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CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Sapphire Nursing and Rehab at Goshen is a 120-bed nursing home that provides short-term rehabilitation and long-term care services within a highly accessible neighborhood carrying a Walk Score of 80. The facility coordinates 24-hour medical coverage and comprehensive physical therapy under a mixed-payer model that integrates Medicare, Medicaid, and private-pay clients, resulting in an average resident stay of 114 days. Financial records show a 2023 operating loss of $894 thousand, with staffing expenses representing 45.9% of overall revenue. Local demand remains strong, with the building maintaining a 92% occupancy rate.
State records reveal high clinical performance alongside a higher frequency of minor regulatory citations. Over three years, the property compiled 25 total deficiencies, averaging 8.3 citations annually to track 63% worse than the New York state baseline, though it maintains a clean record of zero federal fines or enforcement penalties. The latest routine evaluation in April 2025 flagged nine moderate deficiencies involving care plan timing, food sanitation, infection control, and life safety systems like exit signs and sprinkler maintenance, all of which the operator corrected within two months.
Daily direct care lines show that total nursing hours average 3 hours per resident each day, running 14% below the state average. Clinical tracking files show excellent outcomes for short-term rehabilitation clients, who log self-care improvements 31% ahead of the state average and very low emergency room utilization. Permanent resident tracking notes strong physical mobility preservation and low serious fall injury rates, though documented resident depressive symptoms run higher than the state average.
Prospective residents evaluating regional post-acute rehabilitation or long-term nursing care can study these public monitoring reports to analyze the facility’s day-to-day operations. Since the official documentation verifies strong short-term recovery outcomes and a prompt history of correction plans alongside below-average nursing hours, elevated permanent resident depression scores, and frequent minor life safety citations, the paperwork indicates a highly capable rehab environment with specific operational elements requiring attention.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
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.
This home is ranked 263rd out of 387 homes 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.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 36m per day | ▼ 15% State avg: 42m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 54m per day | ▲ 16% State avg: 46m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 12m per day | ■ Avg State avg: 2h 11m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 15m per day | ▲ 3% State avg: 3h 10m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 6m per day | ▼ 8% State avg: 7m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 20m per day | ▼ 28% State avg: 28m per day · National avg: 28m per day |
Similar to the New York average: 88.3%Sapphire Nursing and Rehab at Goshen is legally operated by Goshen Operations, LLC (For Profit).
In New York, the Department of Health, Office of Aging and Long Term Care performs unannounced onsite inspections to monitor compliance with state and federal healthcare regulations.
A composite 0–100 score combining this facility's inspections, citations, complaints, and enforcement actions relative to the New York state average. The score below shows how many points this facility sits above or below the typical New York nursing home score (the benchmark); higher is better.
9 points above the New York average for nursing homes (83/100)
Inspection score: 92 out of 100. Letter grade A-. 9 points above the New York average for nursing homes (83/100)
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
| This Facility | NY Average | vs. NY Avg |
|---|---|---|---|
|
Total citations
Formal regulatory issues recorded by inspectors across all inspection types.
| 16 | 13 | This facility has 23% more total citations than a typical New York nursing home (16 vs. NY avg 13).↑ 23% worse |
|
Health citations
Violations related to resident care, clinical practices, and day-to-day operations.
| 12 | 20 | This facility has 40% fewer health citations than a typical New York nursing home (12 vs. NY avg 20).↓ 40% better |
|
Life safety citations
Violations 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 year
Average citations per year since 2019.
| 2.3 | 1.9 | This facility has 21% more citations per year than a typical New York nursing home (2.3 vs. NY avg 1.9).↑ 21% worse |
|
Citations per inspection
Average citations per inspection.
| 3.2 | 1.4 | This facility has 129% more citations per inspection than a typical New York nursing home (3.2 vs. NY avg 1.4).↑ 129% worse |
Inspections
| This Facility | NY Average | vs. NY Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 5 | 9 | This facility has 44% fewer total inspections than a typical New York nursing home (5 vs. NY avg 9).↓ 44% better |
|
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
| This Facility | NY Average | vs. NY Avg |
|---|---|---|---|
|
Total complaints
Formal expressions of concern made by residents, families, or staff.
| 52 | 79 | This facility has 34% fewer total complaints than a typical New York nursing home (52 vs. NY avg 79).↓ 34% better |
|
Complaints per year
Average complaints per year since 2019.
| 7.4 | 11.3 | This facility has 35% fewer complaints per year than a typical New York nursing home (7.4 vs. NY avg 11.3).↓ 35% better |
|
Complaints per bed
Size-adjusted complaint rate based on occupied beds.
| 0.47 | 0.50 | This facility has 6% fewer complaints per bed than a typical New York nursing home (0.47 vs. NY avg 0.5).↓ 6% better |
|
Complaint investigations
On-site investigations triggered by complaints filed with New York regulators.
| 9 | 15 | This facility has 40% fewer complaint investigations than a typical New York nursing home (9 vs. NY avg 15).↓ 40% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
New York average 3.6
Last Health inspection on Apr 2025
New York average 18.5
New York average 5.05
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
15 of 17 citations resulted from standard inspections; and 2 of 17 resulted from complaint investigations.
100% better than New York averageNew York average: 0.2
100% better than New York averageNew York average: 0.2
Corrected
Corrected
Corrected
Corrected
How this facility protects residents through staff vaccination policies and immunization practices.
Percentage of facility employees vaccinated against influenza.
Summary of court-record activity tied to this facility, compiled from publicly available case dockets.
Source: State court e-filing records
Every lawsuit on record involving this facility since the earliest filing. Long-term volume signals overall legal exposure.
7
Lawsuits still moving through the courts. Active claims can affect day-to-day operations, settlement risk, and insurance posture.
2
Cases that have been disposed of — dismissed, settled, or decided. Shows how the facility has historically resolved disputes.
5
Year of the earliest case on record. A long history with steady filings suggests persistent issues; a recent first filing means newer exposure.
2019
Most recent filing on record. Recent activity means legal disputes are still being raised against this facility.
2025
Next scheduled court appearance on record across active cases.
Apr 29, 2026Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
699% more staff per resident than New York average
0% compared with New York average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
20 total: 19 full-time employees and 1 contractor.
20
Average shift length. Calculated as total hours divided by days worked and average staff per day.
6.7 hoursAssists with medical care and medications.
All 27 LPN Staff are full-time employees. No contractors work on this role.
27
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hoursHelps with daily care and mobility.
66 total: 58 full-time employees and 8 contractors.
66
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
2,135 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 58 | 8 | 66 | 23,281 | 92 | 100% | 7.8 |
| Licensed Practical Nurse | 27 | 0 | 27 | 8,984 | 92 | 100% | 7.8 |
| Registered Nurse | 19 | 1 | 20 | 4,864 | 92 | 100% | 6.7 |
| Speech Language Pathologist | 4 | 0 | 4 | 1,818 | 64 | 70% | 7.8 |
| Physical Therapy Aide | 4 | 0 | 4 | 1,807 | 88 | 96% | 7.9 |
| Dietitian | 7 | 0 | 7 | 1,646 | 92 | 100% | 7.4 |
| Respiratory Therapy Technician | 5 | 0 | 5 | 1,139 | 80 | 87% | 7.5 |
| Mental Health Service Worker | 3 | 0 | 3 | 1,025 | 89 | 97% | 6.4 |
| Physical Therapy Assistant | 4 | 0 | 4 | 873 | 76 | 83% | 7.8 |
| Clinical Nurse Specialist | 6 | 0 | 6 | 834 | 72 | 78% | 3.6 |
| Nurse Practitioner | 2 | 0 | 2 | 612 | 66 | 72% | 4.9 |
| Qualified Social Worker | 2 | 0 | 2 | 479 | 64 | 70% | 6.9 |
| RN Director of Nursing | 1 | 0 | 1 | 456 | 57 | 62% | 8 |
| Medical Director | 1 | 0 | 1 | 439 | 58 | 63% | 7.6 |
| Other Social Services Staff | 1 | 0 | 1 | 408 | 51 | 55% | 8 |
| Occupational Therapy Aide | 1 | 0 | 1 | 377 | 59 | 64% | 6.4 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
5.0
49% better than New York averageNew York average: 9.8
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
13.7
25% better than New York averageNew York average: 18.1
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
10.5%
36% better than New York averageNew York average: 16.4%
Percent of long-stay residents whose ability to move independently worsened
3.8%
77% better than New York averageNew York average: 16.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
26.8%
25% worse than New York averageNew York average: 21.4%
Percent of long-stay residents experiencing one or more falls with major injury
2.1%
29% better than New York averageNew York average: 3.0%
Percent of long-stay high risk residents with pressure ulcers
5.5%
24% better than New York averageNew York average: 7.2%
Percent of long-stay residents with a urinary tract infection
0.6%
56% better than New York averageNew York average: 1.4%
Percent of long-stay residents who lose too much weight
3.1%
49% better than New York averageNew York average: 6.1%
Percent of long-stay residents who have depressive symptoms
65.6%
262% worse than New York averageNew York average: 18.1%
Percent of long-stay residents who received an antipsychotic medication
4.3%
66% better than New York averageNew York average: 12.6%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.1%
8% better than New York averageNew York average: 91.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
99.0%
In line with New York averageNew York average: 95.2%
Number of hospitalizations per 1,000 long-stay resident days.
1.28
25% better than New York averageNew York average: 1.71
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.13
90% better than New York averageNew York average: 1.35
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
89.5%
17% better than New York averageNew York average: 76.6%
Percent of short-stay residents who newly received an antipsychotic medication
0.4%
66% better than New York averageNew York average: 1.3%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
87.8%
11% better than New York averageNew York average: 78.8%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
13.0%
37% better than New York averageNew York average: 20.6%
Percentage of short-stay residents who had an outpatient emergency department visit.
4.3%
56% better than New York averageNew York average: 9.7%
Percentage of SNF residents who experience falls with major injury during their stay.
0.5%
42% better than New York averageNew York average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
70.6%
31% better than New York averageNew York average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
43.9%
13% worse than New York averageNew York average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
65% of new residents, usually for short-term rehab.
31% of new residents, often for short stays.
5% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
110Residents meet regularly to discuss policies, care quality, and activities
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Sapphire Nursing and Rehab at Goshen based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #218 / 382Payroll — State benchmarkedThis home is ranked 218th out of 382 homes in New York. Shows total annual staff payroll benchmarked to the New York average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
0.0 miles from city center
Estimated distance in miles from Goshen's city center to Sapphire Nursing and Rehab at Goshen's address, calculated via Google Maps.
Add your location
Sapphire Nursing and Rehab at Goshen is located in Goshen, New York.
Here are the financial assistance programs available to residents in New York.
The information below is reported by the New York State Department of Health.
| Sapphire Nursing and Rehab at Goshen |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Goshen | 120
Facility
120
NY AVG
160
Rank
#412 / 748 |
91.7%
Facility
91.7%
NY AVG
88.3%
Rank
#381 / 432 | +4% | 3.01
Facility
3.01
NY AVG
3.58
Rank
#263 / 387 | +3% | -16% | $0
Facility
$0
NY AVG
$67.6k
Rank
#1 / 394 | 92 | 17
Facility
17
NY AVG
18.5
Rank
#203 / 393 | 4.3
Facility
4.3
NY AVG
5.1
Rank
#154 / 393 | - | 115 | - |
80
Facility
80
NY AVG
63
Rank
#457 / 1173 | Goshen Operations LLC | $26.8M
Facility
$26.8M
NY AVG
$32.0M
Rank
#218 / 382 | $12.3M
Facility
$12.3M
NY AVG
$10.7M
Rank
#218 / 382 | 45.9%
Facility
45.9%
NY AVG
37%
Rank
#233 / 382 | 335684 | ||||
| Middletown Park Rehabilitation & Health Care Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Middletown | 230
Facility
230
NY AVG
160
Rank
#138 / 748 |
97.0%
Facility
97.0%
NY AVG
88.3%
Rank
#194 / 432 | +10% | 2.93
Facility
2.93
NY AVG
3.58
Rank
#285 / 387 | +24% | -18% | $0
Facility
$0
NY AVG
$67.6k
Rank
#1 / 394 | 94 | 14
Facility
14
NY AVG
18.5
Rank
#148 / 393 | 3.5
Facility
3.5
NY AVG
5.1
Rank
#100 / 393 | - | 220 | A+ |
90
Facility
90
NY AVG
63
Rank
#261 / 1173 | Park Manor Acquisition II, LLC (For Profit) | $39.6M
Facility
$39.6M
NY AVG
$32.0M
Rank
#120 / 382 | $18.3M
Facility
$18.3M
NY AVG
$10.7M
Rank
#135 / 382 | 46.2%
Facility
46.2%
NY AVG
37%
Rank
#227 / 382 | 335655 | ||||
| Highland Rehabilitation and Nursing Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Middletown | 98
Facility
98
NY AVG
160
Rank
#517 / 748 |
87.8%
Facility
87.8%
NY AVG
88.3%
Rank
#202 / 432 | -1% | 3.38
Facility
3.38
NY AVG
3.58
Rank
#173 / 387 | +3% | -6% | $0
Facility
$0
NY AVG
$67.6k
Rank
#1 / 394 | 92 | 36
Facility
36
NY AVG
18.5
Rank
#360 / 393 | 12.0
Facility
12.0
NY AVG
5.1
Rank
#388 / 393 | - | 90 | A+ |
90
Facility
90
NY AVG
63
Rank
#261 / 1173 | Alec Shneider | $21.0M
Facility
$21.0M
NY AVG
$32.0M
Rank
#272 / 382 | $7.4M
Facility
$7.4M
NY AVG
$10.7M
Rank
#323 / 382 | 35.1%
Facility
35.1%
NY AVG
37%
Rank
#353 / 382 | 335526 |
The legal owner and operator of Sapphire Nursing and Rehab at Goshen is Goshen Operations, LLC (For Profit).
Sapphire Nursing and Rehab at Goshen has a walk score of 80. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
According to NY state health department records, Sapphire Nursing and Rehab at Goshen's license number is 3523304N.
Sapphire Nursing and Rehab at Goshen's occupancy is 92%.
Sapphire Nursing and Rehab at Goshen has 120 beds.
Sapphire Nursing and Rehab at Goshen has had 16 recently reported deficiencies.
Sapphire Nursing and Rehab at Goshen is located at 46 Harriman Drive.
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