Highland Rehabilitation and Nursing Center

Nursing Home & Skilled Nursing · Middletown, NY

CMS overall rating

120 Highland Avenue, Middletown, NY 10940 View map

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Highland Rehabilitation and Nursing Center accepts Medicare, Medicaid, and private pay.

Calculator: See prices in your area

Highland Rehabilitation and Nursing Center accepts Medicare, Medicaid, and private pay.

Overview of Highland Rehabilitation and Nursing Center

Located on Highland Avenue in Middletown, New York, Highland Rehabilitation and Nursing Center is a skilled nursing home operated by HRNC Operating, LLC under owner Alec Shneider. Families can choose from Medicare, Medicaid, and private pay to cover both short-term rehabilitation and longer-term nursing care.

With 14 years in operation, the 98-bed home has an occupancy rate of 88%. Residents stay an average of 94 days, which includes a mix of post-acute rehabilitation patients and those receiving ongoing skilled nursing care.

Rehabilitation is the home’s primary focus, supported by 24-hour nursing care. Daily nurse staffing averages 3 hours and 23 minutes per resident. Registered nurses, nurse aides, and licensed practical nurses support residents through recovery and daily needs. The facility also offers ancillary services on site, reducing the need for outside appointments and helping coordinate resident care.

State inspections by the New York Department of Health have identified issues related to care planning, direct care practices, food safety, and the facility environment. The home has addressed identified deficiencies, demonstrating responsiveness to regulatory oversight.

Residents benefit from a highly walkable location with a Walk Score of 90. Visiting family members can easily reach the facility and nearby services on foot.

For families considering rehabilitation or ongoing skilled nursing care, Highland’s focus on 24-hour staffing and rehabilitation services make it a practical choice for post-acute recovery and longer-term support.

Facility Direct Line (845) 342-1033

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day vs New York averages

Total nursing care This home is ranked 189th out of 395 homes we track in New York for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.

3h 20m

7% below state avg

Staff type

Hours / day / resident

vs state avg

Registered Nurse (RN)

33m

LPN / LVN

50m

Nurse Aide

1h 58m

Weekend Total Nursing

2h 42m

Physical Therapist

Weekend RN

15m

5 of 6 metrics below state avg

Capacity and availability

94 days

98-bed community

A larger shared setting that may offer more common spaces and organized community services.

14 years in operation

A community with a solid operating history and experience delivering ongoing care.

Walk Score: 90 / 100

Walker's paradise. Daily errands do not require a car, with many shops and services nearby.

BBB Rating: A+ (Not Accredited)

An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
How BBB ratings work

About this community

Occupancy

Occupancy rate

88%

Similar to the New York average: 88.3%

Occupied beds

86 / 98

Average occupied beds in New York homes 166 beds

Facility TypeNursing Home

StatusActive

CountyOrange

License Number3501305N

CMS Certification Number335526

Highland Rehabilitation and Nursing Center is legally operated by HRNC Operating, LLC (For Profit).

Owner NameHrnc Operating, LLC (For Profit)

Rehabilitation Services

24-Hour Staffing

Pets not allowed

Operating HoursVisiting hours from 10 AM-8 PM; 24 hours a day access with prior notice for after-hours visits.

Inspection Scorecard This scorecard compares key inspection, citation, and complaint metrics at this facility against the New York state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Overall vs. NY average

Citations Citations are formal regulatory issues recorded during state inspections.	This Facility	NY Average	vs. NY Avg
Total citations Formal regulatory issues recorded by inspectors across all inspection types.	14	21	This facility has 33% fewer total citations than a typical New York nursing home (14 vs. NY avg 21).↓ 33% better
Health citations Citations related to resident care, clinical practices, and day-to-day operations.	10	20	This facility has 50% fewer health citations than a typical New York nursing home (10 vs. NY avg 20).↓ 50% better
Life safety citations Citations related to building safety — fire prevention, emergency egress, and similar.	4	4	This facility has life safety citations in line with the New York average (4 vs. NY avg 4).— At avg
Citations per inspection Average citations per inspection.	2.8	2.3	This facility has 22% more citations per inspection than a typical New York nursing home (2.8 vs. NY avg 2.3).↑ 22% worse

Inspections State inspections evaluate whether the facility meets health and safety standards.	This Facility	NY Average	vs. NY Avg
Total inspections Combined count of all inspections conducted at this facility.	5	9	This facility has had 44% fewer total inspections than the New York average (5 vs. NY avg 9). More inspections can mean more regulatory scrutiny rather than worse care.↓ 44% fewer
Inspections with citations Inspections that resulted in at least one regulatory citation.	3	4	This facility has 25% fewer inspections with citations than a typical New York nursing home (3 vs. NY avg 4).↓ 25% better
Inspection citation rate Percentage of inspections that resulted in at least one citation.	60%	44%	This facility has 16 percentage points higher inspection citation rate than a typical New York nursing home (60% vs. NY avg 44%).↑ 16% worse

Complaints & Investigations Complaints are formal concerns filed by residents, families, or staff. Investigations are on-site follow-ups.	This Facility	NY Average	vs. NY Avg
Total complaints Formal expressions of concern made by residents, families, or staff.	55	79	This facility has 30% fewer total complaints than a typical New York nursing home (55 vs. NY avg 79).↓ 30% better
Complaints per year Average complaints per year since 2020.	9.2	13.2	This facility has 30% fewer complaints per year than a typical New York nursing home (9.2 vs. NY avg 13.2).↓ 30% better
Complaints per bed Size-adjusted complaint rate based on occupied beds.	0.64	0.50	This facility has 28% more complaints per bed than a typical New York nursing home (0.64 vs. NY avg 0.5).↑ 28% worse
Complaint investigations On-site investigations triggered by complaints filed with New York regulators.	9	15	This facility has had 40% fewer complaint investigations than the New York average (9 vs. NY avg 15). More inspections can mean more regulatory scrutiny rather than worse care.↓ 40% fewer

Show Inspection Reports

Inspections Since 2020 · 6 years of data

Total health inspections 3

New York average 3.6

Last Health inspection on Jul 2025

Total health citations

New York average 18.5

Citations per inspection

New York average 5.05

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

28 of 36 citations resulted from standard inspections; 1 of 36 resulted from complaint investigations; and 7 of 36 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 6 years)

Critical health citations

100% better than New York average

New York average: 0.2

Serious health citations

100% better than New York average

New York average: 0.2

0 critical citations New York average: 0.2

0 serious citations New York average: 0.2

35 moderate citations New York average: 17.4

1 minor citation New York average: 0.7

Citations history (last 6 years)

Abuse/Neglect moderate citation Jul 03, 2025

Corrected

Administration moderate citation Jul 03, 2025

Corrected

Infection Control moderate citation Jul 03, 2025

Corrected

Infection Control moderate citation Jul 03, 2025

Corrected

Employee Flu Vaccination Rate: 94%

Percentage of facility employees vaccinated against influenza.

Total Cases 14

Active Cases 4

Closed 9

Since 2018

Most Recent 2025

Next Court Date Jul 09, 2026

View full lawsuit report

Total staff 115

Employees 108

Contractors 7

Staff to resident ratio 1.31 : 1

646% more staff per resident than New York average

Avg staff/day 52

Average shift 7.5 hours

0% compared with New York average

Total staff hours (quarter) 36,107

Nursing staff breakdown

7.8 hours

8.5 hours

7.6 hours

Contractor staffing

873 contractor hours this quarter

Qualified Social Worker: 5 Respiratory Therapy Technician: 2

Staff by category


Certified Nursing Assistant	55	0	55	19,024	92	100%	7.6
Licensed Practical Nurse	19	0	19	6,804	92	100%	8.5
Registered Nurse	15	0	15	4,417	92	100%	7.8
Speech Language Pathologist	5	0	5	1,067	65	71%	6.7
Other Dietary Services Staff	3	0	3	943	69	75%	7.1
Respiratory Therapy Technician	0	2	2	760	65	71%	7.3
Occupational Therapy Aide	2	0	2	562	85	92%	4.1
Mental Health Service Worker	1	0	1	489	62	67%	7.9
Administrator	1	0	1	464	58	63%	8
Dietitian	1	0	1	428	55	60%	7.8
Nurse Practitioner	1	0	1	424	53	58%	8
Physical Therapy Aide	2	0	2	381	50	54%	6.3
Physical Therapy Assistant	3	0	3	232	36	39%	5.4
Qualified Social Worker	0	5	5	114	37	40%	3

55 Certified Nursing Assistant

% of Days 100%

19 Licensed Practical Nurse

% of Days 100%

15 Registered Nurse

% of Days 100%

5 Speech Language Pathologist

% of Days 71%

View All Staffing Data in Orange County

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

High-risk clinical events score 12.6

28% worse than New York average

New York average: 9.8

Functional decline score 17.6

In line with New York average

New York average: 18.1

Long-stay resident measures

Below average New York avg: 4.0

Need for Help with Daily Activities Increased 18.1%

10% worse than New York average

New York average: 16.4%

Walking Ability Worsened 21.8%

31% worse than New York average

New York average: 16.6%

Low Risk Residents with Bowel/Bladder Incontinence 12.8%

40% better than New York average

New York average: 21.4%

Falls with Major Injury 2.0%

34% better than New York average

New York average: 3.0%

High Risk Residents with Pressure Ulcers 6.2%

13% better than New York average

New York average: 7.2%

Urinary Tract Infection 1.4%

In line with New York average

New York average: 1.4%

Lost Too Much Weight 15.0%

146% worse than New York average

New York average: 6.1%

Depressive Symptoms 4.4%

76% better than New York average

New York average: 18.1%

Antipsychotic Use 4.4%

65% better than New York average

New York average: 12.6%

Pneumococcal Vaccine 77.2%

15% worse than New York average

New York average: 91.4%

Influenza Vaccine 94.1%

In line with New York average

New York average: 95.2%

Hospitalizations per 1,000 days 2.41

41% worse than New York average

New York average: 1.71

ED visits per 1,000 days 1.96

45% worse than New York average

New York average: 1.35

Short-stay resident measures

Significantly below average New York avg: 3.5

Pneumococcal Vaccine 17.8%

77% worse than New York average

New York average: 76.6%

Antipsychotic medication increase 1.8%

41% worse than New York average

New York average: 1.3%

Influenza Vaccine 28.9%

63% worse than New York average

New York average: 78.8%

Re-hospitalized after SNF stay 29.1%

41% worse than New York average

New York average: 20.6%

Emergency department visits 16.9%

74% worse than New York average

New York average: 9.7%

Falls with major injury 1.2%

60% worse than New York average

New York average: 0.8%

Ability to care for self at discharge 54.6%

In line with New York average

New York average: 53.7%

Successful return to home or community 40.5%

20% worse than New York average

New York average: 50.6%

Breakdown by payment type

Medicare

51% of new residents, usually for short-term rehab.

Typical stay 1 months

Private pay

27% of new residents, often for short stays.

Typical stay 1 - 2 months

Medicaid

22% of new residents, often for long-term daily care.

Typical stay 10 - 11 months

Total residents 88

Medicare

17% of residents

Medicaid

79.5% of residents

Private pay or other

3.4% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for Highland Rehabilitation and Nursing Center from 2011–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 12/2023.

Occupancy Rate 92.6% ↑ 0.8pp vs 2022

Net Patient Income $2.3M ↑ ~$963.0K vs 2022

Payroll Costs $7.0M ↑ ~$548.8K vs 2022

Operating Margin 15.2% ↑ 6.3pp vs 2022

Metric	2011	2012	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	97.6%	94.7%	90.6%	92.8%	88.1%	90.2%	91.4%	89.1%	93.1%	91.1%	91.8%	92.6%
Beds	98	98	98	98	98	98	98	98	98	98	98	98
Net Income	-$199,749	-$1,473,492	-$169,009	$1,084,066	$115,706	-$42,639	$1,619,812	-$16,890	-$486,202	-$1,282,841	$1,374,327	$2,421,644
Gross Revenue	$12,879,396	$13,536,210	$13,981,136	$15,316,368	$15,436,443	$17,046,552	$16,404,795	$15,793,660	$17,409,103	$19,431,733	$19,656,664	$20,814,948
Operating Expenses	$9,138,306	$10,751,359	$9,381,485	$9,840,685	$10,615,159	$11,791,114	$10,706,572	$12,038,133	$13,636,262	$16,131,836	$13,606,535	$12,773,083
Net Patient Income	-$236,610	-$1,485,855	-$178,682	$1,069,414	$28,782	-$68,926	$1,491,979	-$18,874	-$1,365,515	-$3,315,744	$1,319,569	$2,282,608
Net Patient Revenue	$8,901,696	$9,265,504	$9,202,803	$10,910,099	$10,643,941	$11,722,188	$12,198,551	$12,019,259	$12,270,747	$12,816,092	$14,926,104	$15,055,691
Payroll Costs	$5,680,623	$6,833,381	$5,510,780	$5,602,508	$5,496,438	$5,395,733	$5,540,769	$5,304,547	$5,753,977	$5,402,779	$6,429,399	$6,978,222
Operating Margin %	-2.7%	-16.0%	-1.9%	9.8%	0.3%	-0.6%	12.2%	-0.2%	-11.1%	-25.9%	8.8%	15.2%
Medicare %	14.5%	16.0%	15.5%	18.5%	20.6%	22.5%	20.8%	16.1%	19.0%	19.2%	18.1%	17.1%
Medicaid %	0.0%	72.6%	68.7%	61.1%	50.4%	41.2%	45.5%	43.7%	49.5%	61.9%	67.2%	70.3%
Private %	85.5%	11.5%	15.8%	20.4%	29.0%	36.3%	33.6%	40.2%	31.5%	18.9%	14.7%	12.6%
Net Patient Revenue/Day	$255	$273	$284	$329	$337	$363	$373	$377	$367	$393	$454	$454
Cost/Day	$262	$317	$290	$296	$336	$365	$328	$378	$408	$495	$414	$386
Avg Length of Stay	212.8 days	125.3 days	85.9 days	67.9 days	50.0 days	68.4 days	72.6 days	80.1 days	81.7 days	88.1 days	92.0 days	94.1 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$15.1M

Net patient income

$2.3M

For-profit Operated by a single business entity.

Net patient revenue

$15.1M

Net patient income

$2.3M

Other income

$139.0K

Payroll costs

$7.0M 46.3% of net patient revenue

Other operating costs

$5.8M

Total costs

$12.8M

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (51% of admissions), and a typical Medicare stay runs around 1 months.

Coverage residents most often arrive under.

Medicare 51%

Private pay 27%

Medicaid 22%

Coverage residents most often leave under.

Medicare 37%

Private pay 22%

Medicaid 41%

0.0 miles from city center Estimated distance in miles from Middletown's city center to Highland Rehabilitation and Nursing Center's address, calculated via Google Maps.

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Info below is compiled from CMS reports & the NY State Dept. of Health (NYSDOH), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.


Sapphire Nursing and Rehab at Goshen	★ ★ ★ ★ ★	NH ADC	Goshen	120 Facility 120 NY AVG 160 Rank #405 / 736	91.7% Facility 91.7% NY AVG 90.6% Rank #260 / 392	+1%	3.12 Facility 3.12 NY AVG 3.58 Rank #249 / 395	★ ★ ★ ★ ☆	★ ★ ★ ☆ ☆	★ ★ ★ ★ ★	+3%	-13%	$0 Facility $0 NY AVG $67.6k Rank #1 / 398	17 Facility 17 NY AVG 18.5 Rank #200 / 397	4.3 Facility 4.3 NY AVG 5.1 Rank #149 / 397	-	110	-	80 Facility 80 NY AVG 64 Rank #454 / 1,150	Goshen Operations LLC	$20.0MFiscal year ending 12/2023 Facility $20.0MFiscal year ending 12/2023 NY AVG $29.2M Rank #229 / 383	$10.1MFiscal year ending 12/2023 Facility $10.1MFiscal year ending 12/2023 NY AVG $15.4M Rank #235 / 383	50.6%Fiscal year ending 12/2023 Facility 50.6%Fiscal year ending 12/2023 NY AVG 55.8% Rank #209 / 382	335684
Middletown Park Rehabilitation & Health Care Center	★ ★ ★ ★ ☆	NH MC PC SNF	Middletown	230 Facility 230 NY AVG 160 Rank #133 / 736	97.0% Facility 97.0% NY AVG 90.6% Rank #99 / 392	+7%	3.01 Facility 3.01 NY AVG 3.58 Rank #276 / 395	★ ★ ★ ☆ ☆	★ ★ ☆ ☆ ☆	★ ★ ★ ★ ★	+24%	-16%	$0 Facility $0 NY AVG $67.6k Rank #1 / 398	14 Facility 14 NY AVG 18.5 Rank #146 / 397	3.5 Facility 3.5 NY AVG 5.1 Rank #97 / 397	-	223	A+	90 Facility 90 NY AVG 64 Rank #260 / 1,150	Park Manor Acquisition II, LLC (For Profit)	$35.9MFiscal year ending 12/2023 Facility $35.9MFiscal year ending 12/2023 NY AVG $29.2M Rank #102 / 383	$18.3MFiscal year ending 12/2023 Facility $18.3MFiscal year ending 12/2023 NY AVG $15.4M Rank #94 / 383	50.9%Fiscal year ending 12/2023 Facility 50.9%Fiscal year ending 12/2023 NY AVG 55.8% Rank #201 / 382	335655
Highland Rehabilitation and Nursing Center	★ ☆ ☆ ☆ ☆	NH SNF	Middletown	98 Facility 98 NY AVG 160 Rank #509 / 736	87.8% Facility 87.8% NY AVG 90.6% Rank #319 / 392	-3%	3.34 Facility 3.34 NY AVG 3.58 Rank #189 / 395	★ ☆ ☆ ☆ ☆	★ ★ ☆ ☆ ☆	★ ★ ☆ ☆ ☆	+3%	-7%	$0 Facility $0 NY AVG $67.6k Rank #1 / 398	36 Facility 36 NY AVG 18.5 Rank #362 / 397	12.0 Facility 12.0 NY AVG 5.1 Rank #392 / 397	-	86	A+	90 Facility 90 NY AVG 64 Rank #260 / 1,150	Alec Shneider	$15.1MFiscal year ending 12/2023 Facility $15.1MFiscal year ending 12/2023 NY AVG $29.2M Rank #291 / 383	$7.0MFiscal year ending 12/2023 Facility $7.0MFiscal year ending 12/2023 NY AVG $15.4M Rank #311 / 383	46.3%Fiscal year ending 12/2023 Facility 46.3%Fiscal year ending 12/2023 NY AVG 55.8% Rank #256 / 382	335526

Nursing Home Explorer

Community First Choice Option

NY Medicaid CFCO

Age 65+ or disabled

General New York resident, Medicaid- eligible, care need (not necessarily nursing home level).

Income Limits (2025) ~$2,829/month 300% FBR, individual

Asset Limits $30,182 individual, higher due to NY Medicaid expansion

Higher asset limit; urban density increases demand.

Benefits

Personal care (5-7 hours/day) Respite care (240 hours/year) Home modifications ($1,500 avg.) Assistive technology ($500 avg.)

Expanded In-Home Services for the Elderly Program (EISEP)

NY EISEP

Age 60+

General New York resident, at risk of decline but not nursing home level.

Income Limits ~$2,500/month individual, varies

Asset Limits $15,000 individual

Cost-sharing required above certain income; urban/rural balance.

Benefits

In-home care (3-5 hours/week) Respite (up to 10 days/year) Case management Transportation (~5 trips/month)

Who is the owner of Highland Rehabilitation and Nursing Center?

Highland Rehabilitation and Nursing Center is legally operated by HRNC Operating, LLC (For Profit).

Is Highland Rehabilitation and Nursing Center in a walkable area?

Highland Rehabilitation and Nursing Center has a walk score of 90. Walker's paradise. Daily errands do not require a car, with many shops and services nearby.

What is the license number of Highland Rehabilitation and Nursing Center?

According to NY state health department records, Highland Rehabilitation and Nursing Center's license number is 3501305N.

What is the occupancy rate at Highland Rehabilitation and Nursing Center?

Highland Rehabilitation and Nursing Center's occupancy is 88%.

How long has Highland Rehabilitation and Nursing Center been in business?

Highland Rehabilitation and Nursing Center has been operating for approximately 14 years, based on available licensing and registration records.

Are pets allowed at Highland Rehabilitation and Nursing Center?

No, Highland Rehabilitation and Nursing Center has a no-pet policy.

Does Highland Rehabilitation and Nursing Center operate as a for-profit or non-profit?

Highland Rehabilitation and Nursing Center is registered as a for-profit in NY.

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Highland Rehabilitation and Nursing Center

Overview of Highland Rehabilitation and Nursing Center

Quality ratings

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Therapy & Rehabilitation

Staffing & Medical

Additional Policies & Features

Amenities & Lifestyle

Contact Highland Rehabilitation and Nursing Center

Inspection History

Inspection Scorecard This scorecard compares key inspection, citation, and complaint metrics at this facility against the New York state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Citations Citations are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Complaints & Investigations Complaints are formal concerns filed by residents, families, or staff. Investigations are on-site follow-ups.

CMS Health Inspection History

Inspections Since 2020 · 6 years of data

Breakdown of citation severity (last 6 years)

Citations history (last 6 years)

Infection Prevention & Vaccination

Lawsuit overview for Highland Rehabilitation and Nursing Center

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

55 Certified Nursing Assistant

19 Licensed Practical Nurse

15 Registered Nurse

5 Speech Language Pathologist

3 Other Dietary Services Staff

2 Respiratory Therapy Technician

2 Occupational Therapy Aide

1 Mental Health Service Worker

1 Administrator

1 Dietitian

1 Nurse Practitioner

2 Physical Therapy Aide

3 Physical Therapy Assistant

5 Qualified Social Worker

Penalties and fines

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Nurse Aide Training

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly short-term rehab stays

Admissions

Discharges

Places of interest near Highland Rehabilitation and Nursing Center

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Financial Assistance for Nursing Home in New York

Community First Choice Option

Expanded In-Home Services for the Elderly Program (EISEP)

Guides for Better Senior Living

Financial Assistance for
Nursing Home in New York