| General |
| City |
| Clinton |
Forest Hills |
| State attribute explanation |
| Ny |
Ny |
| Street |
| 110 Utica Road |
71 20 110th Street |
| Zip Code |
| 13,323 |
11,375 |
| Phone |
| 3,158,535,515 |
7,187,933,200 |
|
Overall Star Rating |
| 1 |
4 |
|
Health Inspections Star Rating |
| 1 |
4 |
|
Nurse Staffing Star Rating |
| 1 |
4 |
|
Quality Measures Star Rating |
| 4 |
4 |
|
RN Only Star Rating |
| 2 |
3 |
|
Number of Certified Beds |
| 280 |
160 |
|
Total Number of Residents |
| 261 |
155 |
|
Percent of Occupied Beds |
| 93 % |
97 % |
| Health Survey Date |
| 8/19/2011 |
9/20/2011 |
| Fire Survey Date |
| 8/19/2011 |
9/20/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Non Profit - Church Related |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
No |
| Resident and Family Councils |
| Both |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 2 |
75.2 |
| Total Enforcement Actions Count |
| 3 |
75.2 |
| # of deficiencies |
| 4 |
|
|
| Staff Information |
| Number of Residents |
| 261 |
155 |
| Number of RN Hours Per Resident Per Day |
| 0.43 |
0.71 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.88 |
0.81 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.3 |
1.52 |
| Number of CNA Hours Per Resident Per Day |
| 0.06 |
0.12 |
| Number Therapy Hours Per Resident Per Day |
| 0.06 |
0.12 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Somelevel Of Harm: 4deficiency: Give Proper Treatment To Residents With Feeding Tubes To Prevent Problems (such As Aspiration Pneumonia, Diarrhea, Vomiting, Dehydration, Metabolic Abnormalities, Nasal-pharyngeal Ulcers) And Help Restore Eating Skills, If Possible.survey Date: 05/23/2011date Of Correction: 07/01/2011 |
|
| Administration Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 3deficiency: Set Up An Ongoing Quality Assessment And Assurance Group To Review Quality Deficiencies Quarterly, And Develop Corrective Plans Of Action.survey Date: 05/23/2011date Of Correction: 07/01/2011 |
|
| Deficiency #2 |
| Scope: Somelevel Of Harm: 2deficiency: Choose A Doctor To Serve As The Medical Director To Create Resident Care Policies And Coordinate Medical Care In The Facility.survey Date: 05/23/2011date Of Correction: 07/01/2011 |
|
| Deficiency #3 |
| Scope: Somelevel Of Harm: 4deficiency: Be Administered In An Acceptable Way That Maintains The Well-being Of Each Resident .survey Date: 05/23/2011date Of Correction: 07/01/2011 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 18.9 % |
8.5 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 2.4 % |
2.3 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 3.9 % |
7 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 6.6 % |
9.5 % |
| Percent of long-stay residents who lose too much weight |
| 6.7 % |
2.7 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 59.3 % |
40 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1 % |
2.20 % |
| Percent of long-stay residents with a urinary tract infection |
| 6.2 % |
1.8 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
32.4 (90.3) |
| Percent of long-stay residents who were physically restrained |
| 0.4 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 15.5 % |
21.8 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 92 % |
96.6 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 90.9 % |
99.3 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 75.2 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 4.3 % |
0.9 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 20.4 % |
14.1 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 2.9 % |
2.3 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 5.1 % |
5.3 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 6.9 % |
8 % |
| Percent of long-stay residents who lose too much weight |
| 7.2 % |
4.6 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 59.7 % |
36.4 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1 % |
1.3 % |
| Percent of long-stay residents with a urinary tract infection |
| 7.3 % |
3.4 % |
| Percent of long-stay residents who have depressive symptoms |
| 0.2 % |
28.6 % |
| Percent of long-stay residents who were physically restrained |
| 0.9 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 4.2 % |
1.4 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 15.8 % |
21.6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 88 % |
95.8 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 86.8 % |
98.4 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 20.6 % |
17.5 % |