Inspection Reports for
Elderwood at Wheatfield
2600 Niagara Falls Boulevard, Niagara Falls, NY, 14304
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
12.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
141% worse than New York average
New York average: 5.1 deficiencies/yearDeficiencies per year
40
30
20
10
0
Inspection Report
Complaint Investigation
Capacity: 123
Deficiencies: 4
Date: Aug 14, 2024
Visit Reason
The inspection was conducted as a complaint investigation based on multiple complaints regarding resident care, abuse reporting, elopement, and staffing issues at the nursing home.
Complaint Details
The complaint investigations included issues with resident care preferences not being honored, failure to timely report abuse, inadequate supervision leading to elopement, and insufficient staffing causing unmet resident care needs.
Findings
The facility failed to ensure residents' rights to self-determination and care preferences, including shower schedules and getting out of bed. There was a failure to timely report an allegation of abuse. The facility did not provide adequate supervision to prevent elopement. Staffing levels were insufficient to meet residents' needs, resulting in delayed or missed care.
Deficiencies (4)
F 0561: The facility did not ensure residents received showers and care according to their preferences due to staffing shortages, affecting multiple residents.
F 0609: The facility failed to report an allegation of resident abuse to the State Survey Agency within the required two-hour timeframe.
F 0689: The facility did not provide adequate supervision to prevent a resident from eloping and being found in the parking lot.
F 0725: The facility did not provide sufficient nursing staff to meet the needs of residents, resulting in unmet care needs and delayed services.
Report Facts
Facility bed capacity: 123
Average daily census: 107
Staffing shortages: 8
Resident showers missed: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Registered Nurse #2 | Unit Manager | Reported abuse allegation and managed elopement incident |
| Director of Nursing #1 | Director of Nursing | Acknowledged staffing shortages and care plan noncompliance |
| Administrator | Administrator | Oversaw facility operations and staffing issues |
| Certified Nurse Aide #4 | Certified Nurse Aide | Reported inability to provide showers and resident care due to staffing |
| Certified Nurse Aide #10 | Certified Nurse Aide | Reported missed showers and staffing challenges |
| Certified Nurse Aide #7 | Certified Nurse Aide | Reported staffing shortages and missed showers |
| Licensed Practical Nurse #9 | Licensed Practical Nurse | Reported inability to complete all nursing duties due to staffing |
Inspection Report
Routine
Capacity: 123
Deficiencies: 11
Date: Aug 14, 2024
Visit Reason
Routine standard survey inspection of Elderwood at Wheatfield nursing home to assess compliance with regulatory requirements including resident rights, care, safety, staffing, infection control, and environment.
Findings
The facility was found deficient in multiple areas including resident dignity and choice, staffing shortages impacting care delivery, infection control breaches, incomplete medical records, inadequate pest control, and failure to provide appropriate adaptive equipment for meals. Several residents did not receive care according to their preferences or care plans, and privacy and dignity issues were noted during hospice assessments.
Deficiencies (11)
F0550: The facility did not ensure resident dignity and privacy during hospice nursing assessment conducted in the dining room with other residents present.
F0561: Residents #1, #55, and #56 were not provided showers twice weekly as care planned and preferred, and Resident #56 was not assisted out of bed as preferred.
F0584: Unit 1 had a strong urine odor and presence of flies in resident rooms, dining, and lounge areas, indicating inadequate housekeeping and pest control.
F0609: Allegation of abuse to Resident #69 was not reported to the State Survey Agency within the required two-hour timeframe.
F0686: Resident #38 had a newly identified Stage II pressure ulcer on the right buttock that was not promptly assessed, measured, or documented by qualified staff.
F0689: Resident #84 eloped from the facility and was found in the parking lot; the facility failed to provide adequate supervision to prevent elopement.
F0725: Facility failed to maintain sufficient nursing staff on multiple shifts, resulting in inability to provide care according to residents' care plans and preferences.
F0732: Facility did not post daily nurse staffing information with actual numbers of licensed and unlicensed nursing staff per shift and lacked a policy for completing the DOH Staffing Report.
F0810: Resident #85 was not provided special eating equipment as care planned; bowls and mugs were not used, impacting resident's ability to eat independently and safely.
F0880: Staff failed to use proper personal protective equipment and hand hygiene when providing care to residents on enhanced barrier precautions and during incontinent care.
F0925: Facility did not maintain an effective pest control program; flies were observed in resident rooms, dining rooms, and common areas on Unit 1.
Report Facts
Facility bed capacity: 123
Average daily census: 107
Staffing shortages: 9
Urine volume: 550
Pressure ulcer size: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Registered Nurse #2 | Unit Manager | Reported Resident #69 abuse allegation immediately to Director of Nursing and Administrator |
| Director of Nursing | Acknowledged delay in reporting Resident #69 abuse allegation; responsible for staffing and care oversight | |
| Certified Nurse Aide #4 | Observed not wearing PPE during catheter care for Resident #15; failed hand hygiene during incontinent care for Resident #82 | |
| Certified Nurse Aide #18 | Observed not wearing PPE during catheter care for Resident #15; reported staffing shortages impacting care | |
| Certified Nurse Aide #5 | Observed not performing proper hand hygiene during incontinent care for Resident #82 | |
| Scheduling Specialist | Responsible for DOH Staffing Report; did not update actual staffing numbers | |
| Food Service Director | Responsible for ensuring correct adaptive eating equipment provided to residents | |
| Director of Rehabilitation | Provided occupational therapy assessments and recommendations for Resident #85 adaptive equipment |
Inspection Report
Complaint Investigation
Capacity: 60
Deficiencies: 22
Date: Aug 14, 2024
Visit Reason
Inspection identified multiple standard health and life safety code deficiencies, all corrected by October 11, 2024.
Findings
Inspection identified multiple standard health and life safety code deficiencies, all corrected by October 11, 2024.
Deficiencies (22)
Assistive devices - eating equipment/utensils
Free of accident hazards/supervision/devices
Infection prevention & control
Maintains effective pest control program
Posted nurse staffing information
Reporting of alleged violations
Resident records - identifiable information
Resident rights/exercise of rights
Safe/clean/comfortable/homelike environment
Self-determination
Sufficient nursing staff
Treatment/svcs to prevent/heal pressure ulcer
Corridor - doors
Doors with self-closing devices
Electrical equipment - power cords and extens
Electrical systems - essential electric syste
Exit signage
Fire alarm system - testing and maintenance
Fire drills
Hazardous areas - enclosure
Sprinkler system - maintenance and testing
Subdivision of building spaces - smoke barrie
Inspection Report
Capacity: 60
Deficiencies: 1
Date: Mar 13, 2023
Visit Reason
One standard health citation for reporting to national health safety network; no correction noted.
Findings
One standard health citation for reporting to national health safety network; no correction noted.
Deficiencies (1)
Reporting - national health safety network
Inspection Report
Capacity: 60
Deficiencies: 1
Date: Jan 23, 2023
Visit Reason
One standard health citation for reporting to national health safety network; no correction noted.
Findings
One standard health citation for reporting to national health safety network; no correction noted.
Deficiencies (1)
Reporting - national health safety network
Inspection Report
Deficiencies: 0
Date: Nov 9, 2022
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction for Elderwood at Wheatfield, related to a regulatory survey completed on 2022-11-09.
Findings
No health deficiencies were found during the survey.
Inspection Report
Complaint Investigation
Capacity: 60
Deficiencies: 8
Date: Nov 9, 2022
Visit Reason
Multiple standard health and life safety code citations including department criminal history review and general requirements; all corrected by January 6, 2023.
Findings
Multiple standard health and life safety code citations including department criminal history review and general requirements; all corrected by January 6, 2023.
Deficiencies (8)
Department criminal history review
General requirements
Alcohol based hand rub dispenser (abhr)
Electrical equipment - power cords and extens
Electrical systems - essential electric syste
Hazardous areas - enclosure
Portable space heaters
Sprinkler system - maintenance and testing
Inspection Report
Capacity: 60
Deficiencies: 1
Date: May 30, 2022
Visit Reason
One standard health citation for reporting to national health safety network; no correction noted.
Findings
One standard health citation for reporting to national health safety network; no correction noted.
Deficiencies (1)
Reporting - national health safety network
Inspection Report
Routine
Deficiencies: 1
Date: Dec 6, 2019
Visit Reason
The inspection was conducted as a Standard Survey to assess the facility's compliance with infection prevention and control requirements.
Findings
The facility failed to ensure a safe, sanitary, and comfortable environment to prevent communicable diseases. Specifically, improper infection control practices were observed during incontinence care for a resident on contact precautions for VRE.
Deficiencies (1)
F 0880: The facility did not provide and implement an effective infection prevention and control program. Staff failed to maintain proper infection control practices during incontinence care, including improper hand hygiene and reuse of soiled washcloths, leading to potential cross contamination.
Report Facts
Residents Affected: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA #5 | Certified Nursing Assistant | Observed and intervened during improper incontinence care |
| CNA #6 | Certified Nursing Assistant | Performed improper incontinence care and infection control practices |
| RN Unit Manager #2 | Registered Nurse Unit Manager | Provided interview regarding proper infection control procedures |
Viewing
Loading inspection reports...
