Williamsville Suburban LLC
163 South Union Road
Williamsville, NY 14221
7166326152
http:www.williamsvillesuburban.com/Services: Baseline Services, Outpatient/Occupational Therapy, Outpatient/Physical Therapy
| Behavioral Intervention: | |
| Pediatric: | |
| Pediatric Ventilator Dependent: | |
| Residential Health Care: | 220 |
| Transitional Care Unit: | |
| Ventilator Dependent: | |
| Total Number of Beds: | 220 |
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
Employee Flu Vaccination Rate: 68%
Occupancy Rate: 79%
| Measure Code | Measure Description | Average Score | Footnote | Processing Date |
|---|---|---|---|---|
| 430 | Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 64.2100 | 11/1/2019 | |
| 434 | Percentage of short-stay residents who newly received an antipsychotic medication | 1.0500 | 11/1/2019 | |
| 471 | Percentage of short-stay residents who made improvements in function | 70.8800 | 11/1/2019 |
| Measure Code | Measure Description | Average Score | Footnote | Processing Date |
|---|---|---|---|---|
| 401 | Percentage of long-stay residents whose need for help with daily activities has increased | 24.9600 | 11/1/2019 | |
| 404 | Percentage of long-stay residents who lose too much weight | 5.7700 | 11/1/2019 | |
| 405 | Percentage of low risk long-stay residents who lose control of their bowels or bladder | 58.5000 | 11/1/2019 | |
| 406 | Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.2000 | 11/1/2019 | |
| 407 | Percentage of long-stay residents with a urinary tract infection | 1.1700 | 11/1/2019 | |
| 408 | Percentage of long-stay residents who have depressive symptoms | 1.4100 | 11/1/2019 | |
| 409 | Percentage of long-stay residents who were physically restrained | 0.0000 | 11/1/2019 | |
| 410 | Percentage of long-stay residents experiencing one or more falls with major injury | 1.9900 | 11/1/2019 | |
| 415 | Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 81.2300 | 11/1/2019 | |
| 419 | Percentage of long-stay residents who received an antipsychotic medication | 5.3900 | 11/1/2019 | |
| 451 | Percentage of long-stay residents whose ability to move independently worsened | 21.3100 | 11/1/2019 | |
| 452 | Percentage of long-stay residents who received an antianxiety or hypnotic medication | 8.4000 | 11/1/2019 |
| 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 |
| Survey Date | Deficiency Category | Stipulation Date | Fine Assessed |
|---|---|---|---|
| 6/16/2005 | Quality of Care | 6/8/2006 | 1000 |
| Initial Survey Date | Survey Type | Total Visits Required |
|---|---|---|
| 1/18/2017 | CERTIFICATION/COMPLAINT | 2 |
| 2/8/2016 | CERTIFICATION/COMPLAINT | 2 |
| 3/30/2018 | CERTIFICATION/COMPLAINT | 2 |
| 4/19/2019 | CERTIFICATION/COMPLAINT | 2 |
| 6/4/2018 | COMPLAINT | 2 |
| Inspection Type | Deficiency | Severity | Residents Affected | Date of Initial Survey | Date Citation Corrected |
|---|---|---|---|---|---|
| Health | DIGNITY AND RESPECT OF INDIVIDUALITY | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | ADL CARE PROVIDED FOR DEPENDENT RESIDENTS | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | FREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES | 2 | 1 | 6/4/2018 | 3/14/2017 |
| LSC | HAZARDOUS AREAS - ENCLOSURE | 2 | 2 | 6/4/2018 | 3/14/2017 |
| LSC | GAS EQUIPMENT - CYLINDER AND CONTAINER STORAG | 2 | 2 | 6/4/2018 | 3/14/2017 |
| LSC | FIRE DRILLS | 2 | 2 | 6/4/2018 | 3/14/2017 |
| LSC | PORTABLE FIRE EXTINGUISHERS | 2 | 2 | 6/4/2018 | 3/14/2017 |
| Health | SUFFICIENT 24-HR NURSING STAFF PER CARE PLANS | 2 | 2 | 6/4/2018 | 3/14/2017 |
| Health | SELF-DETERMINATION - RIGHT TO MAKE CHOICES | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | RES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | PROVIDE CARE/SERVICES FOR HIGHEST WELL BEING | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | NOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC) | 2 | 1 | 6/4/2018 | 3/14/2017 |
| Health | HOUSEKEEPING & MAINTENANCE SERVICES | 1 | 2 | 6/4/2018 | 3/14/2017 |
| Health | FOOD PROCURE, STORE/PREPARE/SERVE - SANITARY | 2 | 2 | 6/4/2018 | 3/14/2017 |
| LSC | FIRE DRILLS | 2 | 1 | 6/4/2018 | 4/27/2018 |
| LSC | HAZARDOUS AREAS - ENCLOSURE | 2 | 2 | 6/4/2018 | 4/27/2018 |
| Health | INFECTION CONTROL | 2 | 2 | 6/4/2018 | 4/27/2018 |
| Health | INFECTION PREVENTION & CONTROL | 2 | 2 | 6/4/2018 | 4/27/2018 |
| LSC | SPRINKLER SYSTEM - MAINTENANCE AND TESTING | 2 | 2 | 6/4/2018 | 4/27/2018 |
| Health | INVESTIGATE/REPORT ALLEGATIONS/INDIVIDUALS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | ADL CARE PROVIDED FOR DEPENDENT RESIDENTS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | COMPREHENSIVE ASSESS AT LEAST EVERY 12 MONTHS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | DEVELOP COMPREHENSIVE CARE PLANS | 2 | 2 | 6/4/2018 | 4/4/2016 |
| Health | DEVELOP/IMPLMENT ABUSE/NEGLECT, ETC POLICIES | 2 | 2 | 6/4/2018 | 4/4/2016 |
| Health | DIGNITY AND RESPECT OF INDIVIDUALITY | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | FACILITY MANAGEMENT OF PERSONAL FUNDS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | FREE OF MEDICATION ERROR RATES OF 5% OR MORE | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | HOUSEKEEPING & MAINTENANCE SERVICES | 2 | 2 | 6/4/2018 | 4/4/2016 |
| Health | INFECTION CONTROL, PREVENT SPREAD, LINENS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | NOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC) | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | POSTED NURSE STAFFING INFORMATION | 1 | 2 | 6/4/2018 | 4/4/2016 |
| Health | PROVIDE CARE/SERVICES FOR HIGHEST WELL BEING | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | QAA COMMITTEE-MEMBERS/MEET QUARTERLY/PLANS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | QUARTERLY ASSESSMENT AT LEAST EVERY 3 MONTHS | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | RESIDENTS FREE OF SIGNIFICANT MED ERRORS | 2 | 2 | 6/4/2018 | 4/4/2016 |
| Health | RIGHT TO PARTICIPATE PLANNING CARE-REVISE CP | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | SAFE/FUNCTIONAL/SANITARY/COMFORTABLE ENVIRON | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | SERVICES BY QUALIFIED PERSONS/PER CARE PLAN | 2 | 1 | 6/4/2018 | 4/4/2016 |
| Health | TREATMENT/SERVICES TO IMPROVE/MAINTAIN ADLS | 2 | 2 | 6/4/2018 | 4/4/2016 |
| Health | TREATMENT/SVCS TO PREVENT/HEAL PRESSURE SORES | 2 | 1 | 6/4/2018 | 4/4/2016 |
| LSC | LIFE SAFETY CODE STANDARD | 2 | 2 | 6/4/2018 | 4/4/2016 |
| LSC | LIFE SAFETY CODE STANDARD | 2 | 2 | 6/4/2018 | 4/4/2016 |
| LSC | PRIMARY/ALTERNATE MEANS FOR COMMUNICATION | 1 | 3 | 6/4/2018 | 5/11/2018 |
| LSC | SUBDIVISION OF BUILDING SPACES - SMOKE BARRIE | 2 | 2 | 6/4/2018 | 5/11/2018 |
| LSC | SUBSISTENCE NEEDS FOR STAFF AND PATIENTS | 1 | 3 | 6/4/2018 | 5/11/2018 |
| Health | NUTRITION/HYDRATION STATUS MAINTENANCE | 2 | 1 | 6/4/2018 | 5/11/2018 |
| LSC | POLICIES/PROCEDURES-VOLUNTEERS AND STAFFING | 1 | 3 | 6/4/2018 | 5/11/2018 |
| LSC | FUNDAMENTALS - BUILDING SYSTEM CATEGORIES | 2 | 2 | 6/4/2018 | 5/11/2018 |
| LSC | EXIT SIGNAGE | 2 | 2 | 6/4/2018 | 5/11/2018 |
| Health | RESIDENT RIGHTS/EXERCISE OF RIGHTS | 1 | 2 | 6/4/2018 | 5/11/2018 |
| LSC | EP TRAINING PROGRAM | 1 | 3 | 6/4/2018 | 5/11/2018 |
| LSC | ELECTRICAL EQUIPMENT - TESTING AND MAINTENANC | 2 | 2 | 6/4/2018 | 5/11/2018 |
| Health | SERVICES PROVIDED MEET PROFESSIONAL STANDARDS | 2 | 1 | 6/4/2018 | 5/11/2018 |
| Health | REQUIREMENTS FOR DINING AND ACTIVITY ROOMS | 2 | 2 | 6/4/2018 | 5/11/2018 |
| Health | NOT EMPLOY/ENGAGE STAFF W/ ADVERSE ACTIONS | 2 | 1 | 6/4/2018 | 5/11/2018 |
| Health | INVESTIGATE/PREVENT/CORRECT ALLEGED VIOLATION | 2 | 1 | 6/4/2018 | 5/11/2018 |
| Health | FREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE | 2 | 1 | 6/4/2018 | 5/11/2018 |
| Health | BASELINE CARE PLAN | 2 | 1 | 6/4/2018 | 5/11/2018 |
| LSC | BUILDING REHABILITATION | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | CORRIDOR - DOORS | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | ELECTRICAL EQUIPMENT - TESTING AND MAINTENANC | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | ELECTRICAL SYSTEMS - ESSENTIAL ELECTRIC SYSTE | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | EMERGENCY LIGHTING | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | INFECTION PREVENTION & CONTROL | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | GAS EQUIPMENT - PRECAUTIONS FOR HANDLING OXYG | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | HAZARDOUS AREAS - ENCLOSURE | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | PORTABLE FIRE EXTINGUISHERS | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | SPRINKLER SYSTEM - MAINTENANCE AND TESTING | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | STAIRWAYS AND SMOKEPROOF ENCLOSURES | 2 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | SUBDIVISION OF BUILDING SPACES - SMOKE BARRIE | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | DISPOSE GARBAGE AND REFUSE PROPERLY | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | ADL CARE PROVIDED FOR DEPENDENT RESIDENTS | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | BOWEL/BLADDER INCONTINENCE, CATHETER, UTI | 2 | 1 | 6/4/2018 | 6/14/2019 |
| Health | ESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | FOOD PROCUREMENT,STORE/PREPARE/SERVE-SANITARY | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | FREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE | 2 | 1 | 6/4/2018 | 6/14/2019 |
| Health | INCREASE/PREVENT DECREASE IN ROM/MOBILITY | 2 | 1 | 6/4/2018 | 6/14/2019 |
| Health | LABEL/STORE DRUGS AND BIOLOGICALS | 2 | 1 | 6/4/2018 | 6/14/2019 |
| LSC | EXIT SIGNAGE | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | NOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC.) | 2 | 1 | 6/4/2018 | 6/14/2019 |
| Health | NUTRITIVE VALUE/APPEAR, PALATABLE/PREFER TEMP | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | RESPECT, DIGNITY/RIGHT TO HAVE PRSNL PROPERTY | 2 | 1 | 6/4/2018 | 6/14/2019 |
| Health | SAFE/CLEAN/COMFORTABLE/HOMELIKE ENVIRONMENT | 1 | 2 | 6/4/2018 | 6/14/2019 |
| LSC | FIRE ALARM SYSTEM - TESTING AND MAINTENANCE | 2 | 2 | 6/4/2018 | 6/14/2019 |
| Health | NUTRITION/HYDRATION STATUS MAINTENANCE | 2 | 1 | 6/4/2018 | 7/11/2018 |
