Williamsville Suburban LLC

Williamsville Suburban LLC

163 South Union Road

Williamsville, NY 14221

7166326152

http: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: 80%

Occupancy Rate: 70%

Nursing Home CMS Quality (Short Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
430Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine83.92309/1/2020
434Percentage of short-stay residents who newly received an antipsychotic medication0.75809/1/2020
471Percentage of short-stay residents who made improvements in function57.91009/1/2020

Nursing Home CMS Quality (Long Stay)

Measure CodeMeasure DescriptionAverage ScoreFootnoteProcessing Date
401Percentage of long-stay residents whose need for help with daily activities has increased21.731011/1/2019
404Percentage of long-stay residents who lose too much weight5.245011/1/2019
405Percentage of low risk long-stay residents who lose control of their bowels or bladder60.079011/1/2019
406Percentage of long-stay residents with a catheter inserted and left in their bladder2.009011/1/2019
407Percentage of long-stay residents with a urinary tract infection2.156011/1/2019
408Percentage of long-stay residents who have depressive symptoms2.618011/1/2019
409Percentage of long-stay residents who were physically restrained0.000011/1/2019
410Percentage of long-stay residents experiencing one or more falls with major injury1.977011/1/2019
415Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine98.188011/1/2019
419Percentage of long-stay residents who received an antipsychotic medication6.818011/1/2019
451Percentage of long-stay residents whose ability to move independently worsened21.327011/1/2019
452Percentage of long-stay residents who received an antianxiety or hypnotic medication7.538011/1/2019

Complaints

Number of Standard Health Deficiencies:35
Number of Live Safety Code Deficiencies:28
Number of Total Deficiencies:63
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):214
Intakes received per 100 occupied beds (last three years):112.4
Percent of total intakes received that were facility self reported incidents (last three years):40
On-site complaint investigations (last three years):45
Complaint investigations resulting in citations (last three years):4
Complaint investigations resulting in citations per 100 occupied beds (last three years):2.1
Complaint Citations in deficiency category: Administration:1
Complaint Citations in deficiency category: Quality of Care:1
Complaint Citations in deficiency category: Resident Rights:0
Complaint Citations in deficiency category: Dietary Services:0
Complaint Citations in deficiency category: Physical Environment:0
Complaint Citations in deficiency category: Other Services:2
Complaint Citations across all deficiency categories (last three years):8

Enforcements

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

Surveys

Initial Survey DateSurvey TypeTotal Visits Required
1/18/2017CERTIFICATION/COMPLAINT2
3/30/2018CERTIFICATION/COMPLAINT2
4/19/2019CERTIFICATION/COMPLAINT2
6/1/2020COMPLAINT2
6/4/2018COMPLAINT2

Citations

Inspection TypeDeficiencySeverityResidents AffectedDate of Initial SurveyDate Citation Corrected
HealthFREE OF ACCIDENT HAZARDS/SUPERVISION/DEVICES216/1/20203/14/2017
HealthSUFFICIENT 24-HR NURSING STAFF PER CARE PLANS226/1/20203/14/2017
HealthFOOD PROCURE, STORE/PREPARE/SERVE - SANITARY226/1/20203/14/2017
HealthDIGNITY AND RESPECT OF INDIVIDUALITY216/1/20203/14/2017
LSCPORTABLE FIRE EXTINGUISHERS226/1/20203/14/2017
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS216/1/20203/14/2017
HealthPROVIDE CARE/SERVICES FOR HIGHEST WELL BEING216/1/20203/14/2017
HealthRES RECORDS-COMPLETE/ACCURATE/ACCESSIBLE216/1/20203/14/2017
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC)216/1/20203/14/2017
HealthHOUSEKEEPING & MAINTENANCE SERVICES126/1/20203/14/2017
HealthSELF-DETERMINATION - RIGHT TO MAKE CHOICES216/1/20203/14/2017
LSCFIRE DRILLS226/1/20203/14/2017
LSCGAS EQUIPMENT - CYLINDER AND CONTAINER STORAG226/1/20203/14/2017
LSCHAZARDOUS AREAS - ENCLOSURE226/1/20203/14/2017
LSCHAZARDOUS AREAS - ENCLOSURE226/1/20204/27/2018
HealthINFECTION CONTROL226/1/20204/27/2018
HealthINFECTION PREVENTION & CONTROL226/1/20204/27/2018
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING226/1/20204/27/2018
LSCFIRE DRILLS216/1/20204/27/2018
HealthINVESTIGATE/PREVENT/CORRECT ALLEGED VIOLATION216/1/20205/11/2018
HealthNUTRITION/HYDRATION STATUS MAINTENANCE216/1/20205/11/2018
HealthREQUIREMENTS FOR DINING AND ACTIVITY ROOMS226/1/20205/11/2018
HealthRESIDENT RIGHTS/EXERCISE OF RIGHTS126/1/20205/11/2018
HealthSERVICES PROVIDED MEET PROFESSIONAL STANDARDS216/1/20205/11/2018
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC226/1/20205/11/2018
LSCEP TRAINING PROGRAM136/1/20205/11/2018
LSCFUNDAMENTALS - BUILDING SYSTEM CATEGORIES226/1/20205/11/2018
LSCPOLICIES/PROCEDURES-VOLUNTEERS AND STAFFING136/1/20205/11/2018
LSCPRIMARY/ALTERNATE MEANS FOR COMMUNICATION136/1/20205/11/2018
LSCSUBDIVISION OF BUILDING SPACES - SMOKE BARRIE226/1/20205/11/2018
LSCSUBSISTENCE NEEDS FOR STAFF AND PATIENTS136/1/20205/11/2018
LSCEXIT SIGNAGE226/1/20205/11/2018
HealthNOT EMPLOY/ENGAGE STAFF W/ ADVERSE ACTIONS216/1/20205/11/2018
HealthBASELINE CARE PLAN216/1/20205/11/2018
HealthFREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE216/1/20205/11/2018
HealthSAFE/CLEAN/COMFORTABLE/HOMELIKE ENVIRONMENT126/1/20206/14/2019
LSCBUILDING REHABILITATION226/1/20206/14/2019
LSCCORRIDOR - DOORS226/1/20206/14/2019
LSCELECTRICAL EQUIPMENT - TESTING AND MAINTENANC226/1/20206/14/2019
LSCELECTRICAL SYSTEMS - ESSENTIAL ELECTRIC SYSTE226/1/20206/14/2019
LSCEMERGENCY LIGHTING226/1/20206/14/2019
LSCEXIT SIGNAGE226/1/20206/14/2019
LSCFIRE ALARM SYSTEM - TESTING AND MAINTENANCE226/1/20206/14/2019
LSCGAS EQUIPMENT - PRECAUTIONS FOR HANDLING OXYG226/1/20206/14/2019
LSCHAZARDOUS AREAS - ENCLOSURE226/1/20206/14/2019
LSCPORTABLE FIRE EXTINGUISHERS226/1/20206/14/2019
LSCSPRINKLER SYSTEM - MAINTENANCE AND TESTING226/1/20206/14/2019
LSCSTAIRWAYS AND SMOKEPROOF ENCLOSURES226/1/20206/14/2019
HealthINFECTION PREVENTION & CONTROL226/1/20206/14/2019
HealthINCREASE/PREVENT DECREASE IN ROM/MOBILITY216/1/20206/14/2019
HealthFREE FROM UNNEC PSYCHOTROPIC MEDS/PRN USE216/1/20206/14/2019
HealthFOOD PROCUREMENT,STORE/PREPARE/SERVE-SANITARY226/1/20206/14/2019
HealthESSENTIAL EQUIPMENT, SAFE OPERATING CONDITION226/1/20206/14/2019
HealthDISPOSE GARBAGE AND REFUSE PROPERLY226/1/20206/14/2019
HealthBOWEL/BLADDER INCONTINENCE, CATHETER, UTI216/1/20206/14/2019
HealthLABEL/STORE DRUGS AND BIOLOGICALS216/1/20206/14/2019
HealthADL CARE PROVIDED FOR DEPENDENT RESIDENTS226/1/20206/14/2019
HealthNOTIFY OF CHANGES (INJURY/DECLINE/ROOM, ETC.)216/1/20206/14/2019
HealthNUTRITIVE VALUE/APPEAR, PALATABLE/PREFER TEMP226/1/20206/14/2019
HealthRESPECT, DIGNITY/RIGHT TO HAVE PRSNL PROPERTY216/1/20206/14/2019
LSCSUBDIVISION OF BUILDING SPACES - SMOKE BARRIE226/1/20206/14/2019
HealthNUTRITION/HYDRATION STATUS MAINTENANCE216/1/20207/11/2018
HealthLICENSE/COMPLY W/ FED/STATE/LOCL LAW/PROF STD126/1/20207/7/2020