01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-04-17 | 6 | 2025-04-17 | 2 |
| Cycle 2 | 2024-05-08 | 26 | 2024-05-08 | 6 |
| Cycle 3 | 2023-07-14 | 28 | 2023-07-14 | 1 |
CMS CCN 4150992026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Crystal Lake Rehabilitation And Care Center
999 South Main Street · Pascoag, RI 02859 · Providence County
Certified beds71CMS provider file
Recent citation rows69current CMS citation release
Penalty rows17current 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
69 rows in the current release
8 rows carry G–L scope/severity codes; 5 carry J–L. 14 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-04-17 · HEALTHF0582Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2025-05-172025-04-17 · HEALTHF0641Severity E · pattern; 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 · 2025-05-172025-04-17 · 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 · 2025-05-172025-04-17 · HEALTHF0684Severity E · pattern; 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 · 2025-05-172025-04-17 · 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 · 2025-05-172025-04-17 · HEALTHF0838Severity F · widespread; 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 · 2025-05-172025-04-17 · FIREK0211Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2025-05-162025-04-17 · FIREK0761Severity F · widespread; 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 · 2025-05-162024-11-06 · 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 · 2024-11-20 · complaint2024-11-06 · HEALTHF0760Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-11-20 · complaint2024-11-06 · HEALTHF0839Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Employ staff that are licensed, certified, or registered in accordance with state laws.
Correction field: Deficient, Provider has date of correction · 2024-11-20 · complaint2024-09-25 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-10-07 · complaint2024-06-13 · HEALTHF0689Severity J · isolated immediate jeopardy
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 · 2024-06-27 · complaint2024-05-08 · FIREE0036Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish emergency prep training and testing.
Correction field: Deficient, Provider has date of correction · 2024-05-292024-05-08 · 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 · 2024-05-292024-05-08 · HEALTHF0577Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Correction field: Deficient, Provider has date of correction · 2024-05-292024-05-08 · HEALTHF0641Severity E · pattern; 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 · 2024-05-292024-05-08 · HEALTHF0656Severity E · pattern; 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 · 2024-05-292024-05-08 · 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 · 2024-05-292024-05-08 · HEALTHF0684Severity H · pattern of actual 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 · 2024-05-292024-05-08 · 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 · 2024-05-292024-05-08 · HEALTHF0690Severity E · pattern; 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 · 2024-05-292024-05-08 · 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 · 2024-05-292024-05-08 · HEALTHF0726Severity E · pattern; 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 · 2024-05-2903 / 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 |
|---|---|---|---|
| 2024-09-25 | Fine | $29,328 | 0 |
| 2024-06-13 | Fine | $27,213 | 0 |
| 2024-02-27 | Fine | $9,318 | 0 |
| 2024-02-27 | Fine | $10,845 | 0 |
| 2024-02-27 | Fine | $105,651 | 0 |
| 2024-02-27 | Payment Denial | $0 | 2 |
| 2024-02-20 | Fine | $4,938 | 0 |
| 2024-02-12 | Fine | $4,938 | 0 |
| 2024-01-22 | Fine | $14,814 | 0 |
| 2024-01-08 | Fine | $4,938 | 0 |
| 2024-01-02 | Fine | $4,545 | 0 |
| 2023-12-11 | Fine | $13,762 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- FINK, BORUCHIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 04/01/2019
- LEIFER, JOELIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST48% · since 04/01/2019
- OBERLANDER, DAVIDIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST48% · since 04/01/2019
- HERMANN, EDWARDIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 04/01/2019
- STERN, SAMUELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/01/2019
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 hours3.58per resident day
RN hours1.04per resident day
Weekend nurse hours3.13per resident day
Staff turnover57.6%CMS reported field
06 / LOCAL RECORDS
Open the Pascoag ledger →