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Elderwood of Lakeside at Brockport

170 West Avenue, Brockport, NY 14420 · Monroe County · (585) 395-6095

120 certified beds, about 105 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1976

Certified for Medicaid Certified for Medicare
Overall
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 335569 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on April 2, 2025, inspectors cited 4 health deficiencies (the New York average is 8.1, the national average 9.2).

None of its 7 health citations since October 2021 was rated as actual harm or immediate jeopardy.

CMS lists no fines against this home in the last three years.

Nurses and nurse aides worked 2.69 hours per resident per day, against 3.63 across New York and 3.86 nationally. Registered nurses accounted for 0.65 of those hours.

68.5% of nursing staff left within the year CMS measured (New York average 40.3%).

CMS links it to Elderwood, an affiliated group of 17 nursing homes.

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 7 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
5D
2E
0F
Potential for minimal harm
0A
0B
0C
April 2, 2025Standard inspection, Complaint inspection · 4 citations
  1. E
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) May 23, 2025
    Inspectors wroteBased on observations, interviews, and record review conducted during a Recertification Survey and complaint investigation (NY00365495) from 03/28/2025 to 04/02/2025, for two (2) (Resident #55 and #59) of nine (9) residents, the facility did not ensure residents who were unable to carry out activities of daily living (basic self-care tasks people perform regularly to maintain their well-being, such as bathing and nail care) received the necessary services to maintain good grooming and personal hygiene. Specifically, Resident #55 had not received a shower in four (4) weeks, had unshaved facial hair, and unclean hair and fingernails. Resident #59 had not received a shower in three (3) weeks, was unshaven, and was observed using their hands to eat with debris underneath their fingernails. This is evidenced by the following: [...]
  2. D
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) May 23, 2025
    Inspectors wroteBased on observations, interviews, and record review conducted during the Recertification Survey from 03/27/2025 to 04/02/2025, the facility did not ensure residents received care in accordance with professional standards of practice for 1 (Residents #55) of 21 residents reviewed. Specifically, Resident #55 had edema (swelling in the legs) to both legs and did not receive compression therapy per physician order and their comprehensive care plan did not include goals and interventions related to the resident's diagnosis of diabetes, chronic kidney disease, or edema. This is evidenced by the following: 1. Resident #55 had diagnoses that included chronic kidney disease (a gradual loss of kidney function that can cause swelling in the feet and legs), hypertension (high blood pressure), and diabetes. [...]
  3. D
    Assist a resident in gaining access to vision and hearing services.
    F685 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) May 23, 2025
    Inspectors wroteBased on interviews and record review conducted during the Recertification Survey from 03/27/2025 to 04/02/2025, for one (1)(Resident #55) of three (3) residents reviewed the facility did not provide proper treatment and assistive devices to maintain vision. Specifically, the facility did not ensure Resident #55 was seen by the facility medical provider in a timely manner after reporting changes in vision, did not make an appointment with the resident's eye doctor per medical provider recommendation, and did not ensure the resident made it to a scheduled eye doctor appointment. This is evidenced by the following: The facility policy Optometry and Eye Care dated 06/18/2018 included eye examinations and other consultant optometry services will be obtained as ordered by the attending physician. [...]
  4. D
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) May 23, 2025
    Inspectors wroteBased on observations, interviews, and record review conducted during a Recertification Survey from 03/27/2025 to 04/02/2025, it was determined for one (1) (Resident #78) of seven (7) residents reviewed, the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of infection. [...]
January 8, 2025Complaint inspection · 1 citation
  1. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on observations, interviews, and record review conducted during an Abbreviated Survey (NY00340497) for one (Resident #6) of three residents reviewed, the facility did not ensure adequate supervision and monitoring devices were in place to prevent a resident from elopement (when a resident leaves the facility without supervision creating a potential threat to their health and safety). Specifically, Resident #6 was moderately impaired of cognitive function with a history of wandering and eloped from the facility by walking out the front door. The resident was not found for 42 minutes approximately 0.3 miles away. This is evidenced by the following: The facility policy Elopement - Wandering - Missing Resident, dated 10/08/2018, documented that appropriate safety measures are put into place for residents determined to be at risk for unsafe wandering/elopement. [...]
July 13, 2023Standard inspection · 2 citations
  1. E
    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.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) July 31, 2023
    Inspectors wroteBased on observations, interviews, and record reviews conducted during the Recertification Survey from [DATE] to [DATE], it was determined that for three of three residential units the facility did not ensure that drugs and biologicals were securely stored. Specifically, multiple medications were observed stored in an unlocked and unsupervised charting room. This is evidenced by the following: The facility policy Medication Rooms on Nursing Units dated [DATE], included that medication rooms on the nursing units of the facility will be the areas where medications for residents are stored. The rooms will have included but not limited to adequate means for security. [...]
  2. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) July 31, 2023
    Inspectors wroteBased on observations, interviews and record review conducted during the Recertification Survey 7/6/23 to 7/13/23, it was determined that for one (Resident #51) of three residents reviewed for accidents, the facility did not ensure that the resident's environment remained as free of accident hazards as possible. Specifically, Resident #51, who was observed to have multiple medications left on their bedside table, had not been assessed, and care planned for safe self-administration of medication. This is evidenced by the following: The facility policy Medications Administration dated modified 7/12/22 documented that a medication must never be left at bedside or be out of sight of the nurse administering the medication. The nurse must watch each resident take the medication, and ensure the medication is swallowed, unless the resident has an order for self-administration of medications. [...]
October 15, 2021Standard inspection · 0 citations

Fire safety inspections

3 fire safety citations on file: 1 on April 2, 2025, 2 on July 13, 2023.

Every fire safety citation3 citations
  1. E
    Inspect, test, and maintain automatic sprinkler systems.
    K 353 · April 2, 2025 · Corrected (the home has a date of correction)
  2. E
    Have approved installation, maintenance and testing program for fire alarm systems.
    K 345 · July 13, 2023 · Corrected (the home has a date of correction)
  3. D
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · July 13, 2023 · Corrected (the home has a date of correction)

Fines and payment denials

CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeNew YorkUnited States
All nursing staff (RN, LPN and aides)2.693.633.86
Registered nurses0.650.710.69
All nursing staff on weekends2.173.183.42
Nurse aides1.25
Licensed practical nurses0.79
Nursing staff turnover (share who left in a year)68.5%40.3%45.8%
Registered nurse turnover66.7%39.8%42.9%
Administrators who left0

CMS expects 3.55 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 2.90 on weekdays and 2.17 on weekends, 25% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 2.96 in April to June 2025 to 2.69 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20262.690.652.902.17 0.0%0 of 90105
Oct to Dec 20252.800.603.032.23 0.0%0 of 92106
Jul to Sep 20253.100.653.332.51 0.0%0 of 92103
Apr to Jun 20252.960.633.172.45 0.0%0 of 91102
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
New York, Jan to Mar 20263.550.683.723.139.8%0.1% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Staff pay reports

Staff pay at this home

No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.

Official wage estimates for New York

JobMedianMiddle halfEmployed
New York, all employers
CNAs (nursing assistants)$23.36$21.04 to $24.9987,990
LPNs and LVNs$32.30$29.52 to $37.0039,400
Registered nurses$52.62$45.60 to $62.34205,810
United States, nursing care facilities
CNAs (nursing assistants)$20.67$17.91 to $22.55534,270
LPNs and LVNs$33.86$30.05 to $37.40188,210
Registered nurses$41.11$37.85 to $47.68142,270

Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeNew YorkUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
16.614.113.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.00.50.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
1.61.31.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
7.13.13.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
1.11.21.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
13.012.514.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
5.76.54.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
17.313.715.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission
Short Stay residents, 20250101-20251231
13.920.623.8
Percentage of short-stay residents who had an outpatient emergency department visit
Short Stay residents, 20250101-20251231
7.19.612.0
Number of hospitalizations per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.71.71.9
Number of outpatient emergency department visits per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.31.41.8

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for Elderwood of Lakeside at Brockport's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (49.2% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

49.2% this home

No different from the national rate

US median of homes 51.5% · New York: 101 better, 157 worse

Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 136 eligible stays.

Potentially preventable readmissions

10.3% this home

No different from the national rate

US median of homes 10.7% · New York: 12 better, 5 worse

Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 143 eligible stays.

Infections that led to a hospital stay

6.3% this home

No different from the national rate

US median of homes 7.1% · New York: 7 better, 21 worse

Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 76 eligible stays.

Self-care and mobility at discharge

65.8% this home

Median of homes: New York60.6% · US 56.6%

Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 73 residents counted.

Falls with major injury

1.2% this home

Median of homes: New York0.6% · US 0.0%

Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 84 residents counted.

New or worsened pressure ulcers

1.3% this home

Median of homes: New York2.0% · US 1.7%

Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 84 residents counted.

Medication list given at discharge

100.0% this home

Median of homes: New York98.5% · US 98.7%

Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 52 residents counted.

Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.

Owners and operators

Legal business name: 170 WEST AVENUE OPERATING COMPANY LLC. CMS links this home to Elderwood, a group of 17 nursing homes averaging 2.3 stars overall.

NameRoleTypeShareSince
170 West Avenue Operating Holdco LLC5% or greater direct ownership interestOrganization100%05/05/2016
Cole, Warren5% or greater indirect ownership interestIndividual50%05/06/2016
Klinetob, KimberlyW-2 managing employeeIndividual11/01/2017
Cole, WarrenCorporate officerIndividual05/06/2016
Rubin, JeffreyCorporate officerIndividual05/06/2016
Cole, WarrenOperational/managerial controlIndividual05/06/2016
Quillard, PhilipOperational/managerial controlIndividual05/06/2016
Rubin, JeffreyOperational/managerial controlIndividual05/06/2016

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 5 problems in this area, most recently on April 2, 2025: "Provide care and assistance to perform activities of daily living for any resident who is unable."
  2. What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 1 problem in this area, most recently on April 2, 2025: "Provide and implement an infection prevention and control program."
  3. How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 1 problem in this area, most recently on July 13, 2023: "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."
  4. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.17 hours per resident per day, below the New York average of 3.18.

Other nursing homes nearby

New York contacts for a concern about a nursing home

These are the official offices in New York. NursingHomeClear cannot take or act on complaints.

Common questions

What is Elderwood of Lakeside at Brockport's Medicare star rating?
CMS rates Elderwood of Lakeside at Brockport 4 out of 5 stars overall, with 4 for health inspections, 1 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Elderwood of Lakeside at Brockport get at its last inspection?
4 health deficiencies at the standard inspection on April 2, 2025. The New York average is 8.1.
Has Elderwood of Lakeside at Brockport been fined?
CMS lists no fines in the last three years.
Does Elderwood of Lakeside at Brockport accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Elderwood of Lakeside at Brockport?
CMS lists 8 owners and managers, and links the home to Elderwood. Legal business name: 170 WEST AVENUE OPERATING COMPANY LLC.

Sources

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