New York State Veterans Home at Montrose
2090 Albany Post Road · Montrose, NY · 10548 · 9147886000
252 certified beds Government - State
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspection results are getting worse cycle over cycle, not better.
- 4 citations involved actual harm to residents.
- Staffing hours comfortably above national benchmarks.
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Red flags
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
2 abuse-related citations at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
2 actual-harm citations in the most recent cycle
Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.
No standard inspection in over 2 years
The inspection record here is older than usual — conditions may have changed since.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 2 of 5 Inspections: 1 of 5 Staffing: 5 of 5 Quality measures: 3 of 5
| Total nurse hours / resident-day | 3.77 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 1.09 | 0.55–0.75 |
| Weekend hours / resident-day | 3.12 | ≈ weekday level |
| Nursing turnover / year | 20% | median 45% |
| Fines (3-yr window) | 1 · $29,153 |
Inspection citations (22 in the current record)
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Actual harm · G March 24, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 8, 2026 · Quality of Life and Care
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Potential for harm · D March 24, 2026 · found via complaint
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected May 8, 2026 · Resident Rights
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Potential for harm · D March 24, 2026 · found via complaint
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected May 8, 2026 · Resident Rights
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Actual harm · G March 11, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected April 17, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D June 4, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected July 31, 2025 · Quality of Life and Care
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Potential for harm · E June 4, 2025 · found via complaint
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected July 31, 2025 · Nursing and Physician Services
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Actual harm · G April 3, 2025 · found via complaint
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected May 23, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Actual harm · G April 3, 2025 · found via complaint
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected May 23, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 3, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected May 23, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 3, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected May 23, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 3, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected May 23, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D July 27, 2023
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected September 12, 2023 · Resident Assessment and Care Planning
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Potential for harm · D July 27, 2023
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected September 12, 2023 · Resident Assessment and Care Planning
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Potential for harm · D July 27, 2023
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected September 12, 2023 · Pharmacy Service
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Potential for harm · D July 27, 2023
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected September 12, 2023 · Nutrition and Dietary
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Potential for harm · D July 27, 2023
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Corrected September 12, 2023 · Administration
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Potential for harm · D July 27, 2023
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected September 12, 2023 · Environmental
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Potential for harm · D July 27, 2023 · found via complaint
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected September 12, 2023 · Resident Rights
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Potential for harm · D July 27, 2023 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected September 12, 2023 · Resident Rights
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Potential for harm · D June 22, 2019
Reasonably accommodate the needs and preferences of each resident.
Corrected August 15, 2019 · Resident Rights
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Potential for harm · D June 22, 2019
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected August 15, 2019 · Resident Rights
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Potential for harm · D July 13, 2018
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected September 12, 2018 · Resident Assessment and Care Planning
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| April 3, 2025 | Fine | $29,153 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 335832 · certified since October 5, 2001. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.