Cycle 1
Health 2025-02-28 · Fire 2025-02-28
7 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
1 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Medford, NY
Medford Multicare Center For Living
1-star overall rating with 1-star inspections with $134,713 in total fines with 7 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
3115 Horseblock Road, Medford, NY
(631) 730-3000
Overall
1 / 5
CMS overall stars
Health inspections
1 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
320
Certified beds
Average residents
280
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
2002-10-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
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
0.47
Registered nurse staffing · state 0.70 · national 0.68
LPN hours / resident day
1.10
Licensed practical nurse staffing · state 0.78 · national 0.87
Aide hours / resident day
2.32
Nurse aide staffing · state 2.20 · national 2.35
Total nurse hours
3.89
All reported nurse hours · state 3.65 · national 3.89
Licensed hours
1.57
RN + LPN hours · state 1.47 · national 1.54
Weekend hours
3.39
Weekend nurse staffing · state 3.16 · national 3.43
Weekend RN hours
0.22
Weekend registered nurse coverage · state 0.47 · national 0.47
Physical therapist
0.04
Reported PT staffing · state 0.11 · national 0.07
Adjusted RN hours
0.32
CMS adjusted RN staffing hours
Adjusted total hours
2.64
CMS adjusted total nurse staffing hours
Case-mix index
2.01
Higher values indicate more complex resident acuity
RN turnover
55%
Annual RN turnover · state 41% · national 45%
Total nurse turnover
38%
Annual nurse turnover · state 41% · national 46%
SNF VBP
Value-based purchasing
Program rank
8,878
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
25.39
Composite VBP score used to determine payment impact.
Payment multiplier
0.9838
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
1.04
Baseline 20.11% · Performance 20.95% · Measure score 1.04 · Achievement 1.04 · Improvement 0
Healthcare-associated infections
1.80
Baseline 10.84% · Performance 9.50% · Measure score 1.80 · Achievement 0 · Improvement 1.80
Total nurse turnover
6.89
Baseline 36.47% · Performance 35.51% · Measure score 6.89 · Achievement 6.89 · Improvement 0.33
Adjusted total nurse staffing
0.43
Baseline 2.67 hours · Performance 2.96 hours · Measure score 0.43 · Achievement 0 · Improvement 0.43
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.27% |
10.72%
0.5 pts better
|
No Different than the National Rate · Eligible stays 181 · Observed rate 13.81% · Lower 95% interval 7.79% |
| Discharge to community | 36.19% |
50.57%
14.4 pts worse
|
Worse than the National Rate · Eligible stays 187 · Observed rate 22.99% · Lower 95% interval 28.74% |
| Medicare spending per beneficiary | 1.46 |
1.02
0.4 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 278 · Denominator 278 |
| Falls with major injury | 1.08% |
0.77%
0.3 pts worse
|
Numerator 3 · Denominator 278 |
| Discharge self-care score | 46.85% |
53.69%
6.8 pts worse
|
Numerator 67 · Denominator 143 |
| Discharge mobility score | 39.86% |
50.94%
11.1 pts worse
|
Numerator 57 · Denominator 143 |
| Pressure ulcers or injuries, new or worsened | 4.32% |
2.29%
2 pts worse
|
Numerator 12 · Denominator 278 · Adjusted rate 2.93% |
| Healthcare-associated infections requiring hospitalization | 9.5% |
7.12%
2.4 pts worse
|
No Different than the National Rate · Eligible stays 161 · Observed rate 16.15% · Lower 95% interval 6.67% |
| Staff COVID-19 vaccination coverage | 100% |
8.2%
91.8 pts better
|
Numerator 466 · Denominator 466 |
| Staff flu vaccination coverage | 77.9% |
42%
35.9 pts better
|
Numerator 363 · Denominator 466 |
| Discharge function score | 46.85% |
56.45%
9.6 pts worse
|
Numerator 67 · Denominator 143 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 118 · Denominator 118 |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 66 · Denominator 66 |
| Resident COVID-19 vaccinations up to date | 7.19% |
25.2%
18 pts worse
|
Numerator 12 · Denominator 167 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.4 |
1.7
0.7 pts worse
|
1.9
0.5 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.4 · Observed 3.0 · Expected 2.4 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.5 |
1.3
0.2 pts worse
|
1.8
0.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.5 · Observed 1.6 · Expected 1.9 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 94.4% |
91.2%
3.2 pts better
|
93.4%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 97.9% · Q2 94.9% · Q3 93.2% · Q4 91.4% · 4Q avg 94.4% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 78.2% |
95.3%
17.1 pts worse
|
95.5%
17.3 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 78.2% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.5% |
3.0%
0.5 pts better
|
3.3%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.9% · Q2 1.7% · Q3 2.1% · Q4 3.4% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 74.4% |
18.5%
55.9 pts worse
|
11.4%
63 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 76.1% · Q2 64.7% · Q3 65.3% · Q4 91.3% · 4Q avg 74.4% |
| Percentage of long-stay residents who lose too much weight | 6.0% |
6.1%
0.1 pts better
|
5.4%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.6% · Q2 5.1% · Q3 7.7% · Q4 5.4% · 4Q avg 6.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 26.3% |
13.5%
12.8 pts worse
|
19.6%
6.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 26.1% · Q2 26.0% · Q3 26.6% · Q4 26.4% · 4Q avg 26.3% |
| Percentage of long-stay residents who received an antipsychotic medication | 12.5% |
14.8%
2.3 pts better
|
16.7%
4.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 13.1% · Q2 13.2% · Q3 10.3% · Q4 13.3% · 4Q avg 12.5% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.6% |
0.2%
0.4 pts worse
|
0.1%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.4% · Q2 1.3% · Q3 0.9% · Q4 0.0% · 4Q avg 0.6% |
| Percentage of long-stay residents whose ability to walk independently worsened | 9.0% |
15.1%
6.1 pts better
|
16.3%
7.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 13.2% · Q2 14.7% · Q3 4.1% · Q4 5.9% · 4Q avg 9.0% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 10.5% |
15.5%
5 pts better
|
14.9%
4.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 10.7% · Q2 12.3% · Q3 7.8% · Q4 11.3% · 4Q avg 10.5% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.2% |
0.6%
0.4 pts better
|
1.0%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.8% · Q4 0.0% · 4Q avg 0.2% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.1% |
1.4%
1.3 pts better
|
1.7%
1.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.4% · 4Q avg 0.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 10.3% |
20.8%
10.5 pts better
|
19.8%
9.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.1% · Q2 10.8% · Q3 11.5% · Q4 11.4% · 4Q avg 10.3% |
| Percentage of long-stay residents with pressure ulcers | 4.8% |
6.9%
2.1 pts better
|
5.1%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.2% · Q2 5.4% · Q3 4.4% · Q4 4.4% · 4Q avg 4.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 80.0% |
76.7%
3.3 pts better
|
81.7%
1.7 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 83.9% · Q2 83.5% · Q3 80.9% · Q4 72.4% · 4Q avg 80.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 9.3% |
9.7%
0.4 pts better
|
12.0%
2.7 pts better
|
Short Stay · 20240701-20250630 · Adjusted 9.3% · Observed 11.2% · Expected 13.5% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.2% |
1.2%
About the same
|
1.6%
0.4 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 1.5% · Q3 0.8% · Q4 0.8% · 4Q avg 1.2% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 74.9% |
78.8%
3.9 pts worse
|
79.7%
4.8 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 74.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 20.9% |
20.6%
0.3 pts worse
|
23.9%
3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 20.9% · Observed 30.0% · Expected 34.2% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-04-26 · Fire 2024-04-26
11 health deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2022-06-08 · Fire 2022-06-08
13 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
2 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Fire safety
Fire-safety citations
E · Potential for more than minimal harm
2025-02-28
E15 · Emergency Preparedness Deficiencies
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2025-04-09
D · Potential for more than minimal harm
2022-06-08
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2022-07-29
D · Potential for more than minimal harm
2022-06-08
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2022-07-29
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-06-02
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2025-07-03
D · Potential for more than minimal harm
2025-05-01
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2005-04-18
D · Potential for more than minimal harm
2025-02-28
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2025-04-09
D · Potential for more than minimal harm
2025-02-28
F694 · Quality of Life and Care Deficiencies
Health
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Corrected 2025-04-09
D · Potential for more than minimal harm
2025-02-28
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2025-04-09
D · Potential for more than minimal harm
2025-02-28
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 2025-04-09
D · Potential for more than minimal harm
2025-02-28
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-04-09
J · Immediate jeopardy
2024-04-26
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 2024-06-07
J · Immediate jeopardy
2024-04-26
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2024-06-07
E · Potential for more than minimal harm
2024-04-26
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
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 2024-06-14
D · Potential for more than minimal harm
2024-04-26
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 2024-07-17
D · Potential for more than minimal harm
2024-04-26
F693 · Quality of Life and Care Deficiencies
Health
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
F698 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
F760 · Pharmacy Service Deficiencies
Health
Ensure that residents are free from significant medication errors.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-04-26
F914 · Environmental Deficiencies
Health
Provide bedrooms that don't allow residents to see each other when privacy is needed.
Corrected 2024-06-07
E · Potential for more than minimal harm
2022-06-08
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 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F559 · Resident Rights Deficiencies
Health
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
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 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F685 · Quality of Life and Care Deficiencies
Health
Assist a resident in gaining access to vision and hearing services.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F698 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F712 · Nursing and Physician Services Deficiencies
Health
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F791 · Quality of Life and Care Deficiencies
Health
Provide or obtain dental services for each resident.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F838 · Administration Deficiencies
Health
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.
Corrected 2022-08-05
D · Potential for more than minimal harm
2022-06-08
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2022-07-31
D · Potential for more than minimal harm
2022-06-08
F888 · Infection Control Deficiencies
Health
Ensure staff are vaccinated for COVID-19
Corrected 2022-08-05
Penalties and ownership
What sits behind the stars
$134,713
2024-04-26
Fine
Fine · fine $134,713
Fine
Ownership
Klein, Mordechai
5% Or Greater Direct Ownership Interest · Individual
Braska, Lauren
Operational/Managerial Control · Individual
Kumar, Neeru
Operational/Managerial Control · Individual
Loeb, Martin
General Partnership Interest · Individual
Rausman, Norman
Corporate Director · Individual
Rausman, Norman
Corporate Officer · Individual
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#3
Swan Lake Nursing & Rehabilitation
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