01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-10-30 | 14 | 2024-10-30 | 15 |
| Cycle 2 | 2023-06-15 | 22 | 2023-06-15 | 14 |
| Cycle 3 | 2021-05-21 | 18 | 2021-05-21 | 11 |
CMS CCN 3154672026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Little Brook Nursing And Convalescent Home
78 Sliker Road · Califon, NJ 07830 · Hunterdon County
Certified beds36CMS provider file
Recent citation rows94current CMS citation release
Penalty rows3current 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
94 rows in the current release
8 rows carry G–L scope/severity codes; 8 carry J–L. 20 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-07-10 · 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 · 2025-08-18 · complaint2025-03-18 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-05-14 · complaint2025-03-18 · HEALTHF0610Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-05-14 · complaint2025-03-18 · 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 · 2025-05-14 · complaint2025-03-18 · HEALTHF0657Severity E · pattern; 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 · 2025-05-14 · complaint2025-03-18 · HEALTHF0730Severity D · isolated; potential for more than 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 · 2025-05-14 · complaint2024-10-30 · FIREE0006Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Correction field: Deficient, Provider has date of correction · 2024-11-222024-10-30 · FIREE0015Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2024-11-222024-10-30 · 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 · 2024-12-092024-10-30 · HEALTHF0582Severity D · isolated; potential for more than 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 · 2024-11-212024-10-30 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-11-21 · complaint2024-10-30 · HEALTHF0623Severity D · isolated; potential for more than 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 · 2024-11-222024-10-30 · HEALTHF0640Severity F · widespread; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Correction field: Deficient, Provider has date of correction · 2024-11-212024-10-30 · 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 · 2024-11-212024-10-30 · 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 · 2024-11-202024-10-30 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2024-11-222024-10-30 · HEALTHF0730Severity F · widespread; potential for more than 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 · 2024-11-212024-10-30 · 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 · 2024-11-212024-10-30 · 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 · 2024-11-212024-10-30 · HEALTHF0808Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Correction field: Deficient, Provider has date of correction · 2025-01-222024-10-30 · 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 · 2024-11-212024-10-30 · HEALTHF0842Severity D · isolated; potential for more than 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 · 2024-11-212024-10-30 · 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 · 2025-01-222024-10-30 · FIREK0223Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2024-11-2203 / 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 |
|---|---|---|---|
| 2025-07-10 | Fine | $62,493 | 0 |
| 2025-03-18 | Fine | $255,403 | 0 |
| 2024-10-30 | Fine | $37,522 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- FERNANDEZ, ROSAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST51% · since 11/09/2005
- HAMPILOS, JOHNIndividual · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 12/30/2005
- LAZARE GROUP, INCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 02/13/2002
- BETHANE PROPERTIES, INCOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 02/13/2002
- BRADFORD, CYNTHIAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/27/2021
- SEGARAM, SANDIRAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/30/2005
- CAISSIE, ELIZABETHIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2018
- FERNANDEZ, ROSEMARIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/30/2005
- HAMPILOS, JOHNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/30/2005
- LAZARE GROUP, INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/13/2002
- BRADFORD, CYNTHIAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/27/2021
- CAISSIE, ELIZABETHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/03/2017
- HAMPILOS, JOHNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/09/2005
- SEGARAM, SANDIRAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/30/2005
- FERNANDEZ, ROSAIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 11/09/2005
- HAMPILOS, JOHNIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 11/09/2005
- BETHANE PROPERTIES, INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/13/2002
- LAZARE GROUP, INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/13/2002
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 hours—per resident day
RN hours—per resident day
Weekend nurse hours—per resident day
Staff turnover40.7%CMS reported field
06 / LOCAL RECORDS
Open the New Jersey ledger →Other published facilities nearby
No second facility in the same city met the directory rule.