Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Taconic Rehabilitation And Nursing At Ulster during CMS and state inspections, most recent first.
The facility did not ensure annual testing of all fire alarm system devices, specifically the magnetic fire/smoke barrier doors' hold open devices and magnetic delayed egress locks, as required by NFPA standards. This was identified during a life safety recertification survey, and the Director of Maintenance confirmed the oversight.
The facility did not ensure its HVAC system was maintained according to NFPA 80 standards. A survey revealed that while fire dampers were inspected and deficiencies noted, the follow-up report for repairs was missing. The Director of Maintenance confirmed that repairs were not done and the vendor would be contacted.
The facility was found to have maintenance deficiencies, including a window in a resident's room that could not stay open without a washcloth and a window shade with a mold-like substance. Additionally, a corridor window was propped open with a glove box. These issues were observed on one of the three resident floors.
The facility did not ensure the linen chute door latched properly, as required by NFPA 82 standards. During a Life Safety recertification survey, it was observed that the self-closing device on the intake door to the linen chute on one resident floor did not latch when closed. The Director of Maintenance confirmed the issue during an interview.
The facility did not ensure compliance with plumbing requirements for hand washing fixtures in the kitchen's food prep areas. During a survey, it was found that the sink adjacent to the refrigerator had 3-inch blade handles instead of the required 4-inch wrist blade handles, affecting 2 of 3 food prep locations. The Director of Maintenance acknowledged the issue.
The facility did not conduct a required facility-based or community-based emergency preparedness drill, as confirmed by the Director of Maintenance. Although tabletop drills were conducted, the necessary drill was missing, leading to non-compliance with 483.73(d).
A resident with significant mobility and cognitive impairments experienced a fall and sustained a facial hematoma and hip fracture. The resident was moved from the floor to bed by an LPN and two CNAs without an RN assessment, contrary to facility policy. No neurological checks or timely physician evaluation were documented, and the resident was not sent to the hospital until after an x-ray revealed a femur fracture, resulting in actual harm.
A resident with severely impaired cognition and dependent on assistance for daily living activities was found with long, stained fingernails, indicating a failure in personal hygiene care. The facility's policy required routine nail care following baths and showers, but there was no documentation of nail care for this resident. A CNA admitted to not noticing the long fingernails, and the LPN Unit Manager confirmed the oversight, highlighting a lapse in the facility's adherence to its hygiene policies.
A facility failed to update a care plan for a resident with pressure ulcers, despite staff observing that the current intervention of floating heels with pillows was ineffective due to the resident's movements. The resident, who required maximum assistance with rolling in bed, was observed with their heels directly on the mattress multiple times, and no alternative interventions were provided. Staff did not report the issue to management, resulting in a deficiency.
The facility failed to document COVID-19 vaccination screening and education for two staff members, a CNA and a Laundry Aide, as required by their policy. The LPN responsible for immunization data collection was unaware of the need to offer the vaccine, and the DON was unsure why documentation was incomplete, leading to a deficiency in infection control practices.
The Assistant Director of Nursing failed to perform proper hand hygiene while serving beverages to residents, wearing disposable gloves without changing them between services and touching various surfaces without sanitizing hands. The staff member admitted to using gloves unnecessarily and acknowledged the lack of soap at the sink, which contributed to the deficiency.
The facility failed to maintain infection control practices, including lack of documentation for pneumococcal vaccination for two staff members, an undated Water Management Plan for Legionella prevention, and improper sanitization of a blood pressure cuff by an LPN. The DON and maintenance staff were unaware of these oversights.
A recertification survey found expired medications in a medication room and cart, and a resident with multiple medications left unattended on their bedside table. Staff acknowledged the errors, noting that expired items should not have been used and medications should have been secured.
The facility failed to provide written notices of the bed hold policy to residents or their representatives during hospital transfers. This deficiency affected five residents, including those with intact and moderately impaired cognition, who were transferred without documented evidence of receiving the required notices. The issue was attributed to a service gap and administrative changes.
The facility failed to provide written transfer or discharge notices to five residents who were sent to the hospital, as required by policy. The deficiency was attributed to a service gap due to recent administrative changes and new staff, resulting in a lapse in following the established procedure for notifying residents and their representatives.
A resident with a history of falls and moderately impaired cognition was found without access to a call system to request assistance, as the call bell was consistently out of reach and sight. Despite facility policy requiring call lights to be within reach, the resident had to yell for help and was observed transferring themselves without assistance. Staff interviews confirmed the expectation for call bells to be accessible.
A resident with impaired decision-making and memory issues was observed wearing socks with their name visibly labeled, compromising their dignity. Staff interviews revealed a lack of awareness about the visibility of name labels, although the DON recognized it as a dignity issue and took steps to address it.
Two residents at risk for pressure ulcers did not receive necessary treatments as per their care plans. One resident's heels were not floated in bed, and skin prep treatments were not documented as administered multiple times. Another resident did not receive documented wound care treatments for their pressure ulcers on several occasions. Staff interviews confirmed the lack of treatment administration and documentation.
Failure to Test Fire Alarm System Devices Annually
Penalty
Summary
The facility failed to ensure that all devices associated with the fire alarm system were maintained and tested annually in accordance with NFPA 101 and NFPA 72 standards. During a life safety recertification survey, it was observed that the facility's maintenance logs did not include documentation of annual testing for the magnetic fire/smoke barrier doors' hold open devices and the magnetic delayed egress locks. The last recorded service by the vendor occurred on three separate occasions, but none included the required testing of these specific devices. This deficiency was confirmed during an interview with the Director of Maintenance, who acknowledged the oversight and stated that the vendor would be contacted to address the issue.
Plan Of Correction
Plan of Correction: Approved March 31, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - Facility contracted fire alarm vendor was contacted via telephone on 3/14/25 and informed that hold open devices and magnetic egress locks are required to be tested annually as per NFPA 101 and NFPA 72 and such testing was not included as part of the vendor conducted inspections. - Facility contracted fire alarm vendor was asked to complete a full house test of all hold open devices and magnetic egress locks. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All residents have the potential to be affected; however, no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: - The facility policy and procedure on Fire Alarm System Testing and Inspection was reviewed and revised to include testing of all hold open devices, magnetic fire/smoke barrier doors, and magnetic delayed egress locks. - Maintenance staff will be re-educated on the fire alarm system testing requirements by the administrator, and a record of education will be maintained for reference and validation. - Facility contracted fire alarm vendor will include in all inspection reports the location and inspection of all doors with magnetic egress locks and hold open devices that are released upon fire alarm activation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Maintenance has created an audit tool to ensure that fire alarm system testing and inspection documentation is completed and validate that all required doors/magnetic devices are included in the documentation maintained on file. - The Director of Maintenance/designee will audit monthly for 3 months. Negative findings will be immediately reported to the administrator. - Results of audits will be reviewed during monthly QAPI meetings, and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is 4/18/25.
Failure to Maintain HVAC System in Compliance with NFPA 80
Penalty
Summary
The facility failed to maintain its heating, ventilation, and air conditioning (HVAC) system in compliance with NFPA 80 standards. During a life safety recertification survey, it was discovered that the facility's fire damper log indicated inspections and tests were conducted by a vendor, and deficiencies were noted. However, the required follow-up report detailing the corrections of these deficiencies was missing and not available at the time of the survey. In an interview, the Director of Maintenance admitted that the repairs had not been completed and stated that the vendor would be contacted to address the issue.
Plan Of Correction
Plan of Correction: Approved March 31, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - Facility fire damper inspection vendor was contacted on 3/24/25 and was contracted to complete a full house fire damper inspection. - Fire Damper vendor will provide a written report of any deficient areas, schedule any required repairs identified in the report, and provide documentation of such after the completion of repairs. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All residents have the potential to be affected; however, no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: - Maintenance staff will be re-educated by the administrator on the testing and maintenance requirements for fire dampers, including ensuring necessary repairs are completed and documentation of repairs are retained. A record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Maintenance has created an audit tool to ensure that fire damper testing, inspection, and repair documentation is completed every 4 years as required by 2010 NFPA 80. - The Director of Maintenance/designee will conduct an initial audit of fire damper inspection(s) and immediately report any negative findings to the administrator. - Results of additional inspections or repairs will be reviewed during monthly QAPI meetings, and the QAPI committee will determine ongoing audit frequency for continued compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is 4/18/25.
Facility Maintenance Deficiencies
Penalty
Summary
The facility failed to maintain a safe and functional environment as required by regulations. During an offsite post-survey revisit, it was observed that a window in a resident's room was in disrepair, as it could not remain open without being propped up by a washcloth. Additionally, the window shade in the same room was found to have a black mold-like substance. Furthermore, a window in the corridor on the same floor was also in disrepair, being propped open with a glove box. These deficiencies were noted on one of the three resident floors. The Director of Maintenance acknowledged the issues, stating that the facility has central air conditioning for resident rooms and that the window shade would be replaced.
Plan Of Correction
Plan of Correction: Approved May 2, 2025 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - The window shade in room [ROOM NUMBER] was replaced on 3/24/25 by the maintenance department. - The window in room [ROOM NUMBER] and the corridor window were repaired by the maintenance director and maintenance assistant. Repairs included lubrication and replacement of pivot shoes and spiral tilt window balance. - A full house audit of windows and window shades was completed on 3/27/25 and any negative findings will be scheduled for repair. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All residents have the potential to be affected; however, no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: - Maintenance staff will be re-educated on the facility preventative maintenance requirements for windows. A record of education will be maintained for reference and validation. - All staff will be educated on maintaining and providing a safe and functional environment to residents; including reporting any observed repairs needed in the facility to the maintenance department via the facility work order system. A record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Maintenance has created an audit tool to ensure all facility windows are able to be opened and stay open without any outside intervention and that all window shades are present, clean, and in good repair. - The Director of Maintenance/designee will audit 25% of rooms 1 x week for 4 weeks then monthly thereafter for 3 months. Negative findings will be corrected immediately and reported to the administrator. - Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is: 4/18/25.
Linen Chute Door Latching Deficiency
Penalty
Summary
The facility failed to maintain the linen and trash chutes in accordance with NFPA 82 standards. Specifically, the self-closing device on the intake door to the linen chute did not latch when self-closed. This deficiency was observed during a Life Safety recertification survey on one of the three resident floors. The issue was identified during a tour of the linen chute room on the first floor, where it was noted that the intake door to the linen chute did not properly latch. The Director of Maintenance acknowledged the finding during an interview at the time of the survey.
Plan Of Correction
Plan of Correction: Approved May 2, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - The latches and pistons were replaced on all three laundry chute doors on 3/25/25 by the maintenance director. - A full house audit of laundry chutes will be completed and any negative findings will be immediately corrected. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All residents have the potential to be affected; however, no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: - Maintenance staff will be re-educated on the maintenance requirements for rubbish chutes, incinerators, and laundry chutes NFPA 101 to meet code requirements. A record of education will be maintained for reference and validation. - All staff that routinely use the laundry chutes (nursing, dietary, maintenance, housekeeping) will be educated on the requirements that the linen chute door is required to latch when self-closed and to report negative findings to maintenance director/designee immediately. A record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Maintenance has created an audit tool to ensure that laundry chute doors are operational and that all chute doors close and latch. - The Director of Maintenance/designee will audit 2 x week for 4 weeks then weekly thereafter for 3 months. Negative findings will be corrected immediately and reported to the administrator. - Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is 4/18/25.
Non-compliant Hand Washing Fixtures in Kitchen
Penalty
Summary
The facility failed to ensure that hand washing fixtures in the food preparation areas of the kitchen were compliant with regulatory requirements. During a recertification survey, it was observed that the hand washing sink in the food prep area adjacent to the refrigerator was equipped with 3-inch long blade handles instead of the required 4-inch wrist blade handles. This deficiency was noted in 2 out of 3 food prep locations in the kitchen. The Director of Maintenance acknowledged the finding during an interview conducted at the time of the survey.
Plan Of Correction
Plan of Correction: Approved March 31, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - 4-inch wrist blade handles were installed on the hand washing sink in the food prep area on 3/24/25. - An audit of the sinks in the kitchen was conducted on 3/25/25 and no other concerns were identified for the hands-free fixtures. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All residents have the potential to be affected; however, no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: - Kitchen and maintenance staff will be educated by the administrator on the wrist blade hand free fixtures and requirement in the event future repairs are needed. A record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Maintenance/designee will audit 1 x week for 4 weeks, then monthly thereafter for 3 months. Negative findings will be corrected immediately and reported to the administrator. - Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is 4/18/25.
Failure to Conduct Required Emergency Preparedness Drill
Penalty
Summary
The facility failed to ensure compliance with the emergency preparedness requirements as outlined in 483.73(d). During a documentation review and staff interview conducted on March 13, 2025, it was found that the facility did not conduct a required facility-based or community-based emergency preparedness drill. Although tabletop drills were conducted on April 23, 2024, and August 28, 2024, the necessary facility-based or community-based drill was missing. This deficiency was confirmed in an interview with the Director of Maintenance, who acknowledged that the required drill had not been conducted.
Plan Of Correction
Plan of Correction: Approved March 31, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: A facility based or community based drill will be scheduled and completed by 4/18/2025. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: All residents have the potential to be affected, however no residents were negatively impacted. Element #3: The following system changes will be implemented to prevent reoccurrence: Maintenance staff and department heads will be in-serviced by the administrator on the requirements for LTC facilities to conduct exercises at least twice per year including unannounced staff drills and participation in an annual full-scale exercise that is either community based, or a facility based functional exercise. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: The Administrator has created an audit tool to track dates of disaster drills, type of disaster drill completed to ensure continued compliance. The Director of Maintenance/designee will audit 1 x week for 4 weeks then monthly thereafter for 3 months. Negative findings will immediately be reported to the administrator. Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Maintenance/designee. Date of Compliance is 4/18/25.
Failure to Ensure Timely RN Assessment and Appropriate Response After Resident Fall
Penalty
Summary
A resident with a history of seizure disorder, heart failure, and traumatic brain injury, who was non-ambulatory and required maximum assistance for transfers, experienced a fall in the early morning hours. The resident was found on the bathroom floor by a Certified Nurse Aide (CNA), who reported the incident to an LPN. The resident had a hematoma on the face and complained of pain in the right lower back. Despite facility policy requiring assessment by a Registered Nurse (RN) after any accident or injury, there was no documented assessment by an RN or physician prior to the resident being moved from the floor to a wheelchair and then to bed by the LPN and two CNAs. Following the fall, the resident continued to complain of pain and exhibited swelling in the right groin and upper thigh. An x-ray was ordered and performed later that evening, revealing an acute fracture of the right femur. There was no documented evidence of a medical evaluation by a physician on the day of the fall, and neurological checks were not initiated. The resident was not transferred to the hospital until the following morning, after the x-ray results were reviewed and the physician was notified. Interviews with facility staff revealed that the LPN did not notify the RN Supervisor or the Director of Nursing (DON) about the fall or the transfer of the resident from the floor. The DON confirmed that the LPN should not have moved the resident without an RN assessment, as per facility policy. The lack of timely assessment and appropriate response resulted in actual harm to the resident, who ultimately required surgical intervention for the hip fracture.
Deficiency in Personal Hygiene Care for Resident
Penalty
Summary
The facility failed to ensure that a resident who was unable to carry out activities of daily living received the necessary services to maintain personal hygiene. Specifically, Resident #29, who had severely impaired cognition and required dependent assistance with showers, was observed on multiple occasions with long, stained fingernails. The facility's policy on nail care, revised in 2011, stated that routine nail care should be done following baths and showers whenever possible. However, there was no documented evidence regarding the trimming or cleaning of Resident #29's fingernails, despite the resident's care plan indicating a need for maximal assistance with upper body bathing. During the survey, Certified Nurse Aide #7 admitted to not paying attention to the resident's fingernails when providing care and did not notice the long fingernails during a previous care session. The Licensed Practical Nurse Unit Manager #4 stated that CNAs were responsible for cutting residents' fingernails unless the resident was diabetic and that the CNA should have informed the nurse if a resident's nails were long. Upon observation, the Unit Manager confirmed that Resident #29's fingernails were indeed long, indicating a lapse in the facility's adherence to its own policies and procedures for maintaining residents' personal hygiene.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Resident #29 was offered nail care and declined nail care. Residents care plan was updated to reflect to encourage nail care per residents’ preference and as tolerated by the resident. The resident was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs and a medical record review completed with no abnormal findings. Certified nurse aid #7 was educated on the policy of providing nail care to the residents as part of daily ADL’s. The CNA has since been re-audited and successfully demonstrated her understanding. All residents on the CNA's assignment had the potential to be affected by the deficient practice. Full house audit by Nurse Managers/designee will be completed to assure all residents' nails are clean and trimmed and care planned appropriately. Any instances of dirty nails were immediately rectified. Nurses and CNA’s will be educated by the DON/designee on the process of providing nail care during daily ADL’s and ensuring residents' nails are clean and trimmed as outlined in the resident’s plan of care. Weekly audits to be completed by the nurse manager/designee to ensure compliance with proper nail care and that residents' nails are clean and trimmed per care plan. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review the audits for compliance. Any negative findings will result in immediate education. The audit results will be reported at the Monthly QAPI meeting. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Failure to Update Care Plan for Resident with Pressure Ulcers
Penalty
Summary
The facility failed to ensure that the Comprehensive Care Plans were reviewed and revised in a timely manner for a resident with pressure ulcers. Specifically, the care plan for a resident, who had a history of [DIAGNOSES REDACTED] and required maximum assistance with rolling in bed, was not updated to include a new intervention when staff observed the resident moving their legs frequently while in bed. The care plan initially documented an intervention to float the resident's heels, but this was not effective as the resident was observed with their heels directly on the mattress on multiple occasions, and no alternative interventions such as heel booties or an air mattress were provided. During interviews, it was revealed that the nursing staff, including an LPN, were aware that the current intervention of using pillows to float the resident's heels was ineffective due to the resident's movements. However, they did not report this issue to the Nurse Manager or suggest alternative interventions. The facility's policy required that care plans be reviewed and updated regularly, especially with changes in the resident's condition, but this was not adhered to in this case, leading to the deficiency.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Resident # 68 comprehensive care plan was reviewed and revised on 3/8/25 to reflect an air mattress for pressure relief of her heels. The resident was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs and a medical record review completed with no abnormal findings. Unit manager was educated on the requirement to update the resident care plan to accurately reflect interventions. Full house audits will be completed by the nurse managers for all residents with wounds and ensure that the comprehensive individualized care plan for wounds is reviewed and revised to accurately reflect the residents' needs. All unit managers/supervisors educated by the DON/designee to review and revise comprehensive individual care plan weekly or with noted ineffective interventions. Weekly audits will be completed by the unit managers/designee to ensure all residents with wounds have a comprehensive individualized care plan with effective interventions in place. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review audits for compliance. Any negative findings will result in immediate education. The audit results will be reported at the monthly QAPI meeting. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Deficiency in COVID-19 Vaccination Documentation for Staff
Penalty
Summary
The facility failed to maintain infection control prevention practices, specifically regarding COVID-19 vaccinations for staff. During a recertification survey, it was found that the facility did not provide documentation of screening, administration, or declination of the COVID-19 vaccine for two staff members, a Certified Nurse Aide and a Laundry Aide. The facility's COVID-19 policy required that all employees and contracted staff be screened and educated about the vaccine, with documentation maintained to reflect this process. However, the facility was unable to provide such documentation for the two staff members in question. Interviews conducted during the survey revealed that the Licensed Practical Nurse responsible for collecting employee immunization data did not have completed forms for the two staff members, indicating a lack of awareness that the COVID-19 vaccine needed to be offered to staff. The Director of Nursing stated that the responsibility for ensuring forms were signed was delegated to the Licensed Practical Nurse, but they were unsure why the documentation was not completed. This oversight led to a deficiency in the facility's infection control practices as per the regulatory requirements.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Staff #15 and #16 were both offered and declined COVID vaccinations for the year. Consent form was signed on (MONTH) 12, 2025. Staff #17 has been educated on the importance of completion of vaccination forms in its entirety. That Covid vaccinations are available in the facility throughout the year. A full house audit of all staff vaccination status will be conducted by DON/designee. All staff will be offered the Covid vaccines with education and eligibility information. Education provided to Staff #17 all staff can accept or decline all vaccinations throughout the year. Covid vaccinations are available at any time in the facility. Upon request. Covid vaccinations are offered at time of hire and, throughout the year. All vaccinations are available at any time. House wide audit of vaccinations records will be completed by ADON/designee monthly until 100% compliance is attained for 3 consecutive months. Any abnormal findings will be reported to the DON. These findings will be corrected immediately with education provided. The DON/ADON will review audits for compliance. Any negative findings will result in immediate education. The audit results will be reported to QAPI monthly meeting. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Improper Hand Hygiene During Beverage Service
Penalty
Summary
The facility failed to ensure food was distributed and served in accordance with professional standards for food service safety during a recertification survey. The Assistant Director of Nursing was observed serving beverages to multiple residents in the main dining room without performing proper hand hygiene. The staff member wore disposable gloves while serving but did not change them between serving different residents. Additionally, the Assistant Director of Nursing touched various surfaces, such as the beverage cart handle and a resident's walker, without changing gloves or sanitizing hands, and continued to serve beverages to residents. The Assistant Director of Nursing also touched their own face with bare hands while taking a beverage order and proceeded to serve a resident without washing or sanitizing hands. The staff member admitted to wearing gloves to prevent contamination of the ice but acknowledged that gloves were not necessary and that hand hygiene should have been performed. The surveyor confirmed that the sink was out of soap, which contributed to the lack of proper hand hygiene during the beverage service.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Resident # 93 had no ill effects from the deficient practice noted during the meal service on 3/5/25. The resident was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs and a medical record review completed with no abnormal findings. ADON was educated on proper hand hygiene while serving in the main dining room. She has since been re-audited and successfully redemonstrated understanding. All facility residents have the potential to be affected by the alleged practices. A meal service audit was conducted on all units to verify that disposable gloves were not being used during meal pass and that hand hygiene was performed properly. No further issues were identified. All nursing staff will be in-serviced regarding proper hand hygiene in accordance with professional standards for food service safety while serving meals. Weekly audits will be completed across all 3 meals in each dining room on a rotating basis by DON/designee to assure proper hand hygiene during meal service. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review audits for compliance. Any negative findings will result in immediate education. The audit results will be reported at the monthly QAPI meeting. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Infection Control Deficiencies in Vaccination, Water Management, and Equipment Sanitization
Penalty
Summary
The facility failed to maintain proper infection control prevention practices, as evidenced by three specific deficiencies. Firstly, the facility did not provide documentation of pneumococcal vaccination screening, administration, or declination for two staff members, a Certified Nurse Aide and a Laundry Aide. The Licensed Practical Nurse responsible for collecting immunization data admitted to not having completed forms for these staff members, indicating a lapse in ensuring that employees were educated and had the opportunity to consent to or decline the vaccine. The Director of Nursing acknowledged the oversight and attributed it to the delegation of vaccine tasks to the Licensed Practical Nurse. Secondly, the facility's Water Management Plan, crucial for preventing and controlling Legionella, was found to be undated with no evidence of annual review or updates. The Director of Maintenance was unaware of the oversight. Lastly, during a medication pass observation, an LPN was seen placing an unsanitized blood pressure cuff back into the medication cart after use, contrary to the facility's policy requiring sanitization between uses. The Director of Nursing confirmed that shared equipment should be sanitized with alcohol or sanitizing wipes after each use.
Plan Of Correction
Plan of Correction: Approved April 11, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - Nurse Aide #15 and laundry aide #16 were offered the pneumococcal vaccine on 3/12/25; both declined and signed a declination form. - Education provided to LPN #17 on the requirements for all employees to have documented immunization status; including eligibility, education and administration of vaccines and that signed consents/declinations are maintained on file. - The water management plan was reviewed and updated on 3/5/2025 and verbal education was provided to the Maintenance Director on the documentation requirements for the water management plan which includes, at minimum, an annual documented review of the water management plan. - Licensed practical nurse #18 was educated on the requirement to sanitize blood pressure cuffs after use, prior to being placed in the medication cart. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All Residents have the potential to be affected; however, no residents have been negatively impacted. - Staff Educator/designee completed an audit of all employee vaccination status, and the pneumococcal vaccine will be offered to any employee identified as needing such based off of audit findings. Element #3: The following system changes will be implemented to prevent reoccurrence: - The facility policy and procedure titled “Pneumococcal Vaccination Program for Employees” was reviewed and found to be appropriate. - The staff educator/designee will provide education to all employees upon hire and at least annually on the pneumococcal vaccine and will obtain a signed consent or declination for the vaccine. Consent/declination forms will be retained on file. - The staff educator/designee will provide education to all licensed nurses on the requirement to properly sanitize blood pressure cuffs after use and prior to placing in medication cart for storage. - The administrator provided verbal education to the Maintenance Director on 3/5/2025 on the requirement to complete and update the water management plan on an annual basis. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Nursing has created an audit tool to ensure that all employees were offered the pneumococcal vaccine upon hire and annually and that a consent/declination form is signed by the employee. - The Director of Nursing has created an audit tool to ensure that licensed staff are properly sanitizing blood pressure cuffs after use. - ADON/Designee will complete a full house audit of employee vaccination records monthly until 100% compliance is attained for 3 consecutive months. Negative findings will be corrected and reported to the Director of Nursing. - Unit managers/designee will audit once a week to ensure that blood pressure cuffs are properly sanitized in between residents until 100% compliance is attained for 4 consecutive weeks. Negative findings will be corrected and reported to the Director of Nursing. - Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency for blood pressure cuffs after 4 weeks of 100% compliance; and for employee vaccinations after 3 months of 100% compliance. Element #5: The person responsible for the corrective actions is the Director of Nursing/designee. Date of compliance is 4/18/25.
Expired Medications and Improper Storage in LTC Facility
Penalty
Summary
The facility failed to maintain drugs and biologicals in accordance with professional standards for expiration dates and storage. During a recertification survey, it was observed that one of the medication rooms contained an open box of expired [MEDICATION NAME] 1.5 Cal, which was being used for a resident's feeding. Additionally, expired nicotine patches were found in a medication cart without proper labeling. Interviews with nursing staff revealed that the expired items should not have been in use, and it was the responsibility of the medication nurses to check and dispose of expired items. Furthermore, a resident was found with multiple medications left unattended on their bedside table, despite not having documented permission to self-administer medications. The medications included Carvedilol, an anti-depressant, Aspirin, Apixaban, Folic Acid, Levetiracetam, a stool softener, and an anti-acid. A nurse had left the medications with instructions for the resident to wait for water, which was against facility policy. The nurse acknowledged that the medications should have been secured in the medication cart while retrieving water.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** The expired [MEDICATION NAME] feed and nicotine patches were immediately discarded. Resident #60 received appropriate medications on [DATE] and resident has been discharged from the facility. Resident’s preference was to have all medications administered by the nursing department and not to self-administer medications. Resident #90 was assessed and had no negative outcome related to tube feed. MD made aware. The resident was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs, and a medical record review was completed with no abnormal findings. All nursing staff who administered the expired [MEDICATION NAME] and did not discard the expired nicotine patches were re-educated on checking of expiration dates and discarding as appropriate. Nurse manager #6 was re-educated on med pass policy to not leave residents' medications at the bedside and to assure medications are consumed. She has since been re-audited and successfully redemonstrated her understanding. All residents receiving tube feed and medication have the potential to be affected by practice. DNS and Maintenance Director completed a full house audit of tube feeding expiration dates. Additionally, all medication rooms and medication carts were checked to verify that no medications were expired. Any additional medications/feeds that were found to be expired were immediately discarded. All residents who self-administer medications were audited to verify that a Self Administration evaluation was completed and appropriate. Residents that do not have a care plan for self-administering medications will have medications provided by nurses. The nurses will not leave medications unattended. All Nurses and the Maintenance Director were educated by DON/designee to check expiration dates on all tube feed and medications administered items used. Prior to use, dates will be checked. All Nurses will be re-educated by DON/designee pertaining to proper medication administration. All licensed nurses will be re-educated on the facility procedure for residents that request to self-administer medication. Nursing and Maintenance will monitor expiration of tube feeding and supplies. Weekly audits by Unit Manager/designee of tube feeding will be conducted. Medication cart checks will continue to be checked by Pharmacy Consultant monthly. Tube feed will be checked by maintenance before being brought to the unit to ensure that tube feeding has not exceeded expiration date. Tube feeding will be checked by the nurse prior to hanging it. Audits will be ongoing. Weekly audits on med passes by Unit Managers will ensure medication is not left at the bedside. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review audits for compliance. Any negative findings will result in immediate education. The audit results will be reported to QAPI monthly. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is [DATE].
Failure to Provide Written Bed Hold Policy Notices
Penalty
Summary
The facility failed to ensure that residents or their representatives were notified in writing of the facility's bed hold policy during transfers to the hospital. This deficiency was identified for five residents who were reviewed for discharge. Specifically, these residents were transferred to the hospital, and the facility could not provide evidence that written notice of the bed hold policy was given to the residents or their representatives. The facility's policy requires that the bed hold policy be communicated both verbally and in writing at the time of admission and transfer. Resident #50, who had intact cognition and was dependent on staff for all activities of daily living, was transferred to the hospital due to respiratory issues. Similarly, Residents #202 and #203, both with moderately impaired cognition and requiring staff assistance, were transferred to the hospital following incidents that necessitated evaluation. In each case, there was no documented evidence that the residents or their representatives received written notice of the bed hold policy. Interviews with the Director of Social Work and the Administrator revealed that there was a service gap and inconsistency in providing these notices, attributed to recent administrative changes.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: ò Review of identified residents revealed that Residents #50, 69, 68 experienced transfers to the hospital and all were readmitted to the facility after completion of acute hospital stay and are current residents. Resident #202 was transferred to the hospital for acute needs and expired in the hospital. Resident #203 was scheduled for discharge to ALF prior to hospital admission and was directly discharged to ALF from acute care hospital. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: ò All residents who were transferred have the potential to be affected, however no residents were negatively impacted. ò An audit of the last 30 days of resident hospital transfers was completed to ensure that a notice of bedhold was given. Element #3: The following system changes will be implemented to prevent reoccurrence: ò The facility policy and procedure on ‘Bed Hold and Notice’ was reviewed and found to be appropriate. ò Social Work staff, medical records, and admissions will be reeducated on the facility policy and requirement for Bed hold notification for all residents and a record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: ò The Director of Social Work has created an audit tool to ensure that Notice of Bed Hold documentation is accurately completed for all hospital transfers/discharges and validate that all required documentation is uploaded to the facility eMAR system. ò The Director of Social Work/designee will audit, and audits will continue until 100% compliance is attained for 4 consecutive weeks. Negative findings will be corrected immediately and reported to the administrator. ò Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Social Work/designee. Date of Compliance is [DATE].
Failure to Provide Written Transfer Notices
Penalty
Summary
The facility failed to provide written notification of transfer or discharge to the hospital for five residents, as required by their policy and regulations. Residents involved had varying levels of cognitive impairment and required assistance with activities of daily living. For instance, one resident with intact cognition and dependent on staff for all activities was transferred to the hospital due to respiratory issues, but there was no documented evidence of written notification to the resident or their representative. Similarly, other residents with moderately impaired cognition were transferred to the hospital without documented written notice being provided. The Director of Social Work acknowledged the lack of documented evidence for providing written notices, attributing it to a service gap caused by recent administrative changes. The facility's Administrator, who had recently started, identified the issue during an audit and noted that the facility had not been issuing discharge notices in writing for some time. This deficiency was recognized as a result of new staff and changes in administration, which led to a lapse in following the established procedure for notifying residents and their representatives in writing about transfers or discharges.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: ò Review of identified residents revealed that Residents #50, 69, 68 experienced transfers to the hospital and all were readmitted to the facility after completion of acute hospital stay and are current residents. Resident #202 was transferred to the hospital for acute needs and expired in the hospital. Resident #203 was scheduled for discharge to ALF prior to hospital admission and was directly discharged to ALF from acute care hospital. ò Education provided to social workers on the requirement for notice of transfer/discharge to accompany all residents transferred/discharged from the facility. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: ò All residents who were transferred/discharged had the potential to be affected, however no residents were negatively impacted. ò An audit of past 30 days of discharges was conducted to ensure Notice of Transfer/Discharge was provided and to ensure the resident or the resident's representative were notified in writing of the reason for transfer/discharge to the hospital in a language they understood and to notify the Ombudsman for discharge or transfer and hospitalization. Negative findings will be immediately corrected. Element #3: The following system changes will be implemented to prevent reoccurrence: ò The facility policy and procedure on 'Discharge Notice' was reviewed and found to be appropriate. ò Social Work staff, medical records and licensed nursing staff will be reeducated on the facility policy and requirement for discharge/transfer notification for all residents and a record of education will be maintained for reference and validation. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: ò The Director of Social Work has created an audit tool to ensure that Notice of Transfer/Discharge documentation is accurately completed for all planned and unplanned discharges and validate that all required documentation is uploaded to the facility eMAR system. ò The Director of Social Work/designee will audit, and audits will continue until 100% compliance is attained for 4 consecutive weeks. Negative findings will be corrected immediately and reported to the administrator. ò Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after three months of compliance. Element #5: The person responsible for the corrective action is the Director of Social Work/designee. Date of Compliance is [DATE].
Inaccessible Call System for Resident at Risk of Falls
Penalty
Summary
The facility failed to ensure that Resident #30 had access to a call system to request staff assistance, as required by their policy. The call bell for Resident #30 was consistently found out of reach and out of sight, placed on a stationary chair in the corner of the room. This was observed multiple times over several days, and the resident expressed difficulty in calling for help, stating they had to yell for assistance. The resident, who had a history of falls and was at risk for further falls, was observed transferring themselves to the toilet without assistance, indicating a lack of available support due to the inaccessible call system. The facility's policy mandates that call lights be within reach of residents at all times to ensure their safety and ability to communicate needs. Despite this, the call bell for Resident #30 was repeatedly found in an inaccessible location, and staff interviews confirmed that call bells should be within reach. The resident's care plan highlighted the need for supervision with transfers and ambulation, yet the lack of an accessible call system compromised their ability to request necessary assistance, potentially increasing their risk of falls.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Resident #30 was immediately provided with her call bell, and the call bell has been kept within reach. The resident was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs and a medical record review completed with no abnormal findings. All residents had the potential to be affected by the deficient practice. Unit Managers completed a Full house audit of residents to assure call bells are within reach. No further call bells not within reach were found. The Staff educator/Designee provided reeducation for all staff to place call bell within reach for all residents, while in bedroom. Weekly call bell placement audits will be conducted by Unit Manager/designee and reported to DON. All issues will be corrected immediately. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review audits. For compliance, any negative findings will result in immediate education. The audit's results will be reported to QAPI monthly meetings. Then quarterly, the frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Resident Dignity Compromised by Visible Name Labels on Clothing
Penalty
Summary
The facility failed to ensure that a resident was treated with respect and dignity, which compromised the maintenance or enhancement of their quality of life. This deficiency was identified during a recertification survey, where it was observed that a resident, who had severely impaired decision-making and memory problems, was ambulating independently in the hallway wearing socks labeled with their name on the top of the foot. This labeling was visible to other residents, staff, and visitors, which is contrary to the facility's policy on dignity, respect, and privacy in treatment and care. Interviews conducted during the survey revealed a lack of awareness among staff regarding the visibility of name labels on residents' clothing. The LPN Unit Manager stated that the labels were intended to ensure clothing items were returned to the correct resident after laundry, and they were not aware that such labels should not be visible. Similarly, the Social Worker did not perceive the visibility of the name label as a problem. However, the Director of Nursing acknowledged that visible clothing labels were a dignity issue and took steps to address the situation by requesting the relabeling of the resident's socks.
Plan Of Correction
Plan of Correction: Approved April 4, 2025 Resident #65’s socks were immediately removed. Resident #65 was monitored for 5 consecutive days for any emotional distress with no issues noted. The resident’s care plan was reviewed and is in concert with the resident’s current needs, and a medical record review was completed with no abnormal findings. LPN #14 and the Social Worker were reeducated by ADON/Designee on resident dignity and privacy, as well as policy and procedure for clothing labeling. All residents to have clothing labeled in a non-visible area. Both the LPN and Social Worker state their understanding. All residents who have clothing labeled had the potential to be affected by the deficient practice. A full audit of each unit’s resident clothing was conducted by unit managers/designee to identify other potential residents affected by deficient practices. Any instances where clothing labels were found to be visible were rectified immediately. The Staff Educator/designee will conduct educational sessions for all nursing and laundry staff on resident dignity and the use of clothing labels, and policy and procedure for labeling clothing for residents, to ensure all residents are treated in a dignified manner, keeping labels private. Weekly audits will be completed by unit manager/designee to assure residents' rights are observed and policy and procedure is adhered to, with no name labels being visible. Audits will continue until 100% compliance is attained for 4 consecutive weeks. The DON/ADON will review audits for compliance. Any negative findings will result in immediate education. The audit results will be reported at the monthly QAPI meeting. The frequency of ongoing audits will be determined by the QAPI committee based on audit results. The person responsible for the corrective action is the Director of Nursing/designee. Date of Compliance is 4/18/25.
Failure to Administer and Document Pressure Ulcer Treatments
Penalty
Summary
The facility failed to ensure that residents at risk for pressure ulcers and those with existing pressure ulcers received necessary treatment and services consistent with professional standards of practice. Resident #68, who had a history of [DIAGNOSES REDACTED], was not provided with the required interventions to float their heels in bed, as documented in their care plan. Observations revealed that Resident #68's heels were directly on the mattress without any heel booties or pillows to float them, and there was no air mattress in place. Additionally, there was no documented evidence that skin prep treatments were administered as ordered on multiple occasions in February and March. Resident #352, who had [DIAGNOSES REDACTED], was also not provided with the necessary wound care treatments for their Stage 3 and Stage 4 pressure ulcers. The Treatment and Medication Administration Records showed no documented evidence that treatments were completed on several dates in May and June. Interviews with staff, including Licensed Practical Nurses and the Director of Nursing, confirmed that the treatments were not signed off, indicating they were not administered, and there was no documentation explaining the omissions. The facility's policy required daily monitoring and documentation of pressure ulcers and chronic wounds, but this was not adhered to for the residents in question. The lack of adherence to care plans and treatment orders, as well as the failure to document treatment administration, contributed to the deficiency in providing adequate care for residents with pressure ulcers.
Plan Of Correction
Plan of Correction: Approved April 11, 2025 Element #1: The following actions were accomplished for the resident(s) identified in the deficient practice: - Resident #68’s heels were immediately floated and the attending physician was notified of the missed treatments. The resident’s care plan and treatment protocol was reviewed and revised to reflect the use of an air mattress. Resident #68 was monitored for 5 consecutive days with no issues noted. A medical record review was completed and no abnormal findings were identified. - Resident #352 was discharged from the facility on 7/2/2024. A medical record review was completed with no additional abnormal findings. Element #2: The following actions will be implemented to identify other residents who have the potential to be impacted by the deficient practice: - All Residents at risk for skin breakdown as per facility skin risk assessment have the potential to be affected. All residents identified as being at risk based on documented skin assessment were reviewed with no issues noted and care plan is in concert with the resident needs. No deficient practice noted. - ADON/designee completed an audit of all residents with skin breakdown to ensure all devices and treatments are in place and are being signed for by the licensed nurses. Element #3: The following system changes will be implemented to prevent reoccurrence: - The facility policy and procedure titled “Documentation of Pressure Ulcer and Chronic Wounds” was reviewed and found to be appropriate. - The staff educator/designee will provide education to all licensed nurses on documentation of pressure ulcers and chronic wounds policy; including closely monitoring the effectiveness of treatments, daily documentation of treatments provided, as well as documenting an explanation when a treatment is not completed. Additionally, education will be provided to all licensed nurses on updating the resident(s) care plan to accurately reflect interventions in place; such as floating heels and use of air mattress. Element #4: The facility’s compliance with the corrective action will be monitored using the following quality assurance system: - The Director of Nursing has created an audit tool to ensure that all residents with pressure ulcers/chronic wounds have proper treatment orders in place that are signed for by licensed nurses and that proper interventions are in place. - Unit managers/designee will audit once a week until 100% compliance is attained for 4 consecutive weeks. Negative findings will be corrected and reported to the Director of Nursing. - Results of audits will be reviewed during monthly QAPI meetings and the QAPI committee will determine ongoing audit frequency after 4 weeks of 100% compliance. Element #5: The person responsible for the corrective actions is the Director of Nursing/designee. Date of compliance is 4/18/25.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 142 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Highland
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hudson Valley Rehabilitation & Extended Care Ctr | 1.6 mi | ★★★★★ | 37 | 0 |
| The Grand Rehabilitation And Nrsg At River Valley | 3.8 mi | ★★★★★ | 12 | 0 |
| Woodland Pond At New Paltz | 4 mi | ★★★★★ | 0 | 0 |
| The Pines At Poughkeepsie Ctr For Nursing & Rehab | 4.2 mi | ★★★★★ | 0 | 0 |
| New Paltz Center For Rehabilitation And Nursing | 4.9 mi | ★★★★★ | 8 | 0 |
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