Smithtown Center for Rehabilitation & Nursing Care

Inspectors wroteBased on observation, record review and interviews during an abbreviated survey (Intake ID: 2682221) initiated on 01/21/2026, the facility did not ensure that the designated representative was notified when the need to discontinue a treatment was identified. This was identified for one (1) resident (Resident #3) of three (3) residents reviewed for Notification of Change. Specifically, Resident #3's two half siderails were removed without notification to designated representative as required. Based on observation, record review and interviews during an abbreviated survey (Intake ID: 2682221) initiated on 01/21/2026, the facility did not ensure that the designated representative was notified when the need to discontinue a treatment was identified. This was identified for one (1) resident (Resident #3) of three (3) residents reviewed for Notification of Change. [...]

Inspectors wroteBased on record review and interviews during the Abbreviated Survey initiated on 01/21/2026, the facility did not ensure the Minimum Data Set assessment was completed accurately and reflected each resident's status. This was identified for one (1) resident (Resident #2) of three (3) residents reviewed for Activities of Daily Living. Specifically, Resident #2's Annual Minimum Data Set assessment dated [DATE] documented Resident #2's functional ability as needing substantial/maximal assistance with putting on and taking off footwear. Resident #2 had bilateral (both sides) above the knee amputations and did not utilize footwear. Based on record review and interviews during the Abbreviated Survey initiated on 01/21/2026, the facility did not ensure the Minimum Data Set assessment was completed accurately and reflected each resident's status. [...]

Inspectors wroteBased on observation, Record review, and staff interviews during the Abbreviated Survey (Intake ID: 2682221) initiated on 01/21/2026, the facility did not ensure that each resident's Comprehensive Care Plan was revised by the interdisciplinary team after each assessment to reflect the resident's current status. This was identified for one (1) resident (Resident #2) of three (3) residents reviewed for Siderails. Specifically, Resident #2's Comprehensive Care Plan was not revised to reflect the discontinuation of the residents siderails. Based on observation, Record review, and staff interviews during the Abbreviated Survey (Intake ID: 2682221) initiated on 01/21/2026, the facility did not ensure that each resident's Comprehensive Care Plan was revised by the interdisciplinary team after each assessment to reflect the resident's current status. [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure the right to self-administer medications. This was identified for one (Resident #30) of two residents reviewed for Skin Condition. Specifically, Resident #30 was self-administering their eyedrop medications by themselves. The resident was not assessed by the Interdisciplinary team and did not have a physician's order to self-administer their medications. The finding is: The facility's Self Administration of Medications policy and procedure, revised in January 2025, documented to permit bedside medications for residents when ordered by the Attending Physician. The Interdisciplinary Care Team shall review the resident's request to self-administer medication. [...]

Inspectors wroteBased on record review and staff interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure that accurate Preadmission Screening for individuals with a mental disorder was accurately completed. This was identified for two (Resident #32 and #74) of 30 residents reviewed for the Pre-admission Screen review. Specifically, Resident #32 and Resident #74 did not have a completed Level I Screen, Additionally, the screen did not accurately indicate the diagnosis of Dementia for both residents.

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure that services provided or arranged by the facility met the current professional standards of quality. This was identified for one (Unit B Medication Cart) of three Medication carts observed during the Medication Storage Task. Specifically, Licensed Practical Nurse #5 stored the unlabeled and unidentifiable pre-poured medications that were refused by five residents in the top drawer of the medication cart. Licensed Practical Nurse #5 stated they knew the medications by their appearance and intended to administer the medications to the residents at a later time. The finding is: [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure each resident with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection, and prevent new ulcers from developing. This was identified for one (Resident #61) of two residents reviewed for Pressure Ulcers. Specifically, Resident #61 was at high risk for pressure ulcer development and had a physician's order to use an air mattress to prevent skin breakdown. During observations on 4/23/2025, the resident was in bed, and the air mattress weight setting was not consistent with the resident's weight. The finding is: [...]

Inspectors wroteBased on observations, record review, and interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure that all drugs and biologicals were stored and labeled in accordance with currently accepted professional principles. This was identified for one (Unit B Medication Cart) of three medication carts reviewed during the Medication Storage Task, and one (Resident #30) of five residents reviewed during the Medication Administration Task. Specifically, 1) the Unit B Medication Cart was observed containing five (5) unlabeled medication souffle cups with various unidentified medications in the top drawer of the cart. 2) Resident #30 was observed with three (3) eyedrop medications and a bottle of eye lubricant at their bedside during the Medication Administration Task.

Inspectors wroteBased on observations, record review, and staff interviews during the Recertification Survey initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure that an infection prevention and control program designed to prevent the development and transmission of infection was maintained. This was identified for two (Resident #253 and Resident #254) of the three residents reviewed for Transmission Based Precautions. Specifically, Resident #253 had wounds with multi-drug drug-resistant organisms, and Resident #254 had a surgical wound. Both residents had physician orders for Enhanced Barrier Precautions for a wound. Certified Nursing Assistant #1 did not wash their hands after providing care to Resident #253 and then entered Resident #254's room.

Inspectors wroteBased on observations, record reviews, and staff interviews, during the Recertification Survey and Abbreviated Survey (NY 00375290) initiated on 4/23/2025 and completed on 4/29/2025, the facility did not provide proper respiratory treatments and care consistent with professional standards of practice. This was identified for one (Resident #203) of five residents reviewed for Respiratory Care. Specifically, Resident # 203 was admitted on [DATE] and did not receive all their inhaler medications as ordered until 3/9/2025. The finding is: The facility policy and procedure titled Pharmacy Vendor Services, updated in January 2025, documented that medication/treatments will be supplied by the pharmacy. Medications/treatments will be obtained from the [contracted] Pharmacy in accordance with the policies and procedures outlined in this manual. [...]

Inspectors wroteBased on observations, record reviews, and staff interviews, during the Recertification Survey and Abbreviated Survey (NY 00375290) initiated on 4/23/2025 and completed on 4/29/2025, the facility did not ensure pharmaceutical services were provided to meet the needs of each resident and that medications were administered to residents in a timely manner as ordered by the physician. This was identified for one (Resident #203) of five residents reviewed for Respiratory Care. Specifically, Resident # 203, with diagnoses of Chronic Obstructive Pulmonary Disease and Lung Cancer remission, did not have all prescribed inhaler medications available in the facility until three days after the resident was admitted to the facility. Cross Reference: F695 Respiratory/Tracheostomy Care and Suctioning. The finding is: [...]

Inspectors wroteBased on record review and interviews during the Recertification Survey initiated on 2/21/2024 and completed on 2/27/2024, the facility did not ensure that the resident's Primary Care Physician comprehensively reviewed the resident's total program of care, including medications and treatments, and a decision about the continued appropriateness of the resident's current medical regimen. This was identified for one (Resident #52) of two residents reviewed for antibiotic use. Specifically, Resident #52 had a Physician's order to administer Xifaxan (an antibiotic that fights bacterial infection only in the intestines) for a prolonged period from 1/10/2024 until 2/27/2024. The physician's progress notes lacked documentation related to the prolonged use of and the reason for the antibiotic use. The finding is: [...]

Inspectors wroteBased on record review and interviews conducted during the Recertification Survey initiated on 2/21/2024 and completed on 2/27/2024, the facility did not implement an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use for all residents receiving antibiotic therapy. This was identified for one (Resident #52) of two residents reviewed for antibiotic use. Specifically, Resident #52 was receiving Xifixan (an antibiotic) since 1/10/2024 for Irritable Bowel Syndrome prophylactically (prevention) without documented evidence to support its continued use, or appropriate indications for its continued use. Additionally, there was a lack of monitoring and tracking of Xifixan's use. The finding is: [...]

Inspectors wroteBased on observation, record review, and interviews during the Recertification Survey initiated on 4/18/2022 and completed on 4/22/2022, the facility did not ensure that each resident's right to personal privacy including medical treatment was maintained. This was identified for one (Resident #310) of one resident reviewed for privacy. Specifically, the Dentist was observed performing an oral examination for Resident #310 in the resident's room with the room door opened. The resident and the Dentist were both visible from the hallway while the Dentist was examining the resident's mouth. The finding is: The facility Policy and Procedure for Privacy dated 7/2005 documented the resident is to be treated with consideration, respect, and full recognition of his/her dignity and individuality, including privacy in treatment and care. [...]

Inspectors wroteBased on record review, and interviews during the Recertification Survey initiated on 4/18/2022 and completed on 4/22/2022, the facility did not ensure that each resident had a person-centered care plan developed and implemented that includes measurable objectives and times frames to meet the resident's medical and nursing needs. This was identified for one (Resident #108) of two residents reviewed for vision and hearing. Specifically, Resident #108 was admitted to the facility with a hearing impairment. There was no documented evidence that a Comprehensive Care Plan (CCP) was developed to address the resident's hearing impairment. The finding is: Resident #108 was admitted with diagnoses that included Dementia without Behavioral Disturbances, Hypertension and Depression. [...]

Inspectors wroteBased on observations, record review, and staff interviews during the Recertification Survey initiated on 4/18/2022 and completed on 4/22/2022 the facility did not ensure that a resident who enters the facility with an indwelling catheter was assessed for the need of the indwelling catheter and had physician's orders for care of the indwelling catheter. This was identified for 1 (Resident #70) of 3 residents reviewed for Urinary Catheter. Specifically, Resident #70 was admitted to the facility with an indwelling Foley catheter on 4/6/22 without physician orders for the justification and care the catheter. The finding is: The policy and Procedure for Catheter- Urinary and Suprapubic dated 7/1/2005 documented physician orders must be obtained for the use of a catheter. The orders should include catheter and balloon size. [...]

Inspectors wroteBased on observation, record review and interview during the Recertification Survey initiated on 4/18/2022 and completed on 4/22/2022, the facility did not ensure that all drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles. This was identified for 1 of 3 medication carts reviewed during the Medication Storage and Labeling Task. Specifically, 1) Resident #75's Ademelog insulin pen, 2) Resident #360's Humalog insulin pen, and 3) Resident #119's Ademelog and Basaglar insulin pens were observed opened with no date indicating when the insulin pens were first opened. The finding is: The facility Medication/Treatment Labeling and Storage policy and procedure, last revised on 4/2016, documented that the facility shall maintain proper labels for medications. Insulin vials and pens must be dated when the first dose is administered. [...]