01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-07 | 1 | 2025-05-07 | 0 |
| Cycle 2 | 2024-01-26 | 5 | 2024-01-26 | 0 |
| Cycle 3 | 2021-10-22 | 3 | 2021-10-22 | 0 |
CMS CCN 3154292026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Clover Rest Home
28 Washington Street · Columbia, NJ 07832 · Warren County
Certified beds33CMS provider file
Recent citation rows9current CMS citation release
Penalty rows0current 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
9 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-05-07 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-06-022024-01-26 · 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 · 2024-03-262024-01-26 · HEALTHF0658Severity D · isolated; 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 · 2024-03-262024-01-26 · HEALTHF0727Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-03-26 · complaint2024-01-26 · HEALTHF0812Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-03-262024-01-26 · HEALTHF0912Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Correction field: Waiver has been granted · 2024-03-262021-10-22 · 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 · 2021-11-222021-10-22 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2021-11-222021-10-22 · HEALTHF0912Severity B · pattern; potential for minimal harm
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Correction field: Waiver has been granted · 2021-11-1503 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- EGERT, USHERIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 10/01/2020
- KATZ, NATHANIELIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST25% · since 10/01/2020
- LEBOVIC, DOVIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · GENERAL PARTNERSHIP INTERESTNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · LIMITED PARTNERSHIP INTERESTNOT APPLICABLE · since 10/01/2020
- LEBOVIC, DOVIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/01/2020
- SMOTKIN, JOSEPHIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/03/2025
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 hours4.42per resident day
RN hours0.42per resident day
Weekend nurse hours3.93per resident day
Staff turnover42.9%CMS reported field
06 / LOCAL RECORDS
Open the New Jersey ledger →Other published facilities nearby
No second facility in the same city met the directory rule.