Humboldt House Rehabilitation and Nursing Center

Humboldt House Rehabilitation and Nursing Center

64 Hager Street

Buffalo, NY 14208

(716) 886-4377

www.niagaralutheran.org/content/pages/nl-rehabilitation-center

Services: Baseline Services

Beds

Behavioral Intervention:
Pediatric:
Pediatric Ventilator Dependent:
Residential Health Care:173
Transitional Care Unit:
Ventilator Dependent:
Total Number of Beds:173

Administrative

Ownership: Proprietary--LLC

Operated by: NHRC Acquisition, LLC
68 Hager Street
Buffalo, NY 14208

Permanent Facility Identifier: 244

Operating Certificate: 1401340N

Medicaid Certified

Medicare Certified

Medicare Number: 335164

Statistics

Employee Flu Vaccination Rate: 50%

Occupancy Rate: 95%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
424Percentage of short-stay residents who self-report moderate to severe pain17.727273/1/2017
425Percentage of short-stay residents with pressure ulcers that are new or worsened2.869313/1/2017
426Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine37.637363/1/2017
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine37.800683/1/2017
434Percentage of short-stay residents who newly received an antipsychotic medication2.290073/1/2017
471Percentage of short-stay residents who made improvements in function88.406593/1/2017

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased18.969075003/1/2017
402Percentage of long-stay residents who self-report moderate to severe pain2.551173003/1/2017
403Percentage of high risk long-stay residents with pressure ulcers7.517086003/1/2017
404Percentage of long-stay residents who lose too much weight6.706114003/1/2017
405Percentage of low risk long-stay residents who lose control of their bowels or bladder41.025640003/1/2017
406Percentage of long-stay residents with a catheter inserted and left in their bladder1.290984003/1/2017
407Percentage of long-stay residents with a urinary tract infection4.044118003/1/2017
408Percentage of long-stay residents who have depressive symptoms47.495364003/1/2017
409Percentage of long-stay residents who were physically restrained0.179212003/1/2017
410Percentage of long-stay residents experiencing one or more falls with major injury2.504470003/1/2017
411Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine93.499999003/1/2017
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine93.023257003/1/2017
419Percentage of long-stay residents who received an antipsychotic medication15.020575003/1/2017
451Percentage of long-stay residents whose ability to move independently worsened21.599293003/1/2017
452Percentage of long-stay residents who received an antianxiety or hypnotic medication14.130436003/1/2017

Complaints

Number of Standard Health Deficiencies:51
Number of Live Safety Code Deficiencies:28
Number of Total Deficiencies:79
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):130
Intakes received per 100 occupied beds (last three years):84.2
Percent of total intakes received that were facility self reported incidents (last three years):56
On-site complaint investigations (last three years):35
Complaint investigations resulting in citations (last three years):13
Complaint investigations resulting in citations per 100 occupied beds (last three years):8.4
Complaint Citations in deficiency category: Administration:0
Complaint Citations in deficiency category: Quality of Care:8
Complaint Citations in deficiency category: Resident Rights:3
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:2
Complaint Citations in deficiency category: Other Services:0
Complaint Citations across all deficiency categories (last three years):13

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/27/2017Complaint1
11/10/2014Certification2
11/13/2013Certification2
2/2/2017Complaint1
5/13/2016Certification4
7/2/2013Complaint2
7/2/2014Complaint2
8/29/2016Complaint2
9/15/2015Certification2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate citation corrected
HealthRESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS31
HealthPROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES21
HealthDRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS21
HealthRESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS22
HealthCOMPREHENSIVE ASSESSMENTS211/6/2015
HealthDIGNITY211/6/2015
HealthMEDICATION ERROR RATES OF 5% OR MORE211/6/2015
LSCMEDICAL GAS SYSTEM221/6/2015
HealthPROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES211/6/2015
HealthDEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN211/6/2015
HealthSERVICES BY QUALIFIED PERSONS IN ACCORDANCE WITH CARE PLAN211/6/2015
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING221/6/2015
LSCPORTABLE FIRE EXTINGUISHERS221/6/2015
LSCFIRE DRILLS221/6/2015
LSCHAZARDOUS AREAS - SEPARATION221/6/2015
LSCCORRIDOR DOORS221/6/2015
HealthPROPER LABELING OF DRUGS AND BIOLOGICALS211/6/2015
HealthINFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.211/6/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS211/6/2015
HealthDENTAL SERVICES211/7/2014
HealthACCOMMODATION OF NEEDS AND PREFERENCES221/7/2014
LSCFURNISHING AND DECORATIONS221/7/2014
LSCSPRINKLER SYSTEM MAINTENANCE221/7/2014
LSCEXIT ACCESS221/7/2014
HealthCRIMINAL HISTORY RECORD CHECK NOT PERFORMED PROVIDER SHALL SUBMIT REQUEST FOR CHECK221/7/2014
HealthSELF-DETERMINATION - RESIDENT MAKES CHOICES211/7/2014
LSCCONSTRUCTION TYPE221/7/2014
LSCCORRIDOR DOORS221/7/2014
LSCSTAIRWAY ENCLOSURES AND VERTICAL SHAFTS221/7/2014
LSCHAZARDOUS AREAS - SEPARATION221/7/2014
LSCDOORS IN SMOKE PARTITIONS221/7/2014
LSCSMOKE PARTITION CONSTRUCTION221/7/2014
HealthMAINTAINS EFFECTIVE PEST CONTROL PROGRAM2210/7/2016
HealthACCOMMODATION OF NEEDS AND PREFERENCES2211/13/2015
HealthRESIDENT RECEIVES NOTICE BEFORE ROOM/ROOMMATE CHANGE2111/13/2015
HealthACTIVITY PROGRAM MEETS INDIVIDUAL NEEDS2211/13/2015
HealthDEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN2111/13/2015
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING2111/13/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS2111/13/2015
HealthNOT EMPLOY PERSONS GUILTY OF ABUSE2111/13/2015
HealthRANGE OF MOTION TREATMENT AND SERVICES2111/13/2015
LSCEMERGENCY PLAN2211/13/2015
LSCCONSTRUCTION TYPE2211/13/2015
HealthCLINICAL RECORDS MEET PROFESSIONAL STANDARDS2211/13/2015
HealthFACILITY IS FREE OF ACCIDENT HAZARDS2211/13/2015
LSCCONSTRUCTION TYPE2212/6/2015
LSCCORRIDOR DOORS227/1/2016
LSCCONSTRUCTION TYPE227/1/2016
HealthMAINTAINS EFFECTIVE PEST CONTROL PROGRAM227/1/2016
HealthFACILITY PROVIDES SPECIALIZED REHABILITATION SERVICES217/1/2016
HealthDISPOSE GARBAGE AND REFUSE PROPERLY227/1/2016
HealthSTORE/PREPARE/DISTRIBUTE FOOD UNDER SANITARY CONDITIONS227/1/2016
LSCEMERGENCY PLAN227/1/2016
LSCSTAIRWAY ENCLOSURES AND VERTICAL SHAFTS227/1/2016
LSCDOORS IN FIRE AND SMOKE PARTITIONS227/1/2016
LSCSMOKE PARTITION CONSTRUCTION227/1/2016
LSCSTAIRS AND SMOKE PROOF TOWERS227/1/2016
LSCEXIT ACCESS227/1/2016
LSCFIRE DRILLS227/1/2016
LSCSPRINKLER SYSTEM MAINTENANCE227/1/2016
LSCMEDICAL GAS SYSTEM227/1/2016
HealthFACILITY PROVIDES SUFFICIENT FLUID INTAKE317/1/2016
HealthFACILITY IS FREE OF ACCIDENT HAZARDS217/1/2016
HealthDIGNITY227/1/2016
HealthSELF-DETERMINATION - RESIDENT MAKES CHOICES217/1/2016
HealthHOUSEKEEPING AND MAINTENANCE SERVICES127/1/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS217/1/2016
HealthPROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING217/1/2016
HealthINFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.217/1/2016
HealthRESIDENT NOT CATHETERIZED UNLESS UNAVOIDABLE217/1/2016
HealthNOT EMPLOY PERSONS GUILTY OF ABUSE218/10/2016
HealthPROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES218/10/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS218/10/2016
HealthCOMPREHENSIVE ASSESSMENTS218/10/2016
HealthFACILITY ESTABLISHES INFECTION CONTROL PROGRAM228/10/2016
HealthDEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN218/10/2016
HealthSERVICES BY QUALIFIED PERSONS IN ACCORDANCE WITH CARE PLAN218/10/2016
HealthFACILITY IS FREE OF ACCIDENT HAZARDS218/28/2013
HealthINFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.218/8/2014