Fiddlers Green Manor Rehabilitation and Nursing Center

Fiddlers Green Manor Rehabilitation and Nursing Center

168 West Main Street

Springville, NY 14141

(716) 592-4781

www.fiddlersgreenmanor.com/

Services: Baseline Services

Beds

Behavioral Intervention:
Pediatric:
Pediatric Ventilator Dependent:
Residential Health Care:82
Transitional Care Unit:
Ventilator Dependent:
Total Number of Beds:82

Administrative

Ownership: Proprietary--LLC

Operated by: JSSG Healthcare, LLC
255 Warner Avenue
Roslyn Heights, NY 11577

Permanent Facility Identifier: 282

Operating Certificate: 1427303N

Medicaid Certified

Medicare Certified

Medicare Number: 335457

Statistics

Employee Flu Vaccination Rate: 50%

Occupancy Rate: 0%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
424Percentage of short-stay residents who self-report moderate to severe pain37.362634/1/2017
425Percentage of short-stay residents with pressure ulcers that are new or worsened3.767844/1/2017
426Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine43.046354/1/2017
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine40.361444/1/2017
434Percentage of short-stay residents who newly received an antipsychotic medication5.882354/1/2017
471Percentage of short-stay residents who made improvements in function44.559544/1/2017

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased21.938775004/1/2017
402Percentage of long-stay residents who self-report moderate to severe pain14.585662004/1/2017
403Percentage of high risk long-stay residents with pressure ulcers12.582782004/1/2017
404Percentage of long-stay residents who lose too much weight10.096155004/1/2017
405Percentage of low risk long-stay residents who lose control of their bowels or bladder29.310346004/1/2017
406Percentage of long-stay residents with a catheter inserted and left in their bladder4.116447004/1/2017
407Percentage of long-stay residents with a urinary tract infection11.330047004/1/2017
408Percentage of long-stay residents who have depressive symptoms1.904763004/1/2017
409Percentage of long-stay residents who were physically restrained3.587444004/1/2017
410Percentage of long-stay residents experiencing one or more falls with major injury0.896861004/1/2017
411Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine90.733592004/1/2017
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine89.237668004/1/2017
419Percentage of long-stay residents who received an antipsychotic medication25.698323004/1/2017
451Percentage of long-stay residents whose ability to move independently worsened26.468135004/1/2017
452Percentage of long-stay residents who received an antianxiety or hypnotic medication36.036036004/1/2017

Complaints

Number of Standard Health Deficiencies:67
Number of Live Safety Code Deficiencies:26
Number of Total Deficiencies:93
Number of Deficiencies related to Actual Harm or Immediate Jeopardy:0
Percent of Total Deficiencies related to Actual Harm or Immediate Jeopardy :0
Total intakes received (last three years):58
Intakes received per 100 occupied beds (last three years):74.4
Percent of total intakes received that were facility self reported incidents (last three years):36
On-site complaint investigations (last three years):23
Complaint investigations resulting in citations (last three years):10
Complaint investigations resulting in citations per 100 occupied beds (last three years):12.8
Complaint Citations in deficiency category: Administration:2
Complaint Citations in deficiency category: Quality of Care:6
Complaint Citations in deficiency category: Resident Rights:2
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:0
Complaint Citations in deficiency category: Other Services:0
Complaint Citations across all deficiency categories (last three years):10

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed
Multiple Deficiencies3/5/20084000
1/29/2004 0:00:00Quality of Care12/6/20061000
1/5/2016 0:00:00Multiple Deficiencies7/12/201612000
8/29/2002 0:00:00Quality of Care12/6/20061000
9/12/2011 0:00:00Quality of Care6/10/20134000

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/5/2016Complaint2
10/8/2015Complaint2
4/14/2015Certification2
4/5/2016Certification2
5/23/2014Certification2
6/25/2015Complaint2
8/22/2013Certification2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate citation corrected
HealthCRIMINAL HISTORY RECORD CHECK NOT PERFORMED PROVIDER SHALL SUBMIT REQUEST FOR CHECK2210/15/2013
LSCEMERGENCY PLAN2210/15/2013
LSCMEDICAL GAS SYSTEM2210/15/2013
HealthPOLICIES, PROCEDURES PROHIBIT ABUSE, NEGLECT2110/15/2013
HealthDEVELOP COMPREHENSIVE CARE PLANS2110/15/2013
HealthSTORE/PREPARE/DISTRIBUTE FOOD UNDER SANITARY CONDITIONS2110/15/2013
HealthRESIDENT DRUG REGIMEN REVIEWED MONTHLY BY PHARMACIST2110/15/2013
HealthFACILITY ESTABLISHES INFECTION CONTROL PROGRAM2110/15/2013
HealthESSENTIAL EQUIPMENT IN SAFE OPERATING CONDITION2210/15/2013
HealthCORRIDORS HAVE FIRMLY SECURED HANDRAILS2110/15/2013
HealthPROPER LABELING OF DRUGS AND BIOLOGICALS2210/15/2013
HealthCLINICAL RECORDS MEET PROFESSIONAL STANDARDS2210/15/2013
LSCCONSTRUCTION TYPE2210/15/2013
LSCCORRIDOR DOORS2210/15/2013
LSCHAZARDOUS AREAS - SEPARATION2210/15/2013
HealthCLINICAL RECORDS MEET PROFESSIONAL STANDARDS2112/5/2015
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING2112/5/2015
HealthFACILITY MAINTAINS QA COMMITTEE2212/5/2015
HealthPROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES223/4/2016
HealthRESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS225/27/2016
HealthMEDICATION ERROR RATES OF 5% OR MORE215/27/2016
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS225/27/2016
HealthRESIDENT MAINTAIN NUTRITIONAL STATUS UNLESS UNAVOIDABLE215/27/2016
HealthFACILITY IS FREE OF ACCIDENT HAZARDS215/27/2016
HealthRANGE OF MOTION TREATMENT AND SERVICES225/27/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS215/27/2016
LSCMEDICAL GAS SYSTEM215/27/2016
HealthNURSE STAFFING125/27/2016
HealthQUARTERLY REVIEW OF ASSESSMENTS225/27/2016
LSCEMERGENCY PLAN225/27/2016
LSCPORTABLE FIRE EXTINGUISHERS225/27/2016
LSCFIRE DRILLS225/27/2016
LSCCONSTRUCTION TYPE225/27/2016
HealthLAB SERVICES ONLY WHEN ORDERED BY PHYSICIAN215/27/2016
HealthFACILITY ESTABLISHES INFECTION CONTROL PROGRAM215/27/2016
HealthRESIDENT DRUG REGIMEN REVIEWED MONTHLY BY PHARMACIST225/27/2016
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING215/27/2016
HealthDEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN215/27/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS215/27/2016
HealthUSE OF CHARGE NURSE AND REGISTERED NURSE215/27/2016
HealthCRIMINAL HISTORY RECORD CHECK NOT PERFORMED PROVIDER SHALL SUBMIT REQUEST FOR CHECK215/27/2016
HealthCRIMINAL HISTORY RECORD CHECK TEMPORARY APPROVAL PENDING RESULTS/ SUPERVISION REQUIRED215/27/2016
HealthCRIMINAL HISTORY RECORD CHECK REQUIRED NOTIFICATION TO DOH PER CESSATION OF EMPLOYMENT215/27/2016
HealthCONVEYANCE OF RESIDENT FUNDS UPON DEATH125/27/2016
HealthSURVEY RESULTS READILY ACCESSIBLE TO RESIDENTS125/27/2016
HealthPOLICIES, PROCEDURES PROHIBIT ABUSE, NEGLECT225/27/2016
HealthDIGNITY215/27/2016
HealthSELF-DETERMINATION - RESIDENT MAKES CHOICES225/27/2016
HealthACCOMMODATION OF NEEDS AND PREFERENCES215/27/2016
HealthHOUSEKEEPING AND MAINTENANCE SERVICES225/27/2016
HealthINFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.215/27/2016
HealthNURSE STAFFING126/11/2015
LSCCONSTRUCTION TYPE226/11/2015
HealthSTORE/PREPARE/DISTRIBUTE FOOD UNDER SANITARY CONDITIONS226/11/2015
HealthFACILITY ESTABLISHES INFECTION CONTROL PROGRAM216/11/2015
LSCTESTING OF FIRE ALARM226/11/2015
LSCSPRINKLER SYSTEM MAINTENANCE226/11/2015
LSCCOOKING EQUIPMENT226/11/2015
LSCMEDICAL GAS SYSTEM226/11/2015
HealthRESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS216/11/2015
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS216/11/2015
HealthINFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.216/11/2015
HealthDIGNITY216/11/2015
HealthSAFE/CLEAN/COMFORTABLE/HOMELIKE ENVIRONMENT126/11/2015
HealthDEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN216/11/2015
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS216/11/2015
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING216/11/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS216/11/2015
HealthPROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES226/11/2015
HealthAPPROPRIATE TREATMENT FOR MENTAL/PSYCHOSOCIAL DIFFICULTIES216/11/2015
LSCEMERGENCY PLAN226/11/2015
HealthFACILITY IS FREE OF ACCIDENT HAZARDS216/11/2015
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING217/17/2015
LSCMEDICAL GAS SYSTEM227/20/2014
HealthDENTAL SERVICES IN SKILLED NURSING FACILITIES217/20/2014
HealthPASARR REQUIREMENTS FOR MI AND MR217/20/2014
HealthQUARTERLY REVIEW OF ASSESSMENTS217/20/2014
HealthCOMPREHENSIVE ASSESSMENTS217/20/2014
HealthSELF-DETERMINATION - RESIDENT MAKES CHOICES217/20/2014
HealthINFORM RESIDENT OF SERVICES/CHARGES/LEGAL RIGHTS/ETC.127/20/2014
HealthRIGHT TO REFUSE TREATMENT/RESEARCH; FORM ADVANCE DIRECTIVES217/20/2014
HealthCRIMINAL HISTORY RECORD CHECK PROCESS SUBMIT APPROVED FORM & FINGERPRINTS WITHIN TEN DAYS127/20/2014
HealthFACILITY ESTABLISHES INFECTION CONTROL PROGRAM217/20/2014
LSCGENERATORS INSPECTED/TESTED227/20/2014
LSCWASTEBASKETS227/20/2014
LSCSPRINKLER SYSTEM MAINTENANCE227/20/2014
LSCEXIT LIGHTING227/20/2014
LSCHAZARDOUS AREAS - SEPARATION227/20/2014
LSCSMOKE PARTITION CONSTRUCTION227/20/2014
LSCDOORS IN FIRE AND SMOKE PARTITIONS227/20/2014
LSCCORRIDOR DOORS227/20/2014
HealthFACILITY IS FREE OF ACCIDENT HAZARDS227/20/2014
LSCCONSTRUCTION TYPE227/20/2014