Federal inspection record · CMS data as of October 1, 2026
Highland Rehabilitation And Nursing Center
120 Highland Avenue, Middletown, NY · (845) 342-1033
- Certified beds
- 98
- Residents per day
- 84
- Ownership
- For-Profit
- Chain
- Personal Healthcare Management
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 1, 1976
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in New York.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among New York homes
Highland Rehabilitation And Nursing Center carries 89 inspection points. That is fewer than 17% of New York's 589 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in New York: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–12 pts
- 4★ 12–27 pts
- 3★ 27–46 pts
- 2★ 46–82 pts
- 1★ over 82 pts
Bars show every rated home in New York by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
41 health citations on record since 2020. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Quality of Life and Care11E
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
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.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Resident Rights10E
- D
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- E
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.
- D
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- D
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- B
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.
Resident Assessment and Care Planning6D
- D
Ensure each resident receives an accurate assessment.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Nutrition and Dietary4E
- E
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Infection Control3E
- E
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- D
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Protect each resident from the wrongful use of the resident's belongings or money.
Pharmacy Service2D
- D
Ensure medication error rates are not 5 percent or greater.
- D
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.
Environmental2E
- E
Keep all essential equipment working safely.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Administration1E
- E
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Inspection history
2025-07-03
20 health deficiencies · 9 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2023-08-25
9 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Rights (4 deficiencies)
2020-01-31
12 health deficiencies · 7 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 32 min of nursing staff time a day, 41 min of it from a registered nurse.
This home
3 h 32 min
New York average
3 h 41 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 52% of nursing staff and 63% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.5 pts worse | 2.2 | 1.7 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.1 pts worse | 2.4 | 1.3 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine2.8 pts worse | 89.0% | 91.8% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine6.4 pts worse | 88.8% | 95.2% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.5 pts better | 2.6% | 3.1% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms19.4 pts better | 0.7% | 20.1% | 13.5% |
| Percentage of long-stay residents who lose too much weight15.7 pts worse | 21.4% | 5.7% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.7 pts better | 9.5% | 13.2% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.2 pts better | 5.5% | 13.7% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened6.2 pts worse | 17.3% | 11.1% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.2 pts better | 13.5% | 13.7% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.5 pts better | 0.0% | 0.5% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2.5 pts worse | 3.7% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence13.4 pts better | 5.2% | 18.6% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.2 pts better | 6.3% | 6.5% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine18.4 pts worse | 59.2% | 77.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit9.7 pts worse | 19.1% | 9.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.2 pts worse | 1.3% | 1.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine11.4 pts worse | 67.5% | 78.9% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission7.1 pts worse | 27.7% | 20.6% | 23.4% |
·
Who owns and runs it
10 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Zagelbaum, Ephraim | 5% Or Greater Direct Ownership Interest · Individual | 40% | 15 facilities |
| Barth, Alexander | 5% Or Greater Direct Ownership Interest · Individual | 20% | 21 facilities |
| Walden, Yehudah | 5% Or Greater Direct Ownership Interest · Individual | 20% | 12 facilities |
| Zalgelbaum, Pincus | 5% Or Greater Direct Ownership Interest · Individual | 10% | 1 facilities |
| M&T Bank Corporation | 5% Or Greater Mortgage Interest · Organization | 0% | 20 facilities |
| Ostrovitsky, Israel | Operational/Managerial Control · Individual | 0% | 10 facilities |
| Shneider, Alec | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Walden, Yehudah | Operational/Managerial Control · Individual | 0% | 12 facilities |
| Zagelbaum, Ephraim | W-2 Managing Employee · Individual | 0% | 15 facilities |
| Zagelbaum, Ephraim | Operational/Managerial Control · Individual | 0% | 15 facilities |
·
Fire safety
18 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- F
Inspect, test, and maintain automatic sprinkler systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install corridor and hallway doors that block smoke.
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install an approved automatic sprinkler system.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Gas, Vacuum, and Electrical Systems5E
- D
Ensure proper usage of power strips and extension cords.
- E
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- E
Have a battery powered remote alarm panel in a location accessible by operating personnel.
- D
Ensure proper usage of power strips and extension cords.
- D
Ensure that testing and maintenance of electrical equipment is performed.
Emergency Preparedness2C
- C
Establish procedures for tracking staff and patients during an emergency.
- C
Conduct testing and exercise requirements.
Services1F
- F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Miscellaneous1E
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Construction1D
- D
Use approved construction type or materials.
Egress1D
- D
Have exits that are accessible at all times.
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Other homes nearby
-
Middletown Park Rehab & Health Care Center
Middletown, NY · Epic Healthcare Management
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 28 min
- Fines
- $0
-
Sapphire Nursing And Rehab At Goshen
Goshen, NY · Sapphire Care Group
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 3 h 46 min
- Fines
- $0
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Glen Arden Inc
Goshen, NY
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 35 min
- Fines
- $108,046