01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-10-30 | 7 | 2024-10-30 | 2 |
| Cycle 2 | 2023-10-19 | 12 | 2023-10-19 | 3 |
| Cycle 3 | 2022-08-03 | 19 | 2022-08-03 | 9 |
CMS CCN 3152522026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Complete Care At Bayshore Llc
715 North Beers Street · Holmdel, NJ 07733 · Monmouth County
Certified beds232CMS provider file
Recent citation rows52current 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
52 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 12 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-16 · 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 · 2026-05-16 · complaint2025-12-29 · HEALTHF0838Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-02-13 · complaint2024-10-30 · HEALTHF0624Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Prepare residents for a safe transfer or discharge from the nursing home.
Correction field: Deficient, Provider has date of correction · 2024-11-11 · complaint2024-10-30 · 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 · 2024-11-112024-10-30 · 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 · 2024-11-11 · complaint2024-10-30 · 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 · 2024-11-112024-10-30 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2024-11-112024-10-30 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-11-112024-10-30 · HEALTHF0812Severity F · widespread; 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 · 2024-11-122024-10-30 · FIREK0311Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Deficient, Provider has date of correction · 2024-11-122024-10-30 · FIREK0914Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2024-11-122024-04-04 · 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 · 2024-05-01 · complaint2024-02-14 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2024-03-12 · complaint2023-10-19 · 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 · 2023-11-172023-10-19 · 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 · 2023-11-17 · complaint2023-10-19 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2023-11-032023-10-19 · 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 · 2023-11-172023-10-19 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2023-11-172023-10-19 · HEALTHF0755Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2023-11-17 · complaint2023-10-19 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2023-11-172023-10-19 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-11-172023-10-19 · HEALTHF0842Severity B · pattern; potential for 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 · 2023-11-17 · complaint2023-10-19 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-11-172023-10-19 · FIREK0311Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Deficient, Provider has date of correction · 2023-11-0103 / 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
- PC HMH OPCO HOLDNGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 03/16/2023
- PC HMH HOLDINGS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 03/16/2023
- SMS 2021 TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 03/16/2023
- STEIN, SHALOMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/16/2023
- STEIN, SHALOMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/16/2023
- STEIN, SHALOMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/16/2023
- GREWAL, BALJINDERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/16/2023
- LEVOVITZ, YITZCHOKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/16/2023
- MATZLIAH, MENACHEMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/16/2023
- MERCADO, WANDAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/16/2023
- NASRA, MAGDYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/16/2023
- STEIN, SHALOMIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 03/16/2023
- BAYSHORE PROPCO HOLDCO LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
- BAYSHORE PROPCO LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
- EEF CAPITAL LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
- PC HMH HOLDINGS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
- PC HMH PROPCO INTERMEDIATE 9 LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
- PC HMH TOPCO PROPCO HOLDINGS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/16/2023
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 hours3.78per resident day
RN hours0.37per resident day
Weekend nurse hours3.52per resident day
Staff turnover37.8%CMS reported field
06 / LOCAL RECORDS
Open the Holmdel ledger →