01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-04-16 | 6 | 2026-04-16 | 7 |
| Cycle 2 | 2025-03-26 | 12 | 2025-03-26 | 11 |
| Cycle 3 | 2024-04-12 | 22 | 2024-04-12 | 0 |
CMS CCN 2255302026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Andover Forest Post Acute Care Center
1801 Turnpike Street · North Andover, MA 01845 · Essex County
Certified beds142CMS provider file
Recent citation rows58current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
58 rows in the current release
5 rows carry G–L scope/severity codes; 1 carry J–L. 11 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-16 · HEALTHF0638Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Assure that each resident’s assessment is updated at least once every 3 months.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · HEALTHF0640Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · HEALTHF0814Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · HEALTHF0842Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2026-05-042026-04-16 · FIREK0345Severity C · widespread; potential for minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2026-06-262026-04-16 · FIREK0351Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2026-07-172026-04-16 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-06-182026-04-16 · FIREK0361Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.
Correction field: Deficient, Provider has date of correction · 2026-07-172026-04-16 · FIREK0711Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2026-06-182026-04-16 · FIREK0712Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-06-182026-04-16 · FIREK0761Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2026-06-182025-03-26 · FIREE0006Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Correction field: Deficient, Provider has date of correction · 2025-04-142025-03-26 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-04-212025-03-26 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0658Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0677Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-26 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2025-04-1603 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-04-12 | Fine | $25,847 | 0 |
| 2023-09-26 | Fine | $10,517 | 0 |
| 2023-08-29 | Fine | $7,901 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- FRIEDMAN, SHANAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST12% · since 10/16/2023
- ETN FAMILY HOLDINGS LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/16/2023
- TLCO HOLDINGS LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/16/2023
- COM FAMILY TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST10% · since 10/16/2023
- MILLMAN, CHAIMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/16/2023
- NEWHOUSE, ERICIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/16/2023
- HERNANDEZ, AMANDAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2025
- MILLMAN, CHAIMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/16/2023
- NEWHOUSE, ERICIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/16/2023
- ETN FAMILY HOLDINGS LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/16/2023
- TLCO HOLDINGS LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/16/2023
- CORDEIRO, KALIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/30/2023
- ERBLICH, AVRAHAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/16/2023
- HERNANDEZ, AMANDAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- MILLMAN, CHAIMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/16/2023
- MILLMAN, CHAIMIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 10/16/2023
- NEWHOUSE, ERICIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 10/16/2023
- COM FAMILY TRUSTOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/16/2023
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.59per resident day
RN hours0.44per resident day
Weekend nurse hours3.08per resident day
Staff turnover38.9%CMS reported field
06 / LOCAL RECORDS
Open the North Andover ledger →