Safire Rehabilitation of Southtowns, LLC

300 Dorrance Avenue

Buffalo, NY 14220

(716) 566-5252

Services: Baseline Services

Beds

Behavioral Intervention:
Pediatric:
Pediatric Ventilator Dependent:
Residential Health Care:	120
Transitional Care Unit:
Ventilator Dependent:
Total Number of Beds:	120

Administrative

Ownership: Proprietary--LLC

Operated by: Safire Rehabilitation of Southtowns, LLC
300 Dorrance Avenue
Buffalo, NY 14220

Permanent Facility Identifier: 3084

Operating Certificate: 1401342N

Medicaid Certified

Medicare Certified

Medicare Number: 335663

Statistics

Employee Flu Vaccination Rate: 30%

Occupancy Rate: 92%

Nursing Home CMS Quality (Short Stay)

Measure Code	Measure Description	Average Score	Processing Date
424	Percentage of short-stay residents who self-report moderate to severe pain	7.29729	6/1/2017
425	Percentage of short-stay residents with pressure ulcers that are new or worsened	0.68625	6/1/2017
426	Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	63.7037	6/1/2017
430	Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	54.90605	6/1/2017
434	Percentage of short-stay residents who newly received an antipsychotic medication	2.74914	6/1/2017
471	Percentage of short-stay residents who made improvements in function	94.08235	6/1/2017

Nursing Home CMS Quality (Long Stay)

Measure Code	Measure Description	Average Score	Processing Date
401	Percentage of long-stay residents whose need for help with daily activities has increased	9.48275600	6/1/2017
402	Percentage of long-stay residents who self-report moderate to severe pain	16.03156100	6/1/2017
403	Percentage of high risk long-stay residents with pressure ulcers	7.81250200	6/1/2017
404	Percentage of long-stay residents who lose too much weight	6.85358200	6/1/2017
405	Percentage of low risk long-stay residents who lose control of their bowels or bladder	46.20689400	6/1/2017
406	Percentage of long-stay residents with a catheter inserted and left in their bladder	4.72346500	6/1/2017
407	Percentage of long-stay residents with a urinary tract infection	1.58311400	6/1/2017
408	Percentage of long-stay residents who have depressive symptoms	5.07042100	6/1/2017
409	Percentage of long-stay residents who were physically restrained	0.52356100	6/1/2017
410	Percentage of long-stay residents experiencing one or more falls with major injury	0.52356100	6/1/2017
411	Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	94.23076900	6/1/2017
415	Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	94.24083700	6/1/2017
419	Percentage of long-stay residents who received an antipsychotic medication	21.72701900	6/1/2017
451	Percentage of long-stay residents whose ability to move independently worsened	8.81707300	6/1/2017
452	Percentage of long-stay residents who received an antianxiety or hypnotic medication	13.61111200	6/1/2017

Complaints

Number of Standard Health Deficiencies:	78
Number of Live Safety Code Deficiencies:	34
Number of Total Deficiencies:	112
Number of Deficiencies related to Actual Harm or Immediate Jeopardy:	3
Percent of Total Deficiencies related to Actual Harm or Immediate Jeopardy :	3
Total intakes received (last three years):	160
Intakes received per 100 occupied beds (last three years):	142.9
Percent of total intakes received that were facility self reported incidents (last three years):	56
On-site complaint investigations (last three years):	52
Complaint investigations resulting in citations (last three years):	18
Complaint investigations resulting in citations per 100 occupied beds (last three years):	16.1
Complaint Citations in deficiency category: Administration:	1
Complaint Citations in deficiency category: Quality of Care:	7
Complaint Citations in deficiency category: Resident Rights:	9
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):	18

Enforcements

Survey Date	Deficiency Category	Stipulation Date	Fine Assessed
2/20/2002 0:00	Quality of Care	12/10/2002	2000
5/19/2016 0:00	Multiple Deficiencies	1/3/2017	6000

Surveys

Initial Survey Date	Survey Type	Total Visits Required
1/25/2017	Complaint	2
10/7/2013	Certification	2
11/9/2015	Complaint	2
12/21/2016	Complaint	2
3/29/2017	Certification	2
5/14/2015	Certification	2
5/19/2016	Certification	5
6/11/2014	Complaint	2
8/29/2014	Certification	2

Citations

Inspection Type	Deficiency	Severity	Residents Affected	Date citation corrected
Health	DEVELOP COMPREHENSIVE CARE PLANS	2	1	10/21/2014
Health	HOUSEKEEPING AND MAINTENANCE SERVICES	2	2	10/21/2014
Health	DEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN	2	1	10/21/2014
Health	FACILITY IS FREE OF ACCIDENT HAZARDS	2	2	10/21/2014
Health	RESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS	2	2	10/21/2014
Health	PROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING	2	2	10/21/2014
LSC	DOORS IN FIRE AND SMOKE PARTITIONS	2	2	10/21/2014
LSC	MEDICAL GAS SYSTEM	2	2	10/21/2014
LSC	COOKING EQUIPMENT	2	2	10/21/2014
LSC	SMOKING REGULATIONS	2	2	10/21/2014
LSC	DOORS IN SMOKE PARTITIONS	2	2	10/21/2014
Health	CLINICAL RECORDS MEET PROFESSIONAL STANDARDS	2	2	10/21/2014
Health	MEDICALLY RELATED SOCIAL SERVICES	2	1	10/21/2014
Health	CRIMINAL HISTORY RECORD CHECK TEMPORARY APPROVAL PENDING RESULTS/ SUPERVISION REQUIRED	2	2	10/21/2014
Health	SERVICES BY QUALIFIED PERSONS IN ACCORDANCE WITH CARE PLAN	2	1	10/21/2014
Health	DEPARTMENT CRIMINAL HISTORY REVIEW DOH PROPOSED DISAPPROVAL/DIRECT CARE PROHIBITED	2	2	10/21/2014
Health	INFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.	2	1	10/21/2014
Health	RIGHT TO REFUSE TREATMENT/RESEARCH; FORM ADVANCE DIRECTIVES	2	2	10/21/2014
LSC	TESTING OF FIRE ALARM	2	2	10/21/2014
Health	NOT EMPLOY PERSONS GUILTY OF ABUSE	2	1	10/21/2014
Health	RESIDENT DRUG REGIMEN REVIEWED MONTHLY BY PHARMACIST	2	2	10/21/2014
Health	PROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES	2	2	10/21/2016
Health	CLINICAL RECORDS MEET PROFESSIONAL STANDARDS	2	1	10/21/2016
Health	INFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.	2	1	12/18/2015
Health	NOT EMPLOY PERSONS GUILTY OF ABUSE	2	1	12/18/2015
Health	CLINICAL RECORDS MEET PROFESSIONAL STANDARDS	2	1	12/3/2013
LSC	GENERATORS INSPECTED/TESTED	2	2	12/3/2013
LSC	EMERGENCY PLAN	2	2	12/3/2013
LSC	MEDICAL GAS SYSTEM	2	2	12/3/2013
LSC	WASTEBASKETS	2	2	12/3/2013
LSC	SPRINKLER SYSTEM MAINTENANCE	2	2	12/3/2013
LSC	CORRIDOR WIDTH	2	2	12/3/2013
LSC	STAIRS AND SMOKE PROOF TOWERS	2	2	12/3/2013
LSC	EXIT PARTITIONS	2	2	12/3/2013
LSC	HAZARDOUS AREAS - SEPARATION	2	2	12/3/2013
LSC	DOORS IN FIRE AND SMOKE PARTITIONS	2	2	12/3/2013
Health	DISPOSE GARBAGE AND REFUSE PROPERLY	2	2	12/3/2013
LSC	CORRIDOR DOORS	2	2	12/3/2013
Health	HOUSEKEEPING AND MAINTENANCE SERVICES	1	3	12/3/2013
Health	DEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN	2	1	12/3/2013
Health	ADL CARE PROVIDED FOR DEPENDENT RESIDENTS	2	1	12/3/2013
Health	RESIDENT MAINTAIN NUTRITIONAL STATUS UNLESS UNAVOIDABLE	2	1	12/3/2013
Health	STORE/PREPARE/DISTRIBUTE FOOD UNDER SANITARY CONDITIONS	2	2	12/3/2013
Health	DRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS	2	1	12/3/2013
Health	PROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING	2	1	2/17/2017
Health	INFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.	2	1	2/17/2017
Health	RESIDENTS FREE FROM SIGNIFICANT MEDICATION ERRORS	2	2	3/5/2017
Health	RESIDENT DRUG REGIMEN REVIEWED MONTHLY BY PHARMACIST	2	1	3/5/2017
Health	PROPER TREATMENT TO PREVENT/HEAL PRESSURE SORES	2	1	5/26/2017
Health	PROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING	2	1	5/26/2017
Health	DEPARTMENT CRIMINAL HISTORY REVIEW DOH PROPOSED DISAPPROVAL/DIRECT CARE PROHIBITED	2	2	5/26/2017
Health	CRIMINAL HISTORY RECORD CHECK REQUIRED NOTIFICATION PROVIDER RECORD KEEPING REQUIREMENTS	1	2	5/26/2017
Health	SURVEY RESULTS READILY ACCESSIBLE TO RESIDENTS	1	2	5/26/2017
Health	CRIMINAL HISTORY RECORD CHECK NOT PERFORMED PROVIDER SHALL SUBMIT REQUEST FOR CHECK	2	2	5/26/2017
Health	FACILITY IS FREE OF ACCIDENT HAZARDS	2	1	5/26/2017
Health	CRIMINAL HISTORY RECORD CHECK REQUIRED NOTIFICATION TO DOH PER CESSATION OF EMPLOYMENT	1	2	5/26/2017
Health	STANDARDS OF CONSTRUCTION FOR NEW NURSING HOME	2	2	5/26/2017
LSC		2	2	5/26/2017
LSC		2	1	5/26/2017
Health	INFLUENZA AND PNEUMOCOCCAL IMMUNIZATION	2	1	5/26/2017
Health	RESIDENT MAINTAIN NUTRITIONAL STATUS UNLESS UNAVOIDABLE	2	1	5/26/2017
Health	INFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.	2	1	6/30/2015
Health	NOT EMPLOY PERSONS GUILTY OF ABUSE	2	1	6/30/2015
Health	RESIDENT RECEIVES NOTICE BEFORE ROOM/ROOMMATE CHANGE	2	1	6/30/2015
Health	COMPREHENSIVE ASSESSMENTS	2	1	6/30/2015
Health	DEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN	2	1	6/30/2015
Health	SERVICES BY QUALIFIED PERSONS IN ACCORDANCE WITH CARE PLAN	2	1	6/30/2015
LSC	DOORS IN SMOKE PARTITIONS	2	2	6/30/2015
Health	PROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING	2	1	6/30/2015
Health	ADL CARE PROVIDED FOR DEPENDENT RESIDENTS	2	1	6/30/2015
Health	FACILITY IS FREE OF ACCIDENT HAZARDS	2	1	6/30/2015
Health	RESIDENT MAINTAIN NUTRITIONAL STATUS UNLESS UNAVOIDABLE	2	1	6/30/2015
Health	DIGNITY	2	2	6/30/2015
Health	CRIMINAL HISTORY RECORD CHECK TEMPORARY APPROVAL PENDING RESULTS/ SUPERVISION REQUIRED	2	1	6/30/2015
Health	INFLUENZA AND PNEUMOCOCCAL IMMUNIZATION	2	1	6/30/2015
Health	RESIDENT CALL SYSTEM	2	1	6/30/2015
Health	PROPER LABELING OF DRUGS AND BIOLOGICALS	2	1	6/30/2015
Health	STORE/PREPARE/DISTRIBUTE FOOD UNDER SANITARY CONDITIONS	2	1	6/30/2015
Health	FACILITY ESTABLISHES INFECTION CONTROL PROGRAM	2	1	6/30/2015
Health	ESSENTIAL EQUIPMENT IN SAFE OPERATING CONDITION	2	1	6/30/2015
Health	CLINICAL RECORDS MEET PROFESSIONAL STANDARDS	2	2	6/30/2015
LSC	HAZARDOUS AREAS - SEPARATION	2	2	6/30/2015
LSC	EXIT PARTITIONS	2	2	6/30/2015
LSC	EVACUATION PLAN	2	2	6/30/2015
LSC	PORTABLE FIRE EXTINGUISHERS	2	2	6/30/2015
LSC	SMOKING REGULATIONS	2	2	6/30/2015
LSC	MEDICAL GAS SYSTEM	2	2	6/30/2015
Health	NURSE STAFFING	1	2	6/30/2015
LSC	COOKING EQUIPMENT	2	2	6/30/2015
Health	HOUSEKEEPING AND MAINTENANCE SERVICES	2	1	6/30/2015
Health	FACILITY IS FREE OF ACCIDENT HAZARDS	2	2	7/14/2014
Health	DRUG REGIMEN IS FREE FROM UNNECESSARY DRUGS	2	1	7/8/2016
Health	RESIDENT MAINTAIN NUTRITIONAL STATUS UNLESS UNAVOIDABLE	2	1	7/8/2016
Health	POLICIES, PROCEDURES PROHIBIT ABUSE, NEGLECT	2	1	7/8/2016
LSC	SMOKE PARTITION CONSTRUCTION	2	2	7/8/2016
Health	FACILITY ADMINISTERED EFFECTIVELY TO OBTAIN HIGHEST PRACTICABLE WELL BEING	4	2	7/8/2016
Health	RIGHT TO REFUSE TREATMENT/RESEARCH; FORM ADVANCE DIRECTIVES	2	1	7/8/2016
Health	INFORM OF ACCIDENTS/SIGNIFICANT CHANGES/TRANSFER/ETC.	2	1	7/8/2016
Health	NOT EMPLOY PERSONS GUILTY OF ABUSE	2	1	7/8/2016
Health	PROVIDE NECESSARY CARE FOR HIGHEST PRACTICABLE WELL BEING	2	2	7/8/2016
Health	FACILITY IS FREE OF ACCIDENT HAZARDS	2	2	7/8/2016
Health	RESIDENT GIVEN TREATMENT TO IMPROVE/MAINTAIN ADLS	2	1	7/8/2016
Health	HOUSEKEEPING AND MAINTENANCE SERVICES	2	2	7/8/2016
Health	MEDICATION ERROR RATES OF 5% OR MORE	2	1	7/8/2016
LSC	EMERGENCY PLAN	2	2	7/8/2016
LSC	EXIT PARTITIONS	2	2	7/8/2016
Health	LAB SERVICES PROVIDED BY FACILITY/REFERRING SPECIMENS	2	2	7/8/2016
Health	FACILITY MAINTAINS QA COMMITTEE	4	2	7/8/2016
LSC	CORRIDOR DOORS	2	2	7/8/2016
LSC	HAZARDOUS AREAS - SEPARATION	2	2	7/8/2016
LSC	EVACUATION PLAN	2	2	7/8/2016
LSC	TESTING OF FIRE ALARM	2	2	7/8/2016
LSC	AUTOMATIC SPRINKLER SYSTEM	2	2	7/8/2016
LSC	MEDICAL GAS SYSTEM	2	2	7/8/2016
Health	QUALITY ASSURANCE AND ASSESSMENT	2	2	7/8/2016
Health	DEVELOPMENT/PREPARE/REVIEW OF COMPREHENSIVE CARE PLAN	2	2	8/23/2016
Health	FACILITY ESTABLISHES INFECTION CONTROL PROGRAM	4	2	8/23/2016
Health	PROPER LABELING OF DRUGS AND BIOLOGICALS	2	2	8/23/2016
Health	RESIDENT RECEIVES NOTICE BEFORE ROOM/ROOMMATE CHANGE	2	1	8/23/2016
Health	FACILITY PROHIBITS ABUSE, NEGLECT	2	1	8/26/2016
Health	SELF-DETERMINATION - RESIDENT MAKES CHOICES	2	1	8/26/2016
Health	DIGNITY	2	2	8/26/2016
Health	DEVELOP COMPREHENSIVE CARE PLANS	2	1	8/29/2016
Health	MEDICALLY RELATED SOCIAL SERVICES	2	1	8/29/2016