Woodland Pond At New Paltz

F-F677)

3) During the Resident Council meeting on 4/22/2025 at 11:10 AM, Residents #9, #15, and #30 stated the night shift had problems as 40 residents was too much for 2 Certified Nurse Aides. All residents in attendance reported the night shift staff were not able to attend to resident activity of daily living needs and that many waited until 7 AM-7 PM to receive assistance with incontinence care and to be transferred to bed.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 4 of 5 335858 Department of Health & Human Services Printed: 08/28/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 335858 B. Wing 04/24/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Woodland Pond at New Paltz 100 Woodland Pond Circle New Paltz, NY 12561

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)

F 0725 During the Resident Council meeting on 4/22/2025 at 11:51 AM Resident #15 stated during the overnight shift there have been 2 Certified Nurse Aides and during the day shift there were 3 Certified nurse Aides. Level of Harm - Minimal harm or They stated the day shift staff were used to get them in bed because they would have to wait a very long potential for actual harm time to go to bed with the night shift starting at 7 PM.

Residents Affected - Many During the Resident Council meeting on 4/22/2025 at 11:51 AM, Resident #19 and Resident #33 stated residents were told to urinate in their brief because they had not had a bowel movement.

During an interview on 4/23/2025 at 12:08 PM, the Director of Nursing stated that they felt staffing numbers were adequate to provide the care needed for their residents. The stated Resident #28 had to wait for 66 minutes to receive incontinence care and that a wait time of more than 20-25 minutes was unreasonable and was the cut off for their audit.

During an interview on 4/24/2025 at 10:33 AM Resident #18's family member expressed concern over the time it took for staff to answer call bell/s. They stated when staff answered they frequently stated they needed a second person, left and did not return for 20-30 minutes.

During an interview on 4/24/2025 at 11:57 AM Certified Nursing Assistant #8 stated there were usually 3 Certified Nurse Aides on the unit during evening/night shift, occasionally there there were only two. They stated when there was only two, the assignment was not easy, but doable, especially with all the residents that required a lift for transfers. They stated nurses assisted with resident care and answering call bells, but

the extra nurse was not given an aide assignment to make it a three-way split, it remained a two-way split.

10 NYCRR 415.13

40686

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 5 of 5 335858