FOLTSBROOK CENTER FOR NURSING AND REHABILITATION Inspection Report, Violations & Safety Grade (HERKIMER, New York)

104 NORTH WASHINGTON STREET, HERKIMER, New York 13350

Phone: 3158666964

CMS Overall:1/5

Overview & Bed Count

Certified Beds

163

Avg Residents/Day

134.1

Ownership

For profit - Corporation

Provider Type

Medicare and Medicaid

County

Herkimer

Sprinkler Systems

Yes

Special Focus

None

Abuse Icon

CMS Star Ratings

Overall1/5

Health2/5

Staffing1/5

Quality3/5

Nurse Staffing Check

Metric	This Facility	New York Avg	Difference
RN Hours per Resident per Day	0.44	0.73	-0.29
Total Nurse Hours per Resident per Day	2.97	3.69	-0.72
CMS Staffing Rating	1/5	2.9/5	-
Nursing Staff Turnover	55.9%	40.3%	-

Health Citation History

27 health citations on record

Date	Category	Description	Severity
2025-01-29	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	E – Moderate Harm Potential
2025-01-29	Nutrition and Dietary Deficiencies	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.	E – Moderate Harm Potential
2025-01-29	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E – Moderate Harm Potential
2025-01-29	Environmental Deficiencies	Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.	E – Moderate Harm Potential
2025-01-29	Resident Rights Deficiencies	Reasonably accommodate the needs and preferences of each resident.	D – Moderate Harm Potential
2025-01-29	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D – Moderate Harm Potential
2025-01-29	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D – Moderate Harm Potential
2025-01-29	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D – Moderate Harm Potential
2025-01-29	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D – Moderate Harm Potential
2025-01-02	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D – Moderate Harm Potential
2023-06-30	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	E – Moderate Harm Potential
2023-06-30	Nutrition and Dietary Deficiencies	Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.	E – Moderate Harm Potential
2023-06-30	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	D – Moderate Harm Potential
2023-06-30	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D – Moderate Harm Potential
2023-06-30	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D – Moderate Harm Potential
2023-06-30	Quality of Life and Care Deficiencies	Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.	D – Moderate Harm Potential
2021-06-09	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	J – Immediate Jeopardy
2021-06-09	Nutrition and Dietary Deficiencies	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.	F – Moderate Harm Potential
2021-06-09	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F – Moderate Harm Potential
2021-06-09	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D – Moderate Harm Potential
2021-06-09	Quality of Life and Care Deficiencies	Provide enough food/fluids to maintain a resident's health.	D – Moderate Harm Potential
2021-06-09	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D – Moderate Harm Potential
2021-06-09	Nutrition and Dietary Deficiencies	Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.	D – Moderate Harm Potential
2021-06-09	Nutrition and Dietary Deficiencies	Provide special eating equipment and utensils for residents who need them and appropriate assistance.	D – Moderate Harm Potential
2021-06-09	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.	D – Moderate Harm Potential
2021-06-09	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D – Moderate Harm Potential
2021-06-09	Resident Rights Deficiencies	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.	B – Minimal Harm Potential

Fire Safety Citation History

32 fire safety citations on record

Date	Category	Description	Severity
2025-01-29	Smoke Deficiencies	Inspect, test, and maintain automatic sprinkler systems.	F – Moderate Harm Potential
2025-01-29	Gas, Vacuum, and Electrical Systems Deficiencies	Have generator or other power source capable of supplying service within 10 seconds.	F – Moderate Harm Potential
2025-01-29	Emergency Preparedness Deficiencies	Address subsistence needs for staff and patients.	E – Moderate Harm Potential
2025-01-29	Construction Deficiencies	Install a two-hour-resistant firewall separation.	E – Moderate Harm Potential
2025-01-29	Egress Deficiencies	Keep aisles, corridors, and exits free of obstruction in case of emergency.	E – Moderate Harm Potential
2025-01-29	Egress Deficiencies	Have exits that are accessible at all times.	E – Moderate Harm Potential
2025-01-29	Smoke Deficiencies	Have an enclosure around a vertical opening shaft.	E – Moderate Harm Potential
2025-01-29	Smoke Deficiencies	Have approved installation, maintenance and testing program for fire alarm systems.	E – Moderate Harm Potential
2025-01-29	Miscellaneous Deficiencies	To conduct inspection, testing and maintenance of fire doors by qualified individuals.	E – Moderate Harm Potential
2025-01-29	Gas, Vacuum, and Electrical Systems Deficiencies	Ensure that testing and maintenance of electrical equipment is performed.	E – Moderate Harm Potential
2025-01-29	Gas, Vacuum, and Electrical Systems Deficiencies	Have proper medical gas storage and administration areas.	E – Moderate Harm Potential
2025-01-29	Gas, Vacuum, and Electrical Systems Deficiencies	Have proper fire barriers, ventilation and signs for the transfilling of oxygen.	E – Moderate Harm Potential
2025-01-29	Egress Deficiencies	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.	D – Moderate Harm Potential
2025-01-29	Smoke Deficiencies	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.	D – Moderate Harm Potential
2025-01-29	Smoke Deficiencies	Provide properly protected cooking facilities.	D – Moderate Harm Potential
2025-01-29	Smoke Deficiencies	Install corridor and hallway doors that block smoke.	D – Moderate Harm Potential
2023-06-30	Construction Deficiencies	Install a two-hour-resistant firewall separation.	E – Moderate Harm Potential
2023-06-30	Smoke Deficiencies	Inspect, test, and maintain automatic sprinkler systems.	E – Moderate Harm Potential
2023-06-30	Smoke Deficiencies	Ensure smoke barriers are constructed to a 1 hour fire resistance rating.	E – Moderate Harm Potential
2023-06-30	Services Deficiencies	Have elevators that firefighters can control in the event of a fire.	E – Moderate Harm Potential
2023-06-30	Gas, Vacuum, and Electrical Systems Deficiencies	Have a battery powered remote alarm panel in a location accessible by operating personnel.	E – Moderate Harm Potential
2023-06-30	Gas, Vacuum, and Electrical Systems Deficiencies	Have generator or other power source capable of supplying service within 10 seconds.	E – Moderate Harm Potential
2023-06-30	Egress Deficiencies	Install emergency lighting that can last at least 1 1/2 hours.	D – Moderate Harm Potential
2023-06-30	Smoke Deficiencies	Have an enclosure around a vertical opening shaft.	D – Moderate Harm Potential
2023-06-30	Smoke Deficiencies	Install an approved automatic sprinkler system.	D – Moderate Harm Potential
2023-06-30	Gas, Vacuum, and Electrical Systems Deficiencies	Ensure that testing and maintenance of electrical equipment is performed.	D – Moderate Harm Potential
2021-06-09	Smoke Deficiencies	Have an enclosure around a vertical opening shaft.	E – Moderate Harm Potential
2021-06-09	Smoke Deficiencies	Install corridor and hallway doors that block smoke.	E – Moderate Harm Potential
2021-06-09	Gas, Vacuum, and Electrical Systems Deficiencies	Have proper fire barriers, ventilation and signs for the transfilling of oxygen.	E – Moderate Harm Potential
2021-06-09	Construction Deficiencies	Install a two-hour-resistant firewall separation.	D – Moderate Harm Potential
2021-06-09	Smoke Deficiencies	Install an approved automatic sprinkler system.	D – Moderate Harm Potential
2021-06-09	Smoke Deficiencies	Install smoke barrier doors that can resist smoke for at least 20 minutes.	D – Moderate Harm Potential

Total Penalties & Fines

Total Fine Amount (CMS)

Number of Fines

Total Penalties

No penalty records found.

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3-Year Complete Report ($19)

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