01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-06-21 | 3 | 2024-06-21 | 2 |
| Cycle 2 | 2022-05-25 | 7 | 2022-05-25 | 20 |
| Cycle 3 | 2019-08-09 | 2 | 2019-08-09 | 1 |
CMS CCN 3357912026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Queens Boulevard Extended Care Facility
61 11 Queens Boulevard · Woodside, NY 11377 · Queens County
Certified beds280CMS provider file
Recent citation rows35current 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
35 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-06-21 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2024-08-02 · complaint2024-06-21 · HEALTHF0638Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assure that each resident’s assessment is updated at least once every 3 months.
Correction field: Deficient, Provider has date of correction · 2024-08-022024-06-21 · 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 · 2024-08-022024-06-21 · HEALTHF0804Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2024-08-022024-06-21 · FIREK0311Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Deficient, Provider has date of correction · 2024-07-022024-06-21 · 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 · 2024-07-022022-05-25 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREE0015Severity E · pattern; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · 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 · 2022-06-302022-05-25 · 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 · 2022-06-302022-05-25 · 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 · 2022-06-302022-05-25 · HEALTHF0657Severity D · isolated; 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 · 2022-06-302022-05-25 · 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 · 2022-06-302022-05-25 · 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 · 2022-06-302022-05-25 · 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 · 2022-06-302022-05-25 · FIREK0161Severity F · widespread; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · 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 · 2022-08-042022-05-25 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREK0223Severity F · widespread; 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 · 2022-08-042022-05-25 · FIREK0225Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREK0281Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Install proper backup exit lighting.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREK0293Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2022-08-042022-05-25 · FIREK0311Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Deficient, Provider has date of correction · 2022-08-0403 / 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
- CLEMENZA, ANTHONYIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 01/15/2014
- CLEMENZA, JAMESIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 01/14/2015
- MAWERE, JONATHANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/15/2014
- KALPESH AMINOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/26/2024
- AL-EBBINNI, EMMAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/05/2022
- APUHIN, NAOMIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/12/2023
- BUFANO, PAULIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/12/2024
- CASTRO, ALIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/30/2011
- CAVANAGH, CAROLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/17/2023
- CHODKOWSKI, STEFANIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/30/2023
- CLEMENZA, AMANDAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/10/2022
- CLEMENZA, ANTHONYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/05/2023
- GARCIA, NICCOLOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/07/2020
- KUI, KAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/30/2016
- MATTHIAS, DIANAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/09/2022
- MAWERE, JONATHANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/15/2014
- MURRAY, MARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/06/2023
- PEZULICH, PAULIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/17/2021
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 hours3.72per resident day
RN hours1.02per resident day
Weekend nurse hours3.54per resident day
Staff turnover39.8%CMS reported field
06 / LOCAL RECORDS
Open the New York ledger →Other published facilities nearby
No second facility in the same city met the directory rule.