Williamsville Suburban LLC

Williamsville Suburban LLC

163 South Union Road

Williamsville, NY 14221

7166326152

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: 0%

Occupancy Rate: 85%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
424Percentage of short-stay residents who self-report moderate to severe pain0.59004/1/2018
425Percentage of short-stay residents with pressure ulcers that are new or worsened0.67004/1/2018
426Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine48.84004/1/2018
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine47.05004/1/2018
434Percentage of short-stay residents who newly received an antipsychotic medication0.83004/1/2018
471Percentage of short-stay residents who made improvements in function81.35004/1/2018

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased16.21004/1/2018
402Percentage of long-stay residents who self-report moderate to severe pain0.44004/1/2018
403Percentage of high risk long-stay residents with pressure ulcers6.18004/1/2018
404Percentage of long-stay residents who lose too much weight7.34004/1/2018
405Percentage of low risk long-stay residents who lose control of their bowels or bladder41.20004/1/2018
406Percentage of long-stay residents with a catheter inserted and left in their bladder1.31004/1/2018
407Percentage of long-stay residents with a urinary tract infection0.48004/1/2018
408Percentage of long-stay residents who have depressive symptoms9.48004/1/2018
409Percentage of long-stay residents who were physically restrained0.00004/1/2018
410Percentage of long-stay residents experiencing one or more falls with major injury1.59004/1/2018
411Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine77.84004/1/2018
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine66.24004/1/2018
419Percentage of long-stay residents who received an antipsychotic medication13.18004/1/2018
451Percentage of long-stay residents whose ability to move independently worsened14.60004/1/2018
452Percentage of long-stay residents who received an antianxiety or hypnotic medication11.32004/1/2018

Complaints

Number of Standard Health Deficiencies:56
Number of Live Safety Code Deficiencies:13
Number of Total Deficiencies:69
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):236
Intakes received per 100 occupied beds (last three years):129.1
Percent of total intakes received that were facility self reported incidents (last three years):44
On-site complaint investigations (last three years):57
Complaint investigations resulting in citations (last three years):22
Complaint investigations resulting in citations per 100 occupied beds (last three years):12.0
Complaint Citations in deficiency category: Administration:0
Complaint Citations in deficiency category: Quality of Care:10
Complaint Citations in deficiency category: Resident Rights:11
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:1
Complaint Citations in deficiency category: Other Services:0
Complaint Citations across all deficiency categories (last three years):22

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed
6/16/2005 0:00:00Quality of Care6/8/20061000

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/18/2017Certification2
11/4/2015Complaint2
12/8/2014Complaint2
2/18/2015Certification3
2/8/2016Certification2
5/20/2014Complaint2
7/30/2015Complaint2
8/25/2014Complaint2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate of Initial SurveyDate Citation Corrected
HealthResponsibilities of Providers; Required Notif112/18/2015
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)2112/8/20141/30/2015
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING2112/8/20141/30/2015
HealthHOUSEKEEPING & MAINTENANCE SERVICES228/25/201410/17/2014
HealthRIGHT TO REFUSE; FORMULATE ADVANCE DIRECTIVES2111/4/201512/3/2015
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)2111/4/201512/3/2015
HealthSUFFICIENT FLUID TO MAINTAIN HYDRATION2111/4/201512/3/2015
LSCGas Equipment - Cylinder and Container Storag221/18/20173/14/2017
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS211/18/20173/14/2017
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)211/18/20173/14/2017
HealthDIGNITY AND RESPECT OF INDIVIDUALITY211/18/20173/14/2017
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES211/18/20173/14/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES121/18/20173/14/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING211/18/20173/14/2017
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES211/18/20173/14/2017
HealthSUFFICIENT 24-HR NURSING STAFF PER CARE PLANS221/18/20173/14/2017
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY221/18/20173/14/2017
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE211/18/20173/14/2017
LSCHazardous Areas - Enclosure221/18/20173/14/2017
LSCPortable Fire Extinguishers221/18/20173/14/2017
LSCFire Drills221/18/20173/14/2017
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS212/18/20154/10/2015
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS212/18/20154/10/2015
HealthDepartment Criminal History Review212/18/20154/10/2015
HealthHOUSEKEEPING & MAINTENANCE SERVICES222/18/20154/10/2015
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)212/18/20154/10/2015
HealthDISPOSE GARBAGE & REFUSE PROPERLY212/18/20154/10/2015
HealthSERVICES BY QUALIFIED PERSONS/PER CARE PLAN212/18/20154/10/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS212/18/20154/10/2015
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY212/18/20154/10/2015
HealthDRUG RECORDS, LABEL/STORE DRUGS & BIOLOGICALS212/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES222/8/20164/4/2016
HealthDIGNITY AND RESPECT OF INDIVIDUALITY212/8/20164/4/2016
HealthHOUSEKEEPING & MAINTENANCE SERVICES222/8/20164/4/2016
HealthCOMPREHENSIVE ASSESS AT LEAST EVERY 12 MONTHS212/8/20164/4/2016
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS212/8/20164/4/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS222/8/20164/4/2016
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP212/8/20164/4/2016
HealthSERVICES BY QUALIFIED PERSONS/PER CARE PLAN212/8/20164/4/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING212/8/20164/4/2016
HealthTREATMENT/SERVICES TO IMPROVE/MAINTAIN ADLS222/8/20164/4/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS212/8/20164/4/2016
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES212/8/20164/4/2016
HealthFREE OF MEDICATION ERROR RATES OF 5% OR MORE212/8/20164/4/2016
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS222/8/20164/4/2016
LSCLIFE SAFETY CODE STANDARD222/8/20164/4/2016
HealthPOSTED NURSE STAFFING INFORMATION122/8/20164/4/2016
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS212/8/20164/4/2016
HealthSAFE/FUNCTIONAL/SANITARY/COMFORTABLE ENVIRON212/8/20164/4/2016
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS212/8/20164/4/2016
LSCLIFE SAFETY CODE STANDARD222/8/20164/4/2016
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS212/8/20164/4/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)212/8/20164/4/2016
HealthFACILITY MANAGEMENT OF PERSONAL FUNDS212/8/20164/4/2016
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE212/18/20155/18/2015
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS222/18/20155/18/2015
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP212/18/20155/18/2015
HealthINCREASE/PREVENT DECREASE IN RANGE OF MOTION212/18/20155/18/2015
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES212/18/20155/18/2015
HealthRIGHT TO REFUSE; FORMULATE ADVANCE DIRECTIVES222/18/20155/18/2015
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS215/20/20146/20/2014
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS217/30/20158/29/2015
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES227/30/20158/29/2015