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Complaint Investigation

Momentum At South Bay For Rehab And Nursing

Inspection Date: September 9, 2025
Total Violations 5
Facility ID 335401
Location EAST ISLIP, NY
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Inspection Findings

F-Tag F0656

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

Federal health inspectors cited MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING in EAST ISLIP, NY for a deficiency under regulatory tag F-F0656 during a standard health inspection conducted on 2025-09-09.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 5 deficiencies cited during this inspection of MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-28.

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F-Tag F0657

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

Federal health inspectors cited MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING in EAST ISLIP, NY for a deficiency under regulatory tag F-F0657 during a standard health inspection conducted on 2025-09-09.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 5 deficiencies cited during this inspection of MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-28.

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F-Tag F0697

Quality of Life and Care Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0697 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

for the resident. During an interview on 09/09/2025 at 3:00 PM, the Medical Director stated the pain management consultant should have reviewed the resident's Medication Administration Record and communicated their recommendations to the attending physician.During an interview on 09/09/2025 at 3:30 PM, the Director of Nursing Services stated, Pain Management Nurse Practitioner #2 should have reviewed

the resident's Medication orders to know the resident's current medications. Pain Management Nurse Practitioner #2 should have also communicated their recommendations to continue the pain medication for Resident #92 to the nursing supervisor, who then should have informed the Physician. 10 NYCRR 415.12

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Momentum at South Bay for Rehab and Nursing

340 East Montauk Highway East Islip, NY 11730

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

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F-Tag F0710

Nursing and Physician Services Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0710 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

saw the resident on September 7, I thought they were still on Acetaminophen and recommended it be continued. During an interview on 09/09/2025 2:21 PM, the attending Primary Physician #2 stated they ordered the pain medications for 14 days. They relied on staff to notify them of the resident's complaint of pain for them to reorder the pain medications. The attending Primary Physician #2 stated they were not notified of Resident #92's complaints of pain and were also not notified of the recommendations provided by Pain Management Nurse Practitioner #2 to continue the pain medication for the resident. During an

interview on 09/09/2025 at 3:00 PM, the Medical Director stated the pain management consultant should have reviewed the resident's Medication Administration Record and communicated their recommendations to the attending physician.10 NYCRR 415.15 (b)(1)(i)(ii)

Event ID:

Facility ID:

If continuation sheet

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F-Tag F0880

Infection Control Deficiencies
Harm Level: Potential for More Than Minimal Harm

Federal health inspectors cited MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING in EAST ISLIP, NY for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-09-09.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 5 deficiencies cited during this inspection of MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-28.

📋 Inspection Summary

MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING in EAST ISLIP, NY inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in EAST ISLIP, NY, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from MOMENTUM AT SOUTH BAY FOR REHAB AND NURSING or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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