Complaint #s NJ00155172, NJ00161276, NJ00160806, NJ00159306 Refer to F689, F756, F760, F835 Based on observation, interview, record review, and review of facility provided documentation, it was determined that the facility failed maintain the required minimum direct care staff-to-resident ratios as mandated by the state of New Jersey for 118 of 119 day shifts, 54 of 119 evening shifts, and 10 of 119 overnight shifts. The failure of the facility to operate safely by following State minimum staffing requirements while continuing to admit new residents placed all residents at risk for serious harm, impairment or death. This deficient practice was evidenced by the following: Reference: New Jersey Department of Health (NJDOH) memo, dated 1/28/2021, Compliance with N.J.S.A. …
F836 citations in New Jersey
Administration Deficiencies
Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
New Jersey cites F836 more often than its own record predicts
4.08 times the share F836 takes of citations nationally.
Of every deficiency written in New Jersey in 2025, this is the portion that was F836.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What New Jersey surveyors wrote
F836 findings written in New Jersey, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Complaint #2613352Based on interview, and review of facility documentation, it was determined that the facility failed to provide services in compliance with applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards and principles for a resident who was denied admission to the facility to provide services. This deficient practice was identified for 1 of 3 residents' referrals reviewed, Resident #138.This deficient practice was evidenced by the following:Reference: According to the Centers for Disease Control (CDC) guidelines dated 4/24/24, the Transmission-Based Precautions (TBP) and Enhanced Barrier Precautions (EBP) for Candida Auris (C. …
Based on observation, record review and staff interview, the facility failed to ensure the facility received licensure and certification approval prior to changing the name of the facility on the facility sign located outside the facility. Failure to get approval prior to changing the name of the facility on the sign had the potential to result in confusion among visitors, employees, and residents. This had the potential to affect 144 of 144 residents in the facility. Findings include: Review of the facility State license titled New Jersey Department of Health Division of Certification of Need and Licensing License stated the facility was licensed to operate as Atrium Post Acute Care of [NAME] consisting of 209 Long-Term Care Beds. …
The short window
Recent years
| Year | Share of New Jersey citations | vs expected |
|---|---|---|
| 2023 | 0.67% | 6.02× |
| 2024 | 0.35% | 3.83× |
| 2025 | 0.28% | 4.08× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else New Jersey surveyors cite →
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