Above average — CMS composite of the measures below.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Livia Health And Senior Living during CMS and state inspections, most recent first.
Kitchen sanitation and food labeling practices were not maintained. A dietary aide and a chef with facial hair were observed without beard guards, and two dietary aides were observed wearing dangling jewelry. Multiple opened food items in the freezer, refrigerator, and deli station were missing required open or use-by labels, and buildup was observed on refrigerator fans and cooking equipment. Facility policy required beard guards when applicable, prohibited dangling jewelry, and required labeling and sanitation of food items and equipment.
Improperly Set Specialty Mattresses: Two residents were observed on specialty mattresses that were set far above their documented weights. Both residents had intact cognition, active orders for air loss mattresses with shift monitoring, and care plans noting a history of skin impairment. An LPN stated she did not know the correct settings and believed maintenance was responsible for setup and monitoring, while the DON said nurse signatures on the TAR meant the mattresses were being monitored and set to the residents’ weights.
Late MDS Submission: The facility failed to complete and transmit MDS assessments within the required timeframe for three residents. A Quarterly MDS for one resident, another Quarterly MDS for a second resident, and an Annual MDS for a third resident were all transmitted late, and the MDSC acknowledged awareness of late assessments. The DON stated that Admission, Quarterly, and Annual MDS should be completed within 14 days of the ARD.
A resident with multiple diagnoses did not have scheduled IV saline flushes and skin assessments with bi-weekly showers consistently documented on the MAR and TAR. Facility policy and the DON confirmed that nurses are required to document all completed treatments and medications, but blanks were found in the records, indicating a failure to meet professional standards of documentation.
A resident with depression, muscle weakness, and difficulty walking had multiple gaps in ADL documentation by CNAs, including missing entries for bed mobility, dressing, hygiene, toileting, ambulation, elimination, eating, and nutrition. Despite policy requiring real-time documentation and oversight by the DON and ADON, these omissions were found during a review.
A resident with multiple medical conditions and moderate cognitive impairment was left unattended in a facility transport van for five hours after returning from dialysis. The van driver failed to bring the resident inside, and nursing staff, including an LPN, did not follow up on the resident's whereabouts despite being notified by CNAs. The resident missed meals, medications, and treatments, and was eventually found with hypothermia and transferred to a hospital.
A resident with ESRD, moderate cognitive impairment, and limited mobility was left unattended in a facility transport van for about five hours after returning from dialysis. The van driver failed to escort the resident into the building, and staff did not follow tracking and supervision protocols. The resident was found later that night with hypothermia and required transfer to an acute care hospital.
Surveyors identified that two residents did not have individualized, comprehensive care plans addressing their specific needs, including incontinence management and respiratory status. One resident wore incontinence briefs without a documented care plan focus or explanation, despite being continent and preferring regular underwear, while another had a care plan referencing breathing difficulty without specifying the cause. Staff interviews confirmed that care plans were not consistently personalized or updated to reflect resident preferences and diagnoses.
A resident with multiple comorbidities and impaired cognition was admitted with a sacral deep tissue injury, but wound care consult recommendations were not followed due to a delay in obtaining physician orders and a lack of documented wound care. When orders were eventually obtained, daily dressing changes were not performed as prescribed, and documentation did not match observed care, in violation of facility wound care policy.
Staff did not consistently document ADL care, including bed mobility and eating assistance, for a resident with severe cognitive impairment and multiple health conditions. Numerous shifts lacked records in the electronic medical record, and interviews with a CNA, ADON, and DON confirmed that documentation was incomplete, leaving uncertainty about whether required care was provided.
A resident with a gastrostomy tube did not receive appropriate care during enteral feeding and medication administration. An LPN used the push method instead of gravity for administering medications and failed to check the tube's placement, leading to the resident experiencing nausea. The facility's policies required verification of tube placement and gravity administration, which were not followed, increasing the risk of adverse outcomes.
A facility failed to properly clean and disinfect a multi-use glucometer between resident uses, increasing the risk of infection and transmission of blood-borne pathogens. An LPN did not follow the facility's policy and manufacturer's instructions, which required cleaning and disinfecting the glucometer between uses. The resident involved had type two diabetes mellitus and was on long-term insulin use. Interviews with the Unit Manager and DON confirmed the expectation to disinfect glucometers before and after each use.
Kitchen sanitation and food labeling deficiencies
Penalty
Summary
Proper kitchen sanitation practices were not maintained to prevent food borne illness. During an observation in the presence of the Food Service Director, a dietary aide with facial hair was observed without a beard guard, and two dietary aides were observed wearing dangling earrings, with one also wearing a dangling necklace. The Food Service Director stated that facial hair must be covered with a beard guard and jewelry should not dangle. Additional observations found multiple opened food items without required open or use-by labels, including French fries, hash browns, lemon bars, pineapple chunks, anchovy paste, red salsa, fingerling potatoes, and potato salad. The surveyor also observed blackish dust-like buildup on three refrigerator fans and a sticky substance on top of two cooking appliances. Facility policies reviewed required beard guards when applicable, prohibited dangling jewelry, required labeling of prepared or opened food items, and directed that equipment, food contact surfaces, and utensils be cleaned and sanitized.
Improperly Set Specialty Mattresses
Penalty
Summary
The facility failed to ensure that low-air-loss mattresses were accurately set and monitored according to resident weight for 2 of 4 residents reviewed. Resident #12 was observed in bed with a specialty mattress whose pump was set to 325 pounds, while the resident’s record showed a weight of 120 pounds on the quarterly MDS and 132 pounds on monthly weights. The resident had diagnoses including Parkinson’s disease and diabetes mellitus, had a BIMS score of 15 of 15, and had an active physician’s order for an air loss mattress with monitoring of function and placement every shift. The TAR showed the order was transcribed and signed each shift, and the care plan identified a history of skin impairment with a low-air-loss mattress intervention. Resident #9 was also observed in bed on a specialty mattress with the pump set to 350 pounds, while the resident’s record showed a weight of 173 pounds on the quarterly MDS and 173.2 pounds on monthly weights. The resident had diagnoses including diabetes mellitus and osteomyelitis, had a BIMS score of 15 of 15, and had an active physician’s order for an air loss mattress with monitoring of function and placement every shift. During interviews, the LPN stated she did not know the resident’s weight or what the mattress should be set at and said maintenance was responsible for setup and monitoring, while the DON confirmed that nurses signing the TAR indicated they were monitoring the specialty mattresses and ensuring they were set to the resident’s weight. The maintenance director stated maintenance staff were responsible for setting up the specialty mattresses and nurses monitored them. The facility policy stated the support surface would be adjusted per the resident’s weight and physician’s order.
Late MDS Submission
Penalty
Summary
The facility failed to complete and transmit MDS assessments within the required timeframe for 3 of 18 residents reviewed: Resident #27, Resident #50, and Resident #91. The surveyor identified that Resident #27 had a Quarterly MDS with an ARD of 1/15/26 but it was not transmitted until 2/22/26, Resident #50 had a Quarterly MDS with an ARD of 12/11/25 but it was not transmitted until 1/28/26, and Resident #91 had an Annual MDS with an ARD of 1/19/26 but it was not transmitted until 2/11/26. The surveyor also requested the final validation report from CMS after noting that these assessments had not been completed and transmitted within 14 days. On 2/19/26, the MDSC stated she was aware that there were MDS assessments that were late. The surveyor reviewed the facility policies titled MDS-Completion and Submission Timeframe and MDS-Electronic Transmission, which stated that the assessments coordinator or designee is responsible for ensuring resident assessments are submitted to CMS iQIES in accordance with current federal and state guidelines and that all MDS assessments are completed and electronically transmitted in accordance with current regulations. During the survey, the DON stated that Admission, Quarterly, and Annual MDS should be completed within 14 days of the ARD.
Failure to Document Nursing Services on MAR and TAR
Penalty
Summary
The facility failed to ensure that nursing services were provided and documented consistently on the Medication Administration Record (MAR) and Treatment Administration Record (TAR) in accordance with professional standards of practice. Specifically, for one resident with diagnoses including low back pain, depression, muscle weakness, and difficulty walking, there were documented blanks on the MAR for scheduled intravenous normal saline flushes and on the TAR for scheduled skin assessments with bi-weekly showers. These omissions indicate that either the care was not provided or not properly documented as required by facility policy and professional standards. Interviews and policy reviews confirmed that the expectation was for nurses to sign the treatment record after each completed treatment, and to initial the MAR after administering each medication. The Director of Nursing stated that this documentation is the only way to verify that treatments and medications have been completed. The facility's own policies reinforce the requirement for timely and accurate documentation, including the name, title, and signature of the individual providing care. The failure to document these services as required led to the identified deficiency.
Failure to Consistently Document ADL Care Provided
Penalty
Summary
The facility failed to consistently document Activities of Daily Living (ADL) care provided to a resident who required assistance. Specifically, a review of the ADL documentation for one resident with diagnoses including depression, muscle weakness, and difficulty walking, revealed multiple instances where documentation was left blank. These omissions included bed mobility, dressing, personal hygiene, toilet use, walking in the corridor and room, bowel and bladder elimination, eating, and nutrition intake on specified shifts. The resident was assessed as having intact cognition, with a BIMS score of 15 out of 15. Interviews with facility leadership confirmed that CNAs were responsible for documenting ADL care, and that the DON and ADON were tasked with auditing this documentation for completion. The facility's policy required that ADLs be documented in real time or immediately after care tasks were completed for each shift. Despite these requirements, the documentation was incomplete for the resident on several occasions, as identified during the review.
Resident Left Unattended in Transport Van Resulting in Hypothermia
Penalty
Summary
A deficiency occurred when a resident who required hemodialysis and had multiple medical conditions, including end-stage renal disease, congestive heart failure, and impaired cognition, was left unattended in a facility transport van for five hours after returning from a dialysis appointment. The van driver parked the vehicle in the facility's parking lot and exited, leaving the resident inside in a wheelchair. The resident was not brought back into the building, and no staff member ensured the resident's safe return. During this period, nursing staff, including the assigned LPN, failed to follow up on the resident's whereabouts despite being notified multiple times by CNAs that the resident had not returned from the appointment. The LPN did not escalate the concern to the nursing supervisor until nearly five hours after the resident's expected return. As a result, the resident missed scheduled meals, medications, and treatment services for the shift. When the nursing supervisor was finally notified, a search was initiated, and the resident was found lying on the van floor, cold, with a recorded temperature of 92.0°F, indicating hypothermia. The resident was subsequently transferred to an acute care hospital for evaluation and treatment. The incident was determined to be a result of neglect, as the facility failed to provide the necessary care and services to meet the resident's needs and did not follow its own policies regarding abuse prevention, elopement, and resident tracking.
Removal Plan
- Notify family and MD after incidents.
- Suspend and terminate staff involved in incidents pending investigation.
- Remove transport van from service until safety measures are implemented.
- Purchase and install a safety device system (child check-mate system) to remind drivers to check for residents after each route.
- Implement Resident Transport Safety Checklist for all facility van drivers, requiring a second staff member to sign tracker when all transported residents have returned safely.
- Provide in-services and education to all staff on elopement/missing person procedures.
- Provide in-services and education to all staff on tracking logs, purposeful rounding, shift-to-shift report, and documentation.
- Provide in-services and education to all staff on Resident Transport Safety Checklist, Child Check-Mate system, and revised policy for Tracker for Residents leaving the building.
- Identify all residents on hemodialysis and with medical appointments requiring transportation and verify that the plan of care is in place and being followed.
- Revise and update policy on Resident Transportation.
- Revise and update policy on Tracker for Residents Leaving the Building.
- Complete a Root-Cause-Analysis (RCA) Report, including a post-implementation review to ensure continued adherence and further policy adjustments if necessary.
Resident Left Unattended in Facility Van After Dialysis
Penalty
Summary
A deficiency occurred when a resident with multiple medical conditions, including end-stage renal disease, moderate cognitive impairment, and limited mobility, was left unattended in a facility transport van for approximately five hours after returning from a dialysis appointment. The van driver parked the vehicle in the facility's parking lot, exited, and failed to escort the resident back into the building, leaving the resident inside the van. The resident was not discovered until later that night, when a nursing supervisor initiated a search after being notified by an LPN that the resident had not returned from dialysis. Upon discovery, the resident was found lying on the floor of the van, expressing that they were cold. An initial assessment revealed a temporal temperature of 92.0°F, indicating hypothermia due to prolonged exposure to cold temperatures. The resident was subsequently transferred to an acute care hospital emergency room for further evaluation and treatment. The incident was documented in facility records, including transfer logs, progress notes, and a universal transfer form, all of which confirmed the timeline and the resident's condition upon discovery. The facility's policies on elopement, resident transportation, and tracking for residents leaving the building were not followed. The driver did not sign the tracking log upon return, and the receptionist did not record the resident's return time or confirm the resident's safe entry into the building. The failure to adhere to established procedures and lack of adequate supervision directly led to the resident being left unattended in the van for an extended period, resulting in immediate jeopardy to the resident's health and safety.
Failure to Develop Comprehensive, Person-Centered Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive, person-centered care plans for two residents, as evidenced by observations, interviews, and record reviews. One resident, who was admitted with orthopedic aftercare needs and had intact cognition, was observed wearing incontinence underwear despite being continent and not using such products at home. The resident reported that they wore the incontinence brief in the facility due to delays in receiving assistance to the bathroom and expressed a preference for wearing their own underwear. The care plan for this resident did not include any focus, goals, or interventions related to bowel and bladder function or the use of incontinence products, and staff interviews confirmed that the resident's preferences and needs were not addressed in the care plan. Another resident, admitted with multiple diagnoses including dementia and altered respiratory status, had a care plan that referenced difficulty breathing but failed to specify the underlying cause or provide individualized details. This resident had severely impaired cognition, and the care plan lacked customization with the resident's name and diagnosis. Interviews with facility staff, including the Unit Manager, ADON, and DON, revealed that care plans were generated automatically upon admission and were expected to be personalized with resident-specific goals and interventions, but this was not consistently done. The facility's policy required that care plans incorporate residents' personal and cultural preferences and address identified problem areas. However, the care plans for both residents did not meet these requirements, as they were not individualized or updated to reflect the residents' current needs and preferences. This resulted in a failure to provide comprehensive, person-centered care planning as required by facility policy and state regulations.
Failure to Obtain Orders and Provide Pressure Ulcer Care as Ordered
Penalty
Summary
A deficiency was identified when a resident with multiple medical conditions, including pneumonitis, diabetes, and impaired cognition, was admitted with existing wounds, including a deep tissue injury to the sacrum. The initial assessment documented the presence of these wounds and indicated the resident was at risk for pressure ulcer development. Despite a wound care consult recommending specific treatments for the sacral wound, no physician's orders for these treatments were obtained or documented from admission through several days after the consult. During this period, there was no evidence of wound care being provided or documented for the sacral wound, as confirmed by the Assistant Director of Nursing (ADON) and Director of Nursing (DON). When a physician's order was eventually entered, the prescribed daily dressing changes were not performed as ordered. Observations revealed that the resident's dressing remained unchanged for multiple days, despite the Medication Administration Record (MAR) being initialed to indicate that care was provided. Interviews with staff confirmed that the dressing date did not align with the documented care, and the responsible nurses could not be reached for clarification. The facility's wound care policy required verification of a physician's order before treatment and proper documentation of dressing changes, including dating and initialing the dressing. These procedures were not followed, as there was a delay in obtaining orders, a lack of documentation of wound care, and failure to perform and document dressing changes as ordered. The deficiency was substantiated by direct observation, record review, and staff interviews.
Failure to Document ADL Care and Services Provided
Penalty
Summary
Facility staff failed to consistently document the Activities of Daily Living (ADL) status and care provided to a resident with severe cognitive impairment and multiple medical conditions, as required by professional standards. The resident, who had diagnoses including Alzheimer's disease, dementia, diverticulitis, and reduced mobility, was dependent on staff for assistance with eating and bed mobility. The care plan identified risks such as malnutrition and skin breakdown, and noted the resident was sometimes resistive to turning and positioning. A review of the resident's Documentation Survey Report (DSR) and progress notes for October and November revealed numerous instances where documentation was missing for bed mobility, eating, and nutrition across all shifts. Specific dates and times were identified where there was no record indicating whether care was provided or refused. This lack of documentation made it unclear if the required care, such as repositioning and assistance with meals, was actually delivered. Interviews with facility staff, including a CNA, the Assistant Director of Nursing (ADON), and the Director of Nursing (DON), confirmed that it was the expectation for CNAs to document care provided before the end of each shift. Both the ADON and DON acknowledged the presence of blank spaces in the DSR and stated that without documentation, there was no way to verify if care was given. The deficiency was cited under NJAC 8:39-35.2 (f).
Improper G-Tube Medication Administration
Penalty
Summary
The facility failed to ensure appropriate care of a gastrostomy tube (g-tube) during enteral feeding and medication administration for a resident. Specifically, an LPN administered g-tube medications using the push method rather than by gravity, and did not check for proper g-tube placement. This was observed during the administration of enteral feeding and medication to a resident who was admitted with conditions including peritoneal abscess, dysphagia, moderate protein-calorie malnutrition, acute pancreatitis, and gastrostomy status. The resident was assessed to be cognitively intact and received nutrition via a feeding tube for more than 51% of daily nutritional needs. The facility's policy on enteral nutrition and medication administration through an enteral tube required verification of tube placement and administration of medications by gravity flow. However, during an observation, the LPN did not check the placement of the g-tube before administering the feeding and used the push method for water flush and medication administration. The resident immediately complained of nausea after the feeding. The LPN later checked for tube placement before administering medications but continued to use the push method, contrary to the facility's policy and expectations. Interviews with the Unit Manager and Director of Nursing revealed that it was expected for nurses to confirm g-tube placement and administer medications via gravity unless specified otherwise by a physician. The DON acknowledged the concerns and stated that the facility obtained an order for gravity administration after the issue was raised. The failure to adhere to the facility's policies and procedures for g-tube care increased the risk of adverse outcomes for the resident.
Failure to Disinfect Glucometer Between Uses
Penalty
Summary
The facility failed to ensure proper cleaning and disinfecting of a multi-use glucometer prior to blood glucose testing for a resident, increasing the risk for infection and transmission of blood-borne pathogens. The facility's policy and the manufacturer's instructions required that glucometers be cleaned and disinfected between resident uses. However, during an observation, an LPN did not follow these procedures. The LPN prepared to check the resident's blood glucose by performing hand hygiene, donning gloves, and cleansing the resident's finger with an alcohol swab. The LPN then used a lancet to prick the resident's finger and obtained a blood sample, but did not wipe away the first drop of blood before applying it to the glucometer strip. Additionally, the LPN admitted to forgetting to wipe down the glucometer and let it dry prior to using it for the resident. The resident involved had a medical history of type two diabetes mellitus and was on long-term insulin use. The resident's admission records and Minimum Data Set (MDS) indicated orders for insulin and documented the administration of insulin over a review period. Interviews with the Unit Manager and the Director of Nursing confirmed that the facility's expectation was to disinfect glucometers before and after each resident use to prevent infection and transmission of pathogens. The failure to adhere to these procedures was identified as a deficiency during the survey.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near East Hanover
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Careone At Hanover Township | 1.5 mi | ★★★★★ | 1 | 0 |
| Troy Hills Center | 2.4 mi | ★★★★★ | 3 | 0 |
| Cheshire Home | 2.7 mi | ★★★★★ | 8 | 0 |
| Florham Park Rehabilitation And Healthcare Center | 2.8 mi | ★★★★★ | 7 | 0 |
| Careone At Parsippany | 3.4 mi | ★★★★★ | 14 | 0 |
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