01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-27 | 6 | 2025-05-27 | 12 |
| Cycle 2 | 2022-08-09 | 7 | 2022-08-09 | 2 |
| Cycle 3 | 2020-02-03 | 7 | 2020-02-03 | 0 |
CMS CCN 3358572026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Wilkinson Residential Health Care Facility
4988 State Hwy 30 · Amsterdam, NY 12010 · Montgomery County
Certified beds160CMS provider file
Recent citation rows34current 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
34 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.
2025-05-27 · FIREE0007Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address patient/client population and determine types of services needed.
Correction field: Deficient, Provider has date of correction · 2025-07-252025-05-27 · FIREE0029Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop a communication plan.
Correction field: Deficient, Provider has date of correction · 2025-07-252025-05-27 · FIREE0037Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2025-07-252025-05-27 · HEALTHF0600Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-07-23 · complaint2025-05-27 · 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 · 2025-07-23 · complaint2025-05-27 · 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 · 2025-07-23 · complaint2025-05-27 · HEALTHF0689Severity E · pattern; 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 · 2025-07-24 · complaint2025-05-27 · 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 · 2025-07-272025-05-27 · HEALTHF0726Severity D · isolated; 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 · 2025-07-23 · complaint2025-05-27 · HEALTHF0727Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · HEALTHF0755Severity F · widespread; 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 · 2025-07-232025-05-27 · HEALTHF0812Severity D · isolated; 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 · 2025-07-232025-05-27 · FIREK0271Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · FIREK0281Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install proper backup exit lighting.
Correction field: Deficient, Provider has plan of correction · 2025-07-232025-05-27 · 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 · 2025-07-232025-05-27 · FIREK0345Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · FIREK0511Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-07-232025-05-27 · FIREK0711Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2025-07-252025-05-27 · FIREK0929Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
Correction field: Deficient, Provider has date of correction · 2025-07-232022-08-09 · 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 · 2022-10-052022-08-09 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2022-09-302022-08-09 · 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 · 2022-09-3003 / 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
- BAGHAEI-RAD, NANCYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- BEIN-AIME, JOELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- CICHY, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- DEMARTINIS, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- ETZKORN, EMILYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- GHAZI-MOGHADAM, MOHAMMAD-REZAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- HECK, ANDREWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- HEENAN, MARY ANNEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- MARSH, RONALDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- METHVEN, JEFFREYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- PEPE, MICHAELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- SANTOS, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- VERTUCCI, RICHARDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- WATERS, KEITHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- ZISKIN, BENJAMINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2022
- FEDULLO, JOHNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2022
- HELD, JOSHUAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2022
- METHVEN, JEFFREYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2022
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 hours3.83per resident day
RN hours0.52per resident day
Weekend nurse hours2.99per resident day
Staff turnover39.3%CMS reported field
06 / LOCAL RECORDS
Open the Amsterdam ledger →