Average — CMS composite of the measures below.
The next survey window likely opens around February 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Throgs Neck Rehabilitation & Nursing Center during CMS and state inspections, most recent first.
A resident with spinal stenosis, cervical radiculopathy, muscle spasm, and pain missed 26 ordered doses of methocarbamol because the eMAR only showed the medication three times daily instead of four. An LPN said the bedtime dose was missed because it was not highlighted on the eMAR, and the record showed no documentation that the MD was notified or that the resident was assessed for adverse effects.
A resident with severe cognitive impairment, right hemiplegia, and a history of attempted unassisted transfers was found on the floor in their room with right hip pain and decreased range of motion after having last been seen in bed. The resident was transferred to the hospital and diagnosed with a right intertrochanteric hip fracture requiring surgical fixation. Facility policy and state regulations required that alleged violations involving serious bodily injury be reported to the New York State Department of Health within 2 hours, but there was no documented evidence that this unwitnessed fall and resulting major injury were reported. The DON and Administrator later acknowledged that the event met criteria for a major injury that should have been reported within the required timeframe.
A resident with intact cognition and cardiac and pulmonary comorbidities, who had documented DNR/DNI status, experienced a change in condition characterized by respiratory distress and chest discomfort. Staff, including an LPN, RN supervisor, and DON, assessed the resident, applied oxygen, attempted IV access, confirmed DNR status, and were present when the resident expired, after which the DON pronounced death and notified the family and funeral home. Despite facility policy requiring detailed documentation of changes in condition, assessments, pronouncement details, notifications, and post-mortem care, no nursing progress note was entered in the medical record describing the resident’s decline, death event, or related notifications, resulting in an incomplete clinical record.
A resident with severely impaired cognition and diagnoses including A-fib, Alzheimer's disease, and repeated falls was observed receiving oxygen at 2 L/min via NC even though no physician order was in place. Staff interviews confirmed the resident had been on oxygen since admission, the RN supervisor said oxygen was started without an order, and the attending physician stated the resident had no wheezing or SOB and that oxygen was being administered without an order.
Failure to Mail NOMNC After Phone Notice: The facility did not ensure that two residents’ representatives received written NOMNCs after being notified by phone that Medicare Part A skilled nursing and rehab coverage was ending. The records showed telephone notification, but no documentation that the notices were mailed the same day, and the DOSS confirmed the forms were not mailed and no delivery proof was in the chart.
The facility failed to submit required direct care staffing and census data to CMS via the Payroll-Based Journal (PBJ) system within the mandated timeframe for a full fiscal quarter. Facility policy and CMS guidance both required electronic submission of staffing and census information, including agency and contract staff, no later than 45 days after the end of each quarter. A CMS PBJ report and a vendor email confirmed that the Quarter 4 submission was attempted after CMS stopped accepting data for that period. The Director of Payroll, who was responsible for timely PBJ submission and aware of the deadline, could not explain the delay, while the Director of Staffing and the Assistant Administrator were unaware of the missed submission until the survey and described it as an oversight.
Missed Ordered Methocarbamol Doses
Penalty
Summary
Resident #193 was not administered 26 ordered doses of methocarbamol, a muscle relaxant prescribed for pain and muscle spasm related to spinal stenosis and cervical radiculopathy. The resident had intact cognition on the admission MDS, and the care plan included monitoring for pain and responses to medications. The hospital discharge instructions and physician order both directed methocarbamol 750 mg by mouth four times daily, but the electronic MAR documented administration only three times daily, with no scheduled bedtime dose entered. The record review found no documentation that the physician was notified of the missed doses and no documentation that Resident #193 was assessed for adverse effects related to the missed methocarbamol doses. An LPN stated the bedtime dose was missed because it was not highlighted on the eMAR, and the nursing supervisor stated the admission orders were supposed to be reviewed and compared across shifts, with medication nurses comparing the blister pack to the physician orders and MAR. The physician stated the resident should have received methocarbamol four times daily and was not aware the bedtime doses had not been given.
Failure to Timely Report Unwitnessed Fall With Hip Fracture to State Authorities
Penalty
Summary
The facility failed to ensure that an alleged violation involving an unwitnessed fall with serious bodily injury was reported to the New York State Department of Health (NYSDOH) within the required timeframe. Facility policy on Abuse, Mistreatment, Neglect, and Misappropriation of Resident's Property required that the Director of Nursing coordinate investigations of alleged violations and report all alleged violations and substantiated incidents to NYSDOH. Regulations required that alleged violations involving abuse or resulting in serious bodily injury be reported immediately, but not later than 2 hours after the allegation was made. Despite these requirements, there was no documented evidence that the resident’s unwitnessed fall and resulting major injury were reported to NYSDOH. The deficiency involved a resident with diagnoses including cerebral infarction, right hemiplegia, and dysarthria, who had severely impaired cognition and required supervision or touching assistance for bathing, dressing, toileting hygiene, transfers, and walking. On the date of the incident at approximately 8:30 PM, the resident was found sitting upright on the floor in their room with their back against the wall, limited range of motion, and complaints of pain in the right hip area, after having last been seen in bed at 8:10 PM. The resident, who was forgetful and confused at baseline and had a history of attempted unassisted transfers despite requiring extensive assistance of one person, was transferred to the hospital and diagnosed with a right intertrochanteric hip fracture, requiring surgical fixation. The DON and Administrator, both hired after the incident, acknowledged during interviews that this unwitnessed fall with hip fracture constituted a major injury that should have been reported to NYSDOH within two hours, but it was not reported.
Failure to Maintain Complete Clinical Record for Resident Death Event
Penalty
Summary
The deficiency involves the facility’s failure to maintain a complete and accurate clinical record for a resident who experienced a change in condition and subsequent death. Facility policy required that when a change in condition is identified, the RN assess the resident, notify the physician, and document all assessment findings, evaluations, interventions, changes in orders, and, if the resident expires, a physical assessment confirming absence of pulse and respirations, pronouncement details, notifications, code status, and post-mortem care. The resident had intact cognition and diagnoses including hypertensive heart disease with heart failure, COPD, and coronary artery disease, and had documented do not intubate and do not resuscitate orders. On the date of death, a social service note and the death certificate documented that the resident passed that morning, and that the next of kin and funeral home were notified. However, review of the resident’s medical record showed no nursing documentation of the death event, including the time the resident was found unresponsive, assessment of the change in condition, confirmation of DNR status, time of death, physician notification, or body release details. Interviews revealed that the resident’s roommate alerted staff that the resident was not feeling well, that the resident was uneasy, gasping, and holding their chest, and that staff assessed vital signs, applied oxygen via non-rebreather mask, attempted IV access, and confirmed DNR status using the wristband and medical orders. The DON and nursing supervisors were present, and the DON pronounced the death, contacted the family, and reported documenting in the electronic record, but there was no corresponding nursing progress note in the resident’s chart. Both the LPN and RN supervisor acknowledged that required progress notes regarding the change in condition and death were not entered, and could not explain the lack of documentation, resulting in an incomplete clinical record not maintained in accordance with accepted professional standards and practices.
Oxygen given without physician order
Penalty
Summary
The facility failed to ensure that a resident receiving respiratory care had oxygen therapy provided consistent with professional standards of practice. Resident #96, who was admitted with diagnoses including atrial fibrillation, Alzheimer's disease, and repeated falls, had severely impaired cognition on the admission MDS dated 02/14/2026. The facility policy stated that oxygen therapy must be ordered by a physician except in an emergency, but a review of physician orders from 02/12/2026 through 03/10/2026 did not include an order for oxygen. Despite the absence of a physician's order, Resident #96 was observed on multiple occasions receiving oxygen at 2 liters per minute via nasal cannula, including while sleeping in bed and while out of bed in a wheelchair with a portable oxygen tank attached. A nurse's progress note documented the resident on 2 liters of oxygen with an oxygen saturation of 99%, and staff interviews confirmed the resident had been receiving oxygen since admission. The LPN stated there was no physician's order for the oxygen, the RN supervisor stated oxygen had been started on 02/13/2026 without an order, and the attending physician stated the resident had no wheezing or shortness of breath and that oxygen was being administered even though no order had been written.
Failure to Mail Medicare Non-Coverage Notices After Telephone Notification
Penalty
Summary
The facility failed to ensure that residents or their designated representatives received appropriate notification at the termination of Medicare Part A benefits for two residents reviewed for beneficiary notification. The facility policy required that a Notice of Medicare Non-Coverage be delivered to the beneficiary and/or responsible party, with a copy kept in the medical record and another copy provided by hand delivery, secured fax, secured email, or certified mail. The CMS instructions for the NOMNC also required that when telephone notification is used, the written notice be mailed on the same day the call is made. For one resident, the record showed that the designated representative was telephoned and told that coverage would end on a specified date, but there was no documented evidence that the notice was mailed the same day. The same issue was documented for a second resident, whose representative was also telephoned and informed that Medicare coverage would end on a later date, but no evidence was found that the written notice was mailed on the same day. During interview, the Director of Social Services stated that family members were notified by phone, but the NOMNC was not mailed and no delivery documentation was present in the records.
Failure to Timely Submit PBJ Direct Care Staffing Data
Penalty
Summary
The deficiency involves the facility’s failure to submit required direct care staffing and census data to CMS through the Payroll-Based Journal (PBJ) system within the mandated timeframe for fiscal Quarter 4, 2025 (July 1–September 30). The facility’s policy on Reporting Direct-Care Staffing Information, dated 11/20/2022, states that staffing and census information will be reported electronically to CMS via PBJ in compliance with Section 6106 of the Affordable Care Act, and that this information is collected daily and reported for each fiscal quarter no later than 45 days after the end of the reporting quarter. CMS’s PBJ Policy Manual similarly requires that direct care staffing and census data, including agency and contract staff, be submitted electronically and received by CMS by the end of the 45th calendar day after the last day of each fiscal quarter to be considered timely. A CMS PBJ Staffing Data Report documented that the facility failed to submit data for Quarter 4, 2025. An email from the facility’s PBJ vendor to the Director of Payroll, dated 11/17/2025, documented that a PBJ submission attempted on that date failed because CMS was no longer accepting submissions for the reporting quarter of 07/01/2025–09/30/2025, indicating the submission was late. During an interview, the Director of Payroll stated they were responsible for ensuring all time management records were completed and that PBJ was submitted on time, acknowledged awareness of the submission deadline, and could not explain why the report was not submitted on time. The Director of Staffing reported they were not aware until the day of the interview that the staffing and census data had not been submitted. The Assistant Administrator also stated they could not explain why the Quarter 4, 2025 direct care staffing data was not submitted and described the failure as an oversight.
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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 Bronx
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Archcare At Providence Rest | 1 mi | ★★★★★ | 0 | 0 |
| Rebekah Rehabilitation And Extended Care Center | 1.3 mi | ★★★★★ | 8 | 0 |
| Grand Manor Nursing & Rehabilitation Center | 1.7 mi | — | 34 | 2 |
| Bronx Center For Rehabilitation & Health Care | 1.8 mi | ★★★★★ | 17 | 0 |
| Williamsbridge Center For Rehabilitation And Nursi | 2 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 October 2026) and official state health department websites.