Tolstoy Foundation Rehabilitation and Nrsg Center
100 Lake Road · Valley Cottage, NY · 10989 · 8452686813
96 certified beds Non profit - Corporation
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (2 citations).
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results are getting worse cycle over cycle, not better.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
Special Focus Facility candidate
CMS lists this facility as a candidate for its Special Focus program for persistently poor inspection performance.
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 immediate-jeopardy citations in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
Cited under the freedom-from-abuse rule
Cited 2 times under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
$126,470 in federal fines in the last 24 months
1 fine — CMS fines are reserved for verified, serious non-compliance.
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: 1 of 5 Inspections: 1 of 5 Staffing: 4 of 5 Quality measures: 3 of 5
| Total nurse hours / resident-day | 4.76 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.51 | 0.55–0.75 |
| Weekend hours / resident-day | 4.13 | ≈ weekday level |
| Nursing turnover / year | 39% | median 45% |
| Fines (3-yr window) | 1 · $126,470 |
Inspection citations (45 in the current record)
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Immediate jeopardy · L September 2, 2025
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 October 23, 2025 · Resident Rights
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Immediate jeopardy · L September 2, 2025
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Corrected October 23, 2025 · Quality of Life and Care
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Potential for harm · D September 2, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected October 23, 2025 · Resident Rights
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Potential for harm · E September 2, 2025
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 October 23, 2025 · Resident Rights
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Potential for harm · E September 2, 2025
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected October 23, 2025 · Resident Rights
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Potential for harm · D September 2, 2025
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected October 23, 2025 · Quality of Life and Care
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Potential for harm · F September 2, 2025
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected October 23, 2025 · Nursing and Physician Services
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Potential for harm · D September 2, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected October 23, 2025 · Pharmacy Service
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Potential for harm · D September 2, 2025
Ensure that residents are free from significant medication errors.
Corrected October 23, 2025 · Pharmacy Service
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Potential for harm · D September 2, 2025
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 October 23, 2025 · Pharmacy Service
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Potential for harm · F September 2, 2025
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected October 23, 2025 · Administration
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Potential for harm · F September 2, 2025
Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Corrected October 23, 2025 · Administration
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Potential for harm · D September 2, 2025
Provide and implement an infection prevention and control program.
Corrected October 23, 2025 · Infection Control
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Potential for harm · E September 2, 2025
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected October 23, 2025 · Environmental
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Potential for harm · D August 6, 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 December 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D August 6, 2025 · found via complaint
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected December 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D August 6, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected December 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D August 6, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected December 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E August 6, 2025 · found via complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected December 3, 2025 · Resident Assessment and Care Planning
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Potential for harm · D August 6, 2025 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected December 3, 2025 · Resident Assessment and Care Planning
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Potential for harm · D August 6, 2025 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected December 3, 2025 · Quality of Life and Care
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Potential for harm · D July 30, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected September 27, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D July 30, 2024 · found via complaint
Respond appropriately to all alleged violations.
Corrected September 27, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D June 4, 2024 · 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 July 19, 2024 · Resident Rights
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Potential for harm · D June 4, 2024 · found via complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected July 19, 2024 · Resident Assessment and Care Planning
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| September 2, 2025 | Fine | $126,470 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 335311 · certified since October 5, 1970. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.