New Paltz Center For Rehabilitation And Nursing

In the surveyor’s words

From the most serious findings on record at New Paltz Center For Rehabilitation And Nursing, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jun 20, 2023

  Based on observations, record reviews and interviews conducted during an abbreviated and extended survey (NY00318363) the facility failed to maintain an environment free of accident hazard for 1 of 12 residents (Resident # 1) reviewed for accidents. The facility did not ensure that a resident was adequately supervised to prevent an elopement. This resulted in actual harm for Resident #1 which was Immediate Jeopardy and Substandard Quality of care with the likelihood of risk for harm to the health and safety of 11 other residents identified as at risk for elopement. Specifically, on 5/31/2023 facility staff failed to provide adequate supervision and did not follow the facility protocol when the front door alarm sounded, which requires that all residents are accounted for. […]

• Immediate jeopardy, isolatedF689Nov 4, 2021

  Based on observations, record review and interviews conducted during an abbreviated survey (Complaint #NY 830) completed on 11/4/2021, the facility failed to have an effective system in place for the resident's environment to remain as free of accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents during meals for residents who are at risk for choking, Specifically, Resident #1 had diagnoses, which include Dysphagia, and Dementia. The Speech-language pathologist's (SLP) reports dated 5/4/21 and 8/23/21 documented dysphagia, oropharyngeal phase. The SLP recommended mechanical soft diet, pureed fruit and vegetables, and no bread allowances. The physician's order indicated the same. […]

• No harm, potential for more than minimal, patternF725Sep 13, 2025

  Based on observations, interviews, and record reviews during the recertification and abbreviated surveys (Intake #2569939), the facility did not ensure sufficient nursing staff to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident. Specifically, the Daily Nurse Staffing Rosters reviewed from 08/10/2025 through 09/12/2025 documented on four (4) of 34 days, there was one (1) certified nurse aide documented for the A unit night shift (1:35 or 1:36 ratio ) and on one (1) of 34 nights, there was one (1) certified nurse aide assigned to B unit (1:36 ratio). On 29 of 34 days reviewed, assigned staff did not complete their assigned shift (came in late or left early). […]

• No harm, potential for more than minimal, patternF727Nov 22, 2024

  Based on record review and interview conducted during the recertification survey from 11/14/24 to 11/22/24, the facility did ensure that a Registered Nurse worked eight cosecutive hours a day, seven days a week. Specifically, the facility was unable to provide documented evidence that a Registered Nurse worked 10/20/24, 11/2/24, 11/3/24, 11/16/24, 11/17/24. Findings include: The Facility Wide assessment dated [DATE] documented the staffing plan as follows: Day shift unit A and B: 2 nurses each unit. Evening shift units A and B: two nurses each unit. Night shift Units A and B: 1 nurse each unit. […]

• No harm, potential for more than minimal, patternF730Nov 22, 2024

  Based on record review and interview conducted during the recertification survey from 11/16/2024 to 11/22/2024, the facility did not ensure Annual Performance Reviews were completed at least once every 12 months. Specifically, the facility was unable to provide Annual Performance Reviews for 3 of 5 Staff Members (#9, #10, #12) reviewed. The findings are: The facility policy titled Employee Evaluations, dated 9/29/2019, documented: A performance evaluation will be completed on each employee at least annually. During an interview and record review with the Assistant Director of Nursing/Nurse Educator on 11/20/24 at 11:07 AM, they stated they were not able to provide documentation of an Annual Performance Review for Staff Members (#9, #10, #12). […]