Christmas Day. As a part of the investigation, the Assistant Director Nurses was interviewed on the afternoon of January 19, 2017, who stated that “the nutritional Plan of Care should be reviewed and updated by the members of the weight variance committee.”
The Assistant Director also stated that the resident’s “Nutritional Plan of Care should have reflected the significant weight loss of 4 pounds and [weight gain of 5 pounds]. She further stated that the appropriate interventions addressing the issues should have been reflected in the Plan of Care.”
Failure to Provide Sufficient Care to Prevent the Development of a New Bedsore or Allow an Existing Bedsore to Heal
In a summary statement of deficiencies dated January 25, 2017, the state investigator noted the facility had failed to “ensure one resident would not develop any pressure injury while at the facility when skin changes were not appropriately assessed.” This failure “to a properly assessed the resident for any changes contributed to the development of a new pressure injury which could cause a further decline in [the resident’s] health condition.”
The surveyor conducted an unannounced visit at the facility on January 4, 2017, to investigate a “complaint related to a quality care issue.” The surveyor reviewed the resident’s hospice records. The records included the date of admission, physician’s orders, and body assessments involving “an unstageable opened area on the scrotal area [measuring 1.8 mm x 1.0 mm.” A second site was also noted “measuring 1.5 mm x 1.8 mm] and an unstageable reopened area on the right in her buttock [measuring 3.5 mm x 2.4 mm”, red inner thigh redness, and “buttock skin tear [measuring 1.0 mm x 0.8 mm].”
Failure to Immediately Notify the Resident’s Doctor or Family Member of a Change in the Resident’s Condition
In a summary statement of deficiencies dated January 25, 2017, the surveyor noted the facility’s deficiencies after an unannounced visit. The surveyor investigated a complaint that the nursing home had failed “to ensure the physician and family members were notified of changes in weight and skin conditions.” This deficiency involved one resident and “had the potential for [the resident’s] physician and family member not being fully aware of the current condition and thereby not to be given the opportunity to be involved in [the resident’s] care.”
Was your loved one was the victim of abuse, neglect or mistreatment while residing at Providence Mt. Rubidoux, or any California nursing facility? If so, they might be entitled to file a compensation claim to ensure their family receives monetary recovery for their damages. However, these cases are complex and often require the skills of a competent personal injury lawyer who specializes in California elder abuse and neglect cases.
Contact us today! An attorney working on your behalf can ensure that all necessary lawsuit documentation is filed in the appropriate courthouse before the statute of limitations expires. You lawyer can build a case for compensation to present in front of a judge at trial or insurance claims adjuster in a negotiated out of court settlement. These cases are typically handled through contingency fee arrangements. This agreement allows immediate legal representation without having to pay any upfront fees, retainers or payments. All legal services are paid only after the case has been resolved successfully.
Attorney Anthony Lanzone
Licensed in California
Riverside Nursing Home Injury Lawyer Nursing Home Law Center LLC Home