Williamsville Suburban LLC

Williamsville Suburban LLC

163 South Union Road

Williamsville, NY 14221

7166326152

www.williamsvillesuburban.com/

Services: Baseline Services, Outpatient/Occupational Therapy, Outpatient/Physical Therapy

Beds

Behavioral Intervention:
Pediatric:
Pediatric Ventilator Dependent:
Residential Health Care:220
Transitional Care Unit:
Ventilator Dependent:
Total Number of Beds:220

Administrative

Ownership: Proprietary--LLC

Operated by: Williamsville Suburban, LLC
163 Union Road
Williamsville, NY 14221

Permanent Facility Identifier: 1378

Operating Certificate: 1421306N

Medicaid Certified

Medicare Certified

Medicare Number: 335647

Statistics

Employee Flu Vaccination Rate: 68%

Occupancy Rate: 79%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine64.210011/1/2019
434Percentage of short-stay residents who newly received an antipsychotic medication1.050011/1/2019
471Percentage of short-stay residents who made improvements in function70.880011/1/2019

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased24.960011/1/2019
404Percentage of long-stay residents who lose too much weight5.770011/1/2019
405Percentage of low risk long-stay residents who lose control of their bowels or bladder58.500011/1/2019
406Percentage of long-stay residents with a catheter inserted and left in their bladder2.200011/1/2019
407Percentage of long-stay residents with a urinary tract infection1.170011/1/2019
408Percentage of long-stay residents who have depressive symptoms1.410011/1/2019
409Percentage of long-stay residents who were physically restrained0.000011/1/2019
410Percentage of long-stay residents experiencing one or more falls with major injury1.990011/1/2019
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine81.230011/1/2019
419Percentage of long-stay residents who received an antipsychotic medication5.390011/1/2019
451Percentage of long-stay residents whose ability to move independently worsened21.310011/1/2019
452Percentage of long-stay residents who received an antianxiety or hypnotic medication8.400011/1/2019

Complaints

Number of Standard Health Deficiencies:55
Number of Live Safety Code Deficiencies:30
Number of Total Deficiencies:85
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):246
Intakes received per 100 occupied beds (last three years):129.2
Percent of total intakes received that were facility self reported incidents (last three years):43
On-site complaint investigations (last three years):51
Complaint investigations resulting in citations (last three years):9
Complaint investigations resulting in citations per 100 occupied beds (last three years):4.7
Complaint Citations in deficiency category: Administration:0
Complaint Citations in deficiency category: Quality of Care:4
Complaint Citations in deficiency category: Resident Rights:1
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:1
Complaint Citations in deficiency category: Other Services:3
Complaint Citations across all deficiency categories (last three years):9

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed
6/16/2005Quality of Care6/8/20061000

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/18/2017CERTIFICATION/COMPLAINT2
2/8/2016CERTIFICATION/COMPLAINT2
3/30/2018CERTIFICATION/COMPLAINT2
4/19/2019CERTIFICATION/COMPLAINT2
6/4/2018COMPLAINT2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate of Initial SurveyDate Citation Corrected
HealthDIGNITY AND RESPECT OF INDIVIDUALITY216/4/20183/14/2017
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS216/4/20183/14/2017
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES216/4/20183/14/2017
LSCHAZARDOUS AREAS - ENCLOSURE226/4/20183/14/2017
LSCGAS EQUIPMENT - CYLINDER AND CONTAINER STORAG226/4/20183/14/2017
LSCFIRE DRILLS226/4/20183/14/2017
LSCPORTABLE FIRE EXTINGUISHERS226/4/20183/14/2017
HealthSUFFICIENT 24-HR NURSING STAFF PER CARE PLANS226/4/20183/14/2017
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES216/4/20183/14/2017
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE216/4/20183/14/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING216/4/20183/14/2017
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)216/4/20183/14/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES126/4/20183/14/2017
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY226/4/20183/14/2017
LSCFIRE DRILLS216/4/20184/27/2018
LSCHAZARDOUS AREAS - ENCLOSURE226/4/20184/27/2018
HealthINFECTION CONTROL226/4/20184/27/2018
HealthINFECTION PREVENTION & CONTROL226/4/20184/27/2018
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING226/4/20184/27/2018
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS216/4/20184/4/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS216/4/20184/4/2016
HealthCOMPREHENSIVE ASSESS AT LEAST EVERY 12 MONTHS216/4/20184/4/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS226/4/20184/4/2016
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES226/4/20184/4/2016
HealthDIGNITY AND RESPECT OF INDIVIDUALITY216/4/20184/4/2016
HealthFACILITY MANAGEMENT OF PERSONAL FUNDS216/4/20184/4/2016
HealthFREE OF MEDICATION ERROR RATES OF 5% OR MORE216/4/20184/4/2016
HealthHOUSEKEEPING & MAINTENANCE SERVICES226/4/20184/4/2016
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS216/4/20184/4/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)216/4/20184/4/2016
HealthPOSTED NURSE STAFFING INFORMATION126/4/20184/4/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING216/4/20184/4/2016
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS216/4/20184/4/2016
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS216/4/20184/4/2016
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS226/4/20184/4/2016
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP216/4/20184/4/2016
HealthSAFE/FUNCTIONAL/SANITARY/COMFORTABLE ENVIRON216/4/20184/4/2016
HealthSERVICES BY QUALIFIED PERSONS/PER CARE PLAN216/4/20184/4/2016
HealthTREATMENT/SERVICES TO IMPROVE/MAINTAIN ADLS226/4/20184/4/2016
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES216/4/20184/4/2016
LSCLIFE SAFETY CODE STANDARD226/4/20184/4/2016
LSCLIFE SAFETY CODE STANDARD226/4/20184/4/2016
LSCPRIMARY/ALTERNATE MEANS FOR COMMUNICATION136/4/20185/11/2018
LSCSUBDIVISION OF BUILDING SPACES - SMOKE BARRIE226/4/20185/11/2018
LSCSUBSISTENCE NEEDS FOR STAFF AND PATIENTS136/4/20185/11/2018
HealthNUTRITION/HYDRATION STATUS MAINTENANCE216/4/20185/11/2018
LSCPOLICIES/PROCEDURES-VOLUNTEERS AND STAFFING136/4/20185/11/2018
LSCFUNDAMENTALS - BUILDING SYSTEM CATEGORIES226/4/20185/11/2018
LSCEXIT SIGNAGE226/4/20185/11/2018
HealthRESIDENT RIGHTS/EXERCISE OF RIGHTS126/4/20185/11/2018
LSCEP TRAINING PROGRAM136/4/20185/11/2018
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC226/4/20185/11/2018
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS216/4/20185/11/2018
HealthREQUIREMENTS FOR DINING AND ACTIVITY ROOMS226/4/20185/11/2018
HealthNOT EMPLOY/ENGAGE STAFF W/ ADVERSE ACTIONS216/4/20185/11/2018
HealthINVESTIGATE/PREVENT/CORRECT ALLEGED VIOLATION216/4/20185/11/2018
HealthFREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE216/4/20185/11/2018
HealthBASELINE CARE PLAN216/4/20185/11/2018
LSCBUILDING REHABILITATION226/4/20186/14/2019
LSCCORRIDOR - DOORS226/4/20186/14/2019
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC226/4/20186/14/2019
LSCELECTRICAL SYSTEMS - ESSENTIAL ELECTRIC SYSTE226/4/20186/14/2019
LSCEMERGENCY LIGHTING226/4/20186/14/2019
HealthINFECTION PREVENTION & CONTROL226/4/20186/14/2019
LSCGAS EQUIPMENT - PRECAUTIONS FOR HANDLING OXYG226/4/20186/14/2019
LSCHAZARDOUS AREAS - ENCLOSURE226/4/20186/14/2019
LSCPORTABLE FIRE EXTINGUISHERS226/4/20186/14/2019
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING226/4/20186/14/2019
LSCSTAIRWAYS AND SMOKEPROOF ENCLOSURES226/4/20186/14/2019
LSCSUBDIVISION OF BUILDING SPACES - SMOKE BARRIE226/4/20186/14/2019
HealthDISPOSE GARBAGE AND REFUSE PROPERLY226/4/20186/14/2019
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS226/4/20186/14/2019
HealthBOWEL/BLADDER INCONTINENCE, CATHETER, UTI216/4/20186/14/2019
HealthESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION226/4/20186/14/2019
HealthFOOD PROCUREMENT,STORE/PREPARE/SERVE-SANITARY226/4/20186/14/2019
HealthFREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE216/4/20186/14/2019
HealthINCREASE/PREVENT DECREASE IN ROM/MOBILITY216/4/20186/14/2019
HealthLABEL/STORE DRUGS AND BIOLOGICALS216/4/20186/14/2019
LSCEXIT SIGNAGE226/4/20186/14/2019
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC.)216/4/20186/14/2019
HealthNUTRITIVE VALUE/APPEAR, PALATABLE/PREFER TEMP226/4/20186/14/2019
HealthRESPECT, DIGNITY/RIGHT TO HAVE PRSNL PROPERTY216/4/20186/14/2019
HealthSAFE/CLEAN/COMFORTABLE/HOMELIKE ENVIRONMENT126/4/20186/14/2019
LSCFIRE ALARM SYSTEM - TESTING AND MAINTENANCE226/4/20186/14/2019
HealthNUTRITION/HYDRATION STATUS MAINTENANCE216/4/20187/11/2018