01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-20 | 1 | 2025-06-20 | 3 |
| Cycle 2 | 2023-09-25 | 10 | 2023-09-25 | 1 |
| Cycle 3 | 2021-09-15 | 3 | 2021-09-15 | 0 |
CMS CCN 0751462026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Complete Care At Middlebury
778 Middlebury Rd · Middlebury, CT 06762 · Naugatuck Vly County
Certified beds58CMS provider file
Recent citation rows18current 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
18 rows in the current release
1 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.
2025-09-19 · HEALTHF0689Severity G · isolated actual 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: Past Non-Compliance · complaint2025-06-20 · FIREK0362Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Correction field: Deficient, Provider has date of correction · 2025-08-142025-06-20 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-08-142025-06-20 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2025-08-142023-09-25 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2023-11-272023-09-25 · 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 · 2023-11-272023-09-25 · HEALTHF0730Severity B · pattern; potential for minimal harm
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
Correction field: Deficient, Provider has date of correction · 2023-11-272023-09-25 · 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 · 2023-11-272023-09-25 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2023-11-272023-09-25 · HEALTHF0757Severity E · pattern; 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 · 2023-11-272023-09-25 · 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 · 2023-11-272023-09-25 · HEALTHF0838Severity B · pattern; potential for 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 · 2023-11-272023-09-25 · HEALTHF0880Severity F · widespread; 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 · 2023-11-272023-09-25 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2023-11-272023-09-25 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2023-11-022021-09-15 · 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 · 2021-11-232021-09-15 · 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 · 2021-11-232021-09-15 · 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 · 2021-11-2303 / 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 |
|---|---|---|---|
| 2025-09-19 | Fine | $12,735 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PC MIDDLEBURY OPCO LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 10/10/2023
- PC MIDDLEBURY TOPCO LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/10/2023
- PEACE CAPITAL HOLDINGS II LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/10/2023
- SMS 2021 TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/10/2023
- DES CAPITAL LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/10/2023
- JRK INVESTMENTS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/10/2023
- KLUGMAN, JACOBIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/10/2023
- STEIN, SHALOMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/10/2023
- STERNBUCH, DANIELIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/10/2023
- LAGANA, KRISTINIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/10/2023
- STEIN, SHALOMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/10/2023
- STEIN, SHALOMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/10/2023
- ADETOLA, ADEDAYOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/14/2025
- HOCH, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/10/2023
- KNIGHTS, PETERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/10/2023
- LAGANA, KRISTINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/10/2023
- TETREAULT, MARNIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/10/2023
- STEIN, SHALOMIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 10/10/2023
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 hours3.84per resident day
RN hours0.73per resident day
Weekend nurse hours3.49per resident day
Staff turnover50.7%CMS reported field
06 / LOCAL RECORDS
Open the Connecticut ledger →Other published facilities nearby
No second facility in the same city met the directory rule.