Fishkill Center for Rehabilitation and Nursing

In the surveyor’s words

From the most serious findings on record at Fishkill Center for Rehabilitation and Nursing, in the surveyor’s own words.

• Immediate jeopardy, patternF689Jan 11, 2024

  Based on observation, record review and interview, during a recertification and extended survey from 1/2/2024 to 1/11/2024, the facility failed to ensure the resident environment remained as free of accident hazards as possible. Specifically, a total of 26 residents on 2 of 2 resident floors were residing in 17 rooms where space heaters were in use (room M1, M2, R6, R2, R1, O1, O2, O3, O4, Q3, Q2, N1, N2 and N3 on the locked dementia unit with residents wandering in and out of the rooms, and rooms S1, S4, and X2). Additionally, facility staff reported that at times they had seen towels placed over the space heaters. Subsequently, residents were at risk for injury with the likelihood for harm or death that was Immediate Jeopardy (IJ) to the health and safety of the facility's 151 residents. […]

• Actual harm, isolatedF689Dec 26, 2025

  Based on observations, record review and interviews, the facility failed to ensure that the resident environment remained as free of accident hazards as is possible; and that each resident received adequate supervision to prevent accidents for one (1) of three (3) residents (Resident #1) reviewed for accidents. Specifically, a review of the facility's fall risk assessment revealed that on 08/12/2025, Resident #1 was identified as a high risk for falls and further review of the resident's medical record revealed that the facility failed to implement interventions to prevent the resident from potential falls or to mitigate harm from actual falls. […]

• No harm, potential for more than minimal, patternF887Feb 14, 2025

  Based on interview and record review during the recertification survey conducted on 2/10/25-2/14/25, the facility did not ensure each staff and was screened, offered the most recent COVID-19 vaccine and provided education regarding the benefits, risks and potential side effects associated with the vaccine for 10 of 10 staff reviewed for COVID vaccines. Specifically, there was no documented evidence Staff were offered, and education was provided for COVID vaccination for Dietary Aide #15, Housekeeping #16, Certified Nurse Aide #17, #18, #20, Licensed Practical Nurse #19, Registered Nurse #21, Social Worker #22, Dining Supervisor #23 and [NAME] #24. […]

• No harm, potential for more than minimal, patternF835Jan 11, 2024

  Based on Observation, record review and interview conducted during the recertification survey (1/2/24-1/11/24) the facility did not ensure that operative oversight for an effective system was in place to maintain health, safety, and the highest practicable well-being of residents reviewed for accidents. Specifically, space heaters were in use for 26 residents in 17 rooms (M1, M2, N1, N2, N3, R1, R2, R6, O1, O2, O3, O4, Q2, and Q3 on the locked dementia unit with residents wandering in and out of the rooms) and rooms S1, S4, X2. The findings are: Review of the undated policy titled Electrical Safety for Residents documented portable space heaters are placed in the facility only on a case-by-case basis. […]

• No harm, potential for more than minimal, patternF837Jan 11, 2024

  Based on observation, record review, and interviews conducted during the recertification survey (1/2/2024-1/11/2024), it was determined the governing body did not establish and implement policies regarding the management and operation of the facility. The governing body did not maintain consistent communication with the Administrator who was responsible for the management of the facility to ensure regulatory compliance. Specifically, multiple deficiencies were identified on the recertification survey including in the areas of accidents and hazards (F689), and space heaters not permitted (K781). Findings include: The policy titled Administrative Management (governing board) dated 2/17/2021: documented the governing board shall be responsible for the management and operation of the facility. […]