Village Crest Center For Health & Rehabilitation
19 Poplar Street, New Milford, CT 06776 · For profit - Corporation · 95 certified beds · (860) 354-9365 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- a middle-of-the-pack inspection score (3/5)
- it has an abuse, neglect, or exploitation citation (F0600), cited Sep 2024
- it has a citation for mishandling residents’ money or property (F0568)
- it has 2 actual-harm citations
- a high number of inspection citations overall (26) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $24,418 in federal fines (most recent 2025-05-06)
- its facility-reported quality-measure score sits well above its independent inspection score
- about 28% of its spending goes to commonly-owned related companies
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 3 of 5 |
| StaffingFrom payroll records (PBJ) | 3 of 5 |
| Quality measuresSelf-reported by the facility | 5 of 5 |
Worth a closer look. This home's quality-measure rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself — so a gap this large is worth reading the inspection record for.
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 5 of 5 |
| Long-stay residentspeople who live here | 5 of 5 |
| Short-stay residentsrehab / post-hospital | 4 of 5 |
Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating fell from 5 to 3 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 9.8% | 18.0% | 15.4% | better |
| Long-stay residents who lose too much weight | 8.6% | 6.5% | 5.4% | worse |
| Long-stay residents with a catheter left in their bladder | 0.3% | 0.7% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 0.8% | 1.5% | 2.0% | better |
| Long-stay residents with depressive symptoms | 39.1% | 22.3% | 6.5% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 1.5% | 3.5% | 3.3% | better |
| Long-stay residents whose ability to walk worsened | 6.0% | 16.4% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 16.7% | 17.6% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 98.6% | 93.5% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 2.9% | 4.0% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 24.5% | 24.7% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 14.2% | 17.8% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 0.0% | 1.5% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 82.6% | 69.7% | 79.4% | typical |
| Short-stay residents rehospitalized after admission | 18.4% | 24.3% | 22.6% | better |
| Short-stay residents with an outpatient ER visit | 18.5% | 10.7% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 0.49 | 2.06 | 1.67 | better |
| Long-stay outpatient ER visits per 1,000 resident days | 2.56 | 1.46 | 1.80 | worse |
‡ On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.
§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
Short-stay rehab — if you are coming here from a hospital
Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.
55.4% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 234 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 50.0% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 34 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.
Therapy staffing: this home’s payroll records show 0.39 therapist hours per resident per day in 2026Q1 — more than 66% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 35% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.
This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 55.4%CMS range 49.4–61.0 | 51.5% | Oct 2022–Sep 2024 | no different from U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 10.6%CMS range 7.0–14.5 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 50.0% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 58.8% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 50.0% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 99.2% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 0.0% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 1.6% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 6.2%CMS range 3.6–10.1 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.06 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 95 beds and averages 86.4 residents a day — about 91% occupied, or roughly 9 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.
Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.62 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.48 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.22 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.
Weekend coverage: total nurse staffing is 3.42 hrs/resident/day on weekends vs 3.71 on weekdays — 8% thinner on weekends. RN hours go from 0.56 to 0.28 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 40% is about the same as the national median of 45%.
Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.
Inspection trend
Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
26 citations, most serious first. The 12 most serious are shown; the remaining 14 are one tap away and print in full.
- Actual harm · Gcited before2025-05-06 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews, review of the clinical record, facility documentation, and facility policy for 1 of 5 residents (Resident #24) reviewed for falls, the facility failed to provide a transfer according to physician orders which resulted in a fall with injury and failed ensure all appropriate doors were secured on the locked memory care unit. The findings include: 1. Resident #24's diagnoses included transient cerebral ischemic attack, morbid obesity, and difficulty in walking. The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #24 was moderately cognitively impaired, had no falls since the previous assessment (5/18/23), had received physical therapy services from 6/2/23 through 7/4/23, required setup or clean-up assistance with eating, substantial/maximal assistance with bed mobility, and was dependent for transfers. A physician order dated 8/23/23 directed to provide extensive assistance of 1 staff member for bed mobility, Resident #24 required the use of a Sarita lift for…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Actual harm · Gcited before2024-09-19 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on a review of clinical records, facility documentation, facility policy, and interviews for one (1) of three (3) residents (Resident #1) reviewed for accidents, the facility failed to provide adequate assistance during a bed linen change and as a result, the resident rolled out of bed onto the floor sustaining a left hip fracture. The finding includes: Resident #1 had diagnoses that included Alzheimer's disease, generalized muscle weakness, and difficulty walking. Review of Resident #1's side rail evaluation dated 6/14/24 identified the indication and use of the side rails is per the request of Resident #1 and h/her responsible party. The side rail evaluation identified Resident #1 has a self-care deficit with interventions that directed the use of quarter (1/4) side rails for assistance/enablers with bed mobility. The side rail evaluation identified for use of the side rails are not to exceed 28 inches in length from the head of bed. The quarterly MDS assessment dated [DATE] identified Resident #1 had…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Fcited before2025-05-06 · tag F0812 — failed to store, cook, and serve food safely — widespreadProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on the tour of the Dietary Department and Nourishment Rooms, staff interviews, and review of facility policies, the facility failed to ensure opened items were labeled and dated when opened, food that was expired was discarded and the 3 of 3 nourishment refrigerator/freezer/ice makers were sanitary. The findings included: Tour of the Dietary Department on 4/28/25 at 10:40 AM during the initial walk through with the Dietary Director identified the following: a. 16 hot dog buns were in an opened package and not dated when opened b. 1 loaf of French bread, opened and not dated when opened c. 2 slices of French toast on a plate, covered with plastic wrap and located in the walk in refrigerator and not dated when opened d. 8 donuts in a box that was opened and not dated when opened e. 1 package (5 lb) egg noodles with an expiration date of 4/2023 f. 1 (48 ounces) plastic container of honey that was ¾ full, opened and not dated when opened g. 1 bag of peas located in the walk in refrigerator was opened and not dated, with a hole in the packaging h. 1 (5 pound) bag of egg noodles was…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2025-05-06 · tag F0791 — failed to provide routine dental services — patternProvide or obtain dental services for each resident.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, review of the clinical record, facility policy and interviews for 1 of 2 residents (Resident #33) reviewed for dental services, the facility failed to ensure timely dental services were provided related to non-restorable teeth. The findings include: Resident #33's diagnoses included weakness and partial paralysis affecting the left side following a stroke, dementia, and depression. The face sheet identified Resident #33's payor source was Medicaid. The Resident Care Plan (RCP) dated 2/14/23 and currently in effect identified Resident #33 had oral/dental health problems related to poor dentition. Interventions included monitor/document/report any signs and symptoms of oral/dental problems needing attention: pain (gums, toothache, palate), abscess, debris in mouth, teething missing/loose/broken/eroded/decayed and report pain, bleeding, broken teeth to the nurse. A quarterly Minimum Data Set (MDS) dated [DATE] identified Resident #33 had intact cognition and required set up assistance with…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2025-05-06 · tag F0880 — failed to prevent and control infections — patternProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interview, review of the clinical record and facility policy for 6 residents (Resident #4/Resident #36 (roommates), Resident #13/Resident #25 (roommates)and Resident #33/Resident #37 (roommates) on isolation precautions, the facility failed to ensure the nursing staff donned the appropriate Personal Protective Equipment (PPE) and for 1 of 6 sampled residents (Resident #36) reviewed for infection control documentation, the facility failed to ensure documentation was accurate and consistent regarding the type of precautions Resident #36 required. The findings include: 1a. Resident #4 was admitted in April 2021 with diagnoses that included Alzheimer's disease and dementia (was roommates with Resident #36). The Quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #4 had a short/long term memory problem and had severely impaired cognitive skills for tasks of daily living. Additionally, the MDS identified Resident #4 required substantial/maximal assistance with…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-06 · tag F0635 — isolatedProvide doctor's orders for the resident's immediate care at the time the resident was admitted.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation(s), review of the clinical record, facility documentation, facility policy and interviews for the only sampled resident (Resident #286) reviewed for non-pressure skin conditions, the facility failed to obtain wound treatment orders upon admission for a resident with a surgical wound and a venous stasis ulcer. The findings include: Resident #286 was admitted to the facility in April 2025 with diagnoses that included chronic venous hypertension with inflammation, cellulitis of the lower limbs, and cutaneous abscess of left foot. Review of the hospital discharge records dated 4/26/25 identified Resident #286 had a left leg cellulitis and abscess with surgical debridement and a right lower extremity cellulitis and venous ulcer. The discharge records directed to continue daily dressing changes with Betadine and dry sterile dressing as well as Sodium Hypochlorite topical solution applied to foot ulcers daily with a dressing of gauze and gauze roll bandage twice daily. Although the discharge…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2025-05-06 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews, clinical record review, and facility policy for one of three residents (Resident #22) reviewed for advanced directives, the facility failed to ensure the Resident Care Plan accurately reflected Resident #22's code status. The findings include: Resident #22 was admitted to the facility in April 2025 with diagnosis that included chronic obstructive pulmonary disease, diabetes, and falls. A Social Service initial assessment dated [DATE] identified that Resident #22 was a full code. There were no physician orders on admission directing Resident #22's code status. The admission Minimum Data Set (MDS) assessment dated [DATE] identified Resident #22 was moderately cognitively impaired, required set up assistance for eating, maximal assistance for toileting, showering, and dressing. Also identified was Resident #22 required moderate assistance with transfers. The Resident Care Plan (RCP) dated 4/15/25 identified that Resident #22's code status was cardiopulmonary resuscitation with interventions…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-06 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide appropriate treatment and care according to orders, resident’s preferences and goals.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the clinical record, facility documentation, facility policy and interviews for 1 of 4 residents (Resident #53) reviewed for accidents, the facility failed to ensure orthostatic blood pressures were monitored per the physician's order for a resident with postural hypotension and history of repeated falls. The findings include: Resident #53's diagnoses included unspecified dementia, orthostatic hypotension, and repeated falls. The quarterly Minimum Data Set assessment dated [DATE] identified Resident #53 was cognitively intact and required setup or clean up assistance with transfers and toileting and was independent with bed mobility. The Resident Care Plan dated 4/1/25 identified recurrent falls, a fall with rupture of the globe of the right eye and orthostatic hypotension. Interventions included to monitor vital signs and monitor for signs and symptoms of orthostatic hypotension. A physician's order dated 4/5/25 identified Resident #53 had a history of postural hypotension and directed to…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-06 · tag F0694 — isolatedProvide for the safe, appropriate administration of IV fluids for a resident when needed.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, review of clinical records, facility documentation, facility policy and interview for 2 of the 2 residents reviewed for infection control, the facility failed to ensure the peripheral lines had appropriate physician orders in place to rotate access site every 96 hours and as needed or the site was to be removed. 1. Resident #19's diagnosis included Covid 19, myocardial infarction, and hyponatremia. The admission Minimum Data Set (MDS) assessment dated [DATE] identified Resident #19 was cognitively intact, required maximal assistance for toileting, set up assistance for oral hygiene and eating. Also identified that Resident #19 was dependent on showering and transfers. Further identifying Resident #19 was not receiving intravenous therapy. A nursing note dated 4/16/25 at 11:42 AM written by Registered Nurse (RN) #1 identified a urine culture was obtained with sensitivities which the Advance Practice Registered Nurse (APRN) reviewed, and intravenous (IV) was to be started with a new order…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-06 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and review of facility policy for two of three medication storage rooms, the facility failed to ensure expired medication was disposed of and supplies and medications were stored properly. The findings include: a. Interview and observation of the 4th floor medication room with Licensed Practical Nurse (LPN) #2 on [DATE] at 10:40 AM identified 20 hemoccult cards were observed that had an expiration date of 8/2023 and a bottle of hemoccult developer that expired in 8/2021 in the cabinet drawer. Further observation identified 6 full unopened tubes of Collagen Hydrogel (3 ounce each) with an expiration date of 3/31/ 25 and a 24-French 8.0 millimeter (mm) indwelling catheter with an expiration date of [DATE]. b. Interview and observation of the 3rd floor medication room with LPN #7 on [DATE] at 11:45 AM identified an unopened box of Lorazepam (a Schedule IV controlled medication) 30 milliliters (ml) oral concentrate on the bottom shelf in the medication refrigerator (not stored in a…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-06 · tag F0887 — isolatedEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the clinical record, facility policy and interviews for 1 of 5 residents (Resident #33) reviewed for vaccinations, the facility failed to ensure the appropriate time was provided between COVID-19 vaccination administration. The findings include: Resident #33 had diagnoses that included weakness and partial paralysis affecting the left side following a stroke, dementia, and COVID-19. The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #33 was cognitively intact, used a wheelchair, required setup or clean-up assistance with eating, partial/moderate assistance with bed mobility and was dependent for transfers. The Resident Care Plan (RCP) dated 8/6/24 identified Resident #33 was immunized against COVID-19, influenza, and pneumonia. Interventions included refer to the immunizations tab in Resident #33's chart for dates of vaccine administration. Review of the Immunization Report dated 4/30/25 identified Resident #33 received administration of the (Pfizer) COVID-19…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-09-19 · tag F0600 — failed to protect residents from abuse and neglect — isolatedProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the clinical record, facility documentation, facility policy, and interviews for one (1) of three (3) residents (Resident #3) reviewed for abuse, the facility failed to ensure a resident with known wandering behaviors was supervised to prevent an incident of sexual abuse. The findings include: Please cross reference F 657 1. Resident #2 diagnoses included Alzheimer's disease and generalized anxiety disorder. The quarterly MDS dated [DATE] identified Resident #2 had severely impaired cognition, and was independent with transfers and ambulation. The care plan dated [DATE] identified Resident #2 has the potential for negative behaviors related to coping with Alzheimer's with interventions that directed to approach and speak in calm manner, divert attention, remove from an overstimulating environment, and redirect to an alternate location as needed. Review of APRN #1's note dated [DATE] identified she was asked to see Resident #2 related to symptoms of restlessness and agitation. APRN #2…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
Show the remaining 14 citations
- Potential for harm · Dcited before2024-09-19 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the clinical record, facility documentation, facility policy, and interviews for one (1) of three (3) residents (Resident #4) reviewed for pressure injury, the facility failed to develop a comprehensive care plan with interventions to prevent skin breakdown when the resident was identified at high risk for developing pressure injuries. The findings include: Resident #4 had diagnoses that included multiple sclerosis, Guillan-Barre syndrome, and generalized muscle weakness. The nursing admission assessment dated [DATE] identified Resident #4 was alert to person, place, and situation, continent of bowel and bladder, required the assistance of one with bed mobility, assistance of 2 to ambulate, and Resident #4's skin was intact. Review of the Resident #4's Braden Scale for predicting pressure sores dated 6/22/24 identified Resident #4 was at high risk. The admission MDS dated [DATE] identified Resident #4's skin was intact, a formal clinical assessment was conducted, and determined Resident #4 was…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-09-19 · tag F0657 — failed to keep the care plan current — isolatedDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the clinical record, facility documentation, facility policy, and interviews for one (1) of three (3) residents (Resident #2) reviewed for behaviors, the facility failed to review and revise a resident's care plan when the resident was identified as wandering in and out of other resident's rooms. The findings include: Resident #2 diagnoses included Alzheimer's disease and generalized anxiety disorder. A nurse's note dated 7/21/24 at 8:37 P.M. written by LPN #8 identified Resident #2 pacing the unit, visibly upset, entering other resident's rooms. The care plan dated 8/15/24 identified Resident #2 has the potential for negative behaviors related to coping with Alzheimer's with interventions that directed to approach and speak in calm manner, divert attention, remove from an overstimulating environment, and redirect to an alternate location as needed. The quarterly MDS dated [DATE] identified Resident #2 had severely impaired cognition, and was independent with transfers and ambulation. A…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-13 · tag F0584 — failed to keep a safe, clean, comfortable home — isolatedHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, review of maintenance logs, and staff interview for 1 of 8 rooms (room [ROOM NUMBER]) observed during tour, the facility failed to ensure the air conditioner grill was not exposed and was free from dust/debris/sediment. The findings include: On 7/10/23 at 1:15 PM, an observation of the air conditioner in room [ROOM NUMBER], conducted with the Director of Maintenance identified an air-conditioned unit located below the window, without a grill cover, exposing dust, debris, sediment, and the presence of a green, fuzzy-like substance the behind vent grill. An interview with the Director or Maintenance at that time identified the air conditioners were checked for functionality and filters changed quarterly, but vent cleaning was not part of the maintenance. Additionally, he identified the facility was in the process of replacing the air conditioner units, and this unit was due. Review of maintenance logs on 7/12/23 at 12:00 PM indicated the air conditioner in room [ROOM NUMBER] was last checked…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-07-13 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, review of facility policy and interviews for one sampled resident (Resident #68) who was at risk for falls, the facility failed to ensure the resident had adequate supervision during ambulation resulting in the resident sustaining a fall. The findings include: Resident #68's diagnoses included bradycardia, history of falls, muscle weakness, difficulty walking, Alzheimer's disease, and dizziness. A fall risk assessment dated [DATE] identified Resident #45 was at risk for falls and that safety devices should be in place as well as appropriate footwear. A physical therapy Discharge summary dated [DATE] identified Resident #68 required supervision for ambulation. A quarterly MDS assessment dated [DATE] identified Resident #68 had significant cognitive impairment, required supervision for transfers, bed mobility, ambulation, and eating, required limited assistance for toileting and hygiene. The assessment further noted that Resident #68 utilized a walker for mobility. The resident…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-13 · tag F0692 — failed to prevent malnutrition and dehydration — isolatedProvide enough food/fluids to maintain a resident's health.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, observations and staff interviews for 1 of 3 sampled residents (Resident #61) reviewed for nutrition, the facility failed to provide large portions per Dietician recommendations. The findings include: Resident #61's diagnoses included anorexia, Type 2 diabetes and anxiety disorder. Quarterly Nutritional Assessment interventions dated 4/13/23 indicated Resident #61 should have received large protein portions with lunch and dinner. A Quarterly Minimum Data Set (MDS) dated [DATE] identified Resident #61 had moderately impaired cognition, and required supervision with 1 for bed mobility, dressing and personal hygiene. The MDS further identified Resident #61 required supervision after set up with transfers and was independent with eating after being set up. Additionally, the MDS identified Resident #61's weight was 124 pounds (lbs) and did not have any significant weight loss. The Resident Care Plan dated 4/27/23 identified Resident #61 was at risk for malnutrition due to advanced age,…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-13 · tag F0693 — failed to provide proper feeding-tube care — isolatedEnsure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, observations, review of facility documentation and interviews for one sampled resident (Resident #30) who had a gastrostomy tube in place and received enteral nutrition on a continuous basis, the facility failed ensure that the enteral nutrition was administered continuously as ordered resulting in the resident not receiving the enteral nutrition for more than three hours. The findings include: Resident #30's diagnoses included dysphagia (difficulty swallowing), cerebrovascular disease, severe protein calorie malnutrition, anemia, dementia, and candida stomatitis. The admission MDS assessment dated [DATE] identified Resident #30 had moderately impaired cognition, required extensive assistance for bed mobility, was totally dependent for eating, experienced weight loss in the past month. The assessment further identified that the resident weighed 122 lbs. and utilized a feeding tube. Resident #30's care plan dated 6/15/23 identified Resident #30 required tube feeding related to…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-13 · tag F0726 — failed to have competent, trained nursing staff — isolatedEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review facility documentation and staff interviews, the facility failed to ensure Registered Nurse (RN) #2 was working with a current nursing license. The findings include: Review of personnel files for RN #2 identified RN #2's State of Connecticut Registered Nurse (RN) License expired on [DATE] (134 days ago). The RN licensed copy in the personnel file identified RN #2's license was initially granted on [DATE]. Human Resources from the facility was not able to provide a copy of a current RN license for RN #2. Interview with the State Agency on [DATE] at 10:54 AM indicated that RN #2's license expired on [DATE]. In addition, RN #2 had a 90-day grace period to renew her license, did not renew her license, now needed to re-apply for a license, so she had been working without a valid nursing license since [DATE]. Review of RN #2's time card identified she worked at the facility on [DATE], [DATE], [DATE], [DATE] from 7:00 AM to 7:30 PM, and on [DATE] from 11:00 PM to 7:30 AM. Additionally, RN #2 worked on…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-07-13 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, review of clinical record, review of facility documentation, facility policy, and interviews for one sampled resident (Resident #20) who was administered insulin, the facility failed to ensure that the glucometer was cleaned in an appropriate manner to maintain acceptable infection prevention and transmission precautions and for one nurse's aide (NA #1) observed with long nails, the facility failed to ensure the nurses' aide's nails were of an appropriate length to prevent the potential transmission of infection. The findings include: 1. Based on observation, review of facility policy and staff interview, the facility failed to ensure NA #1's nails were of the appropriate length. The findings include: Resident #20 diagnoses included Type 2 diabetes mellitus with diabetic neuropathy, peripheral vascular disease, and generalized muscle weakness. Physician's orders dated 3/17/23 directed Humalog solution 100 unit per ml inject per the sliding scale and finger sticks to be administered before…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-13 · tag F0919 — failed to provide a working call system — isolatedMake sure that a working call system is available in each resident's bathroom and bathing area.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and staff interview for 1 of 10 sampled residents (Resident #64) observed during the initial screening process, the facility failed to ensure Resident #64's call bell was within reach and accessible. The findings include: Resident #64's diagnoses included hemiplegia following a cerebral vascular accident, delusional disorder and anxiety. An Annual Minimum Data Set (MDS) dated [DATE] identified Resident #64 was moderately cognitively impaired and required extensive assistance of 1 for bed mobility, dressing, toilet use and personal hygiene. Additionally, the MDS identified Resident #64 required extensive assistance of 2 for transfers and required limited assistance of 1 for eating. A Resident Care Plan dated 7/7/23 identified a problem with having an activities of daily living self-care performance deficit. Interventions included to provide extensive assistance of 1 for showers, dressing, personal hygiene and toilet use. On 7/10/23 at 10:43 AM, observation of Resident #64…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2021-06-23 · tag F0812 — failed to store, cook, and serve food safely — patternProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, review of facility policy, and interviews, the facility failed to ensure that proper handwashing and glove use occurred during the handling of soiled and clean dishes to prevent cross contamination. The findings included: Observation during the kitchen tour on 6/16/21 at 10:42 AM with the Food Services Director (FSD) identified; Dietary Aid (DA) #1 in the dishwashing area with vinyl gloves on her hands. DA #1 was noted to load and then place two racks of soiled dishes through the dishwashing machine. Further observation identified that after the racks with cups and plates went through the dishwashing machine DA #1 pulled one rack loaded with the cleansed dishes from the dishwashing machine while wearing the same vinyl gloves. DA #1 was then observed to empty dirty plates and cups from a food cart and loaded a dishwashing rack with the soiled dishes while wearing the same vinyl gloves. Further observation identified DA #1 removed the vinyl gloves and without the benefit of handwashing or donning clean gloves, she proceeded to unload the clean dishes from the…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · C2025-05-06 · tag F0814 — failed to dispose of garbage properly — widespreadDispose of garbage and refuse properly.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on staff interview, observation and facility policy of the dumpster area, the facility failed to properly dispose of garbage and refuse. The findings include: On 4/30/25 at 9:15 AM observation of the dumpster area with the Dietary Director noted a heavy accumulation of debris alongside the dumpsters consisting of 1 discarded mattress, 2 bedside tables, 2 wheelchairs, leg rest for wheelchairs, 2 pink cloth large garbage containers, a green blanket, flowered curtains, window blinds, and a piece of therapy equipment. An interview with the Dietary Director on 4/30/25 at 9:20 AM identified that the area was not well kept or cleaned. He stated that the items were from maintenance and not dietary related items and that a pickup would be later that week or the following week. An interview, observation of the dumpsters and surrounding areas with the Maintenance Director on 4/30/25 at 9:30 AM identified that the items listed above had been outside the dumpsters for over a week. The Maintenance Director further identified that he usually does not call for a pickup of the debris until the…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · B2025-05-06 · tag F0577 — patternAllow residents to easily view the nursing home's survey results and communicate with advocate agencies.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on staff and resident interviews and observations within the secured unit, the facility failed to ensure state survey results were available and accessible on the secured unit for those residents who resided there. The findings include: During a resident council interview conducted on 4/29/25 at 9:55 AM, 5 residents who resided on the secured unit identified that they were not aware of where to find the state survey results. Observations during a tour of the facility on 4/30/25 at 2:25 PM identified that although the most recent state survey results from 2023 were available in the lobby of the facility, they were not available on the locked unit (3rd floor). Observation of an orange binder on the wall behind the nurse's desk marked State Survey, identified that it had dust on the binder and contained State Survey results from 2019 and was missing results from 2021 and 2023 re-certification surveys. Interview with the Administrator on 4/30/25 at 2:05 PM identified that management had been informed by the Ombudsman recently that the survey results needed to be on each wing as…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · B2025-05-06 · tag F0921 — failed to keep a safe, functional, sanitary building — patternMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and review of facility policy for two of three medication storage rooms, the facility failed to ensure the medication rooms were clean. a. Interview and observation of the 4th floor medication room with Licensed Practical Nurse (LPN) #2 on [DATE] at 10:40 AM identified the medication room floor was dirty with dried spilled liquids and debris. Additionally, 20 hemoccult cards were observed that had an expiration date of 8/2023 and a bottle of hemoccult developer that expired in 8/2021 in the cabinet drawer. LPN #2 identified that it was housekeeping's responsibility to clean the medication room floor, but the floor was not cleaned often. An interview with the Director of Facilities Housekeeping on [DATE] at 12:30 PM identified it was the responsibility of housekeeping staff to dust and mop the floors and clean other areas in the medication rooms daily. The housekeeping staff report directly to the Director of Facilities Housekeeping. b. Interview and observation of the 3rd floor…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · B2023-07-13 · tag F0568 — patternProperly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, facility policy review, and interviews for 1 of 2 residents (Resident #17) reviewed for resident trust accounts, the facility failed to ensure quarterly statements were provided. The findings include: Resident #17's diagnoses included schizo-affective disorder, depression and post traumatic stress disorder. An Annual MDS assessment dated [DATE] identified Resident #17 was cognitively intact and was independent with set up help for bed mobility, transfers, and eating. The MDS further identified Resident #17 required extensive assistance of 1 for dressing and toilet use. Interview with Resident #17 on 7/10/23 at 2:06 PM identified that he/she was not aware of receiving quarterly statements from the Resident Trust Account. On 7/12/23 at 10:31 AM interview with the Business Office Manager identified Resident #17 had money in the Resident Trust Account equaling $438.43 and was unaware of the previous process of providing quarterly statements because she was new to the position (2…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
$24,418 in federal fines across 2 penalties.
- $16,400 — penalty dated 2025-05-06
- $8,018 — penalty dated 2024-09-19
Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.
Part of a chain
This home belongs to NATIONAL HEALTH CARE ASSOCIATES — 42 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →
| Rating | This home | Chain avg | |
|---|---|---|---|
| Overall | 4 of 5 | 3.2 | +0.8 vs chain |
| Health inspection | 3 of 5 | 2.8 | +0.2 vs chain |
| Staffing | 3 of 5 | 3.0 | ≈ chain avg |
| Quality measures | 5 of 5 | 4.1 | +0.9 vs chain |
The other 41 homes this chain runs (chain average 3.2★, per CMS)
Showing 40 of 41; lowest-rated first.
A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| BNB HEALTH CARE FUNDS LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 7% | since 12/31/2012 |
| EDSR ASSOCIATES, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 31% | since 12/01/2020 |
| COHEN, DAVID | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 7% | since 06/04/2007 |
| FUCHS, MORRIS | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 8% | since 06/04/2007 |
| GOLDENBERG, CHAIM | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 5% | since 06/04/2007 |
| LIPMAN, MICHAEL | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 5% | since 06/04/2007 |
| MANELA, MAGDA | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 5% | since 06/04/2007 |
| ROBERTS, TZIVY | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 7% | since 03/01/2014 |
| FLAHERTY, TIMOTHY | Individual | W-2 MANAGING EMPLOYEE | — | since 12/31/2021 |
| OSTREICHER, MARVIN | Individual | CORPORATE DIRECTOR | — | since 09/01/2007 |
| ESTATE OF TALI SKOCZYLAS | Organization | GENERAL PARTNERSHIP INTEREST | — | since 01/22/2020 |
| SENGA TRUST | Organization | GENERAL PARTNERSHIP INTEREST | — | since 09/10/2021 |
| BOKOW, BARRY | Individual | GENERAL PARTNERSHIP INTEREST | — | since 09/01/2007 |
| DAVID, ALBERT | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| EISEN, MORDECHAI | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| GEFFNER, IRA | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| LAUFER, SCHMUEL | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| NEUMAN, GERALD | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| POLLACK, NATHAN | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| SHAYA-MOGRABY, MOSHE | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
| SKOCZYLAS, JOSEF | Individual | GENERAL PARTNERSHIP INTEREST | — | since 06/04/2007 |
4 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
Follow the money — this home’s finances
Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.
This home reported $3.7M paid to related parties — landlords or management companies under common ownership — equal to about 28% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.
What families pay in CT
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Connecticut Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 075208. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-05-06, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.