Below average — CMS composite of the measures below.
The next survey window likely opens around March 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 Riverside Center For Rehabilitation And Nursing during CMS and state inspections, most recent first.
The facility failed to provide palatable, attractive meals at safe, appetizing temperatures and to serve food items consistent with meal tickets. Observations of multiple meals showed missing food components, dry and unseasoned vegetables, and hot and cold items served at inappropriate temperatures, with some foods described as bland or unidentifiable in taste. Several residents reported routinely receiving cold, poor-tasting food, small portions, and meals that did not match what they ordered, including being served spicy items they could not tolerate and not receiving requested alternatives. Resident Council members echoed concerns about unappealing menu choices, lack of fresh produce, incorrect trays, and improper temperatures, and an LPN confirmed ongoing resident complaints about taste and portion sizes.
Food Storage and Preparation Deficiencies: Surveyors observed unlabeled prepared foods and condiments in refrigerators, expired bread in dry storage, personal food stored in a kitchen freezer, beverages placed in the walk-in freezer to cool, and pork thawing in standing water with carrots floating in the water and the meat not secured in packaging. The FSD stated several items had been prepared earlier that day but had not yet been labeled, and that the pork was being thawed for lunch service.
An MDS assessment inaccurately recorded no UE or LE impairment for a resident with documented contractures, left-sided hemiplegia, impaired ROM, and dependence for transfers with a Hoyer lift and splint/brace use. Records from nursing, PT, and OT all showed contracture-related limitations, and staff interviews confirmed the resident had contractures that began before or continued after admission, but the MDS coordinator did not reflect that information in the quarterly assessment.
Failure to Obtain Required PASARR Level II Evaluation: A resident admitted with bipolar disorder and moderate cognitive impairment had a PASARR Level I screen that recommended a Level II mental illness evaluation, but no Level II evaluation was completed. The DOSS stated they had made a mistake and had not read the PASARR to the end of the document where the Level II recommendation appeared.
Incomplete Comprehensive Care Plans for Dementia and CPAP Use: The facility failed to develop person-centered comprehensive care plans for two residents. One resident with severe cognitive impairment and vascular dementia had no care plan addressing dementia, while another resident with OSA had a CPAP machine at the bedside and a H&P encouraging continued use, but the respiratory care plan did not include CPAP use. The DON and ADON acknowledged that care plans should have addressed these issues.
Failure to Apply Ordered Left Hand Splint: A resident with intracerebral hemorrhage, muscle weakness, and left wrist contracture was ordered a left resting hand splint as tolerated, but staff observed the resident without the splint on multiple occasions. CNA documentation did not show the splint was applied, one CNA said they avoided applying it because the resident appeared to be in pain during transfer and did not report it, and an LPN said they were not notified that the splint was needed.
A resident with severe cognitive impairment, dementia, a history of falls, and poor safety awareness was care planned to remain in a supervised area when out of bed. During an observation, the resident was found face down on the floor in the day room with no staff present, and staff responded only after the surveyor called for help. Interviews showed staff considered supervised areas to be locations near the nurses' station or where staff were present.
Improper Foley and Leg Bag Care: A resident with Parkinson's disease, vascular dementia, and a neurogenic bladder was observed with catheter tubing coming out of the pant leg and a urinary drainage bag lying on the floor, with cloudy contents in the tubing and no place to hang the bag. Although the care plan and staff believed the resident handled their own leg bag changes, the DON stated staff should apply the leg bag and not expect the resident to do it themselves for infection control reasons.
Failure to provide appropriate CPAP respiratory care for a resident with OSA, COPD, and a history of headaches. The resident’s CPAP, tubing, and mask were observed open to air at the bedside, the resident said they needed help turning it on and had not used it for two weeks because it needed cleaning, and the chart lacked a CPAP order, settings, and a care plan intervention for CPAP. Staff stated they did not act on the device because it was the resident’s own machine or because no order was present, and the MD was unaware the resident had gone without CPAP use.
A resident with severe cognitive impairment and chronic pain syndrome received repeated oxycodone HCl 10 mg doses despite an order that was entered without required details and was verbally understood differently by staff. The DON identified the issue as a medication error, and an LPN stated they did not closely read the order and there was no system to verify new orders for accuracy.
Failure to Provide Palatable, Proper-Temperature Meals and Accurate Trays
Penalty
Summary
The facility failed to provide food and drink that were palatable, attractive, and at safe and appetizing temperatures during multiple observed meals. Policy required that residents receive nourishing, palatable, attractive meals, with accurate meal tickets and alternatives offered when meals were refused. During a lunch meal observation, three sampled plates from the South unit steam table showed missing items and unappealing food: dry cauliflower without gravy or seasoning, one plate missing pork gravy and penne with marinara, a mechanical soft plate missing soft salad and pudding, and another plate missing cauliflower and tossed salad. During breakfast and lunch tray samplings for one resident, condiments were missing, hot items such as bacon, pancakes, pasta bake, squash, and coffee were served at various temperatures, and cold items such as milk, juice, and applesauce were measured in the 57–64 degrees Fahrenheit range. The pasta bake and applesauce were described as bland and unappetizing or unidentifiable in taste. Multiple resident interviews corroborated problems with food temperature, taste, accuracy of orders, and portion sizes. One resident reported receiving cold tater tots and soup for dinner and being told their food could not be reheated; when they requested a sandwich, it was of such unclear content that they did not eat it. Another resident stated the food was not good, they did not regularly eat facility food, they did not receive what they ordered, portions were small, and on one occasion they did not receive the cheeseburger they were supposed to get but were instead served tacos and beans, which they could not eat due to an inability to tolerate spicy foods; they reported that a requested alternate meal was never received. A third resident reported poor food quality, small portions, and receiving a full plate of rice for dinner at one time, leading them to request sandwiches for most meals because the food was always cold and tasted bad. Resident Council members stated that food choices were undesirable, vegetables and fruits were never fresh, food was not served at the right temperature, and meal tickets did not match what was served. An LPN also reported that residents complained about the food, describing it as lacking taste and served in small portions.
Food Storage and Preparation Deficiencies
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards. During a kitchen tour, surveyors observed a small bag of mixed frozen fruit unlabeled in the small slide-open top freezer in the kitchen prep area, bread and rolls in dry storage past their discard dates, prepared salads with cooked eggs, sliced cheese, and lunchmeat in the walk-in refrigerator without open or discard dates, and opened mayonnaise and relish containers without labeling. In the small kitchen refrigerator, prepared fruit cups and puddings were unlabeled, and a tray of room-temperature prepared applesauce cups was also unlabeled in the prep area. Surveyors also observed free-floating pork thawing in standing water in a metal bowl in the kitchen prep sink, with diced carrots floating in the water and the pork not secured in a bag or packaging. Later observations found a tray of prepared beverages in cups stored in the walk-in freezer for cooling, and a loaf of bread with a discard date already past placed on a shelving unit in the kitchen prep area. During interviews, the Food Service Director stated that beverages and snacks had been prepared earlier that day and had not yet been labeled, that the applesauce had been prepared for medication passes and also had not yet been labeled, that the frozen fruit belonged to an employee who sometimes stored personal food in the freezer, and that the pork was being thawed for lunch service.
Inaccurate MDS Assessment for Resident With Contractures
Penalty
Summary
The facility failed to ensure the accuracy of the Minimum Data Set (MDS) for one resident whose quarterly assessment dated 3/11/2026 documented no impairment to the upper or lower extremities in Section GG, despite multiple records showing contractures and impaired range of motion. The resident was admitted with diagnoses including contracture, left wrist contracture, and contracture of muscle multiple sites, and the care plan documented dependence for transfers with a Hoyer lift and use of a splint/brace. An observation on 4/10/2026 found the resident lying in bed with the left hand drawn up near the chest and the wrist arcing downward. The resident’s history and physical documented left-sided hemiplegia, and therapy records documented left hemiparesis/hemiplegia, prior contracture management and positioning, impaired range of motion in both lower extremities, functional limitations due to contracture, and clinical impressions of left hemiplegia and contractures of the left lower extremity. Occupational therapy also documented decreased range of motion and contractures. During interviews, an LPN stated the resident’s contracture started in the hospital and continued at the facility, the rehab director stated the resident arrived with beginning contracture of the elbow, wrist, and hand, and the MDS coordinator stated they should have used the contracture information when completing the quarterly MDS.
Failure to Obtain Required PASARR Level II Evaluation
Penalty
Summary
PASARR screening for mental disorders or intellectual disabilities was cited because the facility failed to obtain a Level II evaluation after a positive Level I screen recommended one. Resident #55 was admitted with diagnoses of bipolar disorder, chronic hepatitis, and urinary tract infection, and the Minimum Data Set dated 3/26/2026 documented that the resident was understood, could understand others, and was moderately cognitively impaired. The Pre-admission Screening and Resident Review dated 2/29/2024 answered yes to Question 23 regarding serious mental illness and to Question 33A for a Level II mental illness evaluation by a designated mental health review entity. Despite this recommendation, no Level II evaluation was completed for the resident. During interview, the Director of Social Services stated they had made a mistake and had not read the PASARR to the end of the document where the Level II evaluation had been recommended.
Incomplete Comprehensive Care Plans for Dementia and CPAP Use
Penalty
Summary
The facility failed to develop and implement person-centered comprehensive care plans for two residents in accordance with professional standards. The survey found that the comprehensive care plan should describe the resident’s medical, nursing, physical, mental, and psychological needs and preferences and how the facility would assist in meeting those needs and preferences, but this was not done for Resident #3 and Resident #34. Resident #3 was admitted with sepsis, vascular dementia with other behavioral disturbance, and chronic pain syndrome. The Minimum Data Set dated 3/4/2026 documented that the resident usually understood others, was sometimes understood by others, and was severely cognitively impaired. Review of the comprehensive care plans showed there was no comprehensive care plan addressing the resident’s dementia diagnosis. During interviews on 04/10/2026, the DON stated there should be a care plan for dementia, and the ADON stated there should be care plans for any issues with a resident and that a dementia resident should have had a care plan addressing the issue. Resident #34 was admitted with hypertension, COPD, and obstructive sleep apnea. The Minimum Data Set dated 11/05/2025 documented the resident was understood, could understand others, and was cognitively intact. A CPAP machine was observed at the bedside on 04/06/2026 and again on 04/10/2026. The History and Physical dated 11/07/2025 documented the diagnosis of obstructive sleep apnea and encouraged continued use of the CPAP machine, noting the resident may experience or aggravate headaches if it was not used. However, the comprehensive care plan titled Risk for Compromised Respiratory Status, dated 11/05/2025, did not include the use of a CPAP machine. During interview, the ADON stated there should have been care plans for any issues with a resident.
Failure to Apply Ordered Left Hand Splint
Penalty
Summary
The facility failed to ensure that Resident #11 received the ordered left resting hand splint as tolerated. The resident had diagnoses including nontraumatic intracerebral hemorrhage, stiffness of other specified joint, muscle weakness, left wrist contracture, and contracture of multiple muscle sites. The MDS dated 12/02/2025 documented cognitive impairment, and the care plan dated 04/08/2026 included splint/brace interventions referencing the physician order for a left resting hand splint as tolerated. The resident was dependent for transfers and required a Hoyer lift. During observation on 04/10/2026 at 9:05 AM, Resident #11 was lying in bed with the left hand drawn up near the chest and the wrist arcing downward, and no splint was on the left wrist, hand, or arm. During a second observation at 12:15 PM, the resident was sitting bedside in a positioning chair, alert and non-verbal, and the left hand was again observed without a hand splint. The physician order dated 03/27/2026 directed that the left resting hand splint be applied every day during the day shift as tolerated, but CNA accountability records for 04/06/2026 through 04/13/2026 lacked documentation that the splint had been applied. CNA #8 stated the resident was in so much pain during morning mechanical transfer that they did not want to hurt the resident more by applying the splint and did not report this to the nurse. LPN #6 stated they were not notified that the resident needed the splint applied and said that if they could not get the hand splint on, they would notify therapy. The Director of Rehabilitation stated the resident was to wear the left hand and wrist splint as tolerated and that staff should be putting it on every day.
Failure to Provide Adequate Supervision for a High-Fall-Risk Resident
Penalty
Summary
The facility failed to ensure adequate supervision for Resident #16, who was assessed as a high fall risk with severely impaired cognition, a history of falls, and poor safety awareness. The resident was admitted with unspecified dementia with other behavioral disturbance and vascular dementia. The Minimum Data Set dated 03/23/2026 documented that the resident usually understood others, was sometimes understood by others, and was severely cognitively impaired. The care plan dated 09/09/2022 directed staff to keep the resident in a supervised area when out of bed and in the hallway. During an observation on 04/06/2026 at approximately 10:30 AM, a resident was heard yelling for help in the day room, a loud noise was heard, and Resident #16 was found lying face down on the floor in front of the wheelchair with no staff present. The surveyor called for assistance, and staff then responded to assess the resident and move the resident off the floor. In interviews, RN #1 stated the resident needed to be in the front day room, LPN #1 stated the resident was usually in the front day room or in the hallway near the nurses' station, and CNAs described supervised areas as locations such as in front of the nursing station, the first common room, the dining room, activities area, or anywhere staff were present or would walk by.
Improper Foley and Leg Bag Care
Penalty
Summary
The facility failed to provide appropriate treatment and services for a clinically justified indwelling urinary catheter and failed to maintain proper infection control practices for one resident with a Foley catheter. Resident #26 had diagnoses including Parkinson's disease, vascular dementia with psychotic disturbances, and flaccid neuropathic bladder. The resident's MDS documented cognitive intactness and partial/moderate assistance for toileting hygiene and personal hygiene, with independence for transfers and set-up or clean-up assistance for toilet transfer. The physician's order directed the Foley catheter to be changed to a leg bag when out of bed and to a bedside bag every day on day and evening shifts, and the care plan stated the resident would perform their own care of changing the Foley bag to leg bag changes. During observation, the resident was seen sitting in a wheelchair in the dining room with catheter tubing coming out of the left pant leg and a urinary collection bag attached and covered, lying on the floor, with cloudy contents in the tubing and no place to hang the bag. When asked, the resident stated they thought they had the leg bag on. Staff interviews showed CNA #8 believed the resident wore a leg bag on day shift and could put it on themself, and CNA #7 stated the resident was pretty much independent and liked to do their own Foley care. The DON later stated staff should apply the resident's leg bag and should not expect the resident to change it themselves, and that residents do not apply their own leg bags for infection control reasons.
Failure to Provide Ordered CPAP Respiratory Care
Penalty
Summary
The facility failed to ensure appropriate respiratory care and services were provided for a resident with obstructive sleep apnea who required CPAP therapy. The resident also had diagnoses of COPD, chronic pulmonary embolism, and migraines, and the MDS documented the resident was cognitively intact. The medical record lacked a physician’s order for CPAP and settings, and the care plan for compromised respiratory status did not include a CPAP intervention. A history and physical noted the resident should continue CPAP use because not using it may aggravate headaches. During observations, the resident’s CPAP machine, tubing, and mask were seen on the bedside stand with the equipment open to air. The resident stated they needed assistance turning it on and later stated they had not used the machine for two weeks because it needed to be cleaned and they had to take it into the bathroom and wash it. An LPN stated they did not do anything with the machine because it was the resident’s own machine and then noted there was no physician’s order for it. Another LPN stated they did not know the resident had a CPAP and that there was no order, but there should be one. The MD stated residents using CPAP at home would likely continue it in the facility and was not aware the resident had not been using it for two weeks. The DON stated the nurse or CNA was responsible for cleaning the CPAP.
Medication Order Entry and Administration Error
Penalty
Summary
A significant medication error occurred for a resident admitted with sepsis, vascular dementia with behavioral disturbance, and chronic pain syndrome. The resident’s MDS documented severe cognitive impairment. The physician’s order for oxycodone HCl 10 mg, written as needed for pain, did not include a stop date or the other required order elements described in facility policy, and the medication was administered repeatedly over several months on the MAR despite the order language indicating it was limited to one time for chronic pain syndrome. The December 2025 through April 2026 MARs documented multiple administrations of oxycodone HCl 10 mg on numerous dates and times. During interviews, the DON stated this was a medication error and did not know why the order was not entered with a stop date or why the error was not caught. An LPN stated they were told verbally the order was once daily as needed for pain, did not read the entered order closely, and there was no system in place to check new orders for accuracy. The ADON stated new orders required a co-signer to check the order for accuracy.
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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 Castleton On Hudson
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Evergreen Commons Rehabilitation And Nursing Ctr | 5.9 mi | ★★★★★ | 4 | 0 |
| Rosewood Rehabilitation And Nursing Center | 7.2 mi | ★★★★★ | 55 | 2 |
| Delmar Center For Rehabilitation And Nursing | 7.8 mi | ★★★★★ | 17 | 0 |
| St Margarets Center | 8.4 mi | ★★★★★ | 0 | 0 |
| The Grand Rehabilitation And Nursing At Barnwell | 8.4 mi | ★★★★★ | 6 | 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.