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Echelon Care & Rehab

1302 Laurel Oak Road, Voorhees, NJ 08043 · For profit - Limited Liability company · 240 certified beds · (856) 346-1200 Medicare & Medicaid certified

Call the home — (856) 346-1200 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse-prevention, restraint, or reporting citations — no harm found (F0609, F0610) — most recent Aug 2023
Insights

This home’s record is mixed — some reassuring signs, some worth asking about.

In its favor
  • a middle-of-the-pack inspection score (3/5)
  • no federal fines or payment denials on record
  • fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
Worth asking about
  • it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609, F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • a high number of inspection citations overall (25) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its facility-reported quality-measure score sits well above its independent inspection score

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.

4/5
CMS overall
4 of 5
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

Hospital
★★★ 3/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
63 Lakeview Drive North · (856) 435-6000 · Call to confirm hours
Pharmacy
700 Haddonfield-Berlin Rd · (856) 782-1122 · Call to confirm hours
Grocery
Acme0.6 mi
700 Haddonfield Berlin Rd · (856) 782-1122 · Call to confirm hours
Park
121 Laurel Oak Rd · (856) 428-5499 · Typically dawn to dusk
Place of worship

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 improved from 2 to 4 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.

Overall rating4★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased7.7%8.7%15.4%better
Long-stay residents who lose too much weight4.7%4.6%5.4%better
Long-stay residents with a catheter left in their bladder0.0%0.6%0.9%better
Long-stay residents with a urinary tract infection1.6%0.8%2.0%worse than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms32.5%12.1%6.5%check this — see note marked dagger below the table
Long-stay residents who were physically restrained0.0%0.1%0.1%better
Long-stay residents with falls causing major injury1.2%2.3%3.3%better
Long-stay residents whose ability to walk worsened9.1%8.2%16.1%better
Long-stay residents on antianxiety or hypnotic medication25.1%18.8%18.9%worse
Long-stay residents given the seasonal flu vaccine99.5%97.2%95.3%typical
Long-stay residents with pressure ulcers6.9%5.4%4.7%worse
Long-stay residents with worsening bladder/bowel control17.8%15.6%21.2%better
Long-stay residents who got an antipsychotic medication — see the note below the table9.8%12.7%17.1%better
Short-stay residents who newly got an antipsychotic medication0.7%1.2%1.4%better
Short-stay residents given the seasonal flu vaccine78.6%80.1%79.4%typical
Short-stay residents rehospitalized after admission25.9%24.9%22.6%worse
Short-stay residents with an outpatient ER visit6.2%8.1%12.0%better
Long-stay hospitalizations per 1,000 resident days1.752.071.67typical
Long-stay outpatient ER visits per 1,000 resident days0.621.111.80better

This value is several times the typical-state benchmark. It can be real, or it can be a coding artifact in what the facility submitted. Weigh it against the inspection record above.

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.

43.0% 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 163 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

43.0%U.S. median 51.5%
Got home and stayed home
10.6%U.S. median 10.7%
Went back to hospital
77.1%U.S. median 56.6%
Met the expected recovery
0.34U.S. median 0.31
Therapy hours / resident / day
0.16hours / resident / day
Physical therapy
0.13hours / resident / day
Occupational therapy
0.05hours / resident / day
Speech therapy

Met the expected recovery: 77.1% 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 118 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 0.34 therapist hours per resident per day in 2026Q1 — more than 57% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 29% 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
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF43.0%CMS range 36.2–52.651.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF10.6%CMS range 7.6–14.610.7%Oct 2022–Sep 2024no 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 discharge77.1%56.6%Oct 2024–Sep 2025CMS 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 discharge67.8%52.8%Oct 2024–Sep 2025CMS makes no comparison for this measure
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge66.1%50.0%Oct 2024–Sep 2025CMS 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 identified100.0%98.7%Oct 2024–Sep 2025CMS 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 setting100.0%100.0%Oct 2024–Sep 2025CMS 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 discharge100.0%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay0.9%0.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened0.4%1.9%Oct 2024–Sep 2025CMS makes no comparison for this measure
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization8.4%CMS range 4.9–12.37.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.351.02Oct 2022–Sep 2024CMS 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

0.27
RN hours/ resident / day
1.00
LPN hours/ resident / day
2.12
Aide hours/ resident / day
3.39
Total nurse hours/ resident / day
0.17
RN hoursweekends
40.9%
Total nursing turnover
38.9%
RN turnover

How full it usually is: this home is certified for 240 beds and averages 224.7 residents a day — about 94% occupied, or roughly 15 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 3.39 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.27 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.12 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 3.14 hrs/resident/day on weekends vs 3.49 on weekdays — 10% thinner on weekends. RN hours go from 0.31 to 0.17 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 41% 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

6
deficiencies at the latest standard inspection (2025-06-25)
11
at the previous standard inspection (2023-12-20)

Deficiencies are fewer than at the previous inspection — improving. 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.

ABCDEFGHIJKL

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.

25 citations, most serious first. The 10 most serious are shown; the remaining 15 are one tap away and print in full.

  • Potential for harm · F2025-06-25 · tag F0908 — failed to keep essential equipment working — widespread
    Keep all essential equipment working safely.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observation and interview on 6/18/25 in the presence of the Maintenance Director (MD) and Regional Plant Operations Director (RPOD), it was determined that the facility failed to maintain their Packaged Terminal Air Conditioner (PTAC) units in safe operating condition. This deficient practice was evidenced for 52 of 67 PTAC units observed by the following: Observations while touring the facility from 9:00 AM to 1:00 PM, revealed that PTAC filters were missing, clogged and dirty, bent frames and filters laying on the floor not properly installed. In an interview the MD and the RPOD both confirmed the findings. A policy and procedure and PTAC maintenance log was requested but not provided at the time of the LSC exit conference. The Administrator was notified of the deficient practice at the Life Safety Code exit conference on 6/19/25 at 1:30 PM. NJAC 8:39 - 31.2(e)

    Environmental Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2025-06-25 · tag F0921 — failed to keep a safe, functional, sanitary building — pattern
    Make 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

    Based on observation, interview, and review of facility provided documents, it was determined that the facility failed to provide a safe, sanitary, and comfortable environment for residents. This deficient practice was identified for 4 of 4 observed resident pantry rooms (200 Unit, 300 Unit, 400 unit and 500 Unit) as evidence by the following: On 6/18/25 at 12:26 PM, the surveyor toured the 200-Unit pantry room in the presence of the Regional Director of Nursing (RDON and observed the Packaged Terminal Air Conditioner (PTAC) unit had rust on the outside and black colored debris and yellow debris located inside the uncovered area. The RDON stated that housekeeping was responsible to clean the pantries including the PTAC. At that time, the Maintenance Director observed the PTAC and stated that the PTAC did not work but should still be clean. On 6/18/25 at 12:32 PM, the surveyor toured 300-Unit pantry room, in the presence of the RDON and observed the PTAC unit did not have a cover on the top and had black debris inside the unit. On 6/18/25 at 12:43 PM, the surveyor toured 400-unit…

    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.

    Environmental Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2025-06-25 · tag F0924 — pattern
    Put firmly secured handrails on each side of hallways.
    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 and interview from 6/18/25 in the presence of the Maintenance Director (MD) and the Regional Plant Operations Director (RPOD), it was determined that the facility failed to ensure that wooden handrails were installed, secured and splinter free in all required locations. This deficient practice was identified for 3 of 6 areas observed, had the potential to affect all residents, and was evidenced by the following by the following: 1). An observation at 12:22 PM revealed that the handrail by resident rooms [ROOM NUMBERS] had sharp edges due to a missing edge guard. 2). An observation at 12:40 PM revealed that the smoking courtyard exit/egress wooden ramp had a handrail that was unfinished and dry. The wooden ramp handrail was observed to have splinters along the entire length, approximately 30-feet. 3). An observation at 12:58 PM revealed on floor #2, that an approximately 4-foot section of handrail was missing left of elevator # 3. In an interview during the above findings, the MD and the RPOD…

    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.

    Environmental Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-06-25 · tag F0584 — failed to keep a safe, clean, comfortable home — isolated
    Honor 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 Complaint NJ #: 177921 Based on observation, interview, record review, and review of facility documents, it was determined that the facility failed to maintain the resident's environment, and living areas in a safe, sanitary, and homelike manner by ensuring that damaged flooring, chair rail, and wall board were identified and repaired in a timely manner. This deficient was identified for 2 of 4 nursing units (200 Unit and 500 Unit) and was evidenced by the following: 1. On 6/19/25 at 10:45 AM, the surveyor observed that the tile flooring in room [ROOM NUMBER] had multiple areas that were buckled, cracked, and chipped and there was blue painter's tape placed over several of the affected areas. There were no residents present in the room at the time. On 6/19/25 at 10:49 AM, the surveyor interviewed Housekeeper (HK) #1 who stated that the flooring in room [ROOM NUMBER] was buckled prior, but it was not taped, and it was not that bad. HK #1 stated that he mopped the floor yesterday and he was careful not to get too…

    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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-06-25 · tag F0637 — isolated
    Assess the resident when there is a significant change in condition
    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, interview, review of medical records and other facility documents, it was determined that the facility failed to complete a Significant Change in Status Assessment (SCSA) using the Resident Assessment Instrument (RAI) process on a resident who elected hospice benefits. This deficient practice was identified for 1 of 1 resident (Resident #118) reviewed for hospice service. This deficient practice was evidenced by the following: According to the CMS's (Centers for Medicare and Medicaid Services) RAI (Resident Assessment Instrument) Version 3.0 Manual, updated October 2024 showed: An SCSA must be completed within 14 days of determining a significant change from baseline. The resident's condition is not expected to return to baseline within two weeks. Comparison with the most recent comprehensive and quarterly assessments is crucial. Criteria for SCSA include two areas of decline or improvement, or IDT (Interdisciplinary team) recommendation. Documentation of criteria met was essential in 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-06-25 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
    Provide appropriate pressure ulcer care and prevent new ulcers from developing.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, record review, and review of facility documents, it was determined that the facility failed to ensure that a low air loss mattress was accurately set according to the resident's weight and the resident's feet were elevated off of the bed bilaterally with a pillow in accordance with a physician's order for a resident who was previously identified to have had an alteration in skin integrity. This deficient practice was identified for 1 of 2 residents (Resident #192) reviewed for pressure ulcers and was evidenced by the following: On 6/17/25 at 10:55 AM, the surveyor observed Resident #192 lying in bed awake. The resident's bedding covered the foot of the bed where there appeared to have been an outline of an air mattress pump that was covered by the resident's bedding. When interviewed, the resident was unable to state if he/she had a pressure ulcer or a wound. On 6/18/25 at 10:43 AM, the surveyor reviewed the medical record for Resident #192. A review of the admission Record, an admission summary, revealed the resident had diagnoses which included,…

    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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-02-05 · tag F0842 — failed to keep accurate, complete medical records — isolated
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY C #: NJ00170177 Based on interviews, medical record review, and review of other pertinent facility documents on 2/5/2024, it was determined that the facility failed to: document according to the facility policy when the resident's Responsible Representative (RR) was notified of a change in the resident's medication regimen for 1 of 3 residents reviewed (Resident #2) and consistently document in the Documentation Survey Report (DSR) the Activities of Daily Living (ADL) status, and care provided to the resident according to facility policy and protocol for 2 of 3 residents (Resident #2 and #3) reviewed for documentation. This deficient practice was evidenced by the following: 1. According to the facility admission Record (AR), Resident #2 was admitted with diagnoses that included but were not limited to: Dementia (disease that affects the ability to remember, think, or make decisions), Hypertension (blood pressure higher than normal), Atrial Fibrillation (irregular rapid heartbeat). The Quarterly Minimum Data Set…

    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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · F2023-12-20 · tag F0755 — failed to provide safe pharmacy services — widespread
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and pertinent record review, it was determined that the facility failed to ensure: a) accountability of the Narcotic Shift Count logs were completed in accordance with facility policy and accurately accounted for and documented the administration of controlled medications and b) medications were administered in accordance with the medication's cautionary statement and manufacturer specifications. This deficient practice was identified on 5 of 5 medication carts observed on 4 of 4 nursing units and for 2 of 3 nurses who administered medications to 2 of 6 residents (Resident #95 and Resident #179) observed during the medication observation pass. This deficient practice was evidenced by the following: 1. On 12/14/23 at 9:58 AM, the surveyor, in the presence of Licensed Practical Nurse #1 (LPN #1), reviewed the controlled substance logs for the fifth-floor east side medication cart. The surveyor observed the following: Resident #160 was administered Diazepam (anti-anxiety medication) 5 milligram (mg) at 9:00 AM and the LPN stated she did not sign it out…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2023-12-20 · tag F0761 — failed to label and store drugs safely — pattern
    Ensure 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 observation, interview, and review of pertinent facility documentation, it was determined that the facility failed to a.) properly store medications and properly label opened multidose medications. This deficient practice was observed in 4 of 4 medication carts and 1 of 2 medication storage rooms reviewed for medication storage and labeling and was evidenced by the following: On [DATE] at 9:58 AM, the surveyor, in the presence of the Licensed Practical Nurse #1 (LPN #1) reviewed the fifth floor's east side medication cart. The surveyor observed one opened 10 milliliter (ml) bottle of Refresh gel eye drops, and one opened 15 ml bottle of GenTeal Tears eye drops stored in the space as opened containers of over the counter (otc) medications. One opened undated and not labeled 2.5 ml bottle of latanoprost ophthalmic solution 0.005% (prescription eye drops used to treat glaucoma, increased pressure in the eye) and one 10 ml opened bottle of timolol maleate ophthalmic solution 0.5% (prescription eye drops…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-12-20 · tag F0804 — failed to serve food at safe, palatable temperature — pattern
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Complaint #NJ00156539 and NJ00156915 Based on observation, interviews, and review of pertinent facility documentation it was determined that the facility failed to serve hot foods at an acceptable temperature for the residents. This deficient practice was identified in the kitchen tray line during the plating of the lunch meal service for the 4th floor high side. The deficient practice was evidenced by the following: On 12/19/23 at 12:22 PM, the surveyor met with the Food Services Director (FSD) to obtain food temperatures on the kitchen tray line. The FSD obtained a thermometer and stated that it was the thermometer that was used to check the lunch meal. The FSD and surveyor approached the cook area where steam was observed coming from the steam table. The FSD tested the temperature of spaghetti which read 85 degrees Fahrenheit (F). The FSD instructed the cook to mix up the pasta and the FSD rechecked the temperature which read 85 degrees F. The FSD checked the temperature of a meatball which read 127 degrees F and checked the temperature of a hot dog which read 118 degrees F. When…

    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.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
Show the remaining 15 citations
  • Potential for harm · Ecited before2023-12-20 · tag F0812 — failed to store, cook, and serve food safely — pattern
    Procure 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

    Complaint #NJ00156539 Based on observations, interviews and review of facility documentation it was determined that the facility failed to a.) properly handle and store potentially hazardous foods in a manner that is intended to prevent the spread of food borne illnesses, b.) maintain equipment and kitchen areas in a manner to prevent microbial growth and cross contamination and c.) failed to maintain adequate infection control practices during food service in the kitchen. This deficient practice was observed and evidenced by the following: On 12/12/23 from 10:19 AM-11:47 AM, the surveyor toured the kitchen in the presence of the Food Service Director (FSD) and observed the following: 1. A dietary aide (DA#1) was sorting silverware and placing them into clear plastic bags that contained a napkin. He stated that he was bagging clean silverware for the meal trays. The DA was wearing a hairnet on his head with hair exposed behind each ear. DA#1 had long chin hair and was not wearing a beard guard. During an interview at that time, DA#1 acknowledged that no hair should have been exposed…

    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.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-12-20 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, review of medical records and other facility documentation, it was determined that the facility failed to maintain proper infection control practices during the Medication Administration Observation. This deficient practice was identified on 1 of 4 nursing units (Second Floor East/West) and for 2 of 3 nurses observed during the medication pass. This deficient practice was evidenced by the following: On 12/18/23 at 8:03 AM, the surveyor observed Licensed Practical Nurse (LPN #1) who was assigned to the 2 East Medication Cart as she prepared medications and administered them to Resident #95. When finished, LPN #1 failed to perform hand hygiene before she returned to the medication cart and charted the medications as administered. At 8:09 AM, LPN #1 obtained the automated blood pressure machine and entered the room of Resident #31. LPN #1 was observed placing the blood pressure cuff on the resident's upper arm and obtained a reading. LPN #1 removed the blood pressure cuff from the resident and failed to clean the blood pressure cuff or perform hand…

    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.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-12-20 · tag F0580 — failed to tell family and doctor about changes — isolated
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Complaint NJ #:159091 Based on observation, interview, record review and review of pertinent facility documents, it was determined that the facility failed to notify the resident's representative of a change in condition for 1 of 35 residents (Resident #431) reviewed. This deficient practice was evidence by the following: According to the admission Record, Resident #431 was admitted to the facility with diagnoses which included, adult failure to thrive, dementia, and personal history of covid-19. A review of the individualized Care Plan (CP) created 12/9/21, reflected a focus area: the resident's family had established an advanced directive (to appoint a person other than yourself to make health care decisions for you) with an intervention to inform resident/representative of any changes in status or care needs. A review of the Progress Note (PN) reflected the following: -1/16/22 at 15:18 [3:18 PM], rapid covid test positive, + cough, Covid PCR [Polymerase chain reaction - good at detecting the covid virus] collected sent to lab. -1/29/22 at 18:47 [6:47 PM], spoke to daughter, they…

    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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-12-20 · tag F0584 — failed to keep a safe, clean, comfortable home — isolated
    Honor 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

    Complaint #: NJ00159091 Based on observation, interview, record review, and review of other facility documentation, it was determined that the facility failed to maintain a safe, clean, comfortable and homelike environment by: a) ensuring that resident's clothing was laundered and returned in a timely manner and b) ensuring that repairs were made to damaged walls and moldings in a timely manner. This deficient practice was observed for 1 of 2 residents (Resident #69) observed for personal property and for 1 of 4 nursing units (Second Floor/East). This deficient practice was evidenced by the following: a. On 12/12/23 at 12:32 AM, during the initial tour of the facility the surveyor observed Resident #69 seated on the side of the bed. The resident stated that his/her clothing was missing and he/she was only able to be changed into clean clothing once in the past three days. The resident stated that the laundry was sent down to be laundered and never returned. The resident stated that he/she reported the issue to the Certified Nursing Assistant (CNA #1) and the CNA agreed to look into…

    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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-12-20 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    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, interview, and review of medical records and other facility documentation, it was determined that the facility failed to accurately complete the Minimum Data Set (MDS) for 4 of 29 residents reviewed (Residents #23, #428, #132 and #19). This deficient practice was evidenced by the following: 1. The surveyor reviewed the admission Record for Resident #23 which reflected that the resident was admitted with diagnoses that included pancreatitis (an inflammation of the pancreas). The surveyor reviewed the Weights and Vitals Summary which reflected a weight of 142 pounds on 11/21/23 which was corrected on 11/27/23 to reflect a weight of 127.2 pounds. The surveyor reviewed Resident #23's admission MDS, an assessment tool utilized to facilitate the management of care, dated 11/27/23 and reflected a weight of 146 pounds. When interviewed on 12/14/23 at 1:36 PM, the part-time Dietician in the presence of the Corporate Dietician stated that Resident #23 was seen by the full-time Dietician when 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-12-20 · tag F0658 — failed to meet professional standards of care — isolated
    Ensure services provided by the nursing facility meet professional standards of quality.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, record review and review of other pertinent facility documents, it was determined that the facility failed to consistently follow appropriate professional standards of practice for: a) medication administration and b) accurately completing the Psychotropic Monthly Summary for 1 of 5 residents (Resident # 84) reviewed for unnecessary medications, psychotropic medications, and medication regime review for 1 of 3 nurses on 1 of 2 nursing units (2 East) reviewed for the medication administration observation. Reference: New Jersey Statutes Annotated, Title 45. Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual and potential physical and emotional health problems, through such services as case finding, health teaching, health counseling, and provision of care supportive to or restorative of life and wellbeing, and executing medical regimens as prescribed by a licensed or otherwise legally authorized…

    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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-12-20 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
    Provide safe and appropriate respiratory care for a resident when needed.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and review of facility documentation it was determined the facility failed to ensure that physician orders were obtained to change a resident's inner cannula of a tracheostomy (opening surgically created through the neck into the windpipe and inserting a tube to allow air to fill the lungs). This deficient practice was identified in 1 of 1 resident reviewed for tracheostomy care (Resident #433) and was evidenced by the following: On 12/12/23 at 01:06 PM, during the initial tour of the facility the resident was observed sitting at the bedside. The resident had a tracheostomy and oxygen was being provided with a trach collar (a device to deliver humidified oxygen to a tracheostomy). During the observation the resident was with the speech therapist and discussed swallow evaluations and the possibility of diet advancement following the swallow evaluation. Review of the admission Record revealed that Resident #433 was admitted to the facility with medical diagnoses which included but were not limited to tracheostomy, muscle wasting, hyperlipidemia (high…

    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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-12-20 · tag F0697 — failed to manage pain — isolated
    Provide safe, appropriate pain management for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY 2. On 12/12/23 at 10:56 AM, during the initial tour of facility the surveyor observed Resident #132 lying in bed. The resident stated that all was well except for pain and the resident lifted his/her shirt to show a colostomy bag (an opening on the abdomen for bowel discharge). The surveyor reviewed Resident #132's admission Record (an admission summary) which showed that the resident was admitted to the facility with diagnoses that included but not limited to: colostomy, parastomal hernia (part of the bowel pushed through the abdominal muscle around the colostomy opening) and irritable bowel syndrome. A review of the MDS dated [DATE] revealed that Resident #132 had a Brief Interview of Mental Status (BIMS) score of 11 out of 15, which meant the resident had mild cognitive impairment. Review of Section J, titled Health Conditions revealed the resident had a pain assessment completed. It indicated that the resident was on a pain regimen, had pain almost constantly,,,, had pain that interrupted sleep and limited…

    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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-08-01 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Complaint #: NJ165964 Based on observation, interview, and review of pertinent facility documents on 7/31/2023 and 8/1/2023, it was determined that the facility failed to report to the New Jersey Department of Health (NJDOH) an allegation of a resident (Resident#2) exposing himself/herself to other residents (Resident #3 and #4). The facility also failed to implement its policy titled Incident and Accident Report and Investigation. This deficient practice involved 3 of 4 residents reviewed for reporting reportable events, and was evidenced by the following: During a tour of the 5th floor on 7/31/2023 at 9:55 A.M., Resident #3 and Resident #4 told the Surveyor, There is a resident (Resident #2) down the hall who came to our doorway and exposed himself/herself showing the private part. He/She is sometimes loud in the hallways and screams out sexually inappropriate comments to the staff. Resident #3 denied being touched by Resident #2 during this exposure incident. The Resident stated he/she informed the Director…

    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.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-08-01 · tag F0610 — failed to investigate and act on abuse reports — isolated
    Respond appropriately to all alleged violations.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Complaint #: NJ165964 Based on observation, interview, record review, and review of pertinent facility documentation on 7/31/2023 and 8/1/2023, it was determined that the facility failed to thoroughly investigate an allegation of a resident (Resident #2) standing in the doorway of another resident's room and exposing his/her private part to the residents (Resident #3 and #4). The facility also failed to implement its Accident and Incident Report and Investigation policy. This deficient practice involved 3 of 4 residents (Resident #2, #3, and #4) and was evidenced by the following: During a tour of the 5th floor on 7/31/2023 at 9:55 A.M., Resident #3 and Resident #4 told the Surveyor, There is a resident (Resident #2) down the hall who came to our doorway and exposed himself/herself. He/She is sometimes loud in the hallways and screams out sexually inappropriate comments to the staff. Resident #3 denied being touched by Resident #2 during this exposure incident. The Resident stated he/she informed the Director of…

    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.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Fcited before2022-01-31 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure 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 observation, interviews and review of facility documentation it was determined that the facility failed to a.) properly handle and store potentially hazardous foods in a manner that is intended to prevent the spread of food borne illnesses, b.) maintain equipment and kitchen areas in a manner to prevent microbial growth and cross contamination and c.) failed to maintain adequate infection control practices during food service in the kitchen. This deficient practice was observed and evidenced by the following: On 01/24/22 from 09:54 AM -11:55 AM, the surveyor toured the kitchen in the presence of the Food Service Director (FSD) and observed the following: 1. The foot pedal trash can at handwashing sink #1 was not lined with a trash bag and both trash and debris were observed in the can. The FSD acknowledged the debris and stated they usually leave it like that as they empty it every day. The FSD stated they would put a bag in the can. 2. The cook prepping chopped turkey for lunch wearing a hairnet on the hair bun on top of her head leaving the bottom of her head exposed. 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.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-01-31 · tag F0578 — failed to honor advance directives / code status — isolated
    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
    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, interviews, review of medical records and other facility documentation, it was determined that the facility failed to ensure that an updated advance directive was accurately maintained within a resident's medical record, in accordance with the facility policy. This deficient practice was identified for 1 of 2 residents (Resident #48) reviewed for Advance Directives and was evidenced by the following: During the initial tour of the facility on [DATE] at 10:32 AM, the surveyor observed Resident #48 seated in a reclining wheelchair at the bedside. The resident was non-verbal and did not maintain eye contact when spoken to. Review of Resident #48's admission Record that was printed on [DATE] at 09:56 AM, revealed that the resident was readmitted to the facility in November of 2021 with diagnoses which included but were not limited to: Down's Syndrome, adult failure to thrive, sepsis (a life-threatening complication of infection), pneumonia and intestinal obstruction. Further review of 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2022-01-31 · tag F0658 — failed to meet professional standards of care — isolated
    Ensure services provided by the nursing facility meet professional standards of quality.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, record review, and review of other facility documentation, it was determined that the facility failed to administer a medication in accordance with a physician's orders and consistent with professional standards. This deficient practice was identified for 1 of 5 residents (Resident #108) reviewed for medications and was evidenced by the following: Reference: New Jersey Statutes, Annotated Title 45, Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential physical and emotional health problems, through such services as case finding, health teaching, health counseling, and provision of care supportive to or restorative of life and wellbeing, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist. Reference: New Jersey Statutes Annotated, Title 45, Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states:…

    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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2022-01-31 · tag F0804 — failed to serve food at safe, palatable temperature — isolated
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    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, interviews, and review of pertinent facility documentation it was determined that the facility failed to serve hot and cold foods at an acceptable temperature for the residents. This deficient practice was identified for 5 of 5 residents who attended a Resident Council group meeting, and on 1 of 4 nursing units during the lunch meal service and was evidenced by the following: During the initial tour of the 4th floor unit on 01/24/22 at 10:42 AM, Surveyor #1 interviewed Resident # 95 who stated that the food could be warmer. Resident #95 stated that when he/she eats in their room the breakfast meal is not hot. Review of the admission Minimum Data Set (MDS), an assessment tool used to facilitate the management of care, dated 12/9/21, revealed Resident #95 had a Brief Interview for Mental Status (BIMS) of 15, which indicated that the resident was cognitively intact. During the initial tour of the 4th floor unit on 01/24/22 at 10:48 AM, Surveyor #1 interviewed Resident #53 who stated that when…

    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.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2022-01-31 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observations, interviews, review of medical records and other facility documentation, it was determined that the facility failed to ensure infection control practices were implemented in accordance with facility policy and accepted national standards to prevent the possible spread of infection by failing to: a) properly don (put on) and doff (take off) personal protective equipment (PPE) and b) perform hand hygiene after glove removal for 1 of 3 residents reviewed for transmission-based precautions (Resident #132) and c) ensure respiratory equipment was kept in a clean and sanitary condition, and stored properly for 1 of 2 residents reviewed for respiratory equipment (Resident #692). This deficient practice was evidenced by the following: 1. During the initial tour of the facility on 01/24/22 at 11:22 AM, the surveyor observed a clear plastic, three-drawer storage unit which housed Personal Protective Equipment (PPE) (garments or equipment used to protect the body from injury or infection) outside of Resident #132's room. There was no signage posted on the outside of 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.

    Infection Control Deficiencies · Deficient, Provider has date of correction

“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.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • 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.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to PARAMOUNT CARE CENTERS — 10 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 →

RatingThis homeChain avg
Overall 4 of 53.3+0.7 vs chain
Health inspection 3 of 52.8+0.2 vs chain
Staffing 3 of 52.6+0.4 vs chain
Quality measures 5 of 54.4+0.6 vs chain
The other 9 homes this chain runs (chain average 3.3★, per CMS)

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 / managerTypeRoleShareSince
THE PINES AT VOORHEES REHABILITATION AND HEALTHCARE CENTER LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST100%since 05/10/2022
FIRST AMERICAN CAPITAL GROUP CORPORATIONOrganization5% OR GREATER MORTGAGE INTERESTsince 05/10/2022
DAVIS, BRIANIndividualW-2 MANAGING EMPLOYEEsince 05/10/2022
PARAMOUNT CARE CENTERS LLCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 05/10/2022

3 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.

$26.9M
Net patient revenuemost recent cost report
+7.9%
Operating marginrevenue minus expenses
$1.0M
Related-party expense4% of expenses
Who pays — share of resident-days
Medicaid 70%Medicare 12%Other / private 18%

This home reported $1.0M paid to related parties (affiliated landlords or management companies) in its most recent cost report.

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

$308per resident / day
operating cost
$9,376per month
≈ monthly operating cost
$335per day
avg. revenue, all payers

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 NJ

Paying with Medicaid

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 New Jersey Medicaid page.

Typical monthly cost in New Jersey
$12,775/mo
Nursing home (semi-private)
$14,448/mo
Nursing home (private)
$8,710/mo
Assisted living

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 315187. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-06-25, 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.

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