Below average — CMS composite of the measures below.
The next survey window likely opens around December 2026
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 Valley Health Services Inc during CMS and state inspections, most recent first.
Failure to clinically assess residents for self-administration of meds/creams. A resident council meeting included requests to self-administer meds and store them in rooms, but there was no documented follow-up. Two cognitively intact residents were applying prescribed topical treatments on their own despite prior assessments showing they were not safe to self-administer and without clear orders or updated assessments; staff gave inconsistent accounts about which creams the residents could apply and whether assessments had been completed.
A resident with a nephrostomy tube, UTI, and sepsis had incomplete orders, care plan guidance, and documentation for tube care. The chart lacked specific instructions for output description, bag changes, patency/blockage monitoring, and infection monitoring, and staff were unsure who was responsible for emptying and documenting the drainage bag. Records also showed inconsistent documentation of output measurement and several missed entries for emptying the bag, while an LPN and the DON/designee reported no education on nephrostomy tube care.
The facility failed to maintain infection control precautions and its Legionella water management program. A resident with conjunctivitis was placed on contact precautions late, the care plan was not updated, and staff entered the room without the required gown and gloves. Another resident with a urinary catheter was on enhanced barrier precautions, but staff provided catheter care and medication administration without the required PPE, and the care plan did not include those precautions. The facility also did not document annual Legionella policy review or annual water risk assessments, and water samples were not handled or retained as required.
A resident with dementia, severe cognitive impairment, and prior fractures after a fall had a care plan intervention requiring a tap bell to be within reach when out of the room. Surveyors repeatedly observed the resident in a wheelchair in the hallway without the tap bell nearby, and staff interviews confirmed the intervention was expected to be in place but was not consistently provided.
Failure to Provide Person-Centered Activities: A resident with Parkinson's disease, severe dementia, and aphagia had documented preferences for music, reading, sunlight, and hand massages, but the care plan and daily activity support did not consistently reflect those interests. Staff observed the resident spending long periods in bed or in a wheelchair with little stimulation, and interviews showed uncertainty about the resident's preferred music and limited use of individualized activity approaches.
A resident with bilateral lower-extremity contractures and severe cognitive impairment was not properly re-evaluated for positioning in a Broda chair after a fall and hospital stay. Staff observed the resident repeatedly leaning to one side or forward in the chair and used a blue wedge pillow to keep the resident from sliding out, but OT was unaware of the wedge and said it was not issued by therapy. The care instructions documented an abductor/contracture cushion and knee rolls, but there was no documentation for the wedge pillow or how to ensure proper chair alignment.
A resident receiving hemodialysis had no documented pre- or post-treatment assessments, no access site monitoring, and no clear facility policy or care plan details for the dialysis access. The resident returned from dialysis with a dressing on the AV fistula, but staff stated they did not monitor the site and relied on the dialysis binder without documented review or consistent communication with the dialysis center.
A resident with anxiety, insomnia, COPD, and a military trauma history had a care plan that noted the trauma but did not identify triggering factors or include night terrors. After a GDR of quetiapine, the resident reported night terrors and poor sleep, but there was no documented follow-up assessment by SW or the provider. Interviews confirmed staff knew the resident had night terrors, yet no trauma-focused follow-up or trigger review was completed.
A resident with stroke-related deficits, cognitive impairment, and later dementia showed increasing depression, weepiness, agitation, refusal of meals and meds, and passive suicidal statements after LTC admission. Although staff noted the resident appeared sad and frustrated and family requested a mental health evaluation, the record did not show physician orders for psychiatry or social service consults addressing the resident’s psychological status. The resident was later started on mirtazapine after ongoing mood changes and poor intake.
Undated insulin lispro was administered to a resident with diabetes during a sliding-scale insulin pass. An LPN used the same pen for multiple doses without checking an opened date, and the pen had no visible date to confirm it was within the manufacturer’s 28-day use period. Nursing leadership stated opened dates should be checked before insulin administration, and the DI&C/Staff Development Director said formal medication administration education was not in place.
Unsafe and Unsanitary Shower/Tub Area: Residents reported that shower floors were messy, drains did not work, and tubs leaked in one shower/tub unit. Surveyors observed standing discolored water under the tub over multiple days, a musty odor, rusting and frayed tubing, and gray matter in and around the drain. A CNA stated the shower in that room could flood into the hallway, and the ESM said no work orders had been received for the standing water.
Failure to Post Daily Nurse Staffing Information in an Accessible Location: The facility failed to post the daily resident census and the total number and actual hours worked by licensed and unlicensed nursing staff in a prominent location readily accessible to residents and visitors. Surveyors found the staffing information posted on the Unit 1 nursing office door and window, with a sign in the main lobby above the visitors' sign-in sheet, and the DON stated there was no staffing sheet posted at the main entrance and that the sign was not easily seen from wheelchair height.
A resident with dementia and anxiety disorder sustained a head injury from a fall, and the facility failed to perform and document the required neurological checks while awaiting transport to the hospital. The staff did not adhere to the facility's Head Trauma Protocol and Neurological Check policy, resulting in a deficiency in care.
Failure to Clinically Assess Residents for Self-Administration of Medications
Penalty
Summary
The facility failed to ensure that residents’ ability to self-administer medications was clinically appropriate for two residents and for three additional residents who stated at a resident group meeting that they wanted to administer their own medications or creams but were told they could not be assessed to do so. The facility’s pharmacy policy required an interdisciplinary assessment of cognitive and physical ability and a medical order before self-administration, but the record showed no documented follow-up for a resident council request to self-administer and store medications in the room. The Director of Nursing stated the facility had initial and annual assessments, but they had just learned the assessments were not being done annually. Resident #4 had diagnoses including a Stage 2 pressure ulcer of the right buttock and was documented as cognitively intact and independent or needing supervision for activities of daily living. The resident had a physician order for Calmoseptine ointment every shift for wound care, but there was no physician order to self-administer the wound cream and no documented care plan for self-administration of wound care. A prior assessment documented the resident was not safe to self-administer medications. Despite this, the resident stated they performed their own wound care using a napkin and the ointment kept in the room, and an LPN stated the resident was able to apply their own ointment. Resident #137 had diagnoses including venous insufficiency, lymphedema, and hypertension, and was documented as cognitively intact but requiring moderate assistance or supervision for activities of daily living. The resident had multiple topical medication orders, including Cerave itch relief cream, Bengay, Biofreeze, and triamcinolone cream, but the only self-administration assessment in the record documented the resident was not able to self-administer medications, with no updated assessment found. The resident stated they applied all their creams themselves except muscle rub, while an LPN stated the resident could apply Cerave but not the other creams and that the resident had previously expressed wanting to apply their own creams. The Nursing Care Coordinator and DON both stated they were unsure whether the residents had been assessed for the creams they wanted to apply.
Nephrostomy Tube Care and Documentation Not Consistently Provided
Penalty
Summary
The facility failed to provide appropriate nephrostomy tube care/services for one resident who had a nephrostomy tube placed for a left staghorn calculus and had diagnoses including urinary tract infection and sepsis. The resident’s Minimum Data Set documented moderate cognitive impairment and an indwelling catheter, including the nephrostomy tube. On admission, the resident was noted to have a drain to the left back with bloody drainage, but the urinary assessment was left blank and there was no documented evidence that the nurse clarified the drain or notified the provider about the bloody drainage. Physician orders did not include specific instructions to document the description of the nephrostomy output, when to change the drainage bag, how to monitor for tube patency or blockage, or how to monitor and report signs and symptoms of infection. The care plan addressed renal insufficiency and monitoring for acute renal failure, but it did not include nephrostomy tube care instructions or what to monitor for and report. The record also showed that an order to empty and measure nephrostomy output was not documented from admission until several days later, and there was no documented order for output description, bag changes, patency checks, or infection monitoring. Documentation of nephrostomy care was inconsistent. The December 2025 records showed multiple missing entries for when the nephrostomy was emptied, and the MAR/TAR documentation did not consistently show that output was measured on every shift. Staff interviews showed uncertainty about who was responsible for emptying and documenting the drainage bag, and one LPN stated there was no training or education on nephrostomy tubes and was not sure what the problem would be if there was no drainage or if the bag was not emptied. The Director of Infection Control and Staff Development also stated there was no education for nephrostomy tube care and was not sure who was responsible for emptying the drainage bag.
Infection Control and Legionella Program Failures
Penalty
Summary
The facility failed to maintain an infection prevention and control program for residents on transmission-based precautions and for its Legionella water management program. The report identified failures involving Resident #5, who had a chronic indwelling urinary catheter and was ordered to be on enhanced barrier precautions, and Resident #137, who developed conjunctivitis and was later placed on contact precautions. The facility also failed to follow its Legionella policy for annual review, annual water risk assessments, first-draw water sampling, timely laboratory receipt of samples, and retention of assessment and sampling records on site for at least three years. Resident #137 had increased left eye drainage, redness, puffiness, and discomfort, followed by antibiotic eye treatment orders. Contact precautions for conjunctivitis were not ordered until three days after symptoms began. Although the care plan documented contact precautions, it was not updated to include them. During observations, an LPN removed the resident’s lunch tray without PPE, a CNA entered the room with a water pitcher without hand hygiene or PPE, and a housekeeper changed the trash bag without a gown. The Director of Infection Control stated that for a resident on contact precautions, gown and gloves were required any time any staff entered the room, including for tray pickup, trash removal, and returning a water pitcher. Resident #5 had diagnoses including urinary retention and was cognitively intact with an indwelling catheter. The care plan addressed the catheter and monitoring for signs and symptoms of infection, but it did not address enhanced barrier precautions. A physician order required staff to don a gown and gloves with all hands-on care every shift for the urinary catheter. Observations showed two enhanced barrier precaution signs outside the room, but an LPN administered medications wearing only gloves, and a CNA provided catheter care, emptied the bag, and changed the bag from bed bag to leg bag while wearing only gloves. Staff interviews showed differing understanding of the precautions and PPE required for catheter care. For Legionella, the facility policy required annual review, annual environmental assessment of the water system, first-draw sampling, and retention of records for three years. The report found no documented evidence that the policy was reviewed annually in 2024 or 2025 and no documented evidence that annual water risk assessments were completed in 2024 or 2025. Water samples collected in 2024 and 2025 were received by the laboratory after the 48-hour hold time, and the assessment forms and sampling results were not retained on site for the required period. Interviews with facility leadership showed uncertainty about the sampling process, the timing requirements, and the annual review and assessment requirements.
Failure to Keep Tap Bell Within Reach for Resident at Fall Risk
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #144, who had diagnoses including dementia with behavioral disturbances and fractures of the arm and thigh bone. The resident’s 12/05/2025 MDS documented severely impaired cognition, periods of inattention and disorganized thinking, dependence or moderate assistance for all ADLs, use of a wheelchair, and a fall with major injury. Following a 12/05/2025 fall in the hallway next to the resident’s wheelchair, the resident sustained fractures to the left humerus, left patella, and left great toe, and a physician order was written for a tap bell to be within reach when the resident was not in their room every shift for safety. The comprehensive care plan, revised 12/05/2025, identified the resident as at moderate risk for falls and included the intervention to have a tap bell in reach when the resident was not in their room. However, survey observations on 01/05/2026, 01/06/2026, 01/07/2026, and 01/08/2026 found the resident in the hallway or near the nurses’ station in a wheelchair without a tap bell within reach. During interviews, an LPN stated the resident was supposed to have a tap bell when out of bed, another LPN stated the tap bell should be within reach even if the resident did not use it, the Nursing Care Coordinator stated the intervention should be in place, and the DON stated the resident should always have the tap bell when in the hallway outside the room.
Failure to Provide Person-Centered Activities
Penalty
Summary
The facility failed to provide ongoing programs to support each resident in their choice of activities for one resident who had Parkinson's disease, severe dementia, and aphagia. The resident's 12/24/2025 MDS documented severely impaired cognition, total dependence for all ADLs, and an activity preference for listening to music. The 1/6/2026 comprehensive care plan stated the resident was alert and disoriented, often kept their eyes closed, was dependent on staff for activities and awareness, and enjoyed hand massages, being read to, and listening to the radio. The resident's 9/25/2025 Resident Ability and Preference Form documented preferences for being read to, going outside when possible, listening to Country Western music, and having window drapes open so sunlight could shine on their face. The form also noted the resident was non-verbal and the plan was to continue one-to-one visits including hand massages and reading. Activity documentation showed limited interactions such as sitting with the resident during a haircut, checking in while playing music, talking about the weather with a hand massage, and playing music from a phone while the resident appeared asleep. Observations showed the resident in bed or in a wheelchair for extended periods with little or no stimulation, including sitting in a wheelchair near the nursing station staring at the ceiling with no radio or television on, and later lying in bed with the room lights off and neither the television nor radio on. Staff interviews indicated the resident usually sat in front of the television or had a radio on in the room, but the music station was not matched to the resident's stated preferences and staff were unsure what music the resident liked. The Activities Director stated preferences were updated yearly in a binder, the care plan should reflect the resident's music preferences, and the resident was non-verbal with limited family involvement.
Failure to Maintain Proper Positioning in Broda Chair
Penalty
Summary
The facility did not ensure a resident with limited mobility received appropriate services, equipment, and assistance to maintain or improve mobility. Resident #115 had diagnoses including bilateral lower leg contractures, severely impaired cognition, dependence for most activities of daily living, and functional limitation in range of motion in both legs. The resident was not receiving physical or occupational therapy at the time of the 10/22/2025 MDS assessment, and the care plan documented alteration in musculoskeletal status related to contractures of the bilateral extremities, with interventions to anticipate needs, give analgesics as ordered, and monitor for fatigue and falls. After a witnessed fall on 11/03/2025, when the resident slid out of a chair toward the left side and landed on the left side, the resident was hospitalized for observation after a ground level fall with head trauma and then returned to the facility. A physician order on 11/08/2025 requested OT evaluation for ROM, muscle strength, and positioning in bed/chair. Subsequent physician and OT documentation described the resident seated in a recliner with arms and knees flexed, unable to straighten, and OT initiated services to improve safety awareness and quality of life, including trialing an abductor/contracture cushion in bed and in the positioning chair to maintain proper position. During observations in January 2026, the resident was repeatedly seen in the Broda chair leaning to the right, reclined, or leaning forward and to the right, and at one point a CNA repositioned the resident by centering them in the chair. Staff interviews stated the resident leaned frequently, required frequent repositioning, and used a blue wedge pillow to prevent sliding out of the chair, but staff were unsure who initiated it. OT stated they were not aware of the blue wedge pillow and that it was not issued by therapy, and the Nursing Care Coordinator stated no therapy referral had been sent for a repositioning evaluation. The care instructions documented use of an abductor/contracture cushion between the knees and rolls behind the knees in bed and in the Broda chair, but there was no documentation addressing the wedge pillow or how to ensure proper positioning in the chair.
Dialysis resident lacked access site monitoring and pre/post treatment oversight
Penalty
Summary
Safe, appropriate dialysis care/services were not provided for a resident with end-stage kidney disease who received hemodialysis three times a week at a community dialysis center. The resident’s care plan addressed dialysis and included not drawing blood or taking blood pressure in the arm with the graft, but it did not identify the type or location of the dialysis access site, a monitoring plan, or pre- and post-dialysis assessments. The physician order for dialysis also did not include pre- or post-dialysis assessments or access site monitoring, and there was no documented facility policy addressing dialysis. The resident had an arteriovenous fistula in the right arm and returned to the facility after dialysis with a dressing over the access site. During observation and interview, the resident stated the nurse only checked blood sugar before leaving for dialysis, that the facility staff never looked at the dialysis site, and that the resident removed the dressing the day after dialysis. The resident also recalled a prior episode of bleeding from the access site that required a hospital visit. Facility staff stated the resident returned with a binder from dialysis, but there was no documented evidence that the facility reviewed the dialysis summaries or nutrition reports in the binder upon return. Interviews with facility staff showed inconsistent and limited oversight of the dialysis process. An LPN stated the binder was reviewed when the resident returned, medications were given, and blood sugar was checked, but nothing special was done for dialysis residents. The Nursing Care Coordinator stated the facility did not monitor the dialysis site, left the dressing alone, and did not perform pre- or post-dialysis assessments. The Director of Infection Control and Staff Development stated they were not sure of the standards of practice for a dialysis resident and were not sure whether the site was documented or monitored.
Failure to Provide Trauma-Informed Care for Resident With Night Terrors
Penalty
Summary
The facility failed to ensure that a resident with a history of trauma received culturally competent, trauma-informed care in accordance with professional standards of practice. Resident #7 had diagnoses including anxiety disorder, insomnia, and COPD, and the record showed a history of trauma from serving in a combat zone in the military. The resident’s care plan initiated on 7/15/2025 documented the trauma history and included general interventions such as allowing time to answer questions and consulting pastoral care, social services, psychiatric services, and others as needed, but there was no documented evidence of factors that could trigger the trauma. The record also showed that Resident #7 had night terrors. A social work note documented that a trauma assessment was completed and the care plan was reviewed and updated, but there was no documented trauma assessment in the medical record. The resident’s quetiapine had been used for insomnia, and after a gradual dose reduction trial, the resident reported not sleeping well due to night terrors since the medication decrease. The nurse practitioner was notified and the quetiapine was increased back to 25 mg, but there was no documented assessment by social services or the provider after the resident reported night terrors. During interviews, Nursing Care Coordinator #7 stated the resident’s night terrors were new to them and that social work, activities, and dietary were responsible for care plans. The Director of Social Services stated they were informed of the night terrors in morning report and that a history of night terrors should be care planned, but the resident’s care plan did not include night terrors. The Director also stated they had not followed up with the resident regarding the night terrors and that there should have been a conversation with the resident about possible environmental triggers.
Failure to Address Resident Depression and Psychosocial Needs
Penalty
Summary
The facility failed to provide appropriate treatment and services for a resident who displayed symptoms of depression and psychosocial distress after admission. The resident had diagnoses including hemiplegia and hemiparesis following a stroke, moderate cognitive impairment, and later documentation of dementia. The admission MDS showed no symptoms of feeling down, depressed, or hopeless, but the care plan identified a mood problem related to disease process and noted a psychology consult was offered on admission and declined, with behavioral health consults listed as needed. Progress notes documented a worsening emotional state, including being very weepy, upset, agitated, refusing meals, and making statements such as wishing not to be here anymore and wanting to die. The DON and RN documented that the resident appeared sad, frustrated, and denied a suicide plan. Social services attempted follow-up after passive suicidal statements, and a mental health consult was mentioned in one note, but another note documented there was no evidence that a mental health consult was submitted. Later records continued to show weepiness, frustration, refusal of medications and meals, and family concern that the resident might attempt to leave the building. The resident’s record did not contain documented physician orders for psychiatry consults or social service consults addressing the resident’s psychological status. A nurse practitioner later documented the resident was discouraged about the stroke and inability to live independently, was weepy and teary, and considered a low-dose antidepressant after family input. The resident continued to be observed asleep in bed with the room dark and curtains closed during multiple daytime observations, and staff and family described the resident as having a hard time adjusting to LTC and becoming very depressed.
Undated insulin pen used for resident medication administration
Penalty
Summary
Resident #5, who had a diagnosis of diabetes and was cognitively intact, received insulin lispro under a sliding-scale order before meals and at bedtime. On 01/07/2026, the resident’s blood glucose was documented at 165 mg/dL in the morning and 331 mg/dL later in the day, and the MAR showed 2 units were administered in the morning and 8 units at 11:30 AM. During observation of the noon medication pass, the LPN obtained the resident’s blood sugar, set the insulin pen to 8 units, and administered the injection in the resident’s left lower abdomen. The insulin lispro pen used for administration did not have an opened date visible, and there was no documented evidence that the pen had been dated or used within the manufacturer’s recommended 28-day timeframe after opening. When questioned, the LPN stated the opened date label must have come off, that they did not check the date before using the pen, and that they assumed it was acceptable because it was in the resident’s insulin pen bag. The LPN also stated they used the same pen for both doses that day and would discard it. Nursing leadership stated opened dates were expected to be checked before insulin administration, and the Director of Infection Control and Staff Development stated there was no formal education on medication administration.
Unsafe and Unsanitary Shower/Tub Area
Penalty
Summary
The facility failed to ensure a safe, functional, sanitary, and comfortable environment for residents, staff, and the public in one of four shower/tub units on the 2 [NAME] unit. During a resident group meeting, four anonymous residents stated that the shower floors were a mess, the showers and tubs did not work, the drains in the shower rooms did not work, and the tubs leaked. The facility’s maintenance request forms from 12/01/2025 through 01/09/2026 documented no maintenance request notifications for the tubs and/or shower room. Observations in the 2 [NAME] shower room showed standing water under the tub on multiple occasions. On 01/07/2026, the tub was filling and water remained under the pipe connected to the tub, later spreading farther under the tub with visible discoloration and light tan water. A CNA stated the shower next to the tub was given in a shower chair because the shower in that room would flood into the hallway due to the floor conditions. On 01/08/2026, the shower room had a musty wet odor, a brownish gray puddle remained under the tub, the tubing pipe was rusting and frayed in the puddle, the drain under the tub was crusted with gray matter, and gray matter was floating in the water. The Environmental Services Manager stated they had not received any work orders for the standing water and believed the drain may not be draining properly.
Failure to Post Daily Nurse Staffing Information in an Accessible Location
Penalty
Summary
The facility failed to post, on a daily basis at the beginning of each shift, the current resident census and the total number and actual hours worked by licensed and unlicensed nursing staff directly responsible for resident care in a prominent location readily accessible to residents and visitors for 5 of 5 days. Survey observations found the current daily resident census, staffing hours, and nurse staffing schedules posted on the Unit 1 nursing office door and window, which was not easily accessible to all visitors or residents. The facility policy, dated 01/16/2024, stated that nurse staffing information would be posted on the first floor next to the nursing office window at the beginning of each shift and would be legible and posted in a prominent place accessible to residents and visitors. During multiple observations, staffing information was seen on the first floor nursing office door and window across from the Unit 1 elevator, and a sign in the main lobby above the visitors' sign-in sheet was about 5 feet from the ground on a pillar. During interview, the DON stated the staffing numbers were posted on the glass window of the nursing office on the first floor, there was no staffing sheet posted on the second floor at the main entrance, and the sign was not easily seen from wheelchair height.
Failure to Perform Neurological Checks After Resident's Head Injury
Penalty
Summary
The facility did not ensure that residents received treatment and care in accordance with professional standards of practice for one resident who sustained a head injury from a fall. Specifically, the resident did not receive the required neurological checks while awaiting transport to the hospital. The facility's Head Trauma Protocol and Neurological Check policy mandate that neurological checks be performed every 15 minutes for the first hour and every 30 minutes for the next hour following a head injury, but these checks were not documented for the resident in question. The incident involved a resident with dementia and anxiety disorder who was found on the floor with a large hematoma on the forehead and a painful hematoma on the lower thigh. The Registered Nurse Supervisor assessed the resident, notified the physician, and received an order to transfer the resident to the hospital. However, there was no documentation of the required neurological checks being performed from the time of the initial assessment until the arrival of emergency medical services. Interviews with the staff revealed that the Licensed Practical Nurse monitored the resident but did not complete the neurological check flow sheet, assuming it was unnecessary due to the pending hospital transfer. The Director of Nursing confirmed that neurological checks should have been documented according to the protocol until the resident was transported. The lack of documentation and adherence to the protocol resulted in a deficiency in the care provided to the resident.
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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 Herkimer
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Foltsbrook Center For Nursing And Rehabilitation | 0.7 mi | ★★★★★ | 0 | 0 |
| The Grand Rehabilitation And Nursing At Mohawk | 2.5 mi | ★★★★★ | 3 | 1 |
| Alpine Rehabilitation And Nursing Center | 7.6 mi | ★★★★★ | 16 | 0 |
| Masonic Care Community Of New York | 10.4 mi | ★★★★★ | 35 | 1 |
| Charles T Sitrin Health Care Center Inc | 11.8 mi | ★★★★★ | 0 | 0 |
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