Inspection Reports for Family Of Caring Healthcare At Tenafly, Llc
133 County Road, NJ, 07670
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Notice
Deficiencies: 0
Nov 19, 2025
Visit Reason
This document serves to inform individuals about the privacy practices of NJDHSS, including how their medical information may be used and disclosed, and their rights related to this information.
Findings
The notice details the types of information covered, reasons for use and disclosure of health information, individuals' rights to access and control their information, and the legal duties of NJDHSS to protect privacy.
Report Facts
Effective date: 2011
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Devon L. Graf | Director, Office of Legal and Regulatory Compliance | Listed as NJDHSS Privacy Officer contact for questions about the notice |
Inspection Report
Annual Inspection
Census: 55
Capacity: 69
Deficiencies: 7
Nov 22, 2023
Visit Reason
A Recertification Survey was conducted to determine compliance with 42 CFR Part 483, Requirements for Long-Term Care Facilities. Complaint investigations were also completed during this survey.
Findings
The facility was found to be in substantial compliance with emergency preparedness but had deficiencies related to bowel/bladder incontinence care, pharmacy services, medication administration errors, life safety code violations including egress doors and electrical systems, and immunization documentation. Plans of correction were submitted and approved for all cited deficiencies.
Complaint Details
Complaint # NJ00168846 was investigated during the survey. The complaint involved infection control and medication administration issues, which were substantiated as deficiencies.
Severity Breakdown
Level 1: 7
Deficiencies (7)
| Description | Severity |
|---|---|
| Facility failed to provide appropriate care to prevent spread of infection related to bowel/bladder incontinence and catheter care. | Level 1 |
| Facility failed to provide pharmaceutical services in accordance with professional standards including accurate medication administration and documentation. | Level 1 |
| Medication error rate exceeded 5%, with errors in administration and documentation. | Level 1 |
| Facility failed to ensure exit doors were readily accessible and free of obstructions or impediments to full instant use in case of emergency. | Level 1 |
| Facility failed to ensure corridor doors resist passage of smoke in accordance with NFPA requirements. | Level 1 |
| Facility failed to certify emergency electrical generator transfer times within required 10-second timeframe. | Level 1 |
| Facility failed to offer pneumococcal and influenza immunizations to residents as required. | Level 1 |
Report Facts
Census: 55
Total Capacity: 69
Medication Error Rate: 7.1
Medication Opportunities: 28
Medication Errors: 2
Deficiencies Cited: 7
Licensed Beds: 69
Residents with CNA staffing deficiency: 3
Certified Nurse Aides Required: 8
Certified Nurse Aides Present: 7
Certified Nurse Aides Present: 6
Certified Nurse Aides Present: 6
Inspection Report
Routine
Census: 67
Deficiencies: 0
Feb 2, 2023
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the New Jersey Department of Health to assess compliance with infection control regulations.
Findings
The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and has implemented CMS and CDC recommended practices to prepare for COVID-19.
Report Facts
Sample Size: 6
Inspection Report
Complaint Investigation
Census: 52
Deficiencies: 0
Jun 29, 2022
Visit Reason
The inspection was conducted in response to complaint #NJ 151660 to assess compliance with regulatory requirements for long term care facilities.
Findings
The facility was found to be in compliance with the requirements of 42 CFR Part 483, Subpart B, based on this complaint visit.
Complaint Details
Complaint # NJ 151660 was investigated and found to be unsubstantiated as the facility was in compliance.
Report Facts
Sample size: 3
Inspection Report
Follow-Up
Census: 53
Deficiencies: 1
Aug 13, 2021
Visit Reason
The visit was conducted to assess compliance with New Jersey Administrative Code standards for licensure of long term care facilities and to follow up on previously cited deficiencies related to staffing ratios.
Findings
The facility was found not in compliance with mandatory staffing ratios, failing to maintain the required minimum direct care staff-to-resident ratios for the day shift on 7 of 42 shifts reviewed. The facility submitted a plan of correction and subsequently corrected the deficiency as verified by the revisit on 10/13/2021. Additionally, a Life Safety Code survey found the facility in compliance with fire safety requirements.
Deficiencies (1)
| Description |
|---|
| Failed to maintain the required minimum direct care staff-to-resident ratios for the day shift as mandated by the state of New Jersey. |
Report Facts
Census: 53
Deficiency shifts: 7
Staffing ratios: 8.17
Staffing ratios: 12
Staffing ratios: 9.8
Staffing ratios: 10.2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Human Resources / Staffing Coordinator | Interviewed regarding staffing ratio issues and recruitment challenges | |
| Administrator and Director of Nursing | Responsible for reviewing staffing schedules and implementing corrective actions |
Inspection Report
Complaint Investigation
Census: 49
Deficiencies: 0
Jul 4, 2021
Visit Reason
The inspection was conducted as a complaint survey based on complaints NJ144839 and NJ143661.
Findings
The facility was found to be in compliance with the requirements of 42 CFR Part 483, Subpart B for Long Term Care Facilities based on this complaint survey.
Complaint Details
Complaint numbers NJ144839 and NJ143661 were investigated and found to be unsubstantiated as the facility was in compliance.
Report Facts
Sample Size: 9
Loading inspection reports...
