01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-05-08 | 14 | 2026-05-08 | 3 |
| Cycle 2 | 2025-06-06 | 12 | 2025-06-06 | 3 |
| Cycle 3 | 2024-08-23 | 18 | 2024-08-23 | 1 |
CMS CCN 3953972026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Edenbrook On Second Ave
200 Second Avenue · Kingston, PA 18704 · Luzerne County
Certified beds160CMS provider file
Recent citation rows51current 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
51 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 10 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-25 · HEALTHF0584Severity E · pattern; 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 plan of correction · 2026-07-20 · complaint2026-06-25 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has plan of correction · 2026-07-20 · complaint2026-05-08 · HEALTHF0584Severity E · pattern; 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 plan of correction · 2026-07-202026-05-08 · HEALTHF0627Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Correction field: Deficient, Provider has date of correction · 2026-06-252026-05-08 · HEALTHF0628Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-06-252026-05-08 · 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 · 2026-06-252026-05-08 · HEALTHF0695Severity E · pattern; 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 · 2026-06-252026-05-08 · HEALTHF0699Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
Correction field: Deficient, Provider has date of correction · 2026-06-252026-05-08 · HEALTHF0806Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Correction field: Deficient, Provider has date of correction · 2026-06-252026-05-08 · HEALTHF0867Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has plan of correction · 2026-07-202026-05-08 · HEALTHF0919Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2026-06-252026-05-08 · FIREK0321Severity E · pattern; 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 · 2026-06-192026-05-08 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-05-08 · FIREK0911Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-01-21 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2026-03-03 · complaint2025-09-25 · HEALTHF0584Severity E · pattern; 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 · 2025-11-04 · complaint2025-09-25 · 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 · 2025-11-04 · complaint2025-06-06 · HEALTHF0550Severity E · pattern; 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 · 2025-07-162025-06-06 · HEALTHF0553Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Correction field: Deficient, Provider has date of correction · 2025-07-162025-06-06 · 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 · 2025-07-162025-06-06 · 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 · 2025-07-162025-06-06 · 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 · 2025-07-162025-06-06 · HEALTHF0791Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
Correction field: Deficient, Provider has date of correction · 2025-07-16 · complaint2025-06-06 · 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 · 2025-07-1603 / 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
- LIFSICS, CHANNIEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2025
- MAUER, DOVIEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2025
- ZARKH, GLEBIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/01/2025
- KINGSTON SNF REALTY, LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- ALMEKY, IBRAHIMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- CUNDEY, CHELSEYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- KINGSTON SNF REALTY, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- ALMEKY, IBRAHIMIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- CUNDEY, CHELSEYIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- LIFSICS, CHANNIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- MAUER, DOVIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
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 hours3.62per resident day
RN hours0.40per resident day
Weekend nurse hours3.29per resident day
Staff turnover65.6%CMS reported field
06 / LOCAL RECORDS
Open the Kingston ledger →