Inspection Reports for The Hamlet Rehabilitation and Healthcare Center at Nesconset

The facility was found deficient in providing appropriate pressure ulcer care for Resident #11, safe administration and monitoring of a Peripherally Inserted Central Catheter for Resident #323, and ensuring oxygen therapy was available and administered as ordered for Resident #7. Deficiencies included failure to update physician orders timely, lack of routine catheter site monitoring and measurement, and an empty oxygen tank during resident use.

Inspection found 3 health and 1 life safety deficiencies including issues with parenteral/iv fluids, respiratory care, pressure ulcer treatment, and egress doors; all corrected by April 2025.

The complaint was substantiated based on video evidence showing Certified Nursing Assistant #1 verbally abusive and physically aggressive towards Resident #1. The facility's investigation confirmed the abuse, resulting in termination of Certified Nursing Assistant #1 and Registered Nurse #1 for failure to intervene.

The facility failed to prevent and protect Resident #1 from verbal abuse and physical aggression by Certified Nursing Assistant #1, who was captured on video displaying abusive behavior. The facility's administration reviewed the video, confirmed the abuse, and terminated the involved staff. Registered Nurse #1 failed to intervene appropriately and was also terminated.

One health deficiency related to free from abuse and neglect was found and corrected by May 2024; enforcement action included a stipulation and fine for resident rights.

The facility failed to develop and implement comprehensive, person-centered care plans with measurable objectives and time frames for residents' current needs. Specific deficiencies included lack of care plans for the use and monitoring of a self-release seatbelt for Resident #81, hearing aids for Resident #130, and the use and care of a PICC line and Foley catheter for Resident #391. Additionally, there were missing physician orders for the use and care of the PICC line and Foley catheter.

The facility failed to develop and implement comprehensive, person-centered care plans with measurable objectives and time frames for residents' current needs. Deficiencies were found in care planning for residents with PICC lines, Foley catheters, hearing aids, physical restraints, and assistive devices. The facility also failed to ensure adequate supervision to prevent accidents, including leaving medications unattended at a resident's bedside. Physician orders were missing for the use and care of PICC lines and Foley catheters. Care plans were not updated to reflect residents' behaviors such as removing assistive devices.

Multiple health and life safety deficiencies including care plan timing, comprehensive care plan, accident hazards, physician supervision, and electrical systems; all corrected by January 2024.

The facility failed to have an effective system to monitor and document bowel movements for Resident #1, who suffered from constipation leading to fecal impaction, septic shock, and death. Documentation inconsistencies, lack of timely notification to medical staff, and failure to follow bowel protocols were identified, resulting in immediate jeopardy and actual harm.

One health deficiency related to quality of care with immediate jeopardy was found and corrected by October 2023; enforcement action included a stipulation and fine for quality of care.

The facility was found deficient in multiple areas including failure to rotate insulin injection sites for a resident on insulin therapy, failure to provide recommended Nursing Ambulation Program services leading to decline in ambulation for a resident, inadequate personal hygiene care with untrimmed and soiled fingernails for a resident requiring assistance, and improper oxygen administration exceeding physician orders for a resident on oxygen therapy.