Under the order, Apple Rehabilitation of Rocky Hill must hire an independent consultant who is a registered nurse. The consultant must be at the facility 32 hours per week and be on-site at various times during all three shifts. The consultant, who must be pre-approved by the state Department of Public Health (DPH), will work for at least six months to ensure “the safety, welfare and well-being of the residents” and to make sure the facility is obeying laws, the consent order said.
The consultant is responsible for assessing, monitoring and evaluating direct resident care “with particular emphasis and focus on the delivery of nursing services,” according to the consent order. The consultant also will provide staff training and retraining as necessary, the order said.
The order resulted from 24 violations DPH inspectors found during unannounced visits to the nursing home between April 26 and May 12.
Among the violations, according DPH: Staff failed to notify a physician when a resident had low blood sugar and was administered insulin; a nursing assistant struck the hand of a resident with dementia who was pulling on a tablecloth during a meal; staff failed to provide the necessary housekeeping “to ensure environment was clean, comfortable and home-like” (spider webs and dust were found); and staff failed to take steps to prevent residents from developing bedsores and pressure ulcers.
DPH investigators also found staff failed to follow physicians’ orders and failed to keep records correctly in several cases, among other violations, the consent order said.
Apple Rehabilitation President Brian Foley signed the consent order Sept. 21.
Ann Collette, vice president of business development at Apple Rehab, said the Rocky Hill facility is working with the state to ensure its systems promote the health and well-being of residents, and there is a new leadership team in place.
“Both our administrator and our director of nursing are seasoned professionals who have regional-level experience running five-star skilled nursing centers,” she said. “We welcome their experience and commitment to quality care.”
Apple Rehab’s goal is “to provide our valued patients with the very best care and services,” she added.
The independent consultant will confer with the facility’s administrator, director of nursing services and medical director. All those people will meet with DPH officials every four weeks for the first three months, then every eight weeks through the remainder of the consultant’s tenure.
The consultant will make sure the facility has sufficient nursing personnel to meet residents’ needs and to ensure residents are clean and comfortable, are assessed in a timely manner, and that any injuries of unknown origins are investigated.
Under the order, Apple Rehabilitation of Rocky Hill must appoint a “free floating registered nurse supervisor” on first and second shifts to assess resident care, and must ensure minimum staffing requirements are met in most areas of the facility.
There must be a ratio of one nurse’s aide per 10 residents, for instance, during the first shift, one aide per 12 residents on the second shift, and one aide per 20 residents on the third shift. There must be one licensed nurse per 32 residents on the first and second shifts and one licensed nurse per 40 residents on the third shift, according to the order.
