Cycle 1
Health 2025-09-12 · Fire 2025-09-12
1 health deficiencies
Top issue: Quality of Life and Care (1 deficiency)
3 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Jamesville, NY
Nottingham R H C F
5-star overall rating with 5-star inspections with 1 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
1305 Nottingham Road, Jamesville, NY
(315) 445-0123
Overall
5 / 5
CMS overall stars
Health inspections
5 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
40
Certified beds
Average residents
38
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1996-10-29
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
0.74
Registered nurse staffing · state 0.70 · national 0.68
LPN hours / resident day
0.72
Licensed practical nurse staffing · state 0.78 · national 0.87
Aide hours / resident day
2.29
Nurse aide staffing · state 2.20 · national 2.35
Total nurse hours
3.75
All reported nurse hours · state 3.65 · national 3.89
Licensed hours
1.46
RN + LPN hours · state 1.47 · national 1.54
Weekend hours
3.43
Weekend nurse staffing · state 3.16 · national 3.43
Weekend RN hours
0.64
Weekend registered nurse coverage · state 0.47 · national 0.47
Physical therapist
0.05
Reported PT staffing · state 0.11 · national 0.07
Adjusted RN hours
0.76
CMS adjusted RN staffing hours
Adjusted total hours
3.83
CMS adjusted total nurse staffing hours
Case-mix index
1.34
Higher values indicate more complex resident acuity
RN turnover
29%
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
2,744
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
48.01
Composite VBP score used to determine payment impact.
Payment multiplier
1.0017
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
6.57
Performance 18.39% · Measure score 6.57 · Achievement 6.57 · This facility did not have sufficient data to calculate a baseline period measure result.
Healthcare-associated infections
1.36
Performance 7.43% · Measure score 1.36 · Achievement 1.36 · This facility did not have sufficient data to calculate a baseline period measure result.
Total nurse turnover
7.25
Baseline 62.79% · Performance 34.04% · Measure score 7.25 · Achievement 7.25 · Improvement 7.08
Adjusted total nurse staffing
4.03
Baseline 3.84 hours · Performance 4.22 hours · Measure score 4.03 · Achievement 4.03 · Improvement 1.47
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.82% |
10.72%
0.9 pts better
|
No Different than the National Rate · Eligible stays 48 · Observed rate 4.17% · Lower 95% interval 6.01% |
| Discharge to community | 41.69% |
50.57%
8.9 pts worse
|
No Different than the National Rate · Eligible stays 56 · Observed rate 33.93% · Lower 95% interval 31.51% |
| Medicare spending per beneficiary | 0.9 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 31 · Denominator 31 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 31 |
| Discharge self-care score | 53.33% |
53.69%
0.4 pts worse
|
Numerator 16 · Denominator 30 |
| Discharge mobility score | 70% |
50.94%
19.1 pts better
|
Numerator 21 · Denominator 30 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 31 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 7.43% |
7.12%
0.3 pts worse
|
No Different than the National Rate · Eligible stays 39 · Observed rate 7.69% · Lower 95% interval 4.14% |
| Staff COVID-19 vaccination coverage | 34.62% |
8.2%
26.4 pts better
|
Numerator 27 · Denominator 78 |
| Staff flu vaccination coverage | 56.25% |
42%
14.2 pts better
|
Numerator 45 · Denominator 80 |
| Discharge function score | 56.67% |
56.45%
0.2 pts better
|
Numerator 17 · Denominator 30 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 1 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.5 |
1.7
1.2 pts better
|
1.9
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.5 · Observed 0.5 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.5 |
1.3
0.8 pts better
|
1.8
1.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.5 · Observed 0.5 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 84.2% |
91.2%
7 pts worse
|
93.4%
9.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 94.7% · Q2 82.4% · Q3 84.4% · Q4 74.3% · 4Q avg 84.2% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 95.0% |
95.3%
0.3 pts worse
|
95.5%
0.5 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 95.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 0.0% |
3.0%
3 pts better
|
3.3%
3.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 18.5% |
18.5%
About the same
|
11.4%
7.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.7% · Q2 21.2% · Q3 16.1% · Q4 10.7% · 4Q avg 18.5% |
| Percentage of long-stay residents who lose too much weight | 6.2% |
6.1%
0.1 pts worse
|
5.4%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.4% · Q2 6.2% · Q3 3.7% · Q4 2.9% · 4Q avg 6.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 8.5% |
13.5%
5 pts better
|
19.6%
11.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.1% · Q2 3.1% · Q3 7.1% · Q4 11.8% · 4Q avg 8.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 20.7% |
14.8%
5.9 pts worse
|
16.7%
4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.2% · Q2 22.7% · Q4 20.8% · 4Q avg 20.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 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 | 18.9% |
15.1%
3.8 pts worse
|
16.3%
2.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 18.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 17.2% |
15.5%
1.7 pts worse
|
14.9%
2.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.5% · Q2 20.7% · Q3 24.0% · Q4 13.3% · 4Q avg 17.2% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
0.6%
0.6 pts better
|
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% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.7% |
1.4%
0.7 pts better
|
1.7%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.7% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 38.6% |
20.8%
17.8 pts worse
|
19.8%
18.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 42.1% · Q2 35.0% · Q3 41.6% · Q4 35.6% · 4Q avg 38.6% |
| 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 2.7% · Q3 5.3% · Q4 6.0% · 4Q avg 4.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 53.1% |
76.7%
23.6 pts worse
|
81.7%
28.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q2 65.2% · Q3 60.0% · Q4 37.5% · 4Q avg 53.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 11.5% |
9.7%
1.8 pts worse
|
12.0%
0.5 pts better
|
Short Stay · 20240701-20250630 · Adjusted 11.5% · Observed 9.5% · Expected 9.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.2%
1.2 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 87.5% |
78.8%
8.7 pts better
|
79.7%
7.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 87.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 0.0% |
20.6%
20.6 pts better
|
23.9%
23.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 0.0% · Observed 0.0% · Expected 18.7% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-03-07 · Fire 2024-03-07
4 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
6 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Cycle 3
Health 2021-12-03 · Fire 2021-12-03
3 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Fire safety
Fire-safety citations
E · Potential for more than minimal harm
2025-09-12
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-11-01
E · Potential for more than minimal harm
2025-09-12
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-11-01
D · Potential for more than minimal harm
2025-09-12
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-11-01
F · Potential for more than minimal harm
2024-03-07
K133 · Construction Deficiencies
Fire Safety
Install a two-hour-resistant firewall separation.
Corrected 2024-05-03
F · Potential for more than minimal harm
2024-03-07
K916 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have a battery powered remote alarm panel in a location accessible by operating personnel.
Corrected 2024-05-03
F · Potential for more than minimal harm
2024-03-07
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-05-03
E · Potential for more than minimal harm
2024-03-07
K311 · Smoke Deficiencies
Fire Safety
Have an enclosure around a vertical opening shaft.
Corrected 2024-05-03
E · Potential for more than minimal harm
2024-03-07
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2024-05-03
D · Potential for more than minimal harm
2024-03-07
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 2024-05-03
D · Potential for more than minimal harm
2021-12-03
K341 · Smoke Deficiencies
Fire Safety
Install a fire alarm system that can be heard throughout the facility.
Corrected 2022-01-31
D · Potential for more than minimal harm
2021-12-03
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2022-01-31
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-09-12
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-11-15
D · Potential for more than minimal harm
2024-03-07
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 2024-04-15
D · Potential for more than minimal harm
2024-03-07
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 2024-04-15
D · Potential for more than minimal harm
2024-03-07
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-04-15
D · Potential for more than minimal harm
2024-03-07
F882 · Infection Control Deficiencies
Health
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Corrected 2024-04-05
D · Potential for more than minimal harm
2021-12-03
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 2022-01-25
D · Potential for more than minimal harm
2021-12-03
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 2022-01-25
D · Potential for more than minimal harm
2021-12-03
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 2022-01-25
Penalties and ownership
What sits behind the stars
Ownership
Loretto Management Corp
5% Or Greater Direct Ownership Interest · Organization
Brennan, John
Corporate Director · Individual
Bryans, Kevin
Corporate Director · Individual
Murray, John
Corporate Director · Individual
Stanford, Christine
W-2 Managing Employee · Individual
Townsend, Kimberly
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Iroquois Nursing Home Inc
Jamesville, NY
5-star overall rating with 4-star inspections with $3,174 in total fines with 7 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
#2
Jewish Home Of Central New York
Syracuse, NY
1-star overall rating with 1-star inspections with $121,573 in total fines with 18 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
Loretto Health And Rehabilitation Center
Syracuse, NY
2-star overall rating with 1-star inspections with 13 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
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