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 Trustees Of Eastern Star Hall & Home Of The N Y S during CMS and state inspections, most recent first.
The facility failed to store drugs and biologicals according to professional standards, with expired medications found in medication carts and rooms, and an unlocked treatment cart containing medicated creams. LPNs admitted to not checking expiration dates before administering medications, and the DON confirmed that all medications should be checked and labeled, and treatment carts locked when unattended.
The facility did not ensure that the results of the most recent Federal/State survey were accessible to residents, family members, and legal representatives. Residents were unaware of their right to view the survey results, which were placed on a high shelf behind the reception desk, requiring assistance to access. Staff interviews confirmed the inaccessibility, and the Administrator, new to the role, was unaware of the issue.
A facility failed to provide necessary Medicare non-coverage notices to a resident after Medicare Part A services ended. The resident, with a history of stroke and anxiety, was not given timely notices, and the facility lacked a policy for Beneficiary Notification. The Accounts Receivable Coordinator assumed Medicaid would cover the stay, leading to the deficiency.
A facility failed to document blood sugar levels for a newly admitted diabetic resident, as required by physician orders. The LPN responsible for the resident's care was unsure where to record the readings in the electronic medical record, resulting in no documented results for two days. The DON confirmed that this omission constitutes a medication error, as it prevents the medical provider from reviewing the resident's blood sugar levels.
A resident with a sacral pressure ulcer did not have their wound vacuum dressing changed every three days as ordered, leading to the dressing being stuck to the wound bed and a foul odor. The LPN responsible was not trained on changing the dressing and did not document the missed change. The DON confirmed the LPN had not attended the necessary training, contributing to the deficiency in care.
The facility's main kitchen failed to meet professional food service safety standards, with unclean and damaged ceiling tiles, unclean ovens, pans with baked-on debris, and expired sanitizer test strips. The Interim Food Service Director and Kitchen Supervisor acknowledged these issues, emphasizing the importance of maintaining a clean kitchen to prevent illness.
The facility did not maintain an effective pest control program, resulting in fruit flies and drain flies in the main kitchen and [NAME] Unit. Staff were unaware of the pest issue due to poor communication and lack of pest control logs. A new vendor agreement was secured in October, but the deficiency persisted.
A resident with severe cognitive impairment and a history of falling was found in a stairwell after exiting through an unsecured egress door. The resident, who required substantial assistance and was dependent on a wheelchair, managed to push open the door, which was intended to alarm but did not. Staff interviews revealed that the door was an employee entrance and was not equipped with a keypad or delayed egress at the time, leading to a lapse in ensuring a safe environment.
The facility failed to update resident assessments every three months as required, with delays in completing Minimum Data Set (MDS) assessments for three residents. The MDS Coordinator was behind schedule due to an influx of admissions and reduced interdisciplinary team staff, leading to late assessments. The facility lacked a policy for MDS completion, contributing to the deficiency.
Medication Storage and Expiration Deficiencies
Penalty
Summary
The facility failed to ensure that drugs and biologicals were stored in accordance with professional standards, as observed during a recertification survey. Specifically, two medication carts, one medication room, and one treatment cart were found to have expired medications and were not properly secured. The medication carts on two units contained expired stock medications, including insulin, and the medication room had expired stock medications and biologicals. Additionally, the treatment cart was found unlocked and unattended, containing medicated creams that could be harmful if accessed by residents. During observations, it was noted that the treatment cart on one unit was left unlocked, containing medicated creams and other supplies. A Licensed Practical Nurse (LPN) admitted to not locking the cart after removing hearing aid batteries. The medication room on another unit contained expired Vitamin B-12 and influenza vaccines, which an LPN acknowledged should have been disposed of. The LPN was unsure if there was a scheduled process for checking expiration dates, indicating a lack of consistent oversight. Further observations revealed that medication carts contained expired antacid tablets, multivitamins, and aspirin, with some lacking legible expiration dates. An LPN admitted to administering medications without checking expiration dates, relying on the night shift to remove expired items. The Director of Nursing confirmed that all medications should be checked for expiration dates and labeled with an opened date, and that treatment carts should be locked when unattended to prevent potential harm to residents.
Inaccessible Survey Results for Residents
Penalty
Summary
The facility failed to ensure that the results of the most recent Federal/State survey were posted in a location that was readily accessible to residents, family members, and legal representatives. During a Resident Council meeting, eight anonymous residents expressed that they were unaware of their ability to view the previous survey results and did not know where these results were located. An observation revealed that the State Survey binder was placed on a high shelf behind the reception desk, making it inaccessible to residents and visitors without assistance. Interviews with staff members, including a receptionist and a social worker, confirmed that residents or family members would need to request access to the survey results, as they were not easily reachable, especially for those in wheelchairs. The Administrator, who was new to the role, acknowledged the oversight and stated that they were unaware of the inaccessibility issue. The survey results had previously been located in a living room, but were moved when the room was no longer in use, contributing to the deficiency.
Failure to Provide Required Medicare Non-Coverage Notices
Penalty
Summary
The facility failed to provide appropriate liability and appeal notices to a Medicare beneficiary, specifically for a resident who remained in the facility after the discontinuation of Medicare Part A services. The resident, who had a history of cerebral vascular accident, aphasia, and anxiety, was not given a timely Notice of Medicare Non-Coverage (CMS-10123) when Medicare Part A coverage ended. Additionally, the facility did not issue a Skilled Nursing Facility Advanced Beneficiary Notice of Non-Coverage (CMS-10055) as required. The resident's Medicare-covered stay began on 5/7/2024 and ended on 5/23/2024, and the facility failed to provide the necessary notices in advance to allow the resident or their representative to make informed decisions. The facility lacked a policy regarding Beneficiary Notification, as confirmed by the Administrative Assistant. The Accounts Receivable Coordinator stated that they did not issue the Advanced Beneficiary Notification to residents with Medicaid, assuming Medicaid would cover the stay. The Administrator acknowledged familiarity with the notices but was not involved in the process and was unaware that the accounts receivable department was not issuing them to residents with Medicaid. This oversight led to the deficiency identified during the recertification survey.
Failure to Document Blood Sugar Levels for Diabetic Resident
Penalty
Summary
The facility failed to ensure that Resident #218 received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan. Specifically, the resident, who was newly admitted with a diagnosis of Type 2 Diabetes Mellitus, had physician orders for blood sugar monitoring before breakfast and at bedtime. However, the blood sugar results for the specified times on 11/5/2024 and 11/6/2024 were not documented in the medical record, and there was no evidence of these results in the nursing progress notes. This lack of documentation meant that the medical provider could not review the resident's blood sugar levels, which is crucial for managing diabetes effectively. During interviews, Licensed Practical Nurse #21, who was responsible for the resident's care, admitted to obtaining the blood sugar readings but was unsure where to document them in the electronic medical record. The Director of Nursing confirmed that all blood sugars should be recorded in the electronic chart or on a paper Medication Administration Record, and failure to do so constitutes a medication error. The absence of documented blood sugar results could lead to inappropriate insulin administration, potentially causing a diabetic reaction if the blood sugar was too low.
Failure to Change Wound Vacuum Dressing as Ordered
Penalty
Summary
The facility failed to ensure that a resident with a pressure ulcer received necessary treatment and services consistent with professional standards of practice. Specifically, the resident, who had a sacral pressure ulcer, did not have their wound vacuum dressing changed every three days as ordered. The resident's care plan included interventions such as turning and positioning every two hours and weekly wound care rounds, but it did not include the use of a wound vacuum, which was ordered by an outside wound care physician. On one occasion, the wound vacuum dressing was not changed as scheduled, leading to the dressing being stuck to the wound bed, which required soaking to remove. This incident was observed by a Registered Nurse Supervisor, who noted that the dressing had not been changed as ordered, and the wound had a foul odor. The failure to change the dressing as ordered could potentially worsen the wound and lead to infection. The deficiency was further compounded by the fact that the LPN responsible for the resident's care was not trained on how to change the wound vacuum dressing and had not documented the missed dressing change. The Director of Nursing confirmed that the LPN had not attended the training provided by the wound vacuum manufacturer and emphasized the importance of notifying a supervisor if staff were not trained. The lack of training and documentation contributed to the failure to provide appropriate care for the resident's pressure ulcer.
Deficiencies in Kitchen Cleanliness and Food Safety Standards
Penalty
Summary
The facility failed to ensure that food was stored, prepared, distributed, and served in accordance with professional standards for food service safety in the main kitchen. During the recertification survey, it was observed that the main kitchen had unclean, scratched, and dented ceiling tiles, unclean ovens, pans with baked-on debris, and expired canisters of sanitizer test strips for the 3 bay sink. The facility's policy required that conventional ovens be cleaned daily, but observations revealed that two ovens were unclean both inside and outside. Additionally, four pans on a clean pot rack had baked-on debris, and the sanitizer test strips were expired. Interviews with the Interim Food Service Director and Kitchen Supervisor confirmed awareness of the issues. The Interim Food Service Director acknowledged the unclean and damaged ceiling tiles, the unclean ovens, and the expired sanitizer strips, stating that they were responsible for checking the expiration dates. The Kitchen Supervisor confirmed the presence of damaged ceiling tiles and stated that the ovens were supposed to be cleaned twice a week by night cooks. They also verified that the pans with baked-on debris should have been discarded. The previous Food Service Director had left two weeks prior, and the responsibility for ensuring the cleanliness and safety of the kitchen was emphasized to prevent illness among residents and staff.
Deficiency in Pest Control Program
Penalty
Summary
The facility failed to ensure an effective pest control program was in place for the main kitchen and the [NAME] Unit, as evidenced by the presence of fruit flies and drain flies. Observations during the recertification survey revealed multiple instances of these pests in the main kitchen dish machine room and the [NAME] Unit kitchenette. Despite the presence of these pests, the facility's pest control policy was not provided upon request, and there were no pest control logs available from March 2023 through October 2024. Interviews with facility staff highlighted a lack of awareness and communication regarding the pest issue. The Interim Food Service Director was unaware of the pest problem due to a lack of reporting from staff, and the Kitchen Supervisor had not maintained or reviewed pest control logs. The Director of Environmental Services confirmed the absence of pest control logs, and the Administrator, who had been in position since August, acknowledged the lack of a pest control program and had only recently secured a new vendor agreement in October 2024.
Resident Elopement Due to Unsecured Egress Door
Penalty
Summary
The facility failed to ensure the resident environment was free from accident hazards, leading to an incident involving a resident with severe cognitive impairment and a history of falling. The resident, who required substantial assistance for transfers and was dependent on a wheelchair, was found in a stairwell scooting down the steps. The resident's care plan included interventions for cognitive impairment and fall risk, but did not initially identify the resident as at risk for elopement. On the morning of the incident, the resident was not in their room, prompting a search by staff. The resident was eventually found in the stairwell by a dietary aide. The investigation revealed that the resident was able to self-propel in their wheelchair and managed to push open a door to access the stairwell, despite the door being intended to alarm after being opened for more than 15 seconds. However, there was no documented evidence explaining how the resident exited through the door without being noticed or without the door alarming. Interviews with staff indicated that the door to the stairwell was an employee entrance and was not equipped with a keypad or delayed egress at the time of the incident. Maintenance checks were conducted regularly, but the door was not locked as it was used by staff. The Director of Nursing and the Administrator confirmed that the door was unsecured at the time, and the incident highlighted a lapse in ensuring the safety and security of the resident environment.
Failure to Timely Update Resident Assessments
Penalty
Summary
The facility failed to ensure that residents' assessments were updated at least once every three months, as required by the quarterly review instrument specified by the State and approved by CMS. This deficiency was identified during a recertification survey, where it was found that the Minimum Data Set (MDS) assessments for three residents were completed later than 14 days after the Assessment Reference Date. Specifically, Resident #14's assessment was completed 40 days after the reference date, Resident #16's assessment was completed 38 days late, and Resident #50's assessment was completed 47 days late. These delays in completing the assessments were attributed to the facility's MDS Coordinator being behind schedule due to an influx of admissions and a reduction in interdisciplinary team staff, which resulted in the coordinator being responsible for completing the entire assessment process. Interviews conducted during the survey revealed that the facility did not have a policy regarding the completion of MDS assessments. The MDS Coordinator acknowledged the delays and explained that the assessments were late because they were the sole person responsible for completing them on a 92-day rotation. The facility's Administrator confirmed that the responsibility for timely completion of MDS assessments lay with the MDS Coordinator and acknowledged that untimely assessments could result in outdated care plans. The lack of a policy and the staffing issues contributed to the failure to meet the regulatory requirement for timely resident assessments.
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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 Oriskany
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mvhs Rehabilitation And Nursing Center | 5 mi | ★★★★★ | 0 | 0 |
| Presbyterian Home For Central New York Inc | 5.7 mi | ★★★★★ | 0 | 0 |
| The Grand Rehabilitation And Nursing At Utica | 5.8 mi | ★★★★★ | 0 | 0 |
| Utica Rehabilitation & Nursing Center | 5.9 mi | ★★★★★ | 9 | 0 |
| The Pines At Utica Center For Nursing And Rehab | 6.1 mi | ★★★★★ | 1 | 0 |
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