Average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Beach Terrace Care Center during CMS and state inspections, most recent first.
Cold Room Temperatures and Inadequate Heating Maintenance: Multiple resident rooms and a shower room were found below the required temperature range, with readings as low as 62 degrees. Residents complained that their rooms were freezing or cold, and one LPN acknowledged a room was chilly but did not offer a blanket. Maintenance staff identified dirty heaters, gaps allowing cold air in, and a valve issue affecting heat, while unit logs showed repeated cold-room complaints and no heat in common areas.
Heating system deficiencies left multiple resident rooms with temperatures below acceptable levels, including rooms measured at 63 to 69 degrees Fahrenheit, along with a shower room and corridor at 65 to 66 degrees. The Maintenance Director stated the facility checked heat before winter and relied on complaints and maintenance logs, but had no preventive maintenance checklist and did not know the bottoms of radiators were heavily covered with dust and dirt blocking airflow. Surveyors also found log entries for cold rooms, no heat in a dining room, and a heater blowing cold air, while one room’s heating unit was observed to be off.
An MDS assessment did not accurately reflect a resident’s current status because it failed to document that the resident was receiving hemodialysis 3 times a week. The resident had ESRD and Parkinson’s disease, and staff interviews confirmed the RN MDS Assessor overlooked the dialysis information, the RN MDS Coordinator missed the omission during review, and the DON stated the dialysis order should have been captured in Section O.
A resident with severe cognitive impairment and an order for oxygen via NC was found asleep without the ordered oxygen in use. An oxygen concentrator beside the bed was off, the tubing and mask were dirty and undated, no NC was present, and an LPN noted the equipment was dirty. The facility policy required oxygen equipment to be maintained to reduce infection risk and changed weekly.
Facility Assessment did not document unit- and shift-specific nursing staffing needs. Although the assessment listed overall daily staffing totals for licensed nurses, nurse aides, administrative nursing personnel, and behavioral assistants for a census of 170 to 182 residents across five units, it did not identify the number of nursing staff needed for each unit, each shift, or the bed capacity per unit. The Staffing Coordinator, DON, and Administrator all stated they were not familiar with where the staffing levels were documented or how they were determined.
A resident with cognitive impairment was started on IV antibiotics and developed a facility-acquired wound without the designated representative being notified, as required by facility policy. The family member only learned of the IV treatment after observing the resident bleeding from a dislodged catheter and was not informed about the wound or treatment changes. Staff interviews confirmed the lack of notification and documentation.
A recertification survey revealed that the LTC facility failed to provide sufficient nursing staff, particularly on weekends, to meet resident needs. The facility's staffing policy was not adhered to, with weekend staffing consistently below the required number of CNAs. Interviews indicated issues with high turnover, lack of public transportation, and reliance on agency staff who were not mandated to work weekends.
Two residents sustained injuries of unknown origin that were not reported to the New York State Department of Health within the required time frame. One resident had a scrotal avulsion requiring surgery, and another had facial discoloration. The facility's policy lacked clarity on reporting timelines for serious injuries, and investigations were not adequately conducted to rule out abuse.
The facility failed to investigate injuries of unknown origin for two residents, leading to deficiencies in addressing potential abuse, neglect, or mistreatment. One resident with a history of self-injurious behavior sustained a scrotal avulsion requiring surgery, but no investigation was conducted. Another resident with severe cognitive impairment was found with facial discoloration, and the investigation lacked sufficient evidence to rule out abuse. The facility's response was inadequate, relying on assumptions without evidence.
A resident with schizophrenia and mood disorder exhibited ongoing behaviors of stuffing the toilet with objects, causing maintenance issues. Despite this, the care plan had not been updated since 2014. Facility staff failed to communicate the behavior to the Behavior Program Director, resulting in no new interventions being added. The Director of Nursing acknowledged the care plan should have been updated.
The facility failed to ensure proper care for two residents with pressure ulcers by not accurately setting the weight on their alternating pressure relief air mattresses according to their actual weights. Despite physician orders and documented weights, the air mattresses were set at 350 pounds, which was not appropriate for the residents' weights of 156 and 139 pounds. Staff interviews revealed a lack of monitoring and documentation procedures for the air mattress settings.
A resident with heart failure and other conditions was observed receiving higher oxygen levels than prescribed, with the oxygen concentrator settings out of reach. Despite a physician's order for 3 liters per minute, the resident received 4.5 to 5 liters on multiple occasions. An LPN confirmed the discrepancy and adjusted the flow rate, admitting to not consistently checking the settings. The Treatment Administration Record inaccurately documented the correct oxygen level, and the attending physician and DON emphasized adherence to the physician's orders.
A resident with heart failure and other conditions was receiving supplemental oxygen therapy without documented rationale or monitoring by a physician. The attending physician admitted to ordering the therapy without proper documentation and monitoring parameters, and the Medical Director confirmed the need for regular monitoring and adjustment of the treatment plan.
During a survey, it was found that medications in the facility were not labeled or stored according to professional principles. On two units, insulin vials and ophthalmic solutions were either not dated or kept beyond their recommended usage period. Staff interviews confirmed these oversights, highlighting a failure to adhere to the facility's medication management policies.
Cold Room Temperatures and Inadequate Heating Maintenance
Penalty
Summary
The facility did not maintain a comfortable and homelike environment because multiple resident rooms and a shower room were found below the required temperature range. Survey observations identified 18 of 83 resident rooms, including rooms on the ground floor, Unit 1, Unit 2 East, and Unit 2 West, with temperatures measured between 62 and 69.9 degrees Fahrenheit. The first-floor shower room was also measured at 65 degrees Fahrenheit, and residents in several areas were observed wearing extra clothing or blankets and stating that their rooms were cold. During observations, a resident in a geri chair without a blanket yelled that the room was freezing, and another resident walking in the room said it was cold while wearing a heavy sweater and scarf. An LPN entered the room and acknowledged it was a little chilly but did not offer the resident a blanket. In another room, a resident was observed sitting on the bed with a blanket over their head and stated the room was cold. At a resident council meeting, two residents complained that the rooms they lived in were cold. Maintenance staff measured low temperatures throughout the facility and identified issues including dirty heater bottoms from recent renovation debris, corrosion gaps in a heating unit enclosure allowing cold air into a room, and a bleeder valve that needed replacement and affected heat in one room. Maintenance leadership stated they had not known about the heater dirt until the issue was identified, did not have a preventative maintenance checklist, and relied on resident and staff complaints regarding heat issues. Maintenance logs also documented repeated complaints that rooms, the dining room, and the shower area were cold or had no heat.
Heating System Not Maintained for Resident Rooms
Penalty
Summary
The facility failed to maintain the heating system in proper working condition to provide a healthy, functional, and comfortable environment for residents. During the Environment Task, surveyors identified that 19 of 83 resident rooms, including Room G28 and multiple rooms on the 1st and 2nd units, had low temperatures ranging from 63 to 69 degrees Fahrenheit. A first-floor shower room and a corridor were also observed at 65 to 66 degrees Fahrenheit. The deficiency was cited under 10 NYCRR 415.29(h)(1) and cross-referenced to F584. The Maintenance Director stated that the facility checks the heating system before cold weather begins, monitors room temperatures, and relies on maintenance logbooks for staff reports of issues. However, the director also stated there was no preventive maintenance checklist and that the facility relied on resident and staff complaints regarding heat issues. During observation, the Maintenance Director acknowledged that a thick layer of dirt and dust on the bottom of radiators was blocking airflow, and later stated that some units had additional mechanical issues, including radiator valves needing replacement and a heater being off in one room. Record review showed multiple maintenance log entries documenting cold rooms, no heat in a dining room, cold air from an exit door, and a wall heater blowing cold air. The Maintenance Director stated these entries were related to open windows and that the requests had been completed. Subsequent observations continued to show room temperatures below 71 degrees Fahrenheit, including rooms at 65, 66, 67, and 69 degrees Fahrenheit, and one room where the heating unit was observed to be off.
MDS Assessment Did Not Reflect Resident’s Dialysis Status
Penalty
Summary
The facility did not ensure the Minimum Data Set (MDS) assessment accurately reflected Resident #72’s current status. Resident #72 had diagnoses including end stage renal disease and Parkinson’s disease, and the MDS assessment documented a Brief Interview for Mental Status score of 3, indicating severely impaired cognitive skills for daily decision making. However, the MDS assessment did not identify that the resident received dialysis on admission, while a resident, or at discharge, even though the resident was receiving hemodialysis three times a week at an outpatient dialysis facility. The physician’s order documented hemodialysis on Monday, Wednesday, and Friday at 10:00 AM, and staff interviews confirmed the omission. The RN MDS Assessor stated they overlooked documenting the dialysis in the MDS, and the RN MDS Coordinator stated the assessment should have reflected that the resident was receiving dialysis but the omission was missed during review before signing. The DON stated that because there were physician’s orders for dialysis, the RN MDS Assessor should have captured that information in Section O and that each discipline should complete its section accurately.
Dirty and Undated Oxygen Equipment at Bedside
Penalty
Summary
Provide safe and appropriate respiratory care for a resident when needed was not ensured for Resident #63, who had diagnoses including non-Alzheimer's dementia, seizure disorder, and traumatic brain injury. The resident's 12/05/2025 Quarterly MDS documented a BIMS score of 2, indicating severe cognitive impairment, and the resident had a physician order dated 01/09/2026 for oxygen at 3 liters per minute via nasal cannula every shift as needed for seizures and shortness of breath. During an observation on 01/21/2026, Resident #63 was asleep in bed and was not using the ordered supplemental oxygen. An oxygen concentrator next to the bed was not operating, and the oxygen tubing and an oxygen mask were lying on top of it. There was no nasal cannula at the bedside, the tubing was not dated, brown debris was visible inside the tubing, and the inside of the mask was visibly dirty with a blackish brown substance. An LPN stated the tubing and mask were dirty and should be labeled with a date, and the items were removed from the bedside. The facility policy stated oxygen equipment, including tubing, mask, and nasal cannula, should be maintained to reduce infection risk and changed weekly or more often if indicated.
Facility Assessment Did Not Document Unit- and Shift-Specific Nursing Staffing
Penalty
Summary
The facility did not ensure that its Facility Assessment included specific staffing needs for each resident unit and each shift, including day, evening, and night staffing, based on the resident population and unit needs. The assessment dated [DATE] documented that the facility census averaged between 170 and 182 residents and listed overall daily staffing totals of 19 licensed nurses, 42 nurse aides, 6 administrative nursing personnel, and 14 behavioral assistants, but it did not document the number of nursing staff needed for each unit or each shift, or the bed capacity per unit. The facility had five units, including the ground floor, 1 East, 1 West, 2 East, and 2 West, but the Facility Assessment did not show how staffing was determined for each unit and shift. During interviews, the Staffing Coordinator stated staffing levels were memorized and had been in place for as long as they had held the position, but they were not familiar with the Facility Assessment and did not know where the staffing levels came from or whether they were documented. The DON stated they were not familiar with the requirement to document staffing per unit and per shift in the Facility Assessment and did not know where those staffing levels were documented. The Administrator stated they were not aware that staffing levels for each unit and shift had to be incorporated into the Facility Assessment and were not sure where those staffing levels were documented.
Failure to Notify Resident Representative of Condition Changes and Treatment
Penalty
Summary
The facility failed to notify the designated representative of a resident with moderately impaired cognitive skills regarding significant changes in the resident's condition and treatment. The resident, who had a history of stroke, hypertension, diabetes, and non-Alzheimer's dementia, was started on intravenous antibiotics for cellulitis of the left foot and later developed a facility-acquired wound on the left second toe. Despite facility policy requiring timely notification and documentation of such changes to the resident's representative, there was no evidence that the family member listed as the emergency contact was informed about the initiation of intravenous antibiotics or the development and treatment of the wound. Interviews with staff confirmed that the family member was not notified prior to the administration of intravenous antibiotics or the discovery of the wound. The family member only became aware of the intravenous treatment after observing the resident bleeding from a dislodged IV catheter during a visit. The family member stated they would have refused the intravenous antibiotics and expressed a desire to be informed of any changes in the resident's condition or treatment. Staff interviews further revealed a lack of recall or documentation regarding family notification, and the Director of Nursing was unable to provide evidence that the required notifications had occurred.
Insufficient Weekend Staffing in LTC Facility
Penalty
Summary
The facility was found to have insufficient nursing staff to meet the needs of its residents during a recertification survey conducted from June 27, 2024, to July 8, 2024. The deficiency was identified across all five units reviewed, with particular issues noted in weekend staffing levels. The Payroll-Based Journal Staffing Data Report for the first quarter of 2024 highlighted excessively low weekend staffing, and daily staffing sheets confirmed that the facility did not provide the required number of Certified Nursing Assistants (CNAs) as per the facility's assessment. The facility's policy stated that adequate staffing should be maintained on each shift, with CNAs available to meet residents' needs as outlined in their care plans. However, a review of weekend staffing sheets from January 7, 2024, to March 17, 2024, showed that the facility consistently failed to meet the required number of CNAs. For instance, on several weekends, the number of CNAs on duty was significantly lower than the 44 required by the facility assessment, with numbers ranging from 31 to 40 CNAs present. Interviews with the Staffing Coordinator and the Director of Nursing Services revealed ongoing issues with staffing, particularly on weekends due to high turnover and lack of public transportation. The facility relied on a staffing agency, but agency staff were not mandated to work weekends. The Director of Nursing Services acknowledged the problem but had not adjusted staffing schedules to address the issue. The Administrator was aware of the staffing challenges but had not yet implemented solutions such as a job fair to recruit more staff.
Failure to Report Injuries of Unknown Origin
Penalty
Summary
The facility failed to report alleged violations, including injuries of unknown origin, to the New York State Department of Health within the required time frame. This deficiency was identified during a recertification survey for two residents. Resident #48 sustained a scrotal avulsion, an injury of unknown origin, which required surgical intervention. Despite the severity of the injury, the facility did not report it to the Department of Health. The facility's policy did not specify the requirement to report such incidents within two hours if they involved suspected abuse or resulted in serious bodily injury. Resident #48 had a history of self-injurious behavior and aggressive tendencies, which were documented in their care plan. On the day of the incident, the resident was found with a scrotal wound, and the staff did not initiate an investigation to determine the cause of the injury. The Director of Nursing Services and the Registered Nurse Risk Manager acknowledged that the injury was of unknown origin and should have been reported to the Department of Health. However, they did not consider abuse as a possible cause at the time. Similarly, Resident #83 was found with discoloration to the right eye and forehead, an injury of unknown origin. The facility conducted an investigation but did not report the incident to the Department of Health. The Director of Nursing Services admitted that the injury should have been reported due to its unknown origin. The facility's failure to report these incidents in a timely manner constitutes a deficiency in adhering to regulatory requirements for reporting suspected abuse, neglect, or injuries of unknown origin.
Failure to Investigate Injuries of Unknown Origin
Penalty
Summary
The facility failed to ensure thorough investigations of injuries of unknown origin for two residents, leading to deficiencies in addressing potential abuse, neglect, or mistreatment. Resident #48, who had a history of self-injurious behavior and aggressive tendencies, sustained a scrotal avulsion requiring surgical intervention. Despite the severity of the injury and its unknown cause, no investigation was conducted to determine the root cause or to rule out abuse or neglect. Staff interviews revealed assumptions that the injury was self-inflicted due to the resident's behavior, but no formal investigation was initiated. Resident #83, with severe cognitive impairment and a history of falls, was found with discoloration to the right eye and forehead. The incident was unwitnessed, and the resident could not recall what happened. Although an accident investigation report was completed, it lacked sufficient evidence to rule out abuse, mistreatment, or neglect. The investigation did not include interviews with staff from previous shifts, which could have provided additional insights into the cause of the injury. The facility's failure to conduct thorough investigations for both residents' injuries of unknown origin highlights a deficiency in their response to potential abuse, neglect, or mistreatment. The lack of comprehensive investigations and reliance on assumptions without evidence left significant gaps in ensuring resident safety and compliance with regulatory requirements.
Failure to Update Comprehensive Care Plan for Resident with Behavioral Issues
Penalty
Summary
The facility failed to ensure that the comprehensive care plan for a resident was reviewed and revised to meet the resident's current needs. The resident, who has a history of schizophrenia, mood disorder, and anxiety disorder, exhibited behaviors such as stuffing the toilet with objects, which led to maintenance issues and affected other residents. Despite these ongoing behaviors, the interventions in the resident's care plan had not been updated since 2014, even though the care plan was evaluated multiple times over the years. Interviews with facility staff revealed a lack of communication between departments regarding the resident's behavior. Certified Nursing Assistants and Registered Nurses were aware of the resident's behavior of clogging the toilet but did not communicate this to the Behavior Program Director or Behavior Supervisor. As a result, the Behavior Program Director and Supervisor were unaware of the ongoing issue and continued to document that there were no new behaviors, leading to a lack of new interventions in the care plan. The Director of Nursing Services acknowledged that the care plan should have been updated to reflect any changes in the resident's behavior. The failure to update the care plan and implement new interventions resulted in the continued occurrence of the resident's disruptive behavior, which was not effectively managed by the facility.
Failure to Monitor Air Mattress Settings for Residents with Pressure Ulcers
Penalty
Summary
The facility failed to ensure that residents with pressure ulcers received necessary treatment and services consistent with professional standards of practice. This deficiency was identified for two residents who had physician's orders for an alternating pressure relief air mattress. Observations revealed that the adjustable weight setting on the air mattress pump was not accurately set according to each resident's weight, which is crucial for optimal immersion, patient comfort, and compliance. Resident #107, who was admitted with diagnoses including spinal stenosis, a sacral pressure ulcer, and respiratory failure, had a physician's order for an alternating pressure relief air mattress. Despite the resident's weight being documented as 156 pounds, the air mattress pump was consistently set at 350 pounds during multiple observations. Interviews with staff, including the unit manager and wound care manager, confirmed that the weight setting should correspond with the resident's actual weight, but there was no order to monitor the air mattress settings, and thus, monitoring was not being completed and documented every shift. Similarly, Resident #138, who had severe cognitive impairment and a stage 4 sacral pressure ulcer, was observed with an air mattress weight setting of 350 pounds, despite their documented weight being 139 pounds. Interviews with nursing staff revealed that the facility did not have a plan in place for monitoring the air mattress weight setting, and the responsibility for checking the settings was not clearly defined or documented. The Director of Nursing Services acknowledged the lack of a monitoring plan and stated that nurses should monitor the air mattress setting every shift.
Failure to Administer Oxygen Therapy as Prescribed
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards for a resident who required oxygen therapy. Resident #113, who had diagnoses including Heart Failure, Morbid Obesity, and Atrial Fibrillation, was observed receiving higher oxygen levels than prescribed by the physician. The physician's order specified 3 liters of oxygen per minute via a nasal cannula every shift, but observations on multiple occasions showed the resident receiving 4.5 to 5 liters per minute. The resident was unable to adjust the oxygen concentrator settings, which were out of reach, and expressed that the oxygen therapy did not affect their breathing. Licensed Practical Nurse #1 confirmed the discrepancy in oxygen levels and adjusted the flow rate to the prescribed 3 liters per minute. The nurse admitted to not consistently checking the oxygen settings at the start of shifts and acknowledged previous instances of incorrect oxygen levels. The Treatment Administration Record inaccurately documented that the resident received the correct oxygen level during the observed dates. Interviews with the attending physician and the Director of Nursing Services reiterated the expectation that oxygen therapy should be administered as per the physician's orders.
Deficiency in Physician Supervision of Oxygen Therapy
Penalty
Summary
The facility failed to ensure that the medical care of each resident is supervised by a physician, as evidenced by the case of a resident who was receiving supplemental oxygen therapy without documented rationale or monitoring. The resident, who had diagnoses including heart failure, morbid obesity, and atrial fibrillation, was ordered to receive oxygen at 3 liters per minute via nasal cannula every shift. However, there was no documented reason for the initiation of oxygen therapy, and the resident's medical record lacked evidence of physician monitoring or evaluation of the oxygen therapy needs until the issue was highlighted by a surveyor. The attending physician admitted that the oxygen therapy was ordered without a proper rationale and that the order should have included parameters for monitoring the resident's oxygen saturation levels. The physician also acknowledged that the current order was incorrect and should have been adjusted to provide oxygen therapy as needed based on the resident's oxygen saturation levels. The Medical Director confirmed that the attending physician should have documented the rationale for the oxygen therapy and monitored the resident's condition regularly to adjust the treatment plan as necessary.
Medication Labeling and Storage Deficiency
Penalty
Summary
The facility failed to ensure that drugs and biologicals were labeled in accordance with professional principles, as observed during a recertification survey. On Unit 2 East, a vial of Humalog insulin for a resident with Type 2 Diabetes Mellitus and End Stage Renal Disease was found in the medication refrigerator with an open date of over 28 days, contrary to the facility's policy. The LPN responsible for the unit admitted to overlooking the date on the vial, which should have been discarded after 28 days. On Unit 2 West, two bottles of Latanoprost Ophthalmic Solution for two residents with glaucoma-related conditions were found without any indication of when they were first opened. The LPN on this unit acknowledged that the bottles should have been dated upon opening to ensure proper disposal after the recommended period. Additionally, a vial of Insulin Glargine for another resident was found with an open date exceeding 28 days, which was also against the facility's policy. Interviews with the nursing staff and the pharmacist confirmed that the medications should have been discarded after the specified periods to maintain their effectiveness. The Director of Nursing Services reiterated the importance of proper labeling and storage, emphasizing that the medications should have been dated and discarded according to the facility's guidelines.
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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 Long Beach
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Grandell Rehabilitation And Nu | 0.1 mi | ★★★★★ | 0 | 0 |
| Park Avenue Extended Care Facility | 0.9 mi | ★★★★★ | 0 | 0 |
| Long Beach Nursing And Rehabilitation Center | 1.7 mi | ★★★★★ | 3 | 0 |
| The Grand Rehabilitation And Nursing At South Poin | 1.8 mi | ★★★★★ | 0 | 0 |
| West Lawrence Care Center. Llc | 3.4 mi | ★★★★★ | 0 | 0 |
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