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: 90%

Occupancy Rate: 88%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
424Percentage of short-stay residents who self-report moderate to severe pain24.73005/1/2019
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine93.10005/1/2019
434Percentage of short-stay residents who newly received an antipsychotic medication0.00005/1/2019
471Percentage of short-stay residents who made improvements in function58.87005/1/2019

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased9.82005/1/2019
402Percentage of long-stay residents who self-report moderate to severe pain4.55005/1/2019
404Percentage of long-stay residents who lose too much weight6.27005/1/2019
405Percentage of low risk long-stay residents who lose control of their bowels or bladder34.78005/1/2019
406Percentage of long-stay residents with a catheter inserted and left in their bladder0.00005/1/2019
407Percentage of long-stay residents with a urinary tract infection1.04005/1/2019
408Percentage of long-stay residents who have depressive symptoms1.06005/1/2019
409Percentage of long-stay residents who were physically restrained0.00005/1/2019
410Percentage of long-stay residents experiencing one or more falls with major injury4.15005/1/2019
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine100.00005/1/2019
419Percentage of long-stay residents who received an antipsychotic medication9.82005/1/2019
451Percentage of long-stay residents whose ability to move independently worsened18.50005/1/2019
452Percentage of long-stay residents who received an antianxiety or hypnotic medication20.83005/1/2019

Complaints

Number of Standard Health Deficiencies:40
Number of Live Safety Code Deficiencies:21
Number of Total Deficiencies:61
Number of Deficiencies related to Actual Harm or Immediate Jeopardy:2
Percent of Total Deficiencies related to Actual Harm or Immediate Jeopardy :3
Total intakes received (last three years):80
Intakes received per 100 occupied beds (last three years):111.1
Percent of total intakes received that were facility self reported incidents (last three years):61
On-site complaint investigations (last three years):23
Complaint investigations resulting in citations (last three years):11
Complaint investigations resulting in citations per 100 occupied beds (last three years):15.3
Complaint Citations in deficiency category: Administration:2
Complaint Citations in deficiency category: Quality of Care:5
Complaint Citations in deficiency category: Resident Rights:3
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:0
Complaint Citations in deficiency category: Other Services:1
Complaint Citations across all deficiency categories (last three years):11

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed
Multiple Deficiencies5-Mar-084000
12-Sep-11Quality of Care10-Jun-134000
29-Aug-02Quality of Care6-Dec-061000
29-Jan-04Quality of Care6-Dec-061000
5-Jan-16Multiple Deficiencies12-Jul-1612000

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/5/2016COMPLAINT2
10/8/2015COMPLAINT2
4/5/2016CERTIFICATION/COMPLAINT2
5/9/2017CERTIFICATION/COMPLAINT3
6/25/2015COMPLAINT2
9/21/2018CERTIFICATION/COMPLAINT2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate of Initial SurveyDate Citation Corrected
HealthNOTICE OF RIGHTS, RULES, SERVICES, CHARGES115/9/2017
LSCPOLICIES/PROCEDURES-VOLUNTEERS AND STAFFING139/21/201810/10/2018
HealthMEDICAID/MEDICARE COVERAGE/LIABILITY NOTICE129/21/201810/20/2018
LSCBUILDING CONSTRUCTION TYPE AND HEIGHT229/21/201811/20/2018
LSCEP PROGRAM PATIENT POPULATION139/21/201811/20/2018
LSCFIRE ALARM SYSTEM - TESTING AND MAINTENANCE229/21/201811/20/2018
LSCROLES UNDER A WAIVER DECLARED BY SECRETARY139/21/201811/20/2018
LSCSUBSISTENCE NEEDS FOR STAFF AND PATIENTS139/21/201811/20/2018
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING2110/8/201512/5/2015
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS2210/8/201512/5/2015
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE2110/8/201512/5/2015
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)311/5/20163/4/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING311/5/20163/4/2016
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES221/5/20163/4/2016
HealthCRIMINAL HISTORY RECORD CHECK PROCESS214/5/20165/27/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS214/5/20165/27/2016
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES224/5/20165/27/2016
HealthDIGNITY AND RESPECT OF INDIVIDUALITY214/5/20165/27/2016
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS224/5/20165/27/2016
HealthDRUG REGIMEN REVIEW, REPORT IRREGULAR, ACT ON224/5/20165/27/2016
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES214/5/20165/27/2016
HealthFREE OF MEDICATION ERROR RATES OF 5% OR MORE214/5/20165/27/2016
HealthHOUSEKEEPING & MAINTENANCE SERVICES224/5/20165/27/2016
HealthINCREASE/PREVENT DECREASE IN RANGE OF MOTION224/5/20165/27/2016
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS214/5/20165/27/2016
HealthLAB SVCS ONLY WHEN ORDERED BY PHYSICIAN214/5/20165/27/2016
HealthMAINTAIN NUTRITION STATUS UNLESS UNAVOIDABLE214/5/20165/27/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)214/5/20165/27/2016
HealthPOSTED NURSE STAFFING INFORMATION124/5/20165/27/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING214/5/20165/27/2016
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS224/5/20165/27/2016
HealthREASONABLE ACCOMMODATION OF NEEDS/PREFERENCES214/5/20165/27/2016
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS224/5/20165/27/2016
HealthRESPONSIBILITIES OF PROVIDERS; REQUIRED NOTIF214/5/20165/27/2016
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP214/5/20165/27/2016
HealthRIGHT TO SURVEY RESULTS - READILY ACCESSIBLE124/5/20165/27/2016
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES224/5/20165/27/2016
HealthWAIVER-RN 8 HRS 7 DAYS/WK, FULL-TIME DON214/5/20165/27/2016
LSCLIFE SAFETY CODE STANDARD214/5/20165/27/2016
LSCLIFE SAFETY CODE STANDARD224/5/20165/27/2016
LSCLIFE SAFETY CODE STANDARD224/5/20165/27/2016
LSCLIFE SAFETY CODE STANDARD224/5/20165/27/2016
LSCLIFE SAFETY CODE STANDARD224/5/20165/27/2016
HealthCRIMINAL HISTORY RECORD CHECK PROCESS214/5/20165/27/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS214/5/20165/27/2016
HealthCONVEYANCE OF PERSONAL FUNDS UPON DEATH124/5/20165/27/2016
HealthESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION225/9/20177/1/2017
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY225/9/20177/1/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES125/9/20177/1/2017
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS125/9/20177/1/2017
LSCDOORS WITH SELF-CLOSING DEVICES215/9/20177/1/2017
LSCELECTRICAL EQUIPMENT - POWER CORDS AND EXTENS225/9/20177/1/2017
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC225/9/20177/1/2017
LSCELECTRICAL SYSTEMS - ESSENTIAL ELECTRIC SYSTE225/9/20177/1/2017
LSCELECTRICAL SYSTEMS - OTHER225/9/20177/1/2017
LSCGENERAL REQUIREMENTS - OTHER225/9/20177/1/2017
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING225/9/20177/1/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING216/25/20157/17/2015
LSCBUILDING CONSTRUCTION TYPE AND HEIGHT225/9/20178/3/2017
LSCSPRINKLER SYSTEM - INSTALLATION225/9/20178/3/2017
LSCVERTICAL OPENINGS - ENCLOSURE225/9/20178/3/2017