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
424Percentage of short-stay residents who self-report moderate to severe pain1.27002/1/2019
425Percentage of short-stay residents with pressure ulcers that are new or worsened1.36002/1/2019
426Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine62.90002/1/2019
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine55.38002/1/2019
434Percentage of short-stay residents who newly received an antipsychotic medication1.71002/1/2019
471Percentage of short-stay residents who made improvements in function70.44002/1/2019

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased24.32002/1/2019
402Percentage of long-stay residents who self-report moderate to severe pain0.17002/1/2019
403Percentage of high risk long-stay residents with pressure ulcers7.39002/1/2019
404Percentage of long-stay residents who lose too much weight6.97002/1/2019
405Percentage of low risk long-stay residents who lose control of their bowels or bladder57.96002/1/2019
406Percentage of long-stay residents with a catheter inserted and left in their bladder1.92002/1/2019
407Percentage of long-stay residents with a urinary tract infection0.64002/1/2019
408Percentage of long-stay residents who have depressive symptoms10.57002/1/2019
409Percentage of long-stay residents who were physically restrained0.00002/1/2019
410Percentage of long-stay residents experiencing one or more falls with major injury1.28002/1/2019
411Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine87.70002/1/2019
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine51.20002/1/2019
419Percentage of long-stay residents who received an antipsychotic medication4.41002/1/2019
451Percentage of long-stay residents whose ability to move independently worsened20.91002/1/2019
452Percentage of long-stay residents who received an antianxiety or hypnotic medication9.02002/1/2019

Complaints

Number of Standard Health Deficiencies:66
Number of Live Safety Code Deficiencies:24
Number of Total Deficiencies:90
Number of Deficiencies related to Actual Harm or Immediate Jeopardy:1
Percent of Total Deficiencies related to Actual Harm or Immediate Jeopardy :1
Total intakes received (last three years):252
Intakes received per 100 occupied beds (last three years):144.8
Percent of total intakes received that were facility self reported incidents (last three years):44
On-site complaint investigations (last three years):52
Complaint investigations resulting in citations (last three years):21
Complaint investigations resulting in citations per 100 occupied beds (last three years):12.1
Complaint Citations in deficiency category: Administration:0
Complaint Citations in deficiency category: Quality of Care:7
Complaint Citations in deficiency category: Resident Rights:8
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:1
Complaint Citations in deficiency category: Other Services:4
Complaint Citations across all deficiency categories (last three years):21

Enforcements

Survey DateDeficiency CategoryStipulation DateFine Assessed
16-Jun-05Quality of Care8-Jun-061000

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/18/2017CERTIFICATION/COMPLAINT2
11/4/2015COMPLAINT2
12/8/2014COMPLAINT2
2/18/2015CERTIFICATION/COMPLAINT3
2/8/2016CERTIFICATION/COMPLAINT2
3/30/2018CERTIFICATION/COMPLAINT2
6/4/2018COMPLAINT2
7/30/2015COMPLAINT2

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
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)2111/4/201512/3/2015
HealthRIGHT TO REFUSE; FORMULATE ADVANCE DIRECTIVES2111/4/201512/3/2015
HealthSUFFICIENT FLUID TO MAINTAIN HYDRATION2111/4/201512/3/2015
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY221/18/20173/14/2017
LSCHAZARDOUS AREAS - ENCLOSURE221/18/20173/14/2017
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES211/18/20173/14/2017
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS211/18/20173/14/2017
HealthDIGNITY AND RESPECT OF INDIVIDUALITY211/18/20173/14/2017
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES211/18/20173/14/2017
LSCPORTABLE FIRE EXTINGUISHERS221/18/20173/14/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES121/18/20173/14/2017
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)211/18/20173/14/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING211/18/20173/14/2017
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE211/18/20173/14/2017
HealthSUFFICIENT 24-HR NURSING STAFF PER CARE PLANS221/18/20173/14/2017
LSCFIRE DRILLS221/18/20173/14/2017
LSCGAS EQUIPMENT - CYLINDER AND CONTAINER STORAG221/18/20173/14/2017
HealthDISPOSE GARBAGE & REFUSE PROPERLY212/18/20154/10/2015
HealthDEPARTMENT CRIMINAL HISTORY REVIEW212/18/20154/10/2015
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS212/18/20154/10/2015
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS212/18/20154/10/2015
HealthSERVICES BY QUALIFIED PERSONS/PER CARE PLAN212/18/20154/10/2015
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY212/18/20154/10/2015
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)212/18/20154/10/2015
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS212/18/20154/10/2015
HealthHOUSEKEEPING & MAINTENANCE SERVICES222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
LSCLIFE SAFETY CODE STANDARD222/18/20154/10/2015
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
LSCFIRE DRILLS213/30/20184/27/2018
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING223/30/20184/27/2018
LSCHAZARDOUS AREAS - ENCLOSURE223/30/20184/27/2018
HealthINFECTION CONTROL223/30/20184/27/2018
HealthINFECTION PREVENTION & CONTROL223/30/20184/27/2018
HealthTREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES212/8/20164/4/2016
LSCLIFE SAFETY CODE STANDARD222/8/20164/4/2016
LSCLIFE SAFETY CODE STANDARD222/8/20164/4/2016
HealthFACILITY MANAGEMENT OF PERSONAL FUNDS212/8/20164/4/2016
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS212/8/20164/4/2016
HealthCOMPREHENSIVE ASSESS AT LEAST EVERY 12 MONTHS212/8/20164/4/2016
HealthDEVELOP COMPREHENSIVE CARE PLANS222/8/20164/4/2016
HealthDEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES222/8/20164/4/2016
HealthDIGNITY AND RESPECT OF INDIVIDUALITY212/8/20164/4/2016
HealthFREE OF MEDICATION ERROR RATES OF 5% OR MORE212/8/20164/4/2016
HealthHOUSEKEEPING & MAINTENANCE SERVICES222/8/20164/4/2016
HealthINFECTION CONTROL, PREVENT SPREAD, LINENS212/8/20164/4/2016
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS212/8/20164/4/2016
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)212/8/20164/4/2016
HealthPOSTED NURSE STAFFING INFORMATION122/8/20164/4/2016
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING212/8/20164/4/2016
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS212/8/20164/4/2016
HealthQUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS212/8/20164/4/2016
HealthRESIDENTS FREE OF SIGNIFICANT MED ERRORS222/8/20164/4/2016
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP212/8/20164/4/2016
HealthSAFE/FUNCTIONAL/SANITARY/COMFORTABLE ENVIRON212/8/20164/4/2016
HealthSERVICES BY QUALIFIED PERSONS/PER CARE PLAN212/8/20164/4/2016
HealthTREATMENT/SERVICES TO IMPROVE/MAINTAIN ADLS222/8/20164/4/2016
HealthFREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE213/30/20185/11/2018
HealthBASELINE CARE PLAN213/30/20185/11/2018
LSCPRIMARY/ALTERNATE MEANS FOR COMMUNICATION133/30/20185/11/2018
LSCFUNDAMENTALS - BUILDING SYSTEM CATEGORIES223/30/20185/11/2018
LSCSUBDIVISION OF BUILDING SPACES - SMOKE BARRIE223/30/20185/11/2018
LSCSUBSISTENCE NEEDS FOR STAFF AND PATIENTS133/30/20185/11/2018
LSCEXIT SIGNAGE223/30/20185/11/2018
LSCEP TRAINING PROGRAM133/30/20185/11/2018
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC223/30/20185/11/2018
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS213/30/20185/11/2018
LSCPOLICIES/PROCEDURES-VOLUNTEERS AND STAFFING133/30/20185/11/2018
HealthRESIDENT RIGHTS/EXERCISE OF RIGHTS123/30/20185/11/2018
HealthREQUIREMENTS FOR DINING AND ACTIVITY ROOMS223/30/20185/11/2018
HealthNUTRITION/HYDRATION STATUS MAINTENANCE213/30/20185/11/2018
HealthNOT EMPLOY/ENGAGE STAFF W/ ADVERSE ACTIONS213/30/20185/11/2018
HealthINVESTIGATE/PREVENT/CORRECT ALLEGED VIOLATION213/30/20185/11/2018
HealthINCREASE/PREVENT DECREASE IN RANGE OF MOTION212/18/20155/18/2015
HealthQAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS222/18/20155/18/2015
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE212/18/20155/18/2015
HealthRIGHT TO PARTICIPATE PLANNING CARE-REVISE CP212/18/20155/18/2015
HealthRIGHT TO REFUSE; FORMULATE ADVANCE DIRECTIVES222/18/20155/18/2015
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES212/18/20155/18/2015
HealthNUTRITION/HYDRATION STATUS MAINTENANCE216/4/20187/11/2018
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES227/30/20158/29/2015
HealthINVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS217/30/20158/29/2015