Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
Kendal On Hudson
Sleepy Hollow, NY · 26 certified beds · Last Life Safety survey May 6, 2024
CMS Certification Number 335848 · first certified June 2005
Also on this campus
The same campus holds a state-licensed assisted living facility, with its own state record on the Assisted Living Index: Kendal on Hudson (1010 Kendal Way). Matched by the telephone number the two records share. The records are separate and are never added together.
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.
Position within NY
16 citations — more than 60% of the 592 certified nursing homes in NY. Compared within NY 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
The latest survey found 2 citations; the earlier surveys on file averaged 7. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
Well past the typical window (October 2025 to June 2026), and past the point by which nine in ten NY facilities have been surveyed. This facility’s last Life Safety survey was May 2024. Facilities in NY are typically surveyed 18–25 months after the last one (median 21), measured over 520 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 about three years in Virginia. How the window is measured
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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 cited for sprinkler inspection and testing in CMS’s current file are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.
Emergency preparedness
3 of the 16 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index
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 16 Life Safety citations above. The Physical Environment Index
- F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
How that compares
Compared with the median facility in NY, and nationally. Surveyors differ markedly between states, so the NY figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 16 |
| Median facility in NY | 14 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| December 18, 2019 | 6 |
| May 12, 2022 | 8 |
| May 6, 2024 | 2 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | 2 | 2022-05-12 |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 2 | 2022-05-12 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 2 | 2022-05-12 |
| K-0920 | Ensure proper usage of power strips and extension cords. | 2 | 2022-05-12 |
| K-0923 | Have proper medical gas storage and administration areas. | 1 | 2024-05-06 |
| E-0039 | Conduct testing and exercise requirements. | 1 | 2022-05-12 |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | 1 | 2019-12-18 |
| K-0311 | Have an enclosure around a vertical opening shaft. | 1 | 2024-05-06 |
What the citations cover
- Gas, Vacuum, and Electrical Systems Deficiencies 6
- Smoke Deficiencies 6
- Emergency Preparedness Deficiencies 3
- Miscellaneous Deficiencies 1
| Category | Citations |
|---|---|
| Gas, Vacuum, and Electrical Systems Deficiencies | 6 |
| Smoke Deficiencies | 6 |
| Emergency Preparedness Deficiencies | 3 |
| Miscellaneous Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
May 6, 2024 — 2 citations
May 12, 2022 — 8 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0009 | Include a process for Emergency Preparedness collaboration. | Deficient, Provider has date of correction (July 8, 2022) |
| E-0039 | Conduct testing and exercise requirements. | Deficient, Provider has date of correction (July 8, 2022) |
| K-0321 | Ensure 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 (July 8, 2022) |
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has date of correction (July 8, 2022) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (July 8, 2022) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (July 8, 2022) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (July 8, 2022) |
| K-0920 | Ensure proper usage of power strips and extension cords. | Deficient, Provider has date of correction (July 8, 2022) |
December 18, 2019 — 6 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0004 | Develop and maintain an Emergency Preparedness Program (EP). | Deficient, Provider has date of correction (March 21, 2020) |
| K-0321 | Ensure 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 21, 2020) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (March 21, 2020) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (March 21, 2020) |
| K-0920 | Ensure proper usage of power strips and extension cords. | Deficient, Provider has date of correction (March 21, 2020) |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | Deficient, Provider has date of correction (March 21, 2020) |
Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.