Average — CMS composite of the measures below.
The next survey window likely opens around February 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 Bezalel Rehabilitation And Nursing Center during CMS and state inspections, most recent first.
The facility failed to ensure that the Food Service Director was qualified. An Acting Food Service Director was temporarily supervising the kitchen after the prior director resigned, but there was no documented evidence that this employee met the minimum qualifications for a CDM or similar national food service management and safety certification. The Administrator could not provide current certifications or registrations for the Acting Food Service Director.
Air mattress settings were not matched to resident weights for three residents with pressure ulcers or skin breakdown risk. One resident with multiple Stage 4 ulcers had a mattress set far above the documented weight, another resident with a Stage 2 sacral ulcer had the mattress set at 400 pounds despite weighing 146.8 pounds, and a third resident with a Stage 4 hip ulcer and osteomyelitis had the mattress set at 340 pounds despite weighing 129.2 pounds. Staff gave inconsistent accounts of who was responsible for checking and documenting the settings, and one RN supervisor said the unit had not been checking the setting in the prior week.
Incomplete PASRR Screening Before Admission: A resident was admitted with an incomplete PASRR form, with key items related to dementia and possible MI/DD left unanswered. The resident had anxiety, sequelae of CVA, ulcerative colitis, and severe cognitive impairment on MDS (BIMS 7). The admissions and social services staff stated the PASRR should have been completed before admission to determine whether a Level II review was needed.
A resident with dementia, depression, urinary incontinence, and repeated falls had a pharmacist medication regimen review flag oxybutynin as highly anticholinergic and recommend considering an alternative. The prescriber response said to continue the same medication, but the chart lacked physician documentation explaining the disagreement or the rationale for maintaining the medication.
The facility failed to report alleged abuse and neglect within the required 2-hour timeframe and did not submit Follow-up Investigation Reports within 5 working days for incidents involving a resident's inappropriate behavior and another resident's elopement. The delay was attributed to misinterpretation of instructions in the acknowledgment email.
A severely cognitively impaired resident with a wander alert device left the facility undetected and was found hours later near the emergency room. The facility failed to follow its elopement prevention policy, and staff were unaware of the resident's elopement risk. The wander alert system was not effectively monitored, leading to the resident's elopement.
Unqualified Acting Food Service Director
Penalty
Summary
The facility failed to ensure that it employed a qualified staff member to serve as the Director of Food and Nutrition. During the kitchen task, the current Director of Food Service was identified as Employee #11, who stated that they were the Acting Food Service Director because the previous Food Service Director had resigned a few months earlier and they were only temporarily supervising the kitchen. The Facility Assessment documented a Registered Dietitian working part-time, three days per week, but the report states there was no documented evidence that the Acting Food Service Director met the minimum qualifications required for the role. The Acting Food Service Director provided a Dietary Managers Program Certificate dated 12/21/1999, but the report states there was no documented evidence that this individual met the requirements for a Certified Dietary Manager or similar national certification for food service management and safety. During an interview, the Administrator stated that the previous Food Service Director left approximately two months earlier and that they did not anticipate being without a new director for that long. The Administrator was not able to provide any current certifications or registrations for the Acting Food Service Director.
Air mattress settings not matched to resident weights
Penalty
Summary
The facility failed to ensure that residents with pressure ulcers or at risk for pressure ulcer development received air mattress care consistent with their documented weights and clinical needs. Surveyors found that three residents had low air loss mattresses set at weight levels that did not match their actual weights: one resident weighed 201.8 pounds but the mattress was set at 450 pounds, another weighed 146.8 pounds but the mattress was set at 400 pounds, and a third weighed 129.2 pounds but the mattress was set at 340 pounds. The facility policy stated that air mattresses must be set, adjusted, and monitored according to the resident’s current weight, body type, and clinical needs, and that nursing staff were responsible for checking and documenting the settings each shift. Resident #34 was admitted with multiple diagnoses including fractures, morbid obesity, and four Stage 4 pressure ulcers. The resident’s care plan included a pressure-reducing low air loss mattress for a coccyx Stage 4 ulcer, and a physician’s order documented wound treatment for the coccyx. During observation, the resident was in bed on an air mattress set at 450 pounds, while the resident’s documented weight was 201.8 pounds. The medical record contained no documentation that the mattress setting was being monitored. Staff interviews showed inconsistent understanding of who was responsible for checking the setting, and one nurse stated the setting was not documented. A physician later stated the mattress weight setting should be consistent with the resident’s weight and that overinflation was a concern. Resident #1 was readmitted with a Stage 2 sacral pressure ulcer, moderately impaired cognition, and significant dependence for care. The care plan included a low air loss mattress, and a physician order documented the mattress. The resident’s weight was 146.8 pounds, but the mattress was observed set at 400 pounds on one occasion and later at 180 pounds. Staff stated they were supposed to check the mattress settings, but the RN supervisor said the unit had not been checking the weight setting in the prior week and was unaware it had been set at 400 pounds. Resident #79, who had a Stage 4 right hip pressure ulcer, chronic multifocal osteomyelitis, adult failure to thrive, and total staff dependence, was observed on a low air loss mattress set at 340 pounds despite a documented weight of 129.2 pounds. The care plan identified the resident as at risk for skin breakdown and included a pressure relieving air mattress, and an RN later stated the mattress should have been set to the setting closest to the resident’s weight.
Incomplete PASRR Screening Before Admission
Penalty
Summary
PASARR screening for mental disorders or intellectual disabilities was incomplete for one resident admitted to the facility. Resident #21 was admitted with diagnoses including anxiety disorder, sequelae of cerebral infarction, and ulcerative colitis, and the Quarterly MDS documented a BIMS score of 7, indicating severe cognitive impairment. The resident’s PASRR form dated 03/07/2025 had items 22 through 26 left unanswered, including items related to dementia diagnosis and Level I review for possible mental illness and possible mental retardation/developmental disability. The form guidance indicated these items determine whether a Level II evaluation is required. The facility policy stated that all new admissions must be screened for serious mental illness or developmental disability before admission, and the admissions department and social worker were responsible for reviewing the screen and ensuring any needed Level II assessment was obtained. During interviews, the Director of Admissions stated the PASRR should have been completed prior to admission and could not explain why the resident was admitted with an incomplete screen. The Director of Social Services and the Administrator also stated the PASRR was not complete because items 22 through 26 were not answered and should have been completed before admission to determine whether the resident was appropriately placed and whether a Level II screen was warranted.
Physician Did Not Document Rationale After Pharmacist Recommended Reviewing Oxybutynin
Penalty
Summary
The facility failed to ensure that physician documentation was entered in the medical record after a pharmacist’s monthly medication regimen review identified an irregularity. For one resident with diabetes mellitus, non-Alzheimer’s dementia, depression, moderate cognitive impairment, urinary incontinence, and a history of repeated falls, the consultant pharmacist reviewed the resident’s medication profile and recommended re-evaluating oxybutynin 5 mg every 12 hours because it is highly anticholinergic, should be avoided in the elderly, and can lead to falls; the pharmacist suggested considering an alternative such as Myrbetriq. The prescriber response section on the review form had the disagree box checked with the comment “MD disagree, continue same,” but the response was undated, did not identify who entered it, and the Medical Director and DON signature boxes were not signed or dated. The medical record also contained no physician or other provider documentation explaining the rationale for disagreeing with the pharmacist’s recommendation or documenting any action taken regarding the irregularity. Although the DON stated they wrote the comment after speaking with the physician, and the physician stated the DON called them and that the decision was to maintain the medication as is, there was still no documentation in the resident’s chart from the physician regarding the review of the irregularity or the rationale for continuing oxybutynin.
Failure to Timely Report Alleged Abuse and Neglect
Penalty
Summary
The facility failed to ensure that all alleged violations involving abuse and neglect were reported immediately, but not later than 2 hours after the allegation was made to the State Survey Agency. Additionally, the facility did not ensure that the results of all investigations were reported to the State Survey Agency within 5 working days of the incident. This was evident in three residents sampled for abuse. Specifically, Resident #2 was observed kissing and inappropriately touching Resident #1 on 01/30/2023 at approximately 4:30 am. The initial report was made to the New York State Department of Health on 01/30/2023 at 3:12 pm, but the facility did not submit a Follow-up Investigation Report within 5 working days of the incident. Resident #3 eloped from the facility on 01/03/2023 at approximately 3:55 pm. An initial report was made to the New York State Department of Health, but a Follow-up Investigation Report was not submitted by the facility within 5 working days of the incident. The Director of Nursing and the Administrator were aware of the reporting requirements but did not comply due to misinterpretation of the instructions provided in the facility acknowledgment email. The facility's policy required that alleged violations be reported immediately but no later than 2 hours after the initial allegation is made, and the results of the investigation be reported within five working days of the incident. However, the facility failed to adhere to these guidelines, resulting in delayed reporting of the incidents involving Residents #1, #2, and #3. The Administrator and Director of Nursing cited confusion over the instructions in the acknowledgment email as the reason for the delay in submitting the Follow-up Investigation Reports.
Failure to Prevent Elopement of Cognitively Impaired Resident
Penalty
Summary
The facility did not ensure adequate supervision to prevent the elopement of a severely cognitively impaired resident. On 01/01/2023, Resident #3, who had a wander alert device, left the building undetected through the front door at 3:55 pm. The resident was found by the Registered Nurse Supervisor at approximately 8:13 pm, walking towards the emergency room with family members. The facility's policy on elopement, reviewed in 01/2019, stated that the safety of residents who wander should be maintained and elopement prevented. However, the facility failed to adhere to this policy for Resident #3. Resident #3 had a history of wandering and was identified as an elopement risk. A care plan was initiated on 12/30/2022 to address wandering behavior, and the intervention included checking the wander alert device every shift. Despite these measures, the resident was able to exit the facility with a non-related visitor. The wander alert device alarm sounded but was released after a 15-second delay, allowing the resident to leave. Staff interviews revealed that the resident was last seen in their room at 4:00 pm, but there was no documentation of half-hourly checks after that time. Additionally, the resident's name and photo were not listed on the wander alert device list. Interviews with staff indicated that there was confusion and a lack of awareness regarding the resident's elopement risk. The Security Guard was not aware that Resident #3 was an elopement risk, and the wander alert system alarm was not effectively monitored. The Director of Nursing and the Administrator concluded that there was no reasonable cause to assume abuse, neglect, or mistreatment occurred, attributing the incident to the resident's behavior history. However, the facility's failure to follow its own policies and adequately supervise the resident led to the elopement incident.
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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 Far Rockaway
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Far Rockaway Center For Rehabilitation And Nursing | 0 mi | ★★★★★ | 12 | 0 |
| Peninsula Nursing And Rehabilitation Center | 0 mi | ★★★★★ | 3 | 1 |
| Beach Gardens Rehabilitation And Nursing Center | 0 mi | ★★★★★ | 1 | 0 |
| Premier Nsg & Rehab Center Of Far Rockaway | 0.2 mi | ★★★★★ | 0 | 0 |
| Queens Nassau Rehabilitation And Nursing Center | 0.4 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.