Citations Summary
Feb 2022 – Jan 202613 Inspections Conducted
8
No citations found
62% of all inspections
5
Resulted in citations
38% of all inspections
36 Total Citations — state avg: 23
Issued across those 5 inspections
31Standard Health
5Life Safety Code
Severity of Citations
How serious were those 36 citations?
0
Minor potential harm
All corrected ✓
0
No actual harm
None in this period
Inspection Details
Surveys with Citations Only▼
Standard Health Citations
Bowel/bladder Incontinence, Catheter, Uti
Standard Health Citation — quality of care
Department Criminal History Review
Standard Health Citation — quality of care
Entering Into Binding Arbitration Agreements
Standard Health Citation — quality of care
Infection Control
Standard Health Citation — quality of care
Parenteral/iv Fluids
Standard Health Citation — quality of care
Responsibilities Of Providers; Required Notif
Standard Health Citation — quality of care
Right To Be Free From Chemical Restraints
Standard Health Citation — quality of care
Life Safety Code Citations
Fire Alarm System - Testing And Maintenance
Life Safety Code Citation — NFPA requirements
Hvac
Life Safety Code Citation — NFPA requirements
Means Of Egress - General
Life Safety Code Citation — NFPA requirements
Soiled Linen And Trash Containers
Life Safety Code Citation — NFPA requirements
▼
Standard Health Citations
Antibiotic Stewardship Program
Standard Health Citation — quality of care
Free From Abuse And Neglect
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
Personal Privacy/confidentiality Of Records
Standard Health Citation — quality of care
Responsibilities Of Providers; Required Notif
Standard Health Citation — quality of care
Right To Be Free From Physical Restraints
Standard Health Citation — quality of care
Life Safety Code Citations
Cooking Facilities
Life Safety Code Citation — NFPA requirements
Corridor - Doors
Life Safety Code Citation — NFPA requirements
Electrical Systems - Essential Electric Syste
Life Safety Code Citation — NFPA requirements
Fire Drills
Life Safety Code Citation — NFPA requirements
Gas Equipment - Cylinder And Container Storag
Life Safety Code Citation — NFPA requirements
Hazardous Areas - Enclosure
Life Safety Code Citation — NFPA requirements
Means Of Egress - General
Life Safety Code Citation — NFPA requirements
Soiled Linen And Trash Containers
Life Safety Code Citation — NFPA requirements
Sprinkler System - Maintenance And Testing
Life Safety Code Citation — NFPA requirements
▼
Standard Health Citations
Investigate/prevent/correct Alleged Violation
Standard Health Citation — quality of care
▼
Standard Health Citations
Cardio-pulmonary Resuscitation (cpr)
Standard Health Citation — quality of care
Notify Of Changes (injury/decline/room, Etc. )
Standard Health Citation — quality of care
▼
Standard Health Citations
Criminal History Record Check Process
Standard Health Citation — quality of care
Department Criminal History Review
Standard Health Citation — quality of care
Infection Control
Standard Health Citation — quality of care
Reporting Of Alleged Violations
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 2026Above state average. This facility received 94.0 complaints per 100 beds vs. a statewide rate of 55.0. 6 citations resulted from those complaints (4.0 per 100 beds vs. 3.0 statewide).
Total Complaints
142
55,221 statewide
Per 100 Occupied Beds
94.0
55.0 state avg
On-Site Inspections
25
8,103 statewide
Citations Issued
6
4.0 per 100 beds · avg 3.0
Facility-Reported Incidents
84%
55% statewide
| Citations by Category | This Facility |
|---|---|
| Administration | 0 |
| Dietary Services | 1 |
| Other Services | 0 |
| Physical Environment | 1 |
| Quality of Care | 8 |
| Resident Rights | 1 |
| Total | 11 |
Enforcement & Fines
Feb 2016 – Jan 20263 enforcement actions totaling $20,000 in fines over the reporting period. Resolved via Stipulation & Order agreements with the NY Department of Health where applicable.
January 3, 2023
$10,000
Stipulation & Order #NH-23-046 · Signed April 4, 2023
Reason: Quality of Care
Reason: Quality of Care
January 7, 2021
$4,000
Stipulation & Order #NH-21-043 · Signed March 1, 2021
Reason: Quality of Care
Reason: Quality of Care
September 30, 2020
$6,000
Stipulation & Order #NH-20-075 · Signed December 1, 2020
Reason: Multiple Deficiencies
Reason: Multiple Deficiencies