Inspection Reports for
Riverside Center for Rehabilitation and Nursing
90 No Main Street, Castleton-on-hudson, NY, 12033
Back to Facility ProfileCitations (last 4 years)
Citations (over 4 years)
9 citations/year
Citations are regulatory findings recorded during state inspections.
76% worse than New York average
New York average: 5.1 citations/yearCitations per year
16
12
8
4
0
Inspection Report
Annual Inspection
Citations: 6
Date: Jul 12, 2023
Visit Reason
The inspection was conducted as a recertification survey to assess compliance with regulatory requirements for nursing home operations, including resident dignity, environment, infection control, food safety, and pest control.
Findings
The facility was found deficient in maintaining resident dignity during mealtime and care procedures, ensuring privacy, providing a safe and clean environment, maintaining food service safety, designating an infection preventionist, ensuring adequate bedroom privacy, and maintaining an effective pest control program.
Citations (6)
F 0550: The facility did not ensure residents were treated with dignity during mealtime, using terms like 'feeders' and 'bib' without consent, and failed to maintain privacy during blood glucose monitoring on 07/11/23.
F 0584: The facility did not provide effective housekeeping services; floors, walls, ceilings, and privacy curtains were soiled or damaged in multiple areas across resident units and core areas.
F 0812: The facility did not store, prepare, distribute, and serve food in accordance with professional standards; the dishwashing machine was not functioning and sanitizer was unavailable.
F 0882: The facility did not designate a qualified infection preventionist from April 28 to July 7, 2023, resulting in unclear responsibility for infection control.
F 0914: Bedrooms did not provide full visual privacy; privacy curtains were too short, allowing visibility of residents and urinary catheter bags.
F 0925: The facility did not maintain a pest-free environment; small black flies were observed in multiple areas including resident units and administrative offices.
Report Facts
Residents affected: 2
Residents affected: 7
Residents affected: 10
Residents affected: 2
Privacy curtain stain size: 8
Privacy curtain open space: 22
Privacy curtain open space: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #3 | Licensed Practical Nurse | Referred to residents needing feeding assistance as 'feeders' and performed blood glucose monitoring in a group setting |
| Director of Nursing | Director of Nursing (DON) | Acknowledged dignity issues with staff language and privacy breaches; involved in infection preventionist role |
| Resident Assistant #1 | Resident Assistant | Stated importance of using resident names and not terms like 'feeders' or 'bib' |
| CNA #5 | Certified Nurse Aide | Stated staff should call residents by name and not use terms like 'feeders' or 'bib' |
| LPN #4 | Licensed Practical Nurse | Stated residents should be called by name and not 'feeders' |
| Registered Nurse Unit Manager #1 | RNUM | Stated residents needing feeding assistance should not be called 'feeders'; was unaware initially of infection preventionist role |
| LPNUM | Licensed Practical Nurse Unit Manager | Stated residents should be asked before placing clothing protectors and not use term 'bib' |
| RN #3 | Registered Nurse | Placed clothing protectors on residents without asking |
| CNA #3 | Certified Nurse Aide | Placed clothing protector on resident while stating 'I'm going to put your bib on!' |
| Food Service Director | Food Service Director | Reported dishwashing machine malfunction and lack of sanitizer |
| Maintenance Director | Maintenance Director | Reported no prior pest control complaints and acknowledged privacy curtain issues |
| Assistant Administrator | Assistant Administrator | Acknowledged housekeeping and pest control issues; stated new curtains ordered |
Inspection Report
Complaint Investigation
Capacity: 60
Citations: 8
Date: Jul 12, 2023
Visit Reason
Complaint Survey with 6 health and 2 life safety citations including deficiencies in privacy, food sanitation, infection preventionist role, pest control, resident rights, environment, and gas equipment handling.
Findings
Complaint Survey with 6 health and 2 life safety citations including deficiencies in privacy, food sanitation, infection preventionist role, pest control, resident rights, environment, and gas equipment handling.
Citations (8)
Bedrooms assure full visual privacy
Food procurement,store/prepare/serve-sanitary
Infection preventionist qualifications/role
Maintains effective pest control program
Resident rights/exercise of rights
Safe/clean/comfortable/homelike environment
Gas equipment - precautions for handling oxyg
Subdivision of building spaces - smoke barrie
Inspection Report
Complaint Investigation
Capacity: 60
Citations: 1
Date: Feb 28, 2023
Visit Reason
Complaint Survey with one Level 2 health citation for accident hazards and supervision.
Findings
Complaint Survey with one Level 2 health citation for accident hazards and supervision.
Citations (1)
Free of accident hazards/supervision/devices
Inspection Report
Complaint Investigation
Capacity: 60
Citations: 2
Date: Dec 9, 2022
Visit Reason
Complaint Survey with Level 3 citation for abuse and neglect and Level 2 citation for reporting alleged violations.
Findings
Complaint Survey with Level 3 citation for abuse and neglect and Level 2 citation for reporting alleged violations.
Citations (2)
Free from abuse and neglect
Reporting of alleged violations
Inspection Report
Capacity: 60
Citations: 2
Date: Apr 19, 2022
Visit Reason
Covid-19 Survey with Level 1 citation for staff vaccination and Level 3 citation for accident hazards and supervision.
Findings
Covid-19 Survey with Level 1 citation for staff vaccination and Level 3 citation for accident hazards and supervision.
Citations (2)
Covid-19 vaccination of facility staff
Free of accident hazards/supervision/devices
Inspection Report
Annual Inspection
Citations: 3
Date: Jun 11, 2021
Visit Reason
The inspection was a recertification survey to assess compliance with regulatory requirements for Riverside Center for Rehabilitation and Nursing.
Findings
The facility failed to provide timely Medicare Part A service termination notices, did not thoroughly investigate alleged neglect regarding missed medications, and did not ensure medications were administered and reported according to professional standards for multiple residents.
Citations (3)
F 0582: The facility did not provide timely notification of Medicare service termination to Resident #58 as required by regulation.
F 0610: The facility failed to investigate allegations of neglect related to missed medications for Resident #38 and did not document or notify the physician appropriately.
F 0684: The facility did not ensure medications were administered as ordered or that missed medications were reported to the physician for six residents, including failure to follow pharmacist instructions and document refusals.
Report Facts
Residents reviewed: 21
Residents affected: 6
Residents affected: 1
Residents affected: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #2 | Licensed Practical Nurse | Named in medication administration and documentation deficiencies |
| LPNUM #1 | Licensed Practical Nurse Unit Manager | Involved in investigation and disciplinary actions related to medication administration |
| RN #2 | Registered Nurse | Observed administering medications and interviewed about medication issues |
| LPN #5 | Licensed Practical Nurse | Observed administering medication and involved in medication timing deficiency |
| MD #6 | Medical Doctor | Interviewed regarding notification of missed medications |
| Director of Nursing | Director of Nursing | Interviewed about investigation and medication administration policies |
Inspection Report
Annual Inspection
Citations: 14
Date: Jun 18, 2019
Visit Reason
The survey was a recertification annual inspection to assess compliance with regulatory requirements for nursing home care.
Findings
The facility was found deficient in multiple areas including resident dignity and respect during dining, incomplete and non-person-centered care plans, inadequate activity programs for residents with dementia, unsafe environmental hazards, nutritional monitoring and supplementation, mental health and psychosocial care, medication administration errors, food service and sanitation issues, infection control practices, and medical record accuracy.
Citations (14)
F 0550: The facility did not ensure residents were treated with dignity and respect during dining, including isolating a resident facing away from others and inadequate seating space.
F 0656: The facility failed to develop and implement comprehensive person-centered care plans with measurable goals for multiple residents, including care for suprapubic catheter, urinary tract infection, psychotropic drug use, behaviors, psychosocial well-being, and discharge planning.
F 0679: The facility did not provide adequate activities based on residents' abilities and preferences, especially for residents with dementia, due to staffing shortages and poor organization.
F 0689: Resident room wardrobes were unsecured and could topple, posing an accident hazard.
F 0692: The facility did not ensure consistent monitoring of nutrition and supplement intake for a resident with decreased intake and significant weight loss, and failed to document supplement acceptance and weights properly.
F 0742: The facility did not provide appropriate treatment and services to a resident with a history of trauma and mental health needs, failing to assess psychosocial adjustment and develop individualized care plans.
F 0744: The facility did not ensure person-centered, individualized care plans with measurable goals for residents with dementia, and staff were unaware of resident-specific interventions for behavior management.
F 0759: The facility's medication error rate exceeded 5%, with late medication administration and failure to notify physicians or supervisors.
F 0803: The facility did not ensure menus were followed, including failure to provide alternative entrees, incorrect diet consistency meals, and failure to prepare fortified food items as ordered.
F 0812: The facility did not maintain food service equipment and areas in a clean and sanitary manner, including soiled kitchen equipment and sticky floors.
F 0813: The facility lacked a policy and education for safe use and storage of foods brought in by family and visitors, and did not provide food safety information to families.
F 0814: The facility did not properly dispose of garbage and refuse, with grease spilled around the grease disposal drum.
F 0842: The facility did not maintain complete, accurate, and accessible medical records for residents, including failure to document behavior monitoring, inaccurate hearing aid documentation, conflicting blood sugar parameters, and inaccurate tube feeding documentation.
F 0880: The facility failed to implement infection prevention and control measures, including failure to maintain droplet precautions for a resident with MRSA, staff not wearing PPE or performing hand hygiene, and outdated infection control policies.
Report Facts
Medication error rate: 14.81
Weight loss percentage: 7.23
Tube feeding volume left: 400
Tube feeding ordered volume: 910
Number of residents reviewed for care plans: 23
Number of residents reviewed for activities: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #2 | Licensed Practical Nurse | Administered medications late to Resident #49 |
| Director of Nursing | Director of Nursing | Provided statements on care plan expectations, medication administration, infection control |
| Certified Nursing Assistant #5 | Certified Nursing Assistant | Provided statements on dining room conditions and activity participation |
| Registered Nurse #1 | Registered Nurse | Provided statements on dining room organization and medication order parameters |
| Food Service Director | Food Service Director | Provided statements on menu substitutions and food preparation |
| Infection Control Registered Nurse #2 | Infection Control Registered Nurse | Observed not following isolation precautions for MRSA resident |
| Licensed Practical Nurse Unit Manager #4 | Licensed Practical Nurse Unit Manager | Observed not wearing PPE and provided statements on isolation precautions |
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