Pine Acres Rehab & Living Center: COVID-19 Summary

covid-19 pine acres stats

Pine Acres Rehab & Living Center releases COVID-19 statistics showing 50 COVID infections and 1 death.  Levin & Perconti, Illinois nursing home lawyers launch investigation into gross negligence in preventing the spread of COVID-19

On May 28, 2020, Pine Acres Rehab & Living Center, located in DeKalb, Illinois, released long term care outbreak data reporting of laboratory confirmed COVID-19 outbreak cases.  These statics confirm that 50 infections and 1 death have occurred at the facility during the COVID-19 outbreak.

On May 28, 2020, the Daily Chronicle posted an article detailing the COVID-19 outbreak at Pine Acres Rehab & Living Center, describing numerous failures in the facility’s fight against the virus and preventing its transmission. The article explains the lack of information being shared by the community to family members who are extremely concerned for the well-being of their loved ones who are residents in the facility. Numerous attempts to receive updates or any kind of information about how the facility has been dealing with the virus outbreak have been met with silence on the part of Pine Acres. The article further cites a report from the Illinois Department of Public Health which stated Pine Acres had not performed the necessary testing on residents until 12 days after it was discovered an employee of the facility had contracted the virus. This inability on the part of the facility to sufficiently test residents demonstrates a major failure on its part in combating the virus outbreak and further preventing its transmission within Pine Acres.

Quarterly Violations

Based on the Illinois Department of Public Health’s Quarterly Reports of Nursing Home Violations, Pine Acres Rehab & Living Center was found to be in violation of several policies and procedures prescribed by the Illinois Department of Public Health.

In Quarter 2 of 2016 (April – June) a survey conducted on May 5. 2016, found Pine Acres to have committed a Type B violation, including sections of the Code: 300.610(a), 300.1210(b), 300.1210(d)(6), and 300.3240(a). Specifically, the facility was found to have failed to ensure a resident’s safety after the resident left the facility without approval, which resulted in the resident returning to the facility with a fractured clavicle and skin tear to the arm.

In Quarter 2 of 2018 (April – June) a survey conducted on April 4, 2018, found Pine Acres to have committed a Type B Violation, including sections of the code: 300.610(a), 300.1210(b)(5), 300.1210(d)(5), and 300.3240(a). The violation was evidenced by the facility’s failure to ensure a resident requiring assistance was safely transferred from her wheelchair to her bed with the use of a gait belt to prevent further injury. This failure subsequently resulted in the resident sustaining a large hematoma to her chest and extensive bruising across her chest which required hospitalization.

Lastly, in Quarter 1 of 2019 (January – March) a survey conducted on November 21, 2018, found Pine Acres to have committed a Type B Violation, including sections of the Code: 300.1210(b)(4), 300.1210(d)(6), and 300.3240(a). Specifically, the survey concluded that the facility failed to properly supervise a resident in bed while providing personal care, this failure subsequently resulted in the resident falling off of the bed and sustaining two cervical fractures. The facility’s care plan for the injured resident explicitly stated that two CNAs be present at all times during these activities and this failure precipitated the incident.

Regulatory History

The Illinois Department of Public Health conducts yearly recertification procedures in which nursing homes are subjected to a review of their regulatory history and any violations occurring at the home. Furthermore, during the recertification process, when a nursing home has been found to have committed a regulatory violation, the facility is subsequently required to submit a plan of correction for how it will remedy the violation or prevent similar violations from occurring in the future.

The 2016 recertification survey conducted on August 5, 2016, found Pine Acres failed to follow their abuse prevention policy by not immediately reporting an abuse-related incident to the pertinent administrator. Further, the facility failed to investigate the allegation of abuse while continuing to protect the affected resident and her privacy. Moreover, the 2016 recertification survey found Pine Acres failed to follow physician’s orders by not ensuring ordered medications were received and given to ailing residents, nor did the facility ensure a particular resident received the necessary occupational therapy in accordance with the physician’s order.

In addition, the facility was found to have failed to ensure a resident received the necessary incontinence care in a timely manner. Specifically, the resident’s care plan required staff to check on the resident at least every two hours and extensive staff failed to carry-out these requirements. Lastly, the survey concluded the facility failed in its duty to ensure that a resident who enters the facility without pressure sores does not develop such injuries, the record provides an example of a resident entering with no skin breakdowns but soon developed such injuries.

The 2017 recertification survey conducted on July 27. 2017, found Pine Acres staff members failed to wear gloves during feeding tube medication administration, and further failed to flush the tube with the prescribed and necessary amount of water. Moreover, the facility failed to administer medications as ordered to keep their medication error rate below 5%, leading to the finding of medications left out in the open and ultimately wasted. Similar failures continued to appear throughout this survey as another noted failure occurred with regards to removing expired medications from resident use. Additionally, Pine Acres was found to have failed in its capacity to provide for the safe and sanitary storage of food.

Specifically, Pine Acres failed to maintain freezer temperature at or below 0 degrees fahrenheit, and failed to ensure all cooking equipment was sufficiently sanitized. The freezer, refrigerator, and dry storage room floor were all documented as not being properly maintained or sanitized in a clean manner. It is the nature of these types of failures, involving cleanliness and proper disposing of waste or infectious items, that are especially concerning within the scope of combating the COVID-19 virus outbreak.

As for the 2018 recertification survey, conducted on September 13, 2018, the Illinois Department of Public Health found Pine Acres failed to provide a sufficient environment to maintain resident privacy during personal care; failed to ensure resident common areas and rooms were clean, comfortable, and homelike; and failed to ensure a particular prescribed treatment was applied by the requisite professional nurse. Furthermore, the facility failed to ensure fall prevention interventions were adequately assessed, implemented, and evaluated as to determine the effectiveness of such interventions. This particular finding was documented in regard to one resident not being properly monitored, resulting in that resident falling and subsequently making a mess in bathroom, including fecal matter on the toilet.

As has been previously noted in prior recertification surveys, Pine Acres has been cited numerous times for failing to provide adequate and sanitary food to its residents. While the facility’s plan of correction purported to address these reoccurring problems, the 2018 recertification survey again found a failure of a similar nature. Specifically, the facility failed to ensure dairy products served to the residents were not expired or spoiled. This continuing failure demonstrates the facility’s overall inability to effectively implement and follow its plans of corrections and raises serious concerns as to its capacity to handle the COVID-19 outbreak.

The 2019 recertification survey, conducted on October 30, 2019, found Pine Acres failed to ensure wheelchairs and feeding tubes were adequately cleaned and sanitized. The survey provides an account of wheelchairs not being cleaned for over two weeks and being covered in food debris and visibly dirty. Moreover, facility staff failed to provide the necessary dressing was applied on a Stage 4 pressure injury to a resident’s coccyx. Specifically, the resident’s urinary tube was found to be leaking which resulted in the resident being covered in urine. In addition, the resident’s pressure injury on his coccyx was open and had no dressing applied to the wound as is required by his care plan and the facility’s policy on treating pressure injuries.

However, this was not the only resident affected by failures of this nature, in fact two more residents were documented as not being given proper care which included: failure to ensure the catheter tubing was secured to prevent penile tear and abrasion; failed to ensure a urinary drainage bag was kept below the necessary level of the bladder; and failed to provide complete pericare in a manner that would effectively prevent infections. Just as the previous recertification surveys mention, the 2019 recertification survey again finds Pine Acres failed in its capacity to ensure kitchen appliances were properly cleaned and sanitized. This time finding the facility failed to ensure the dishes in the dishwasher were sanitized, which the survey mentions has the potential to adversely affect every resident in the facility.

Lastly, the 2019 recertification survey explains Pine Acres failed to ensure staff members changed their gloves and washed their hands during perineal care, and further failed to handle linen in a manner that would prevent cross contamination. Failures of this nature are extremely concerning in the context of the current COVID-19 pandemic, and the repeated findings throughout the recertification process over years demonstrates a continued inability on the part of Pine Acres to effectively deal with transmission of infections within the facility.

Founding partner Steven M. Levin described these outbreaks in many Illinois Nursing Homes: “for many years prior to this outbreak, Pine Acres Rehab & Living Center operated with insufficient staff and with a lack of adherence to recognized infection control protocols.  It is not surprising that they were ill equipped to handle this outbreak.”

Levin & Perconti: Chicago Attorneys at Law

As experienced advocates for long-term care residents and their families, our firm is ready to help ensure that your loved ones stay safe and healthy during this unprecedented time. Please use our resources to help you stay connected and know that if you find yourself concerned about a resident’s well-being, you can call us at 312-332-2872 or toll-free at 877-374-1417 to request our help during a free consultation.

Share Your COVID-19 Nursing Home Story and Help Others

As COVID-19 continues to spread, it has also magnified systemic breakdowns within Illinois’ long-term care facilities, nursing homes, or assisted living centers. After this latest release of reported data by IDPH, more than half of the COVID-19-related fatalities in Illinois have now occurred at these facilities.

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