Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

ST CATHERINE OF SIENA

CALDWELL, NJ · 30 certified beds · Last Life Safety survey January 7, 2025

CMS Certification Number 315471 · first certified September 2001

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

21
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
5
Tags cited more than once
Across separate surveys
9
Inspection & testing records
Of the citations on file

Position within NJ

21 citations — more than 74% of the 348 certified nursing homes in NJ. Compared within NJ rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Slippingmore citations at the latest survey than at its earlier surveys in the window.

The latest survey found 10 citations; the earlier surveys in the window averaged 5.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Past the typical window (April 2026 to September 2026). Most NJ facilities have been surveyed by February 2027. This facility’s last Life Safety survey was January 2025. Facilities in NJ are typically surveyed 16–20 months after the last one (median 17), measured over 431 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

2 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

How that compares

Citations on file over three years

Compared with the median facility in NJ, and nationally. Surveyors differ markedly between states, so the NJ figure is the meaningful one.

This facility21NJ median15National median11
Citations on file over three years, compared
MeasureCitations
This facility21
Median facility in NJ15
Median facility nationally11

Survey history

Citations at each Life Safety survey
72022-1042023-10102025-01
Citations at each Life Safety survey
Survey dateCitations
October 6, 20227
October 12, 20234
January 7, 202510

Most-cited tags

Most-cited tags at this facility
K-09182K-02932K-03212K-03112K-02912K-03721K-02111K-03531
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0918Have generator or other power source capable of supplying service within 10 seconds.22025-01-07
K-0293Have properly located and lighted "Exit" signs.22025-01-07
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22025-01-07
K-0311Have an enclosure around a vertical opening shaft.22023-10-12
K-0291Install emergency lighting that can last at least 1 1/2 hours.22025-01-07
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.12022-10-06
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.12022-10-06
K-0353Inspect, test, and maintain automatic sprinkler systems.12025-01-07

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 8
  • Egress Deficiencies 7
  • Gas, Vacuum, and Electrical Systems Deficiencies 5
  • Services Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies8
Egress Deficiencies7
Gas, Vacuum, and Electrical Systems Deficiencies5
Services Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

January 7, 2025 — 10 citations

Citations issued on January 7, 2025
TagWhat the surveyor checksStatus
K-0225Have stairways and smokeproof enclosures used as exits that meet safety requirements.Deficient, Provider has date of correction (January 31, 2025)
K-0281Install proper backup exit lighting.Deficient, Provider has date of correction (February 3, 2025)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (February 14, 2025)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (February 26, 2025)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (March 26, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 14, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (February 14, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 14, 2025)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (February 14, 2025)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (February 14, 2025)

October 12, 2023 — 4 citations

Citations issued on October 12, 2023
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (October 25, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (October 25, 2023)
K-0311Have an enclosure around a vertical opening shaft.Deficient, Provider has date of correction (October 25, 2023)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (October 25, 2023)

October 6, 2022 — 7 citations

Citations issued on October 6, 2022
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (October 26, 2022)
K-0311Have an enclosure around a vertical opening shaft.Deficient, Provider has date of correction (December 19, 2022)
K-0341Install a fire alarm system that can be heard throughout the facility.Deficient, Provider has date of correction (November 28, 2022)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (November 28, 2022)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (November 28, 2022)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (November 28, 2022)
K-0926Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.Deficient, Provider has date of correction (November 28, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.