SNF

THE GRAND REHABILITATION AND NRSG AT GUILDERLAND

CCN: 335540 · ALTAMONT, NY 12009 · Albany County

⚠ SFF Candidate

Overview

Address
428 STATE ROUTE 146, ALTAMONT, NY 12009
Phone
5188615141
Certified beds
127
Avg daily residents
120 (95% of beds filled)
Ownership
For-profit LLC
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1976-09-01
Setting
Urban
1 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 1/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 1/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 1/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 2/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 4/5
Short-Stay Quality Measures ★★★★★ 1/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 2.81 3.87 2.81 ≥ 3.48 Below floor
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.30 0.68 0.30 ≥ 0.55 Below floor
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 1.03 0.86 1.02 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 1.48 2.33 1.48 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 1.33 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.13 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
2.34
hrs / resident / day
RN (weekend)
0.21
hrs / resident / day
Total nurse (adjusted, weekend)
2.33
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
57.4%
annual
RN turnover
81.8%
annual
Administrators departed
0
last 12 months

Resident acuity

Nursing Case-Mix Index
1.37
higher acuity than avg
Case-Mix Index Ratio
1.00
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-03-07 29 26 13 239 2 359
Cycle 2/3 (prior) 2024-01-30 9 8 2 52 1 52
Total weighted health score
282.3
lower is better

Deficiencies (56)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

55 D/E/F Actual harm — potential for minor
1 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. E 2025-03-07 2025-04-28
0770 Provide timely, quality laboratory services/tests to meet the needs of residents. D 2025-03-07 2025-04-28
0773 Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. D 2025-03-07 2025-04-28
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. E 2025-03-07 2025-04-28
0554 Allow residents to self-administer drugs if determined clinically appropriate. D 2025-03-07 2025-04-28
0585 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. D 2025-03-07 2025-04-28
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2025-03-07 2025-04-28
0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. D 2025-03-07 2025-04-28
0625 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. D 2025-03-07 2025-04-28
0645 PASARR screening for Mental disorders or Intellectual Disabilities D 2025-03-07 2025-04-28
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. E 2025-03-07 2025-04-28
0657 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. E 2025-03-07 2025-04-28
0695 Provide safe and appropriate respiratory care for a resident when needed. D 2025-03-07 2025-04-28
0759 Ensure medication error rates are not 5 percent or greater. D 2025-03-07 2025-04-28
0761 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. D 2025-03-07 2025-04-28
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. D 2025-03-07 2025-05-19
0814 Dispose of garbage and refuse properly. D 2025-03-07 2025-04-28
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. E 2025-03-07 2025-04-28
0880 Provide and implement an infection prevention and control program. E 2025-03-07 2025-04-28
0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. E 2025-03-07 2025-04-28
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. E 2025-03-07 2025-04-28
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. D 2025-03-07 2025-04-28
0698 Provide safe, appropriate dialysis care/services for a resident who requires such services. D 2025-03-07 2025-04-28
0711 Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. E 2025-03-07 2025-04-28
0725 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. F 2025-03-07 2025-04-28
0726 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. D 2025-03-07 2025-04-28
0760 Ensure that residents are free from significant medication errors. J 2025-03-07 2025-04-28
0808 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. D 2025-03-07 2025-04-28
0837 Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. E 2025-03-07 2025-04-28
0577 Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. D 2024-01-30 2024-03-30
0695 Provide safe and appropriate respiratory care for a resident when needed. D 2024-01-30 2024-03-30
0791 Provide or obtain dental services for each resident. D 2024-01-30 2024-04-05
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. D 2024-01-30 2024-02-20
0814 Dispose of garbage and refuse properly. E 2024-01-30 2024-03-17
0867 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. E 2024-01-30 2024-04-06
0880 Provide and implement an infection prevention and control program. E 2024-01-30 2024-04-06
0725 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. E 2024-01-30 2024-04-05
0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. D 2024-01-30 2024-04-06
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. D 2021-08-23 2021-10-08
0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. E 2021-08-23 2021-10-08
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2021-08-23 2021-10-08
0641 Ensure each resident receives an accurate assessment. D 2021-08-23 2021-10-08
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. E 2021-08-23 2021-10-08
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. D 2021-08-23 2021-10-08
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. D 2021-08-23 2021-10-08
0695 Provide safe and appropriate respiratory care for a resident when needed. D 2021-08-23 2021-10-08
0725 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. E 2021-08-23 2021-10-08
0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. E 2021-08-23 2021-10-08
0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. D 2021-08-23 2021-10-08
0760 Ensure that residents are free from significant medication errors. D 2021-08-23 2021-10-08

Showing 50 most recent of 56. See the All Data CSV for the full list.

Penalties (1)

Fines issued
1
last 3 years
Total fines
$40,937
Date Type Fine amount
2025-03-07 Fine $40,937

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 17.8% Medicaid 74.2% Other 8.0%

Operating performance

Operating Margin
-3.5%
Total Margin
-2.8%
Occupancy Rate
93.8%
Cost per Resident Day
$39

Revenue & costs

Net Patient Revenue
$14.9M
Total Costs
$1.7M
Net Income
-$422K

Balance sheet

Total Assets
$8.2M
Total Liabilities
$10.7M
Fund Balance
-$2.5M
Current Ratio
1.08

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: THE GRAND HEALTHCARE

Chain ID
509
Facilities in chain
16
Legal business name
GUILDERLAND OPERATOR LLC
Chain-average star ratings (for peer context)
Overall
1.8
Health
1.9
Staffing
1.9
QM
2.5

Owner / manager organizations (2)

Organization Role Association
STRAUSS VENTURES LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 11/14/2016
STRAUSS VENTURES LLC OPERATIONAL/MANAGERIAL CONTROL since 11/14/2016

Owner / manager individuals (7)

Name Role Association
STRAUSS, JEREMY 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 08/31/2016
ROGERS, ERIC OPERATIONAL/MANAGERIAL CONTROL since 07/01/2018
STRAUSS, JONATHAN OPERATIONAL/MANAGERIAL CONTROL since 11/14/2016
ROGERS, ERIC CORPORATE OFFICER since 07/01/2018
STERN, SAMUEL CORPORATE OFFICER since 01/01/2020
STRAUSS, JONATHAN CORPORATE OFFICER since 11/14/2016
ROGERS, ERIC W-2 MANAGING EMPLOYEE since 07/01/2018

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Special focus status
SFF Candidate
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 113 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $39 metrics.cost_per_resident_day
Cost Report Current Ratio 1.08 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 74.2% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 17.8% metrics.medicare_day_share
Cost Report Net Income ($) $-422,341 metrics.net_income
Cost Report Net Patient Revenue ($) $14,904,561 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 93.8% metrics.occupancy_rate
Cost Report Operating Margin (%) -3.5% metrics.operating_margin
Cost Report Total Assets ($) $8,178,579 metrics.total_assets
Cost Report Total Costs ($) $1,715,991 metrics.total_costs
Cost Report Total Fund Balances ($) $-2,503,403 metrics.fund_balance
Cost Report Total Liabilities ($) $10,681,982 metrics.total_liabilities
Cost Report Total Margin (%) -2.8% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 1.02344 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 1.47878 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.30299 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 2.80521 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 2.33037 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 120.3 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.85890 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.33431 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.67700 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 3.87022 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.41119 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 1.9 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 1.8 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 2.5 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 1.9 Chain Average Staffing Rating
Provider Information Chain ID 509 Chain ID
Provider Information Chain Name THE GRAND HEALTHCARE Chain Name
Provider Information City/Town ALTAMONT City/Town
Provider Information CMS Certification Number (CCN) 335540 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Albany County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1976-09-01 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 1 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 42.7023 Latitude
Provider Information Legal Business Name GUILDERLAND OPERATOR LLC Legal Business Name
Provider Information Location 428 STATE ROUTE 146,ALTAMONT,NY,12009 Location
Provider Information Long-Stay QM Rating 4 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -73.962 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 0 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 127 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections — Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 16 Number of Facilities in Chain
Provider Information Number of Fines 1 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.37105 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 0.99521 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 1 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type For profit - Limited Liability company Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 428 STATE ROUTE 146 Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name THE GRAND REHABILITATION AND NRSG AT GUILDERLAND Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 000 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 2 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 239 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 120 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 13 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 2 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 26 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-03-07 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 359 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 29 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 8 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2024-01-30 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 52 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 2 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 52 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 9 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.21054 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 81.8 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 1.32962 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 1.02590 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 1.48234 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.12821 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.30372 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 2.81196 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 1 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote — Short-Stay QM Rating Footnote
Provider Information Special Focus Status SFF Candidate Special Focus Status
Provider Information Staffing Rating 1 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State NY State
Provider Information Telephone Number 5188615141 Telephone Number
Provider Information Total Amount of Fines in Dollars 40937.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 2.33598 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 1 Total Number of Penalties
Provider Information Total nursing staff turnover 57.4 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 282.250 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 12009 ZIP Code