01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-11-19 | 7 | 2024-11-19 | 1 |
| Cycle 2 | 2022-05-23 | 18 | 2022-05-23 | 4 |
| Cycle 3 | 2019-10-24 | 12 | 2019-10-24 | 2 |
CMS CCN 0752372026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Complete Care At Kimberly Hall-South
1 Emerson Drive · Windsor, CT 06095 · Capitol County
Certified beds180CMS provider file
Recent citation rows44current CMS citation release
Penalty rows1current 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
44 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 10 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-05-01 · 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 · 2025-06-12 · complaint2025-05-01 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2025-06-12 · complaint2025-04-03 · 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: Past Non-Compliance · 2025-02-20 · complaint2025-02-03 · HEALTHF0698Severity J · isolated immediate jeopardy
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 · 2025-02-03 · complaint2025-02-03 · HEALTHF0726Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2025-02-07 · complaint2025-01-14 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-02-14 · complaint2025-01-14 · HEALTHF0880Severity D · isolated; 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 · 2025-02-14 · complaint2024-11-19 · HEALTHF0561Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-11-19 · 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 · 2024-12-262024-11-19 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-11-19 · HEALTHF0623Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-11-19 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2024-12-262024-11-19 · 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 · 2024-12-262024-11-19 · 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 · 2024-12-262024-11-19 · FIREK0345Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-01-062024-09-13 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-10-17 · complaint2024-09-13 · 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 · 2024-10-17 · complaint2024-09-13 · 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 · 2024-10-17 · complaint2024-07-15 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-08-21 · complaint2024-07-15 · 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 · 2024-08-21 · complaint2024-07-03 · HEALTHF0677Severity D · isolated; 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 · 2024-08-07 · complaint2023-10-19 · 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 · 2023-11-30 · complaint2022-05-23 · HEALTHF0585Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2022-06-302022-05-23 · HEALTHF0625Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2022-06-3003 / 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 |
|---|---|---|---|
| 2025-01-14 | Fine | $14,728 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PC GEN CT OPCO HOLDCO LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 11/15/2022
- PC GEN CT OPCO TOPCO LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/15/2022
- PC GEN CT TOPCO LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/15/2022
- SMS 2021 TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/15/2022
- DES CAPITAL LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/15/2022
- JRK INVESTMENTS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/15/2022
- KLUGMAN, JACOBIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/15/2022
- STEIN, SHALOMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/15/2022
- STERNBUCH, DANIELIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/15/2022
- STEIN, SHALOMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 11/15/2022
- STEIN, SHALOMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/15/2022
- GALLAGHER, JAMESIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/15/2022
- HOCH, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/15/2022
- LAGANA, KRISTINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/15/2022
- RUSSO, THOMASIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/15/2022
- TETREAULT, MARNIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/15/2022
- STEIN, SHALOMIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 11/15/2022
- DES CAPITAL LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/15/2022
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 hours3.74per resident day
RN hours0.75per resident day
Weekend nurse hours3.44per resident day
Staff turnover27.4%CMS reported field
06 / LOCAL RECORDS
Open the Windsor ledger →