Pine Haven Home

In the surveyor’s words

From the most serious findings on record at Pine Haven Home, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF725Apr 1, 2025

  Based on record review and interview conducted during the recertification and abbreviated survey (Case #s NY00309923 and NY00359733), the facility did not ensure provision of sufficient nursing staff to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident throughout the facility. Specifically, between 3/23/2025 and 3/31/2025, the minimum hours of nursing care per resident day was less than the established minimum set by the Centers for Medicaid/Medicare Services. […]

• No harm, potential for more than minimal, patternF812Apr 1, 2025

  Based on observation and interview conducted during the recertification survey, the facility did not ensure food was stored in accordance with professional standards for food service safety. Specifically, (a) a container of tomato juice was found unlabeled in the refrigerator; and (b) a container of opened, unlabeled cranberry juice was found in the dry storage area. This is evidenced by: During the initial tour of the kitchen between 11:00 AM and 12:00 PM on 3/24/2025, the following was observed: (a) A pitcher with red liquid, unlabeled in the dessert refrigerator. At the time of observation, Kitchen Director #1 identified the red liquid to be tomato juice, stated there should have been a label on it stating it was opened today. […]

• No harm, potential for more than minimal, patternF813Mar 30, 2022

  Based on observation, record review, and staff interview during the recertification survey on 03/23/2022 through 03/30/2022 the facility did not ensure foods brought to residents by family and other visitors was in accordance with adopted regulations. Specifically, food brought to residents was not labeled and discarded per the facility policy. This is evidenced as follows: The policy titled Food from Home - Safety dated 09/2021, documented food brought in from the outside will be labeled by staff with the resident name and dated with the current date the item(s) was brought to the facility and will be discarded after 72 hours. […]

• No harm, potential for more than minimal, isolatedF609Apr 1, 2025

  Based on record review and interviews during a recertification and abbreviated survey (Case #NY00309923), the facility did not ensure that all alleged violations involving abuse were reported immediately, or no later than 2 hours after the allegation was made for one (1) (Resident #115) of eight (8) residents reviewed for abuse. Specifically, an allegation of verbal abuse reported by a resident to a Certified Nurse Aide on 2/05/2023 was not reported to Administration until 2/06/2023, and not reported to The New York State Department of Health until 2/08/2023. […]

• No harm, potential for more than minimal, isolatedF689Apr 1, 2025

  Based on record review and interview conducted during a recertification and abbreviated survey (Case #NY00356721), the facility did not ensure the environment remained as free of accident hazards as possible for one (1) (Resident #41) of seven (7) residents reviewed for accident hazards. Specifically, for Resident #41 the temperature of the resident's microwave reheated beverage was not checked prior to serving, resulting in a first degree burn to the resident's chest. This is evidenced by: The facility Policy and Procedure titled Food - Microwave Reheating, last revised 7/26/2024, documented the staff were to use the thermometer to ensure a maximum temperature of the reheated food or beverage was not greater than 140 degrees Fahrenheit prior to serving. […]