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

MOHAWK MEADOWS

LAFAYETTE, NJ · 159 certified beds · Last Life Safety survey November 19, 2024

CMS Certification Number 315044 · first certified January 1967

Ownership

Independently operated (no chain recorded by CMS) · For profit - Limited Liability company

  • Ownership changed February 1, 2024 (change of ownership)from ALLIANCE HC HOLDINGS LLC
33
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
8
Tags cited more than once
Across separate surveys
18
Inspection & testing records
Of the citations on file

Position within NJ

33 citations — more than 97% 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 18 citations; the earlier surveys in the window averaged 7.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Past the typical window (March 2026 to July 2026). Most NJ facilities have been surveyed by December 2026. This facility’s last Life Safety survey was November 2024. 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

5 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.

Physical environment (health survey)

1 physical-environment citation on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 33 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.

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 facility33NJ median15National median11
Citations on file over three years, compared
MeasureCitations
This facility33
Median facility in NJ15
Median facility nationally11

Survey history

Citations at each Life Safety survey
52021-12102023-07182024-11
Citations at each Life Safety survey
Survey dateCitations
December 3, 20215
July 17, 202310
November 19, 202418

Most-cited tags

Most-cited tags at this facility
K-03533K-09183K-02932K-05212K-03512K-09142K-03552K-03242
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.32024-11-19
K-0918Have generator or other power source capable of supplying service within 10 seconds.32024-11-19
K-0293Have properly located and lighted "Exit" signs.22024-11-19
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22024-11-19
K-0351Install an approved automatic sprinkler system.22023-07-17
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.22024-11-19
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.22024-11-19
K-0324Provide properly protected cooking facilities.22024-11-19

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 14
  • Gas, Vacuum, and Electrical Systems Deficiencies 8
  • Egress Deficiencies 7
  • Miscellaneous Deficiencies 2
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies14
Gas, Vacuum, and Electrical Systems Deficiencies8
Egress Deficiencies7
Miscellaneous Deficiencies2
Services Deficiencies2

Every citation on file

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

November 19, 2024 — 18 citations

Citations issued on November 19, 2024
TagWhat the surveyor checksStatus
K-0223Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.Deficient, Provider has date of correction (November 20, 2024)
K-0225Have stairways and smokeproof enclosures used as exits that meet safety requirements.Deficient, Provider has date of correction (December 6, 2024)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (December 6, 2024)
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 (December 6, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (December 13, 2024)
K-0341Install a fire alarm system that can be heard throughout the facility.Deficient, Provider has date of correction (December 10, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (December 9, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (December 10, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (December 6, 2024)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (December 10, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (December 6, 2024)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (December 12, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (December 6, 2024)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (December 10, 2024)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (December 15, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (December 10, 2024)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (December 6, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (December 6, 2024)

July 17, 2023 — 10 citations

Citations issued on July 17, 2023
TagWhat the surveyor checksStatus
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (August 8, 2023)
K-0281Install proper backup exit lighting.Deficient, Provider has date of correction (August 7, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (August 7, 2023)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (August 7, 2023)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (August 1, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (August 7, 2023)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (July 19, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (August 8, 2023)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (August 2, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (August 3, 2023)

December 3, 2021 — 5 citations

Citations issued on December 3, 2021
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (December 13, 2021)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (March 23, 2022)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (December 15, 2021)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (December 4, 2021)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (December 4, 2021)

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