Fiddlers Green Manor Rehabilitation and Nursing Center

Fiddlers Green Manor Rehabilitation and Nursing Center

168 West Main Street

Springville, NY 14141

7165924781

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: 86%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
424Percentage of short-stay residents who self-report moderate to severe pain19.38799999999999810/1/2017
425Percentage of short-stay residents with pressure ulcers that are new or worsened3.00510/1/2017
426Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine71.07810/1/2017
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine80.18410/1/2017
434Percentage of short-stay residents who newly received an antipsychotic medication10.56910/1/2017
471Percentage of short-stay residents who made improvements in function49.90810/1/2017

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased18.0995000010/1/2017
402Percentage of long-stay residents who self-report moderate to severe pain12.0195000010/1/2017
403Percentage of high risk long-stay residents with pressure ulcers10.6667000010/1/2017
404Percentage of long-stay residents who lose too much weight10.1695000010/1/2017
405Percentage of low risk long-stay residents who lose control of their bowels or bladder21.6216000010/1/2017
406Percentage of long-stay residents with a catheter inserted and left in their bladder1.0569000010/1/2017
407Percentage of long-stay residents with a urinary tract infection2.1186000010/1/2017
408Percentage of long-stay residents who have depressive symptoms2.7523000010/1/2017
409Percentage of long-stay residents who were physically restrained0.0000000010/1/2017
410Percentage of long-stay residents experiencing one or more falls with major injury3.3755000010/1/2017
411Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine94.0711000010/1/2017
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine96.6245000010/1/2017
419Percentage of long-stay residents who received an antipsychotic medication18.8776000010/1/2017
451Percentage of long-stay residents whose ability to move independently worsened35.3204000010/1/2017
452Percentage of long-stay residents who received an antianxiety or hypnotic medication30.0429000010/1/2017

Complaints

Number of Standard Health Deficiencies:71
Number of Live Safety Code Deficiencies:36
Number of Total Deficiencies:107
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):62
Intakes received per 100 occupied beds (last three years):82.3
Percent of total intakes received that were facility self reported incidents (last three years):44
On-site complaint investigations (last three years):22
Complaint investigations resulting in citations (last three years):10
Complaint investigations resulting in citations per 100 occupied beds (last three years):13.3
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 0:00Quality of Care12/6/20061000
1/5/2016 0:00Multiple Deficiencies7/12/201612000
8/29/2002 0:00Quality of Care12/6/20061000
9/12/2011 0:00Quality 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
5/9/2017Certification3
6/25/2015Complaint2
8/22/2013Certification2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate citation corrected
HealthNOTICE OF RIGHTS, RULES, SERVICES, CHARGES11
HealthCriminal History Record Check Process2210/15/2013
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES2110/15/2013
HealthDEVELOP COMPREHENSIVE CARE PLANS2110/15/2013
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY2110/15/2013
HealthDRUG REGIMEN REVIEW, REPORT IRREGULAR, ACT ON2110/15/2013
HealthDRUG RECORDS, LABEL/STORE DRUGS & BIOLOGICALS2210/15/2013
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS2110/15/2013
HealthESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION2210/15/2013
HealthCORRIDORS HAVE FIRMLY SECURED HANDRAILS2110/15/2013
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE2210/15/2013
LSCLIFE SAFETY CODE STANDARD2210/15/2013
LSCLIFE SAFETY CODE STANDARD2210/15/2013
LSCLIFE SAFETY CODE STANDARD2210/15/2013
LSCLIFE SAFETY CODE STANDARD2210/15/2013
LSCLIFE SAFETY CODE STANDARD2210/15/2013
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING2112/5/2015
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE2112/5/2015
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS2212/5/2015
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES223/4/2016
HealthCriminal History Record Check Process215/27/2016
HealthCriminal History Record Check Process215/27/2016
HealthResponsibilities of Providers; Required Notif215/27/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)215/27/2016
HealthCONVEYANCE OF PERSONAL FUNDS UPON DEATH125/27/2016
HealthRIGHT TO SURVEY RESULTS - READILY ACCESSIBLE125/27/2016
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES225/27/2016
HealthDIGNITY AND RESPECT OF INDIVIDUALITY215/27/2016
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES225/27/2016
HealthREASONABLE ACCOMMODATION OF NEEDS/PREFERENCES215/27/2016
HealthHOUSEKEEPING & MAINTENANCE SERVICES225/27/2016
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS225/27/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS215/27/2016
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP215/27/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING215/27/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS215/27/2016
HealthINCREASE/PREVENT DECREASE IN RANGE OF MOTION225/27/2016
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES215/27/2016
HealthMAINTAIN NUTRITION STATUS UNLESS UNAVOIDABLE215/27/2016
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS225/27/2016
HealthFREE OF MEDICATION ERROR RATES OF 5% OR MORE215/27/2016
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS225/27/2016
HealthWAIVER-RN 8 HRS 7 DAYS/WK, FULL-TIME DON215/27/2016
HealthPOSTED NURSE STAFFING INFORMATION125/27/2016
HealthDRUG REGIMEN REVIEW, REPORT IRREGULAR, ACT ON225/27/2016
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS215/27/2016
HealthLAB SVCS ONLY WHEN ORDERED BY PHYSICIAN215/27/2016
LSCLIFE SAFETY CODE STANDARD225/27/2016
LSCLIFE SAFETY CODE STANDARD225/27/2016
LSCLIFE SAFETY CODE STANDARD225/27/2016
LSCLIFE SAFETY CODE STANDARD215/27/2016
LSCLIFE SAFETY CODE STANDARD225/27/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)216/11/2015
HealthDIGNITY AND RESPECT OF INDIVIDUALITY216/11/2015
HealthSAFE/CLEAN/COMFORTABLE/HOMELIKE ENVIRONMENT126/11/2015
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP216/11/2015
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS216/11/2015
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING216/11/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS216/11/2015
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES226/11/2015
HealthTX/SVC FOR MENTAL/PSYCHOSOCIAL DIFFICULTIES216/11/2015
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES216/11/2015
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS216/11/2015
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS216/11/2015
HealthPOSTED NURSE STAFFING INFORMATION126/11/2015
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY226/11/2015
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS216/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
LSCLIFE SAFETY CODE STANDARD226/11/2015
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS127/1/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES127/1/2017
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY227/1/2017
HealthESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION227/1/2017
LSCGeneral Requirements - Other227/1/2017
LSCDoors with Self-Closing Devices217/1/2017
LSCSprinkler System - Maintenance and Testing227/1/2017
LSCElectrical Systems - Other227/1/2017
LSCElectrical Systems - Essential Electric Syste227/1/2017
LSCElectrical Equipment - Power Cords and Extens227/1/2017
LSCElectrical Equipment - Testing and Maintenanc227/1/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING217/17/2015
HealthCriminal History Record Check Process127/20/2014
HealthRIGHT TO REFUSE; FORMULATE ADVANCE DIRECTIVES217/20/2014
HealthNOTICE OF RIGHTS, RULES, SERVICES, CHARGES127/20/2014
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES217/20/2014
HealthCOMPREHENSIVE ASSESSMENTS217/20/2014
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS217/20/2014
HealthPASRR REQUIREMENTS FOR MI & MR217/20/2014
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES227/20/2014
HealthROUTINE/EMERGENCY DENTAL SERVICES IN NFS217/20/2014
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS217/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCLIFE SAFETY CODE STANDARD227/20/2014
LSCBuilding Construction Type and Height228/3/2017
LSCVertical Openings - Enclosure228/3/2017
LSCSprinkler System - Installation228/3/2017