Maple City Rehabilitation and Nursing Center
434 Monroe Avenue, Hornell, NY 14843 · For profit - Corporation · 114 certified beds · (607) 324-7740 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- it has an abuse, neglect, or exploitation citation (F0600), cited Oct 2023
- it has a citation for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
- it has 2 actual-harm citations
- 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
- the CMS record shows $62,207 in federal fines (most recent 2024-08-23)
- its independent health-inspection rating is low (1/5)
- its payroll-based staffing rating is low (1/5)
- its facility-reported quality-measure rating is low (1/5)
- nursing-staff turnover (57%) runs well above the national median (45%)
- its last standard health inspection was over 2 years ago — the star rating may not reflect current conditions
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 | 1 of 5 |
| StaffingFrom payroll records (PBJ) | 1 of 5 |
| Quality measuresSelf-reported by the facility | 1 of 5 |
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 | 1 of 5 |
| Long-stay residentspeople who live here | 1 of 5 |
| Short-stay residentsrehab / post-hospital | 1 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 held steady at 1 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 | 22.1% | 14.1% | 15.4% | worse |
| Long-stay residents who lose too much weight | 6.9% | 5.8% | 5.4% | worse |
| Long-stay residents with a catheter left in their bladder | 0.4% | 0.5% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 1.8% | 1.3% | 2.0% | typical |
| Long-stay residents with depressive symptoms | 6.4% | 19.5% | 6.5% | typical |
| Long-stay residents who were physically restrained | 0.0% | 0.2% | 0.1% | better |
| Long-stay residents with falls causing major injury | 3.8% | 3.1% | 3.3% | worse |
| Long-stay residents whose ability to walk worsened | 18.2% | 12.5% | 16.1% | worse |
| Long-stay residents on antianxiety or hypnotic medication | 12.0% | 13.2% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 95.3% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 11.2% | 6.5% | 4.7% | worse |
| Long-stay residents with worsening bladder/bowel control | 18.5% | 19.5% | 21.2% | better |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 23.8% | 13.7% | 17.1% | worse |
| Short-stay residents who newly got an antipsychotic medication | 0.0% | 1.2% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 71.4% | 78.8% | 79.4% | worse |
| Short-stay residents rehospitalized after admission | 22.7% | 20.6% | 22.6% | typical |
| Short-stay residents with an outpatient ER visit | 21.4% | 9.6% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 1.99 | 1.70 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 3.73 | 1.36 | 1.80 | worse |
§ 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.
46.0% 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 120 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 41.4% 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 70 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 0.25 therapist hours per resident per day in 2026Q1 — more than 35% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 4% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. 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 | 46.0%CMS range 37.7–54.2 | 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 | 9.0%CMS range 6.2–12.8 | 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 | 41.4% | 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 | 42.9% | 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 | 34.3% | 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 | 97.2% | 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 | 95.5% | 98.7% | Oct 2024–Sep 2025 | CMS 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 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 | 11.1% | 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 | 7.7%CMS range 4.8–12.7 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.12 | 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 114 beds and averages 109.3 residents a day — about 96% occupied, or roughly 5 beds typically open. It runs essentially full — expect a waiting list. 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 3.01 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.50 is below the 0.55-hour RN benchmark and nurse-aide staffing of 1.69 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 2.35 hrs/resident/day on weekends vs 3.27 on weekdays — 28% thinner on weekends — a notable drop. RN hours go from 0.59 to 0.27 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 57% is well above 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.
This trend is not current. The most recent of these two inspections was over 2 years ago; the arrow describes what inspectors found then, not what the home is like now.
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.
25 citations, most serious first. The 12 most serious are shown; the remaining 13 are one tap away and print in full.
- Actual harm · H2024-08-23 · tag F0684 — failed to provide proper treatment and quality of care — patternProvide 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 observations, interviews, and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice for two (Resident #59 and #71) of two residents reviewed. Specifically, Resident #59 was readmitted from the hospital on [DATE] following surgical treatment of an abscess (a painful, swollen lump filled with pus) and did not have a follow up evaluation as ordered in a timely manner. Resident #71, who had a contracture (a shortening of muscles, tendons, skin, and nearby soft tissues that prevent normal joint movement which is often painful) of the left hand did not have a care plan in place that included measurable goals, interventions, or monitoring which resulted in multiple pressure ulcers and a decrease in range of motion. This resulted in actual harm to Resident #71 that was not Immediate Jeopardy and is evidenced by the following: 1. Resident #71 had diagnoses…
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 · G2024-08-23 · tag F0558 — failed to accommodate residents' needs and preferences — isolatedReasonably accommodate the needs and preferences of 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 observations, interviews, and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, the facility did not allow a resident the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences except when to do so would endanger the health or safety of the resident for one (Resident #31) of five residents reviewed for accidents. Specifically, Resident #31's side rails that were used to increase their independence and mobility in bed were removed by the facility as considered being a restraint without an appropriate assessment resulting in a fall out of bed with injury. This resulted in actual harm to Resident #31 that was not Immediate Jeopardy and is evidenced by the following: The facility policy Use of Side Rails, last reviewed January 2024, documented side rails are considered a restraint when they are used to limit the resident's freedom of movement. Side rails are permissible if they are used to treat a resident's…
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 · F2024-08-23 · tag F0655 — widespreadCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interviews and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, for 24 (Residents #1, #5, #22, #25, #27, #28, #37, #49, #58, #59, #61, #69, #73, #76, #79, #82, #83, #84, #85, #100, #109, #110, #161, #311) of 24 residents, the facility did not ensure that the baseline care plan (care plan developed within 48 hours of admission that includes the minimum healthcare information necessary to properly care for the immediate needs of the resident) was completed within the required timeframe and that a summary of the baseline care plan was provided to the resident and/or their representative. Specifically, for Residents #73 and #82, the facility could not provide evidence that a baseline care plan was completed within 48 hours of the resident's admission. For Residents #1, #5, #22, #25, #27, #28, #37, #49, #58, #59, #61, #69, #76, #79, #83, #84, #85, #100, #109, #110, #161, and #311, the facility could not provide evidence that a summary of the baseline care plan was provided to the resident and/or resident representative. The findings…
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 before2024-08-23 · tag F0584 — failed to keep a safe, clean, comfortable home — patternHonor 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, interviews, and record review conducted during the Recertification Survey and complaint investigation (NY00345323) from 08/18/2024 to 08/23/2024, for two (first and second floors) of two resident-use floors, the facility did not ensure a safe, clean, comfortable, and homelike environment. Specifically, there were roof leaks, missing ceiling tiles, and resident care equipment was dirty. The findings are: Record review of a roof vendor work estimate, dated 07/19/2024, revealed: roof repairs on the Ballasted EPDM (ethylene propylene diene terpolymer; a durable synthetic roofing membrane) roof system as needed in the active leak location on the South side of the building. The notes section of this report listed: Although work will be performed per proper roofing practices and we will stand behind our work, no guarantees can be provided on repair work due to the condition of the existing roof systems. Record review of an undated email communication from the Environmental Services Director 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 · E2024-08-23 · tag F0761 — failed to label and store drugs safely — patternEnsure 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
Based on observations, interviews, and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, the facility did not ensure that all drugs and biologicals were properly stored in accordance with State and Federal Laws for two (Unit One Hall A and Unit Two Hall A) of two medication carts and one (Unit Two) of two medication rooms reviewed. Specifically, medication carts contained expired medications, insulin without an open or expiration date, and one bottle of eye drops without any resident identifiers. Additionally, the medication room contained expired medications. This is evidenced by but not limited to the following: The undated facility policy and procedure, Storage of Medications, included drug containers that have missing, incomplete, improper, or incorrect labels are returned to the pharmacy for proper labeling before storing. Discontinued, outdated, or deteriorated drugs or biologicals are returned to the dispensing pharmacy or destroyed. During an observation on 08/21/24 at 4:45 PM, the Unit Two Hall A medication cart had four bottles 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.
- Potential for harm · E2024-08-23 · 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, interviews, and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, for one of one main kitchen, the facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Specifically, non-food contact surfaces were dirty, utensils and dishware were dirty, floors were dirty, there was missing grout between floor tiles, a reach-in cooler was dirty, and food items were not stored 6 inches above the floor. The findings are: Record review of the facility sanitization policy and procedure, dated 01/2024, listed 2. All utensils, counters, shelves and equipment shall be kept clean, maintained in good repair and shall be free from breaks, corrosions, open seams, cracks and chipped areas that may affect their use or proper cleaning. Seals, hinges and fasteners will be kept in good repair, 3. All equipment, food contact surfaces and utensils shall be washed to remove or completely loosen soils by using the manual or mechanical means necessary and sanitized using hot water…
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 · D2024-08-23 · tag F0677 — failed to help fully-dependent residents with daily care — isolatedProvide care and assistance to perform activities of daily living for any resident who is unable.
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 record review conducted during a Recertification Survey and complaint investigation (NY00338206) from 08/18/2024 through 08/23/2024, for one (Resident #5) of ten residents, the facility did not ensure that residents who were unable to carry out activities of daily living received the necessary services to maintain good grooming and personal hygiene. Specifically, Resident #5 was observed over several days with debris underneath their fingernails including while eating. This is evidenced by the following: The facility policy Care of Fingernails/Toenails, dated January 2024, documented that nail care included daily cleaning and regular trimming. The policy included to remove dirt from around and under each nail. Resident #5 had diagnoses that included muscle weakness, depression, and arthritis. The Minimum Data Set Resident Assessment, dated 07/10/2024, revealed Resident #5 was cognitively intact, had highly impaired vision, and required moderate assistance with personal…
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 · D2024-08-23 · tag F0685 — isolatedAssist a resident in gaining access to vision and hearing services.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and record reviews conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, for one (Resident #16) of one resident, the facility did not ensure the resident received treatment and/or assistive devices to maintain hearing. Specifically, Resident #16 was hard of hearing, had a documented request to be seen for hearing aids, and the facility did not arrange for an audiology (hearing) evaluation. This is evidenced by the following: Resident #16 had diagnoses including diabetes, depression, and bilateral hearing loss. The Minimum Data Set Resident Assessment, dated 07/03/2024, included the resident was cognitively intact, was able to hear with minimal difficulty, and did not have hearing aids. During an interview on 08/19/2024 at 10:24 AM, Resident #16 stated when they were admitted , they were told the facility would help them get hearing aids. They were seen to get their ears cleaned and sent to a hearing specialist, but still had not been evaluated for hearing aids. Resident #16 stated their inability to hear affects them daily and…
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 · D2024-08-23 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolatedProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
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 record review conducted during the Recertification Survey and complaint investigations (NY00338206 and NY00337318) from 08/18/2024 to 08/23/2024, the facility did not ensure that appropriate treatment and services were provided to prevent urinary tract infections for a resident with an indwelling urinary catheter (tube inserted into the bladder to drain urine into a drainage bag) for one (Resident #25) of one resident reviewed. Specifically, Resident #25 had a history of urinary tract infections and was observed on multiple occasions with their urinary catheter drainage bag, catheter drainage port, and catheter tubing lying directly on the floor without a barrier, and with the drainage bag completely full of urine resulting in a backup of urine in the tubing. This is evidenced by the following: Resident #25 had diagnoses including [NAME] disease (a rare genetic disorder that affects the kidneys), neuromuscular dysfunction of the bladder (the bladder does not work properly…
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 · D2024-08-23 · 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
Based on observations, interviews and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, for one (Resident #59) of one resident reviewed for tube feedings (nutrition administered via a tube inserted directly into the stomach via the abdomen due to the residents' inability to consume food and drink by mouth), the facility did not provide appropriate treatment and services to prevent potential complications. Specifically, there was no documented evidence that Resident #59's total daily intake of tube feedings was being monitored to ensure their nutritional needs were being met, physician's orders regarding administration of the tube feedings while consuming food were unclear, and free water flushes and nutritional supplements were not administered as ordered by the physician. This is evidenced by the following: The facility policy Enteral Nutrition (method of supplying nutrition directly into the gastrointestinal tract), dated reviewed January 2024, included that the enteral nutrition would be ordered by the physician based on the recommendations…
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 · D2024-08-23 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolatedProvide safe and appropriate respiratory care 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, interviews, and record review conducted during the Recertification Survey from 08/19/2024 to 08/23/2024, for one (Resident #85) of three residents, the facility did not ensure residents who needed respiratory care were provided such care consistent with professional standards of practice. Specifically, Resident #85 was observed wearing oxygen via a nasal cannula (a device that delivers oxygen through a person's nose), did not have a physician order in place for oxygen use via a nasal cannula, and there was no documentation in the Medication Administration and Treatment Administration Records that reflected the use of oxygen via nasal cannula each shift. This is evidenced by the following: The facility policy Oxygen Administration. dated January 2024, included to verify and review a physician's order for oxygen administration. Resident #85 had diagnoses that included chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (disorder in which breathing stops and starts…
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 · D2024-08-23 · tag F0925 — failed to control pests — isolatedMake sure there is a pest control program to prevent/deal with mice, insects, or other pests.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and records review conducted during a Recertification Survey and complaint investigation (NY00345323) from 08/18/2024 to 08/23/2024, for one of one kitchen, the facility did not ensure there was an effective pest control program. Specifically, small brown flies and fruit flies were present and untreated. The findings are: The facility pest control policy dated 01/2024, documented the following: E. A complaint log will be maintained by the Maintenance Department. Whenever there is a complaint noted, a maintenance work order is to be sent to the Maintenance office. F. Monitoring of pest control is performed as part of the weekly environmental rounds conducted by Performance Improvement Committee designee, daily observations, and documentation by staff in the Maintenance/Engineering log located at all Nursing stations and Security Stations departmental rounds and preventative measures. Record review of the past three months of maintenance logs on units revealed no pest control concerns were noted by staff. Pest control vendor treatment records for 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.
Show the remaining 13 citations
- Potential for harm · D2024-03-28 · tag F0678 — failed to provide CPR when needed — isolatedProvide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
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 and record reviews conducted during the Abbreviated Survey, (complaint #NY00336027) and completed [DATE], it was determined that the facility could not ensure there were adequate number of personnel in the facility to provide basic life support, including cardiopulmonary resuscitation (CPR- emergency lifesaving procedure performed when the heart and/or lungs cease functioning). Specifically, the facility did not maintain an updated list of staff who were currently certified in cardiopulmonary resuscitation and could not provide evidence that a cardiopulmonary resuscitation certified staff member was in the facility at all times to provide basic life support when needed. This is evidenced by the following: Review of the facility-provided list of licensed nursing staff revealed no evidence that 5 of 32 licensed active nurses were currently certified in cardiopulmonary resuscitation. Review of the 'Punch Detail Reports' (timecards) for all licensed nursing staff from [DATE] to [DATE] revealed no…
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 · D2023-10-03 · 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 interviews and record review conducted during an Abbreviated Survey (NY00302380 and NY00321005) 8/3/23 to 10/3/23, the facility did not ensure the resident's right to be free from abuse for three (Residents #3, #4, and #5) of six residents reviewed for abuse. Specifically, staff reported potential abusive behavior towards all three residents by one staff member (Registered Nurse (RN) #1). This is evidenced by the following: The facility policy, Abuse Prohibition Program, dated January 2023, documented that all reports of resident abuse (including injuries of unknown origin), neglect, exploitation, and/or theft/misappropriation of resident property are thoroughly investigated by facility management. Review of an undated Event Summary/Conclusion Report, signed by the RN/Regional Clinical Director, revealed that on 9/16/22 the Director of Nursing (DON) was made aware of a complaint by Resident #5 that RN #1 was inappropriate with them. During the course of the investigation two additional residents…
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 · D2022-06-10 · 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
Based on observations, interview and record review conducted during a Recertification Survey completed on 6/10/22, it was determined that for one (Resident #43) of five residents reviewed, the facility did not ensure that a comprehensive person-centered care plan was developed and implemented to address the resident's medical, physical, mental, and psychosocial needs. Specifically, Resident #43's Comprehensive Care Plan (CCP) was not individualized with goals and interventions to address use of psychotropic medications. This is evidenced by: Resident #43 had diagnoses that included Alzheimer's dementia with behaviors, depression, and adult failure to thrive. The Quarterly Minimum Data Set Assessment, dated 5/12/22, documented that Resident #43 had active diagnoses of Alzheimer's dementia and depression, had severe impairment of cognitive function, was receiving multiple psychotropics medications on a routine basis and had a gradual dose reduction (of a psychotropic medication) last attempted on 4/19/22. Review of the CCP, dated 5/26/22, included a goal of fewer behavioral episodes…
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 · D2022-06-10 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
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 record review conducted during a Recertification Survey, completed on 6/10/22, it was determined that for one (Resident #36) of two residents reviewed the facility did not ensure that the resident received care consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual's clinical condition demonstrates that they were unavoidable and that the resident received the necessary treatment to promote healing of a pressure ulcer, prevent infection and prevent new ulcers from developing. Specifically, Resident # 36 developed two pressure ulcers and the facility was unable to provide documented evidence that the resident's skin issues were evaluated and assessed by the medical team, did not do skin checks consistently per facility protocol, did not administer treatments as ordered by medical team for several days and did not notify the medical team of the missed treatments and did not revise the care plan…
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 · D2022-06-10 · 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
Based on observations, interviews, and record reviews conducted during the Recertification Survey and complaint investigation (#NY00296839), completed on 6/10/22, it was determined that the facility did not ensure the resident's environment was free from accident hazards for one (Resident #32) of three residents reviewed. Specifically, Resident #32, who had severe impairment of cognitive function, was able to exit the facility unsupervised due to a door alarm failure. Additionally, the residents care plan was not revised following actual exit seeking behavior and an elopement. This was evidenced by the following: Resident #32 had diagnoses that included Alzheimer's disease, dementia, and a history of repeated falls. The Quarterly Minimum Data Set Assessment, dated 4/18/22, revealed that Resident #32 had severely impaired cognition, that wandering behavior occured daily, and that the resident was independent with ambulation and required supervision with ambulation both on the unit and off the unit. The 1/16/22 Comprehensive MDS Assessment documented that Resident #32 wandered less…
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 before2019-11-01 · 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
Based on observations and interviews conducted during the Recertification Survey, it was determined that for two of two residential living units the facility did not provide housekeeping services that are necessary to maintain sanitary, orderly, and comfortable conditions. This is evidenced by the following: During an observation on 10/30/19 at 4:07 p.m., in the small dining room (TV room) on the first floor six of six recliners had worn bald spots in the fabric and there was no nap left to some areas of the fabric. The recliners were, stained, discolored, and smelled of urine. The finish on the vinyl upright chair was worn through to a lighter color. The fabric was worn on the red cloth chair and all four of the chair legs were scuffed with lighter colored wood visible below the dark brown top stain. The entire length of the front edge of the heater was chipped through the blue top coat exposing the metal below. When interviewed at that time, the Certified Nursing Assistant (CNA) said that the chairs are worn, dirty, stained, and have been at the facility for at least ten years.…
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 · D2019-11-01 · tag F0609 — failed to report abuse allegations — isolatedTimely 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 Based on observations, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #9) of one resident reviewed for abuse and for one (Resident #13) of five residents reviewed for accidents, the facility did not report resident-to-resident incidents to the State Survey Agency as required. This is evidenced by the following: Review of the facility policy and procedure, Abuse, Neglect, and Exploitation Prohibition, Training, Investigation, and Reporting, dated December 2016, revealed that alleged violations involving abuse, neglect, exploitation or mistreatment are reported immediately to the facility Administrator and to other officials, including the New York State Department of Health. The facility must report the results of all investigations to the facility Administrator and to other officials, including the New York State Department of Health, within five working days of the incident. 1. Resident #9 was admitted to the facility on [DATE] and 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 · D2019-11-01 · 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 observations, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one of one resident reviewed for hydration, the facility did not have a system in place to ensure that daily fluid intakes were consistently or timely monitored or followed physician orders. This is evidenced by the following: Resident #1 was admitted to the facility on [DATE] and had diagnoses including Alzheimer's disease, chronic kidney disease, and a history of urinary tract infections. The Minimum Data Set Assessment, dated 10/12/19, revealed the resident had severely impaired cognition, required set up help for eating, and used a diuretic daily. The Certified Nursing Assistant (CNA) Care Plan, dated 6/12/19, directs to set up and supervise at meals, encourage and assist if needed. A physician order, dated 8/8/19, included an antibiotic four times a day for ten days and directed to increase fluids by an additional 120 cubic centimeters (ccs) every shift. A Dite-O-Gram, dated 8/8/19,…
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 · D2019-11-01 · tag F0836 — isolatedEnsure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations and an interview conducted during the Recertification Survey, it was determined that the carbon monoxide detection was not provided in compliance with Federal, State, and Local Laws and Professional Standards. The International Fire Code, 2015 Edition Section 915 Carbon Monoxide Detection (adopted by New York State), requires carbon monoxide detection in all areas with fuel burning/gas operated equipment. Specifically, carbon monoxide detection was not installed in the basement levels of Buildings 906 and 918 where there was fuel burning equipment. This is evidenced by the following: Observations conducted between 10/28/19 and 10/29/19 revealed there was no carbon monoxide detection installed within the facility on floor one and the basement. Specifically, there was a laundry room with two gas burning (natural gas) clothes dryers and a boiler room with two gas burning boilers. In addition, there was a stove and oven that were gas burning (natural gas) within the main kitchen located on the first floor. When interviewed on 8/7/19 at 3:35 p.m., the Environmental…
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 · B2024-08-23 · tag F0582 — patternGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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 and record review conducted during the Recertification Survey from 08/18/2024 to 08/23/2024, for six (#52, #312, #313, #314, #315, and #317) of seven residents reviewed, the facility did not provide the appropriate liability and appeal notices to Medicare beneficiaries at the termination of their Medicare coverage. Specifically, the facility did not provide a Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN) to Residents #314 and #315 and did not provide a Notice of Medicare Non-Coverage (NOMNC) to Residents #52, #312, #313, #317, and/or their representatives informing them of their appeal rights and/or their liability for services. This is evidenced by but not limited to the following: The Centers for Medicare & Medicaid Services (CMS) Form Instructions for the Notice of Medicare Non-Coverage Form CMS-10123 documented the Notice of Medicare Non-Coverage must be delivered at least two calendar days before Medicare covered services end. The Centers for Medicare & Medicaid Services…
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 · B2024-08-23 · tag F0732 — patternPost nurse staffing information every day.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and record review conducted during a Recertification Survey from 08/18/2024 to 08/23/2024, the facility did not ensure the nurse staffing information was posted daily and included the required information. Specifically, the facility did not post the accurate nurse staffing data on 08/18/2024, 08/20/2024, 08/21/2024 or 08/22/2024, as required per the regulations. This is evidenced by the following: During an observation on 08/18/2024 at 8:30 PM, the daily nurse staffing information was not visibly posted. During observations on 08/20/2024 at approximately 11:15 AM, 08/21/2024 at 10:29 AM, and 08/22/2024 at 9:04 AM, the posted daily nurse staffing information was dated 08/19/2024. During an interview on 08/21/2024 at 10:29 AM, Receptionist #1 stated Scheduler #1 was responsible for printing the daily nurse staffing information. Scheduler #1 was on vacation and no one else had printed the daily nurse staffing information. During an interview on 08/23/2024 at 9:41 AM, the Assistant Director of Nursing stated Scheduler #1 was responsible for posting 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 · B2022-06-10 · tag F0625 — patternNotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
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 and interviews conducted during the Recertification Survey completed 6/7/22 to 6/10/22, it was determined that for one (Resident #47) of one resident reviewed for hospitalizations, the facility did not ensure a written notification, which specifies the duration of the bed-hold policy, was provided to the resident and/or the resident representative at the time of transfer to the hospital. Specifically, Resident #47 was transferred to the hospital and the facility could not provide evidence that a written notice of information regarding the facility's bed-hold policy (including bed reserve policy) was provided to the resident or the resident's representative per the regulation. This was evidenced by the following: The current undated facility policy, 'Bed Hold/Bed Reservation Policy', documented that when a resident is transferred to an acute care hospital setting or is on therapeutic leave, the bed is retained under certain conditions. The policy did not direct that a written notification,…
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 · B2019-11-01 · tag F0623 — patternProvide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
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 and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #35) of one resident reviewed for hospitalization, the facility did not ensure that the resident's representative was provided with a written transfer/discharge notice. This is evidenced by the following: Resident #35 was admitted to the facility on [DATE] with diagnoses including respiratory failure with hypoxia, pneumonia, and dementia. The Minimum Data Set Assessment, dated 9/5/19, revealed the resident's cognitive skills for daily decision making were severely impaired. A nursing progress note, dated 10/24/19, revealed the resident was having trouble breathing and at 11:00 a.m., the resident was transferred to the hospital for evaluation and treatment. Further review of the medical record revealed there was no documented evidence that the resident's representative was notified in writing of the resident transfer to the hospital. Interviews conducted on 11/1/19 included the following:…
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
$62,207 in federal fines across 1 penalty.
- $62,207 — penalty dated 2024-08-23
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 HURLBUT CARE — 13 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 | 1 of 5 | 3.8 | -2.8 vs chain |
| Health inspection | 1 of 5 | 3.8 | -2.8 vs chain |
| Staffing | 1 of 5 | 2.4 | -1.4 vs chain |
| Quality measures | 1 of 5 | 3.2 | -2.2 vs chain |
The other 12 homes this chain runs (chain average 3.8★, 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 / manager | Type | Role | Since |
|---|---|---|---|
| CHASKO, BRIDGETT | Individual | W-2 MANAGING EMPLOYEE; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL | since 09/02/2014 |
| HURLBUT, ROBERT | Individual | W-2 MANAGING EMPLOYEE | since 04/01/2007 |
CMS files one row per role, so the 4 rows in the source record cover these 2 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.
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.
A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.
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 NY
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 York 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 335322. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2024-08-23, 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 →
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