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Tolstoy Foundation Rehabilitation and Nursing Center

100 Lake Road, PO Box 319, Valley Cottage, New York 10989

Tolstoy Foundation Rehabilitation and Nursing Center is located in Valley Cottage, New York. It has 96 certified beds that have been approved by the federal government to participate in Medicare and Medicaid, with an average of 103.4 residents per day. Tolstoy Foundation Rehabilitation and Nursing Center is not in a Continuing Care Retirement Community, and it is not in a hospital. It has a Resident Council to facilitate communications with the staff. The facility is a not-for-profit corporation doing business under the legal business name of Tolstoy Foundation Nursing Home Company Inc.

The Centers for Medicare & Medicaid Services (CMS) gives each nursing home an overall rating* on a scale of 1 to 5 stars: 5 stars = much above average, 4 stars = above average, 3 stars = average, 2 stars = below average, 1 star = much below average. The CMS also assigns star ratings in the categories of health inspections, staffing, and quality of resident care. The overall rating for Tolstoy Foundation Rehabilitation and Nursing Center is “below average” or 2 stars.

Health Inspections

Tolstoy Foundation Rehabilitation and Nursing Center’s star rating for health inspections is 2 stars. New York State inspectors regularly conduct full inspections of nursing homes for compliance with federal Medicare and Medicaid regulations. In addition, at any time during the year a nursing home may also be inspected based on a complaint submitted by a resident or based on an incident self-reported by the facility.

The date of the most recent health inspection of Tolstoy Foundation Rehabilitation and Nursing Center was March 27, 2018. In that report 8 health citations were noted. The average number of citations for New York is 4.8 and the average number of citations in the United States is 7.8.

Among other things, the inspectors concluded that the facility failed to provide activities to meet all resident's needs. Specifically, the facility did not provide ongoing program of activities for a specific resident. The resident was not provided opportunities to consistently attend activities of his choice, and the facility did not regularly reassess the resident's preferences. Upon admission, it was documented that the resident was severely impaired cognitively, was non-verbal, and had impaired hearing. The activity of choice was to listen to music. The admission data also indicated that the resident is totally dependent on the staff for all activities of daily living. Review of the activity plan indicated that it had not been updated. The resident was observed on each day of the survey, alone in his room with the TV turned on. At no time was the resident observed participating in an activity of his choice or attending an activity program on another unit.

Staff interviews about the resident elicited inconsistent information. The unit Registered Nurse manager was interviewed and stated that the staff gets the resident out of bed daily and he routinely sits in the hallway. However, when asked when the resident last attended an activity, the RN manager had no response. In addition, 2 certified nursing assistants were both stated the resident rarely leaves his room to attend an activity

In addition, during the last 3 years, there was 1 occasion in which there was a facility-reported incident that resulted in a citation.

Staffing

According to the CMS, higher staffing levels may mean higher quality of care for residents. Thus, the CMS reviews the staffing levels. Specifically, it looks at the number of hours per resident of licensed nurses, registered nurses, nurses aides, licensed practical/vocational nurses, and physical therapists. For staffing, Tolstoy Foundation Rehabilitation and Nursing Center received 2 stars which is a “below average” rating.

  • The total number of licensed nurse staff hours per resident per day at Tolstoy Foundation Rehabilitation and Nursing Center is 1 hour and 11 minutes, while the New York average is 1 hour and 31 minutes and the national average is 1 hour and 33 minutes.
  • The registered nurse hours per resident per day at Tolstoy Foundation Rehabilitation and Nursing Center is 26 minutes compared to 42 minutes for New York and 41 minutes for the United States.
  • The licensed practical/vocational nurses (LPN/LVN) hours per resident per day at Tolstoy Foundation Rehabilitation and Nursing Center is 45 minutes compared to 49 minutes for New York and 53 minutes for the United States.
  • The nurses aid hours per resident per day is 1 hour and 56 minutes, while the New York average is 2 hours and 15 minutes and the national average is 2 hours and 19 minutes.
  • Tolstoy Foundation Rehabilitation and Nursing Center provides 8 minutes of physical therapist staff hours per resident per day, compared to the New York average is 7 minutes and the national average is 5 minutes. However, not all nursing home residents require physical therapy.
Quality of Resident Care

Tolstoy Foundation Rehabilitation and Nursing Center’s star rating for overall quality of resident care is 3 stars which is an “average” rating. Facilities are also rated on their quality of care for short-stay residents and long-stay residents. Tolstoy Foundation Rehabilitation and Nursing Center’s star rating for short-stay residents is 4 stars, while the rating for long-stay is 2 stars.

Short-stay residents. Short-stay residents are those who spent 100 days or less in a nursing home, or residents covered under the Medicare Part A Skilled Nursing Facility benefit.

In determining a nursing home’s rating for short-stay residents, the CMS reviews records related to residents’ visits to hospitals. 18.2% of Tolstoy Foundation Rehabilitation and Nursing Center’s short-stay residents were re-hospitalized after a nursing home admission. The average for New York is 20.4% and national average is 22.6%. As for outpatient emergency department visits, for Tolstoy Foundation Rehabilitation and Nursing Center, the percentage of short-stay residents who have had an outpatient emergency department visit is 9.5%, while the New York average is 8.8% and the national average is 10.7%.

Pressure ulcers, also referred to as bed sores or pressure injuries, are injuries to skin and underlying tissue resulting from prolonged pressure on the skin, such as staying in one position for a long time. In some, but not all instances, pressure ulcers can be indicative of negligent care. None of the skilled nursing facility residents at Tolstoy Foundation Rehabilitation and Nursing Center had pressure ulcers that were new or worsened while residing at this facility. The national average is 1.6%.

Nursing facilities are also evaluated for their flu and pneumonia prevention measures. 93.2% of Tolstoy Foundation Rehabilitation and Nursing Center’s short-stay residents received the needed flu shot for current flu season. This percentage is higher than both the New York and national averages which stand at 82.6% and 82.3%, respectively. As for the percentage of short-stay residents who needed and got a vaccine to prevent pneumonia, the percentage for Tolstoy Foundation Rehabilitation and Nursing Center is 100%, while the average for New York is 79.3% and the average for the United States is 83.2%.

Long-stay residents. Long-stay residents are those who spent over 100 days in a nursing home.

A part of a nursing home’s quality of resident care rating is the number of resident hospitalizations. For Tolstoy Foundation Rehabilitation and Nursing Center, the number of hospitalizations per 1,000 long-stay resident days is 2.32, while the New York average is 1.55, and the national average is 1.75. As for the number of outpatient emergency department visits per 1,000 long-stay resident, for Tolstoy Foundation Rehabilitation and Nursing Center the number is days is 0.59, while the New York average is 0.74, and the national average is 1.03.

The rating also takes into consideration specific medical issues experienced by residents. The percentage of long-stay residents at Tolstoy Foundation Rehabilitation and Nursing Center experiencing one or more falls with major injury is 3.4, while the New York average is 2.9, and the national average is 3.4. The percentage of long-stay high-risk residents at Tolstoy Foundation Rehabilitation and Nursing Center with pressure ulcers is 11.0%, compared to the New York average of 8.6% and the national average of 7.4%. The percentage of long-stay residents at Tolstoy Foundation Rehabilitation and Nursing Center with a urinary tract infection is 5.6%, compared to the New York average of 2.4% and the national average of 2.8%. The percentage of long-stay residents at Tolstoy Foundation Rehabilitation and Nursing Center who have or had a catheter inserted and left in their bladder is 6.2%, compared to the New York average of 1.6% and the national average of 2.2%.

As for factors related to mobility and pain, the rating examines the percentage of residents whose ability to move independently worsened. For Tolstoy Foundation Rehabilitation and Nursing Center, 12.9% of long-stay residents’ ability to move independently worsened. The average for New York is 16% and the national average is 17.9%. The percentage of long-stay residents at Tolstoy Foundation Rehabilitation and Nursing Center whose need for help with daily activities has increased is 17.5%, compared to the New York average of 13.3% and the national average of 14.8%. The percentage of long-stay residents at Tolstoy Foundation Rehabilitation and Nursing Center who report moderate to severe pain is 1.7%, compared to the New York average of 4.0% and the national average of 6.9%.

Penalties

When a nursing home gets a serious citation or fails to correct a citation for a long period of time, that facility may be assessed a penalty. A penalty can be a fine against the facility or a denied payment from Medicare. Tolstoy Foundation Rehabilitation and Nursing Center has not received a penalty from the federal government in the last 3 years.

*Disclaimer

The information about the performance of Tolstoy Foundation Rehabilitation and Nursing Center is from Medicare.gov and is based on past performance. Past performance is not an indicator of future performance. Further, we recommend that you check the statistics yourself at Medicare.gov for both accuracy and updates. Choosing a nursing home is a very difficult decision, and we make no representation as to the quality of any of the facilities or their ratings on the site.

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