Northeast CTR for Rehabilitation and Brain Injury

In the surveyor’s words

From the most serious findings on record at Northeast CTR for Rehabilitation and Brain Injury, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jul 15, 2026

  Based on observations, interviews and record review during survey, the facility failed to ensure that the environment remained free of accident hazards and that residents received adequate supervision to prevent accidents for one of three residents (Resident #3) reviewed for elopement. Specifically, Resident #3 who was assessed at risk for elopement exited the facility through the front door on 01/10/2026 at 5:38 PM without intervention by staff assigned to monitor activity at the exit. The facility was unaware that Resident #3 was missing until being notified by law enforcement at 8:08 PM. […]

• Actual harm, isolatedF689Jul 23, 2026

  Based on observations, interviews and record review during survey, the facility failed to ensure that the environment remained free of accident hazards and that residents received adequate supervision to prevent accidents for three of eight residents (Resident #8, Resident #33, and Resident #35) reviewed for accidents. Specifically, 1) Resident #8 sustained a fall in the shower on 10/31/2025 when Certified Nurse Aide #44 failed to maintain one-to-one supervision. 2) Resident #33 sustained a fall from bed on 06/06/2025 resulting in abrasions to their back and right elbow after Certified Nurse Aide #39 failed to lower the bed to its lowest position and place floor mats at bedside upon completion of care per the resident's care plan. […]

• Actual harm, isolatedF689Nov 21, 2024

  Based on record review and interview conducted during the recertification and abbreviated surveys (NY00346752) from 11/13/2024 to 11/21/2024, the facility failed to ensure the plan of care for each resident was followed and that adequate supervision and/or assistance was provided to prevent accidents for 1 of 8 residents (Resident #234) reviewed for Abuse. Specifically, Resident #234 required a 2- person assist for transfers and the Certified Nurse Aide #25 attempted to transfer the resident without assistance of another staff member. Subsequently, Resident #234 fell and sustained a laceration (a cut or tear in the skin) to the back of their head which required eight staples. […]

• No harm, potential for more than minimal, widespreadF725Jul 23, 2026

  Based on interview and review of facility records during the abbreviated survey, the facility did not ensure consistent sufficient nursing staff was provided to meet the needs of residents on all shifts. Specifically, 1) See F677 for deficient practice in activities of daily living. 2) multiple complaints were received by the Department of Health that reported the facility was short staffed; 2) Several nursing staff reported there was lack of staff to provide all cares to the residents; 3) facility nursing staff sheets reviewed from 05/19/2026 to 06/13/2026 documented the facility did not staff multiple units at minimum levels daily and did not meet the daily projected staff needs for certified nurse aides and nursing staff as documented in the Facility Assessment for 26 of the 26 dates… […]

• No harm, potential for more than minimal, patternF584Jul 23, 2026

  Based on observations, interviews, and record reviews, the facility did not ensure a clean and homelike environment or take reasonable measures to protect the belongings of residents. Specifically, 1) multiple observations were made of debris and soiled linens on the floors, sticky floors, odors, and walls in disrepair; and 2) personal items were not inventoried on admission for Resident #19 and #40. Findings include: 1) During an observation on 6/02/2026 at 11:18 AM, room [ROOM NUMBER] was cluttered with personal effects and open and unopened food products on one of the beds and the floor. The floor was sticky when walking on it from unknown substance. […]