Wayne, NJ

Alps at Wayne Rehab & Care Center

3-star overall rating with 3-star inspections with $14,507 in total fines with 8 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

1120 Alps Road, Wayne, NJ

(973) 694-2100

Compare this facility

Overall

3 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

3 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

209

Certified beds

Average residents

142

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

1994-07-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.54

Registered nurse staffing · state 0.69 · national 0.68

LPN hours / resident day

0.88

Licensed practical nurse staffing · state 0.94 · national 0.87

Aide hours / resident day

2.37

Nurse aide staffing · state 2.23 · national 2.35

Total nurse hours

3.79

All reported nurse hours · state 3.86 · national 3.89

Licensed hours

1.42

RN + LPN hours · state 1.62 · national 1.54

Weekend hours

3.43

Weekend nurse staffing · state 3.45 · national 3.43

Weekend RN hours

0.41

Weekend registered nurse coverage · state 0.49 · national 0.47

Physical therapist

0.05

Reported PT staffing · state 0.11 · national 0.07

Adjusted RN hours

0.58

CMS adjusted RN staffing hours

Adjusted total hours

4.09

CMS adjusted total nurse staffing hours

Case-mix index

1.27

Higher values indicate more complex resident acuity

RN turnover

58%

Annual RN turnover · state 39% · national 45%

Total nurse turnover

41%

Annual nurse turnover · state 41% · national 46%

SNF VBP

Value-based purchasing

Program rank

7,628

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

29.20

Composite VBP score used to determine payment impact.

Payment multiplier

0.9853

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Baseline 17.92% · Performance 21.42% · Measure score 0 · Achievement 0 · Improvement 0

Healthcare-associated infections

3.49

Baseline 9.32% · Performance 7.60% · Measure score 3.49 · Achievement 0.80 · Improvement 3.49

Total nurse turnover

6.81

Baseline 39.39% · Performance 35.85% · Measure score 6.81 · Achievement 6.81 · Improvement 1.94

Adjusted total nurse staffing

1.39

Baseline 3.61 hours · Performance 3.47 hours · Measure score 1.39 · Achievement 1.39 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	10.63%	10.72% 0.1 pts better	No Different than the National Rate · Eligible stays 160 · Observed rate 10% · Lower 95% interval 7.96%
Discharge to community	42.22%	50.57% 8.4 pts worse	Worse than the National Rate · Eligible stays 169 · Observed rate 34.91% · Lower 95% interval 35.24%
Medicare spending per beneficiary	1.34	1.02 0.3 pts worse
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 92 · Denominator 92
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 92
Discharge self-care score	58.62%	53.69% 4.9 pts better	Numerator 34 · Denominator 58
Discharge mobility score	56.9%	50.94% 6 pts better	Numerator 33 · Denominator 58
Pressure ulcers or injuries, new or worsened	2.17%	2.29% 0.1 pts better	Numerator 2 · Denominator 92 · Adjusted rate 1.76%
Healthcare-associated infections requiring hospitalization	7.6%	7.12% 0.5 pts worse	No Different than the National Rate · Eligible stays 83 · Observed rate 9.64% · Lower 95% interval 4.66%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 191
Staff flu vaccination coverage	81.15%	42% 39.2 pts better	Numerator 155 · Denominator 191
Discharge function score	63.79%	56.45% 7.3 pts better	Numerator 37 · Denominator 58
Transfer of health information to provider	100%	95.95% 4 pts better	Numerator 37 · Denominator 37
Transfer of health information to patient	100%	96.28% 3.7 pts better	Numerator 26 · Denominator 26
Resident COVID-19 vaccinations up to date	5.66%	25.2% 19.5 pts worse	Numerator 3 · Denominator 53

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	2.1	2.1 About the same	1.9 0.2 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.1 · Observed 2.0 · Expected 1.8 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	2.3	1.1 1.2 pts worse	1.8 0.5 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.3 · Observed 2.1 · Expected 1.5 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	72.7%	93.0% 20.3 pts worse	93.4% 20.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 65.9% · Q2 77.7% · Q3 70.5% · Q4 77.0% · 4Q avg 72.7%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	66.4%	97.2% 30.8 pts worse	95.5% 29.1 pts worse	Long Stay · 2024Q3-2025Q2 · 4Q avg 66.4%
Percentage of long-stay residents experiencing one or more falls with major injury	0.8%	2.4% 1.6 pts better	3.3% 2.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.8% · Q2 0.0% · Q3 0.8% · Q4 1.6% · 4Q avg 0.8% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	24.5%	11.4% 13.1 pts worse	11.4% 13.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 38.7% · Q2 21.5% · Q3 20.2% · Q4 17.6% · 4Q avg 24.5%
Percentage of long-stay residents who lose too much weight	1.9%	4.6% 2.7 pts better	5.4% 3.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 1.8% · Q3 0.0% · Q4 3.4% · 4Q avg 1.9%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	18.0%	19.0% 1 pts better	19.6% 1.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 17.5% · Q2 18.1% · Q3 18.9% · Q4 17.6% · 4Q avg 18.0%
Percentage of long-stay residents who received an antipsychotic medication	22.4%	13.5% 8.9 pts worse	16.7% 5.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 22.5% · Q2 21.1% · Q3 23.9% · Q4 21.7% · 4Q avg 22.4% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.1% 0.1 pts better	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	18.0%	9.8% 8.2 pts worse	16.3% 1.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 24.4% · Q2 2.5% · Q3 30.0% · Q4 12.1% · 4Q avg 18.0% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	17.9%	9.7% 8.2 pts worse	14.9% 3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 23.9% · Q2 8.6% · Q3 24.1% · Q4 14.7% · 4Q avg 17.9% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	1.3%	0.7% 0.6 pts worse	1.0% 0.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 0.0% · Q3 1.9% · Q4 1.8% · 4Q avg 1.3% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.2%	0.8% 0.6 pts better	1.7% 1.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.8% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.2% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	22.6%	15.9% 6.7 pts worse	19.8% 2.8 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 18.2% · Q2 22.2% · Q3 23.4% · Q4 26.7% · 4Q avg 22.6%
Percentage of long-stay residents with pressure ulcers	7.7%	6.0% 1.7 pts worse	5.1% 2.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 7.9% · Q2 2.9% · Q3 11.2% · Q4 8.5% · 4Q avg 7.7% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	45.5%	78.7% 33.2 pts worse	81.7% 36.2 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 21.5% · Q2 47.1% · Q3 50.0% · Q4 61.9% · 4Q avg 45.5%
Percentage of short-stay residents who had an outpatient emergency department visit	8.3%	8.2% 0.1 pts worse	12.0% 3.7 pts better	Short Stay · 20240701-20250630 · Adjusted 8.3% · Observed 8.3% · Expected 11.2% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	0.6%	1.2% 0.6 pts better	1.6% 1 pts better	Short Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	42.0%	80.1% 38.1 pts worse	79.7% 37.7 pts worse	Short Stay · 2024Q3-2025Q2 · 4Q avg 42.0%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	26.3%	25.4% 0.9 pts worse	23.9% 2.4 pts worse	Short Stay · 20240701-20250630 · Adjusted 26.3% · Observed 31.9% · Expected 29.0% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-02-25 · Fire 2025-02-25

8 health deficiencies

Top issue: Resident Assessment and Care Planning (5 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 2 Health 2022-12-21 · Fire 2022-12-21

7 health deficiencies

Top issue: Nursing and Physician Services (2 deficiencies)

4 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 3 Health 2020-10-14 · Fire 2020-10-14

8 health deficiencies

Top issue: Resident Rights (3 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-02-25

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2025-03-12

F · Potential for more than minimal harm 2025-02-25

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2025-03-17

F · Potential for more than minimal harm 2025-02-25

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2025-03-12

F · Potential for more than minimal harm 2022-12-21

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2023-02-13

F · Potential for more than minimal harm 2022-12-21

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2023-01-30

F · Potential for more than minimal harm 2022-12-21

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-02-23

E · Potential for more than minimal harm 2022-12-21

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2023-01-30

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-02-25

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2025-03-31

D · Potential for more than minimal harm 2025-02-25

F640 · Resident Assessment and Care Planning Deficiencies

Health

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Corrected 2025-03-31

D · Potential for more than minimal harm 2025-02-25

F645 · Resident Assessment and Care Planning Deficiencies

Health

PASARR screening for Mental disorders or Intellectual Disabilities

Corrected 2025-03-12

D · Potential for more than minimal harm 2025-02-25

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-03-31

D · Potential for more than minimal harm 2025-02-25

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2025-03-31

D · Potential for more than minimal harm 2025-02-25

F688 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Corrected 2025-03-31

D · Potential for more than minimal harm 2025-02-25

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-03-31

C · Minimal harm 2025-02-25

F836 · Administration Deficiencies

Health

Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.

Corrected 2025-03-12

E · Potential for more than minimal harm 2024-04-05

F711 · Nursing and Physician Services Deficiencies

Health

Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

Corrected 2024-05-10

J · Immediate jeopardy 2023-07-20

F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Respond appropriately to all alleged violations.

Corrected 2023-08-11

D · Potential for more than minimal harm 2023-07-20

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2023-08-11

E · Potential for more than minimal harm 2022-12-21

F711 · Nursing and Physician Services Deficiencies

Health

Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

Corrected 2023-01-30

D · Potential for more than minimal harm 2022-12-21

F623 · Resident Rights Deficiencies

Health

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Corrected 2023-01-30

D · Potential for more than minimal harm 2022-12-21

F625 · Resident Rights Deficiencies

Health

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Corrected 2023-01-30

D · Potential for more than minimal harm 2022-12-21

F658 · Resident Assessment and Care Planning Deficiencies

Health

Ensure services provided by the nursing facility meet professional standards of quality.

Corrected 2023-01-30

D · Potential for more than minimal harm 2022-12-21

F698 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Corrected 2023-01-30

D · Potential for more than minimal harm 2022-12-21

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2023-01-30