Inspection Report
Complaint Investigation
Census: 121
Capacity: 65
Deficiencies: 0
Jan 3, 2025
Visit Reason
The inspection was conducted as a licensing inspection and included a complaint investigation related to complaint numbers CT 34329 and 34108.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Complaint Details
Complaint investigation referenced with complaint numbers CT 34329 and 34108; violations were found.
Report Facts
Licensed Bed Capacity: 65
Census: 121
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carrie Riccio | Administrator | Personnel contacted during inspection |
| Denna Donnelly | DNS | Personnel contacted during inspection |
Inspection Report
Follow-Up
Census: 123
Capacity: 128
Deficiencies: 1
Oct 10, 2024
Visit Reason
A desk audit follow-up was conducted to verify correction of a previous violation identified during the survey that ended on 2024-10-10.
Findings
The previously cited violation Tag F 600 was found to be back in compliance as of 2024-11-04. The Administrator was notified via telephone.
Deficiencies (1)
| Description |
|---|
| Violation Tag F 600 |
Report Facts
Licensed Bed Capacity: 128
Census: 123
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carrie Riccio | Administrator | Notified of compliance status via telephone |
| Linda M Gagnon | Surveyor | Conducted the inspection and desk audit |
Inspection Report
Plan of Correction
Census: 125
Capacity: 128
Deficiencies: 0
Jul 18, 2024
Visit Reason
A desk audit was conducted on 7/18/24 to review the implementation of the Plan of Correction for the violation letter dated 6/24/24.
Findings
Violations #1 and #2 were identified as corrected as of 6/28/24. The Administrator was notified by telephone on 7/18/24 that all violations were corrected.
Report Facts
Licensed Bed Capacity: 128
Census: 125
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Schumann | FLIS Staff | Signature of FLIS Staff and report submitter |
| Margaret McKinney | Supervisor | Survey Team Leader Supervisor |
| Carrie Riccio | Administrator | Personnel contacted and notified of correction status |
Inspection Report
Original Licensing
Capacity: 138
Deficiencies: 1
Apr 18, 2024
Visit Reason
This document is a Pre-Licensure Consent Order related to the change of ownership and initial licensing of a Chronic and Convalescent Nursing Home, The Suffield House, in Suffield, Connecticut.
Findings
The document outlines the terms and conditions for the issuance of the initial nursing home license, including requirements for contracting an Independent Nurse Consultant (INC), compliance with federal and state regulations, quality assurance programs, emergency preparedness, and physical plant inspections. It also details timelines for inspections, reports, and corrective actions related to the facility's physical plant and operational compliance.
Deficiencies (1)
| Description |
|---|
| One item is non-compliant related to autoclave provision per PHC Section 19-13-D8t(v)(20)(I). |
Report Facts
Contract duration: 1
INC consulting hours: 8
Fine amount: 1000
Fine amount: 100
Plan of Correction review timeframe: 14
Report submission timeframe: 30
Plan of Correction completion timeframe: 12
Total Patient Capacity: 138
Inspection completion timeframe: 90
Inspection completion timeframe: 60
Inspection completion timeframe: 180
Retention period: 5
Meeting frequency: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kim Hriceniak | R.N., BSN | Mentioned as part of Facility Licensing and Investigations Section. |
| Mark Gottlieb | Managing Member | Managing Member of Suffield SNF Operations LLC, signatory of the Consent Order. |
| Petrina Davis | Public Health Services Manager | Recipient of reports required by the Order. |
| Robert Boulanger | Certified Fire Inspector | Prepared the plan of correction for the facility. |
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