Inspection Reports for Glen Cove Center for Nursing and Rehabilitation
6 Medical Plaza, Glen Cove, NY, 11542
Back to Facility ProfileInspection Report Summary
The most recent inspection on May 17, 2024, identified several deficiencies including issues with call bell accessibility, environmental cleanliness, pressure ulcer care, nursing staffing postings, and timely psychiatric consultations. Earlier inspections showed a pattern of similar issues related to resident care, wound treatment, medical supervision, and environmental safety, with no enforcement actions or fines listed in the available reports. Complaint investigations during this period were unsubstantiated or corrected promptly, with no substantiated complaints noted. Prior reports also cited documentation and care planning deficiencies, as well as some life safety code concerns that were addressed. The facility’s inspection history shows ongoing challenges in care and environment standards without a clear trend of improvement or worsening.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
5.4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
6% worse than New York average
New York average: 5.1 deficiencies/yearDeficiencies per year
8
6
4
2
0
Inspection Report
Annual Inspection
Deficiencies: 5
Date: May 17, 2024
Visit Reason
The inspection was a recertification survey conducted from 5/13/2024 to 5/17/2024 to assess compliance with regulatory requirements for nursing home care.
Findings
The facility was found deficient in several areas including call bell accessibility for residents, maintenance of a clean and homelike environment, pressure ulcer care, nursing staffing postings, and timely psychiatric consultations. Deficiencies involved minimal harm or potential for actual harm affecting a few residents.
Deficiencies (5)
Facility did not ensure each resident had a call bell accessible to alert staff; Resident #80's call bell was out of reach on two occasions.
Facility did not maintain a clean, comfortable, and homelike environment; stained privacy curtain in Resident #24's room and missing window covering in Resident #80's room.
Facility did not ensure residents with pressure ulcers received necessary treatment and services; Resident #109's air mattress weight setting was incorrect and sacral wound staging was not classified.
Facility did not post nursing staffing information daily including total number of licensed and unlicensed staff per shift.
Facility did not ensure timely use of outside professional resources; Resident #91 did not receive initial psychiatry consult until over a month after admission.
Report Facts
Weight setting on air mattress: 230
Pressure ulcer wound measurements: 2
Pressure ulcer wound measurements: 1
Pressure ulcer wound measurements: 0.3
Psychiatry consult delay: 44
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nursing Assistant #9 | Named in call bell accessibility deficiency for Resident #80. | |
| Licensed Practical Nurse #5 | Named in call bell accessibility deficiency for Resident #80 and window covering observation. | |
| Registered Nurse #3 | Unit Manager | Named in call bell accessibility and window covering deficiencies. |
| Director of Nursing Services | Interviewed regarding call bell accessibility, pressure ulcer care, nursing staffing, and psychiatry consult deficiencies. | |
| Maintenance Mechanic #1 | Interviewed regarding privacy curtain and window covering deficiencies. | |
| Housekeeper #1 | Interviewed regarding privacy curtain and window covering deficiencies. | |
| Licensed Practical Nurse #3 | Medication Nurse | Interviewed regarding air mattress weight setting for Resident #109. |
| Licensed Practical Nurse #4 | Charge Nurse | Interviewed regarding air mattress weight setting for Resident #109. |
| Director of Maintenance | Interviewed regarding air mattress weight setting for Resident #109. | |
| Licensed Practical Nurse #2 | Wound Care Nurse | Interviewed regarding pressure ulcer care and air mattress weight setting for Resident #109. |
| Psychiatrist #1 | Interviewed regarding delayed psychiatry consult for Resident #91. | |
| Primary Physician #1 | Interviewed regarding psychiatric medication and consult for Resident #91. | |
| Staffing Coordinator | Interviewed regarding nursing staffing posting deficiencies. |
Inspection Report
Complaint Investigation
Capacity: 60
Deficiencies: 6
Date: May 17, 2024
Visit Reason
Complaint Survey with 5 Standard Health Citations and 1 Life Safety Code Citation, all Level 2 severity, corrected by July 9, 2024 or June 13, 2024.
Findings
Complaint Survey with 5 Standard Health Citations and 1 Life Safety Code Citation, all Level 2 severity, corrected by July 9, 2024 or June 13, 2024.
Deficiencies (6)
Posted nurse staffing information
Reasonable accommodations needs/preferences
Safe/clean/comfortable/homelike environment
Treatment/svcs to prevent/heal pressure ulcer
Use of outside resources
Means of egress - general
Inspection Report
Complaint Investigation
Capacity: 60
Deficiencies: 1
Date: Mar 21, 2023
Visit Reason
Complaint Survey with 1 Standard Health Citation for quality of care, Level 2 severity, corrected by May 10, 2023.
Findings
Complaint Survey with 1 Standard Health Citation for quality of care, Level 2 severity, corrected by May 10, 2023.
Deficiencies (1)
Quality of care
Inspection Report
Abbreviated Survey
Deficiencies: 2
Date: Feb 27, 2023
Visit Reason
The abbreviated survey was conducted to assess compliance with professional standards of practice, comprehensive person-centered care plans, and residents' choices, focusing on wound care and treatment for sampled residents.
Findings
The facility failed to ensure appropriate wound care and documentation for two residents. Resident #1's surgical scalp wound care was inadequately documented, including missing staple counts and incomplete treatment records. Resident #2's wound care was improperly performed, including failure to follow physician orders and aseptic technique breaches during treatment.
Deficiencies (2)
Failure to document assessment and staple removal details for Resident #1's surgical scalp wound.
Failure to follow physician's orders and aseptic technique during wound care for Resident #2.
Report Facts
Treatment days ordered: 14
Dates with undocumented treatment: 7
Dates of resident refusal: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Physician #1 | Physician | Removed staples from Resident #1's head wound; failed to document number of staples removed and wound assessment |
| LPN #1 | Licensed Practical Nurse | Did not follow physician's orders and aseptic technique during Resident #2's wound care; failed to document wound care for Resident #1 on multiple dates |
| LPN #2 | Licensed Practical Nurse, Charge Nurse | Assisted with Resident #2's wound care; interviewed regarding documentation failures for Resident #1's wound care |
| RN #1 | Registered Nurse, Temporary Wound Care Nurse | Interviewed about wound care documentation and standards for Resident #1 |
| RN #2 | Assistant Director of Nursing Services | Interviewed regarding wound care documentation and nursing expectations |
| RN #3 | Registered Nurse, Current Wound Care Nurse | Interviewed about wound care procedures and aseptic technique |
| Director of Nursing Services | Director of Nursing Services | Interviewed about wound care documentation expectations and corrective actions |
Inspection Report
Annual Inspection
Deficiencies: 2
Date: Sep 13, 2022
Visit Reason
The inspection was conducted as a Recertification Survey and Abbreviated survey to assess compliance with regulatory requirements including investigation of alleged violations and supervision of medical care.
Findings
The facility failed to thoroughly investigate alleged violations related to skin tears for Resident #208 and did not ensure that the medical care of residents, specifically monitoring significant weight loss, was supervised by the attending physician for Residents #30 and #86. Significant weight losses were not addressed by physicians in progress notes.
Deficiencies (2)
Failure to investigate alleged violations related to skin tears for Resident #208.
Failure to ensure medical care supervision by physicians including monitoring significant weight loss for Residents #30 and #86.
Report Facts
Significant weight loss: 5
Significant weight loss: 8.6
Significant weight loss: 17.1
Significant weight loss: 10.8
Weight loss: 7.6
Weight loss: 11.4
Weight loss: 20
Weight loss: 12.2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN #3 | Registered Nurse Supervisor | Documented and reported skin tear to wound care nurse. |
| RN #4 | Wound Care Nurse | Entered physician orders for skin tear treatment and interviewed about investigation. |
| RN #1 | Risk Manager/Assistant Director of Nursing Services | Did not conduct investigation for skin tears and provided rationale. |
| LPN #1 | Licensed Practical Nurse | Reported skin tear to RN #3. |
| RN #5 | Registered Nurse Unit Manager | Interviewed regarding weight loss notification and dietician changes. |
| Chief Clinical RD | Registered Dietitian | Interviewed about weight monitoring and reporting procedures. |
| Director of Nursing Services | Director of Nursing Services | Interviewed about reporting weight loss to physicians and investigation policies. |
Inspection Report
Complaint Investigation
Capacity: 60
Deficiencies: 8
Date: Sep 13, 2022
Visit Reason
Complaint Survey with 2 Standard Health Citations and 6 Life Safety Code Citations, mostly Level 2 severity, all corrected by November 2, 2022.
Findings
Complaint Survey with 2 Standard Health Citations and 6 Life Safety Code Citations, mostly Level 2 severity, all corrected by November 2, 2022.
Deficiencies (8)
Investigate/prevent/correct alleged violation
Resident's care supervised by a physician
Electrical equipment - power cords and extens
Elevators
Means of egress - general
Physical environment
Sprinkler system - maintenance and testing
Subdivision of building spaces - smoke barrie
Inspection Report
Capacity: 60
Deficiencies: 1
Date: Nov 15, 2021
Visit Reason
Covid-19 Survey with 1 Standard Health Citation for reporting to national health safety network, Level 2 severity, not corrected as of report.
Findings
Covid-19 Survey with 1 Standard Health Citation for reporting to national health safety network, Level 2 severity, not corrected as of report.
Deficiencies (1)
Reporting - national health safety network
Inspection Report
Annual Inspection
Deficiencies: 2
Date: Dec 20, 2019
Visit Reason
The inspection was conducted as a Recertification Survey to assess compliance with regulatory requirements related to care planning, hydration, and other resident care standards.
Findings
The facility failed to revise Comprehensive Care Plans (CCP) to reflect resident-specific interventions for psychotropic medication use and advanced directives. Additionally, the facility did not ensure adequate hydration for a resident on aspiration precautions, resulting in improper fluid administration and subsequent dehydration requiring intravenous fluids.
Deficiencies (2)
Failure to develop and revise complete care plans within 7 days of comprehensive assessment, including resident-specific interventions for psychotropic medication use and advanced directives.
Failure to provide sufficient fluid intake to maintain proper hydration for a resident with aspiration precautions, resulting in dehydration and need for intravenous fluids.
Report Facts
BUN level: 21
BUN level: 57
Creatinine level: 1.16
Creatinine level: 2.31
Sodium level: 141
Sodium level: 147
Fluid intake restriction: 1500
IV fluid rate: 75
Staff inserviced: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Activity Director | Interviewed regarding care plan meetings and resident interventions | |
| Registered Nurse (RN)/Unit Coordinator | Interviewed regarding care plan meetings and medication increases | |
| Social Work Director | Interviewed regarding incorrect Advance Directives care plan | |
| Speech Therapist (ST) | Provided safe feeding inservice and feeding recommendations for Resident #296 | |
| Registered Nurse (RN) unit manager | Interviewed regarding resident hydration and ice chip allowance | |
| Licensed Practical Nurse (LPN) | Interviewed regarding resident feeding and hydration observations | |
| Registered Dietician (RD) | Interviewed regarding resident hydration status and care plan inaccuracies | |
| Certified Nursing Assistant (CNA) | Interviewed regarding feeding and hydration care for Resident #296 | |
| RN Inservice Coordinator | Interviewed regarding staff training on safe feeding techniques | |
| Administrator and Director of Nursing Services (DNS) | Interviewed regarding staff training and care plan instructions |
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