Sarah Reed Senior Living fined $201,769 since 2021 for incidents injuring four patients
Sarah Reed Senior Living, 227 W. 22nd St., has been fined $201,769 by federal and state government agencies since June 2021 for health and safety violations, some of which directly injured residents at the long-term care facility.
It is the largest amount of money, by far, that any Erie County long-term care facility has been fined during that time.
The fines, imposed by the Pennsylvania Department of Health, and the Centers for Medicare and Medicaid Services, penalize Sarah Reed for citations found during State Health Department inspections. The incidents that involved serious patient harm included:
Three separate instances of improperly lifting a resident by only using one employee instead of two, as required by the patients' medical records. All three incidents led to resident injuries that required hospital visits.
An incident where a patient with diabetes was given insulin despite having a blood-sugar level that did not require it, according to their patient records. The patient was later found on the floor with a fractured right ring finger.
As a result, Sarah Reed is designated on Medicare's website as having been cited recently for resident harm or potential harm due to abuse or neglect.
"Patient health and safety, access to reliable, high-quality care, and the treatment of all residents in nursing homes with dignity and respect are top priorities," CMS officials said in a statement when asked to comment on Sarah Reed's fines. "That includes holding facilities accountable for meeting certain health and safety standards necessary to be certified as a Medicare and Medicaid provider."
Repeated messages left with Sarah Reed officials were not returned.
Details about patient injuries at Sarah Reed
The most recent incident at Sarah Reed occurred July 22, 2022, according to State Health Department inspection reports. A resident was being transferred from their bed to a wheelchair by a nursing aide using a lift device when the resident "fell out of the lift" and "sat down heavy in the wheelchair."
Initial x-rays indicated no acute injury but the resident was taken to a local emergency room a week later after family members said the resident was suffering lower back pain. Doctors diagnosed the resident with acute fractures of the sacrum and L1 vertebrae.
The nursing aide, who knew the patient's records required two employees to lift them, was removed from the schedule and did not return to work at Sarah Reed, according to the inspection report.
Sarah Reed was fined $15,593 by CMS in connection with the incident.
CMS' largest fine against Sarah Reed, $85,790, resulted from the incident involving the resident with diabetes. It occurred March 24, 2022, when the resident was given four units of insulin after dinner, even though their blood-sugar level was too low to receive it, according to their physician orders.
Two-and-a-half hours after the insulin injection, the resident was found to have fallen on the floor. X-rays showed they had fractured their right ring finger.
The resident told staff that they had tried to move from their motorized wheelchair to a manual one when they stood up and could feel that their blood-sugar level was low, according to inspection report filed April 21, 2022. They didn't remember falling.
Sarah Reed was also fined $12,500 by the State Health Department in connection with the incident.
On Oct. 26, 2021, a resident suffered a triangle-shaped leg laceration as a nurse aide moved them from a wheelchair to a shower chair.
The aide moved the resident alone, though the resident's medical records required a two-person physical assist. The resident was taken to the hospital and received seven stitches to close the laceration.
Sarah Reed was fined $45,825 by CMS and $23,250 by the State Health Department in connection with the event. The aide was suspended without pay, according to the inspection report.
On Aug. 24, 2020, a resident suffered a broken femur when a nursing aide tried to lift them out of a wheelchair and the resident became twisted, according to an inspection report.
The resident, whose medical records required two people to lift or transfer them, was transported to the hospital and treated for the broken femur.
Sarah Reed was fined $18,161 by CMS. The aide was taken off the schedule and did not return to work, according to the inspection report.
Inspection reports only tell part of a facility's story
Reading inspection and penalty reports are important when considering a long-term care facility for a family member, but it's only part of the process, said Zach Shamberg, CEO of the Pennsylvania Health Care Association, a statewide advocacy organization.
"It doesn't tell the complete story," Shamberg said. "Families should look at quality measures and also go visit the facility. Talk with the administrator, the staff, other residents and their families."
Sarah Reed is rated below average (two stars out of five) on health inspections on the CMS Care Compare website, but it is rated above average (four stars) in staffing, and average (three stars) in quality measures — such as whether residents have gotten their flu shots, are in pain, or are losing weight.
However, the Pennsylvania Long-Term Care Ombudsman Program cautions against depending too much on the quality measures because they rely heavily on self-reported, and not verifiable, data from the facilities.
"We encourage families to do their research," Ombudsman Program officials said in a statement. "Find a home that not only offers quality care, but also one that offers a homelike environment where their loved one will thrive."
If you hear about problems at a long-term care facility where your loved one resides, there are several steps you can take, according to CMS.
The first step is to talk with the staff. If that doesn't resolve the issue, speak to the facility's administrator, physician or director of nursing.
If the problem still persists, you can contact the State Health Department at 800-254-5164, use the online complaint form, or email c-ncomplai@pa.gov.
"Looking at the inspections with Sarah Reed Senior Living, it seems the facility had its policies in place," Shamberg said. "Perhaps the incidents were due to lapses."
Contact David Bruce at dbruce@timesnews.com. Follow him on X, formerly Twitter, @ETNBruce.
This article originally appeared on Erie Times-News: Sarah Reed Senior Living fined $201,769 by CMS, PA Health Department
