The Center for Nursing and Rehab at Hoosick Falls

Inspectors wroteBased on record review and interviews during an abbreviated survey (Case # 2590765), the facility did not ensure residents received treatment and care in accordance with professional standards of practice that would meet each resident's physical, mental, and psychosocial needs for one (1) (Resident #1) of three (3) residents reviewed. Specifically, the facility did not ensure a physician order for treatment of a new wound on Resident #1's back, identified on 8/04/2025 during a wound care consult. This is evidenced by: Resident #1:Resident #1 was admitted to the facility with diagnoses of spina bifida (a condition that occurs when the spine and spinal cord do not form properly), constipation, and retention of urine with obstructive and reflux uropathy (retention due to a blockage that makes it difficult or impossible to pass urine). [...]

Inspectors wroteBased on record review and interviews during an abbreviated survey (Case # 2590765), the facility did not ensure that a resident with an indwelling catheter (a tube inserted into the bladder to drain urine) received appropriate care and services to prevent urinary tract infections for one (1) (Resident #1) of three (3) residents reviewed. Specifically, for Resident #1, the facility did not ensure daily catheter care for the resident's indwelling Foley catheter in May, June, July, and August 2025. There was no documented physician order for daily catheter care until 8/20/2025. This is evidenced by:Resident #1: [...]

Inspectors wroteBased on observation, interviews, and record review conducted during the recertification survey, the facility did not provide effective housekeeping and maintenance services on 2 (Unit A and Unit B) of 2 resident units. Specifically, the carpeting throughout Unit A, Unit B, and the lobby was heavily soiled with dirt. This is evidenced by: During an observation from 10/03/2024 through 10/08/2024, the carpeting in the corridors on Unit A, Unit B, and the lobby area was heavily soiled with ground-in dirt. During an interview on 10/04/2024 at 1:35 PM, Environmental Manager #1 stated the carpeting cleaning machine has recently been repaired and that the facility had begun working on cleaning the carpeting. During an interview on 10/04/2024 at 1:41 PM, Administrator #1 stated the facility ownership was planning to replace the carpeting. 10 New York Codes, Rules, and Regulations 415.5(h)(4)

Inspectors wroteBased on record review and interview conducted during the recertification survey, the facility did not ensure the development and implementation of comprehensive person-centered care plans that included measurable objectives and time frames to meet the resident's medical, nursing, and mental and psychosocial needs, that were identified in the comprehensive assessment, for 8 (Resident #s 7, 20, 21, 25, 30, 44, 55, and 215) of 19 residents reviewed for comprehensive care plans. Specifically, for (a.) Resident #7 comprehensive care plan was not implemented to provide the resident with a means of communication; (b.) for Resident #20, a comprehensive care plan was not developed for lymphedema, which the resident was receiving treatment for; And (c.) Residents #30 and #215 comprehensive care plan was not developed to be resident centered as to address the specific needs of the residents. [...]

Inspectors wroteBased on observation, record review, and interview conducted during a recertification survey, the facility did not ensure drugs and biologicals were labeled and stored in accordance with professional standards of practice. Specifically, opened insulin had no open and/or expiration dates written on them. This was evident for 1 (Unit B medication cart) of 2 medication carts reviewed for medication storage. This is evidenced by: The facility's Policy and Procedure, titled Medication Administration and last revised 9/2024 did not address labeling multi-use medications with expiration dates. During a medication cart review on Unit B with Licensed Practical Nurse #1 on [DATE] 9:16 AM, the following was observed: Resident #15's Basaglar KwikPen (insulin) was opened, and had no date opened or date of expiration. [...]

Inspectors wroteBased on medical record review and interview during the recertification survey, the facility did not ensure that residents and/or their designated representative were fully informed of their right to an expedited review of a service termination for 1 (Resident #54) of 3 residents reviewed. Specifically, a Notice to Medicare Provider Non-coverage, form CMS-10123 was not issued to Resident #54 prior to the Medicare Part A Service Termination. This is evidenced by: There was no documented evidence that a Notice to Medicare Provider Non-coverage, form CMS-10123 was issued to Resident #54 prior to the Medicare Part A Service Termination. During an interview on 10/08/2024 at 10:21 AM, Social Worker #1 stated they could not find the Notice to Medicare Provider Non-coverage, form CMS-10123 for Resident #54 and issuing this notice could have been overlooked. [...]

Inspectors wroteBased on observation, record review and interview conducted during the recertification survey, the facility did not ensure residents were given the appropriate treatment and services to maintain or improve their ability to carry out the activities of daily living including functional communication systems for 1 (Resident #7) of 1 resident reviewed for communication. Specifically, Resident #7 ' s primary language was Japanese, and was care planned for staff to utilize communication boards. Resident #7 was not consistently provided a functional communication system to communicate their needs independently and effectively. This is evidenced by: [...]

Inspectors wroteBased on observation and interview conducted during the recertification survey, the facility did not store, prepare, distributed, or serve food in accordance with professional standards for food service safety in the main kitchen and 2 (Unit A and Unit B) of 2 nourishment kitchenettes. Specifically, equipment and surfaces were soiled with food particles and plastic single-use articles were stored on the floor. This is evidenced by: During observations on 10/02/2024 at 10:49 AM, single-use plastic tableware and utensils were stored on the floor of the main storeroom and the following items were soiled with food particles or food drips: • Slicer. • Microwave oven. • Table mixer. • Utensil drawers. • Can opener holder. • Cooking line shelving. • K-rated fire extinguisher. • Kitchen mop sink. • Exterior of refrigerator in the Unit A Nourishment Kitchenette. [...]

Inspectors wroteBased on observation, record review, and interview conducted during the recertification and abbreviated survey (NY00354719), the facility did not ensure they provided medications and/or biologicals, as ordered by the prescriber, to meet the needs of 1 (Residents #65) of 1 resident reviewed for Pharmacy Services and 1 (Resident #165) of 4 residents reviewed for Medication Administration. Specifically, Resident #65 was admitted to the facility on [DATE] and ordered medications were not available for administration the evening of 9/09/2024 or the morning of 9/10/2024. For Resident #165, ordered medications were not available for administration on 10/07/2024 and 10/08/2024. This is evidenced by: The undated and untitled facility policy provided upon request of a policy addressing unavailable medications documented the following: [...]

Inspectors wroteBased on observation, record review, and interviews during the recertification survey dated 08/24/2022 through 08/30/2022, the facility did not ensure food was stored, prepared, distributed, or served in accordance with professional standards for food service safety in the main kitchen, the Servery Kitchen, and one (1) of 2 Nourishment Rooms. Specifically, in the main kitchen, the table mixer, slicer, microwave oven, and table fan were soiled with food particles or dust; one spray bottle was not labeled; an obnoxious (sewer odor) odor was detected; and the correct test kit to measure the concentration of sanitizing solution (test kit) used to manually sanitize food contract equipment, was not provided; in the A-Unit Nourishment room, the refrigerator door gasket was soiled with food particles; and in the Servery Kitchen, the microwave oven and cabinets were soiled with food particles. [...]

Inspectors wroteBased on observations, interviews, and record reviews during a recertification survey, the facility did not ensure an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections was maintained for the facility. Specifically, the facility did not ensure that visitors were consistently screened for symptoms of COVID-19 prior to entering the facility; and for Resident #24, the facility did not ensure that contact precautions were implemented as ordered by the physician. This was evidenced by: [...]

Inspectors wroteBased on record review and interview during the recertification survey, the facility did not ensure the development and implementation of comprehensive person-centered care plans (CCP) for each resident that included measurable objectives and timeframes to meet the resident's medical, nursing, mental and psychosocial needs for 3 (Resident # 24, 33, and #47) of 19 residents reviewed for comprehensive care plans (CCP). Specifically, for Resident #24, the facility did not ensure their CCP included the intervention for contact precautions required for the resident's diagnosis of methicillin resistant staph aureus in the urine; for Resident #33's diagnoses of hyperlipidemia (high cholesterol), gastroesophageal reflux disease (GERD), and biliary cholangitis (a disease that causes destruction of the bile ducts in the liver); [...]

Inspectors wroteBased on observation and interviews during the recertification survey dated 08/24/2022 through 08/30/2022, the facility did not provide effective maintenance services for two (2) of 2 resident units. Specifically, the carpeting throughout the A-Unit and B-Unit corridors was heavily soiled with a black build-up and spot stains. This is evidenced as follows: During observations on 08/24/2022 at 11:02 AM, the carpeting throughout the A-Unit and B-Unit corridors was heavily soiled with a black build-up and spot stains. During interviews on 08/25/2022 at 10:44 AM, the Administrator and Director of Housekeeping and Laundry stated that the carpets are spot-cleaned and will need to be deep-cleaned and assessed, but the present condition is due to the age of the carpeting. 483.10(i)(2); 10 NYCRR 415.5(h)(4)

Inspectors wroteBased on observation, record review, and staff interview during the recertification survey, the facility did not store, prepare, distribute or serve food in accordance with professional standards for food service safety. Toxic substances are not to be stored where food or food surfaces can be contaminated, product thermometers are to be kept calibrated, kitchen surfaces are to be cleanable, a test kit is to be provided to measure the parts per million (ppm) concentration of the solution used to sanitize equipment, and floors are to be kept clean. Specifically, toxic substances, product thermometers, kitchen surfaces, test kits, and floors were not in compliance as required. This is evidenced as follows. The kitchen and unit kitchenettes were inspected on 02/18/2020 at 08:41 AM. A spray bottle with sanitizing solution was found above the storage area for food service gloves. [...]

Inspectors wroteBased on record review and interviews during the recertification survey and an abbreviated survey (Case #NY00252358), the facility did not ensure that the resident's environment remained as free of accident hazards as was possible for 1 (Resident #33) of 4 residents reviewed for accident hazards. Specifically, for Resident #33, the facility did not ensure the resident's skin integrity was protected in accordance with manufacturer instructions when a chemical hair relaxant was applied to the resident's hair. This is evidenced by: Resident #33: The resident was admitted to the facility with the diagnoses of paranoid schizophrenia, diabetes, and dementia. The Minimum Data Set (MDS - an assessment tool) dated 12/26/19, documented the resident had moderately impaired cognition, could usually understand others and could usually make self understood. [...]

Inspectors wroteBased on observation and staff interview during the recertification survey, the facility did not dispose of garbage and refuse properly. Specifically, the trash compactor was not clean. This is evidenced as follows. The trash compactor area was inspected on 02/18/2020 at 08:41 AM. The compactor door portal was soiled with a thick white build-up. The Director of Plant Operations stated in an interview on 02/18/2020 at 09:28 AM, that the compactor door has not been cleaned in awhile and sometimes trash falls out when the compactor is being emptied by the compactor vendor. 10 NYCRR 415.14(h)

Inspectors wroteBased on observation, record review and interview during the recertification survey, the facility did not maintain an infection prevention and control program designed to prevent the development and transmission of communicable diseases and infections for 1 of 1 (Resident #29) residents reviewed for a dressing change. Specifically, for Resident #29, during observation of a dressing change to the resident's stage three (3) pressure ulcer (PU) on the right (R) heel, the facility did not ensure that scissors were cleansed throughout the dressing change, a barrier was used under the foot/over the floor, supplies were opened properly, and gloves were changed when contaminated during a dressing change . This is evidenced by: Resident #29: The resident was admitted to the facility with diagnoses of chronic kidney disease, hypertension and pressure ulcer (PU) of the right (R) heel. [...]

Inspectors wroteBased on record review and interviews during the recertification survey and an abbreviated survey (Case #NY00252358), the facility did not ensure training was provided to their staff that at a minimum educated staff on activities that constituted abuse, neglect, exploitation, and misappropriation of resident property, procedures for reporting incidents of abuse, neglect, exploitation, or the misappropriation of resident property, and dementia management and resident abuse prevention. Specifically, the facility did not ensure contracted staff was educated on the prevention and reporting of abuse and neglect. This is evidenced by: [...]