Citations Summary
Feb 2022 – Jan 202621 Total Citations — state avg: 23
Issued in the reporting period
18Standard Health
3Life Safety Code
Severity of Citations
How serious were those 21 citations?
0
Minor potential harm
All corrected ✓
0
No actual harm
None in this period
Inspection Details
Surveys with Citations Only▼
Standard Health Citations
Activities Meet Interest/needs Each Resident
Standard Health Citation — quality of care
Care Plan Timing And Revision
Standard Health Citation — quality of care
Develop/implement Comprehensive Care Plan
Standard Health Citation — quality of care
Develop/implement Comprehensive Care Plan
Standard Health Citation — quality of care
Food Procurement,store/prepare/serve-sanitary
Standard Health Citation — quality of care
Free Of Accident Hazards/supervision/devices
Standard Health Citation — quality of care
Free Of Accident Hazards/supervision/devices
Standard Health Citation — quality of care
Infection Prevention & Control
Standard Health Citation — quality of care
Quality Of Care
Standard Health Citation — quality of care
Reporting Of Alleged Violations
Standard Health Citation — quality of care
Resident Rights/exercise Of Rights
Standard Health Citation — quality of care
Right To Be Free From Physical Restraints
Standard Health Citation — quality of care
Self-determination
Standard Health Citation — quality of care
Sufficient/competent Staff-behav Health Needs
Standard Health Citation — quality of care
Treatment/svcs To Prevent/heal Pressure Ulcer
Standard Health Citation — quality of care
Life Safety Code Citations
Cooking Facilities
Life Safety Code Citation — NFPA requirements
Ep Testing Requirements
Life Safety Code Citation — NFPA requirements
Fire Alarm System - Testing And Maintenance
Life Safety Code Citation — NFPA requirements
Hazardous Areas - Enclosure
Life Safety Code Citation — NFPA requirements
Hvac
Life Safety Code Citation — NFPA requirements
Maintenance, Inspection & Testing - Doors
Life Safety Code Citation — NFPA requirements
▼
Standard Health Citations
Safe/clean/comfortable/homelike Environment
Standard Health Citation — quality of care
▼
Standard Health Citations
ADL Care Provided For Dependent Residents
Standard Health Citation — quality of care
Feeding Asst/training/supervision/resident
Standard Health Citation — quality of care
Infection Prevention & Control
Standard Health Citation — quality of care
Quality Of Care
Standard Health Citation — quality of care
Resident Rights/exercise Of Rights
Standard Health Citation — quality of care
Residents Are Free Of Significant Med Errors
Standard Health Citation — quality of care
Sufficient Nursing Staff
Standard Health Citation — quality of care
▼
Standard Health Citations
Bowel/bladder Incontinence, Catheter, Uti
Standard Health Citation — quality of care
Facility Assessment
Standard Health Citation — quality of care
Free Of Accident Hazards/supervision/devices
Standard Health Citation — quality of care
Quality Of Care
Standard Health Citation — quality of care
Residents Are Free Of Significant Med Errors
Standard Health Citation — quality of care
Sufficient Nursing Staff
Standard Health Citation — quality of care
▼
Standard Health Citations
ADL Care Provided For Dependent Residents
Standard Health Citation — quality of care
Department Criminal History Review
Standard Health Citation — quality of care
Develop/implement Comprehensive Care Plan
Standard Health Citation — quality of care
Facility Hiring And Use Of Nurse Aide
Standard Health Citation — quality of care
Food Procurement,store/prepare/serve-sanitary
Standard Health Citation — quality of care
Free Of Accident Hazards/supervision/devices
Standard Health Citation — quality of care
Free Of Medication Error Rts 5 Prcnt Or More
Standard Health Citation — quality of care
Investigate/prevent/correct Alleged Violation
Standard Health Citation — quality of care
Label/store Drugs And Biologicals
Standard Health Citation — quality of care
Notify Of Changes (injury/decline/room, Etc. )
Standard Health Citation — quality of care
Nurse Aide Peform Review-12 Hr/yr In-service
Standard Health Citation — quality of care
Quality Of Care
Standard Health Citation — quality of care
Reasonable Accommodations Needs/preferences
Standard Health Citation — quality of care
Resident Rights/exercise Of Rights
Standard Health Citation — quality of care
Life Safety Code Citations
Discharge From Exits
Life Safety Code Citation — NFPA requirements
Fire Alarm System - Testing And Maintenance
Life Safety Code Citation — NFPA requirements
Fire Drills
Life Safety Code Citation — NFPA requirements
Horizontal Sliding Doors
Life Safety Code Citation — NFPA requirements
Maintenance, Inspection & Testing - Doors
Life Safety Code Citation — NFPA requirements
Sprinkler System - Installation
Life Safety Code Citation — NFPA requirements
▼
Standard Health Citations
Free From Abuse And Neglect
Standard Health Citation — quality of care
Reporting Of Alleged Violations
Standard Health Citation — quality of care
▼
Standard Health Citations
Notify Of Changes (injury/decline/room, Etc. )
Standard Health Citation — quality of care
Severity Scale Reference
Level 0 — No Harm Potential
Level 2 — Minor Potential Harm
Level 3 — Actual Harm
Level 4 — Immediate Jeopardy
Complaints
Feb 2022 – Jan 2026Below state average. This facility received 39.3 complaints per 100 beds vs. a statewide rate of 55.0. 16 citations resulted from those complaints (10.7 per 100 beds vs. 3.0 statewide).
Total Complaints
59
55,221 statewide
Per 100 Occupied Beds
39.3
55.0 state avg
On-Site Inspections
11
8,103 statewide
Citations Issued
16
10.7 per 100 beds · avg 3.0
Facility-Reported Incidents
25%
55% statewide
| Citations by Category | This Facility |
|---|---|
| Administration | 3 |
| Dietary Services | 2 |
| Other Services | 0 |
| Physical Environment | 4 |
| Quality of Care | 27 |
| Resident Rights | 6 |
| Total | 42 |
Enforcement & Fines
Feb 2016 – Jan 20261 enforcement action totaling $2,000 in fines over the reporting period. Resolved via Stipulation & Order agreements with the NY Department of Health where applicable.
September 23, 2021
$2,000
Stipulation & Order #NH-21-179 · Signed October 15, 2021
Reason: Quality of Care
Reason: Quality of Care