Cycle 1
Health 2025-06-24 · Fire 2025-06-24
7 health deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
1 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Bronx, NY
Bronx Gardens Rehabilitation And Nursing Center
3-star overall rating with 2-star inspections with 7 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
2175 Quarry Rd, Bronx, NY
(718) 960-3910
Overall
3 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
199
Certified beds
Average residents
194
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Citadel Care Centers
Operator or chain grouping
Approved since
1994-05-02
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
5 facilities
Chain averages 3 overall / 3 health / 2 staffing / 4 quality stars
Changed ownership
No
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
1.09
Registered nurse staffing · state 0.70 · national 0.68
LPN hours / resident day
0.33
Licensed practical nurse staffing · state 0.78 · national 0.87
Aide hours / resident day
2.04
Nurse aide staffing · state 2.20 · national 2.35
Total nurse hours
3.46
All reported nurse hours · state 3.65 · national 3.89
Licensed hours
1.42
RN + LPN hours · state 1.47 · national 1.54
Weekend hours
3.17
Weekend nurse staffing · state 3.16 · national 3.43
Weekend RN hours
0.83
Weekend registered nurse coverage · state 0.47 · national 0.47
Physical therapist
0.08
Reported PT staffing · state 0.11 · national 0.07
Adjusted RN hours
0.88
CMS adjusted RN staffing hours
Adjusted total hours
2.78
CMS adjusted total nurse staffing hours
Case-mix index
1.70
Higher values indicate more complex resident acuity
RN turnover
29%
Annual RN turnover · state 41% · national 45%
Total nurse turnover
31%
Annual nurse turnover · state 41% · national 46%
SNF VBP
Value-based purchasing
Program rank
5,727
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
35.20
Composite VBP score used to determine payment impact.
Payment multiplier
0.9889
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.24
Baseline 20.99% · Performance 19.93% · Measure score 3.24 · Achievement 3.24 · Improvement 2.18
Healthcare-associated infections
0.84
Baseline 7.61% · Performance 7.58% · Measure score 0.84 · Achievement 0.84 · Improvement 0
Total nurse turnover
10
Baseline 26.45% · Performance 23.72% · Measure score 10 · Achievement 10 · Improvement 9
Adjusted total nurse staffing
0
Baseline 2.81 hours · Performance 2.68 hours · Measure score 0 · Achievement 0 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 13.05% |
10.72%
2.3 pts worse
|
No Different than the National Rate · Eligible stays 172 · Observed rate 20.35% · Lower 95% interval 10.01% |
| Discharge to community | 32.53% |
50.57%
18 pts worse
|
Worse than the National Rate · Eligible stays 152 · Observed rate 20.39% · Lower 95% interval 23.51% |
| Medicare spending per beneficiary | 1.47 |
1.02
0.4 pts worse
|
|
| Drug regimen review with follow-up | 88.52% |
95.27%
6.8 pts worse
|
Numerator 216 · Denominator 244 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 244 |
| Discharge self-care score | 70.07% |
53.69%
16.4 pts better
|
Numerator 96 · Denominator 137 |
| Discharge mobility score | 62.04% |
50.94%
11.1 pts better
|
Numerator 85 · Denominator 137 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 244 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 7.58% |
7.12%
0.5 pts worse
|
No Different than the National Rate · Eligible stays 97 · Observed rate 10.31% · Lower 95% interval 4.87% |
| Staff COVID-19 vaccination coverage | 2.46% |
8.2%
5.7 pts worse
|
Numerator 8 · Denominator 325 |
| Staff flu vaccination coverage | 30.53% |
42%
11.5 pts worse
|
Numerator 98 · Denominator 321 |
| Discharge function score | 65.69% |
56.45%
9.2 pts better
|
Numerator 90 · Denominator 137 |
| Transfer of health information to provider | 98.86% |
95.95%
2.9 pts better
|
Numerator 87 · Denominator 88 |
| Transfer of health information to patient | 98.31% |
96.28%
2 pts better
|
Numerator 58 · Denominator 59 |
| Resident COVID-19 vaccinations up to date | 15.15% |
25.2%
10 pts worse
|
Numerator 20 · Denominator 132 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.7 |
1.7
1 pts better
|
1.9
1.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.7 · Observed 1.0 · Expected 2.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.6 |
1.3
0.7 pts better
|
1.8
1.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.6 · Observed 0.7 · Expected 1.8 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 57.6% |
91.2%
33.6 pts worse
|
93.4%
35.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 66.9% · Q2 58.7% · Q3 59.2% · Q4 45.4% · 4Q avg 57.6% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 85.6% |
95.3%
9.7 pts worse
|
95.5%
9.9 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 85.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.0% |
3.0%
1 pts better
|
3.3%
1.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 1.8% · Q3 2.4% · Q4 2.5% · 4Q avg 2.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 32.3% |
18.5%
13.8 pts worse
|
11.4%
20.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.5% · Q2 37.9% · Q3 32.7% · Q4 38.3% · 4Q avg 32.3% |
| Percentage of long-stay residents who lose too much weight | 5.3% |
6.1%
0.8 pts better
|
5.4%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.1% · Q2 6.2% · Q3 1.8% · Q4 5.1% · 4Q avg 5.3% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 9.8% |
13.5%
3.7 pts better
|
19.6%
9.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.9% · Q2 9.6% · Q3 9.5% · Q4 12.3% · 4Q avg 9.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 5.8% |
14.8%
9 pts better
|
16.7%
10.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.6% · Q2 4.8% · Q3 4.7% · Q4 5.4% · 4Q avg 5.8% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.2% |
0.2%
About the same
|
0.1%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.6% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.2% |
| Percentage of long-stay residents whose ability to walk independently worsened | 5.4% |
15.1%
9.7 pts better
|
16.3%
10.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 1.9% · Q3 9.9% · Q4 7.4% · 4Q avg 5.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 8.4% |
15.5%
7.1 pts better
|
14.9%
6.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.6% · Q2 5.0% · Q3 8.2% · Q4 12.9% · 4Q avg 8.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.3% |
0.6%
0.3 pts better
|
1.0%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.7% · Q3 0.3% · Q4 0.0% · 4Q avg 0.3% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.5% |
1.4%
0.9 pts better
|
1.7%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.6% · Q3 0.6% · Q4 0.6% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 19.0% |
20.8%
1.8 pts better
|
19.8%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 20.1% · Q2 17.4% · Q3 18.5% · Q4 20.2% · 4Q avg 19.0% |
| Percentage of long-stay residents with pressure ulcers | 9.3% |
6.9%
2.4 pts worse
|
5.1%
4.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.9% · Q2 9.6% · Q3 9.6% · Q4 8.1% · 4Q avg 9.3% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 5.7% |
76.7%
71 pts worse
|
81.7%
76 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 6.8% · Q3 4.5% · Q4 2.4% · 4Q avg 5.7% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 6.9% |
9.7%
2.8 pts better
|
12.0%
5.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 6.9% · Observed 7.5% · Expected 12.1% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.2% |
1.2%
1 pts better
|
1.6%
1.4 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.2% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 44.8% |
78.8%
34 pts worse
|
79.7%
34.9 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 44.8% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 13.2% |
20.6%
7.4 pts better
|
23.9%
10.7 pts better
|
Short Stay · 20240701-20250630 · Adjusted 13.2% · Observed 16.5% · Expected 29.9% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-04-24 · Fire 2023-04-24
5 health deficiencies
Top issue: Pharmacy Service (2 deficiencies)
10 fire-safety deficiencies
Top issue: Smoke (4 deficiencies)
Cycle 3
Health 2020-09-30 · Fire 2020-09-30
1 health deficiencies
Top issue: Resident Assessment and Care Planning (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-06-24
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-07-24
E · Potential for more than minimal harm
2023-04-24
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2023-07-11
E · Potential for more than minimal harm
2023-04-24
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-07-11
D · Potential for more than minimal harm
2023-04-24
K131 · Construction Deficiencies
Fire Safety
Meet requirements for sections of health care facilities separated by fire resistive construction.
Corrected 2023-07-11
D · Potential for more than minimal harm
2023-04-24
K331 · Smoke Deficiencies
Fire Safety
Construct fire resistant interior walls.
Corrected 2023-07-11
D · Potential for more than minimal harm
2023-04-24
K362 · Smoke Deficiencies
Fire Safety
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Corrected 2023-07-11
D · Potential for more than minimal harm
2023-04-24
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2023-07-11
D · Potential for more than minimal harm
2023-04-24
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2023-07-11
C · Minimal harm
2023-04-24
E15 · Emergency Preparedness Deficiencies
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2023-07-11
C · Minimal harm
2023-04-24
E7 · Emergency Preparedness Deficiencies
Fire Safety
Address patient/client population and determine types of services needed.
Corrected 2023-07-11
C · Minimal harm
2023-04-24
K901 · Electrical Deficiencies
Fire Safety
Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel.
Corrected 2023-07-11
Inspection history
Recent health citations
G · Actual harm
2025-12-09
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2026-02-05
E · Potential for more than minimal harm
2025-06-24
F584 · Resident Rights Deficiencies
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2025-08-22
E · Potential for more than minimal harm
2025-06-24
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-08-22
E · Potential for more than minimal harm
2025-06-24
F725 · Nursing and Physician Services Deficiencies
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2025-08-22
D · Potential for more than minimal harm
2025-06-24
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2025-08-22
D · Potential for more than minimal harm
2025-06-24
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 2025-08-22
D · Potential for more than minimal harm
2025-03-17
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 2025-04-30
D · Potential for more than minimal harm
2023-04-24
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 2023-06-23
D · Potential for more than minimal harm
2023-04-24
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 2023-06-23
D · Potential for more than minimal harm
2023-04-24
F759 · Pharmacy Service Deficiencies
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2023-06-23
D · Potential for more than minimal harm
2023-04-24
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2023-06-23
D · Potential for more than minimal harm
2023-04-24
F814 · Nutrition and Dietary Deficiencies
Health
Dispose of garbage and refuse properly.
Corrected 2023-06-23
D · Potential for more than minimal harm
2020-09-30
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2020-10-01
Penalties and ownership
What sits behind the stars
Ownership
Friedman, Leopold
5% Or Greater Direct Ownership Interest · Individual
Farkowitz, Esther
5% Or Greater Direct Ownership Interest · Individual
Philipson, Avi
5% Or Greater Direct Ownership Interest · Individual
Farkowitz, Esther
Corporate Officer · Individual
Friedman, Leopold
Operational/Managerial Control · Individual
Friedman, Leopold
Corporate Officer · Individual
Terrano, Monica
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Casa Promesa
Bronx, NY
2-star overall rating with 1-star inspections with $8,281 in total fines with 9 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
#2
University Center For Rehabilitation And Nursing
Bronx, NY
4-star overall rating with 3-star inspections with 4 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
The Plaza Rehab And Nursing Center
Bronx, NY
5-star overall rating with 4-star inspections with 7 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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