Not rated by CMS — ratings are suppressed for new or low-volume facilities.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Stoneybrook Retirement Community during CMS and state inspections, most recent first.
A facility failed to provide a resident or their representative with written information about the bed hold policy during a hospital transfer. The resident, who had benign prostatic hyperplasia and an indwelling urinary catheter, was at risk of not being allowed to return to the facility. The facility's policy requires a written notice at the time of transfer, but this was not provided, as confirmed by administrative staff.
A facility failed to assess a resident's ability to smoke safely upon recent admission, despite the resident's complex medical history and behaviors related to smoking rules. The resident's care plan required supervision during smoke breaks, but no current smoking assessment was conducted, contrary to the facility's policy. This placed the resident at risk for injury during smoking.
The facility failed to obtain stop dates for PRN Ativan orders for two residents, contrary to its policy requiring a 14-day limit unless extended by a physician. Resident 30, with multiple diagnoses including anxiety disorder, and Resident 188, with an anxiety disorder, were both prescribed Ativan without specific stop dates, placing them at risk for unnecessary medication use. This deficiency was confirmed by an administrative nurse, indicating a lapse in medication management practices.
Failure to Provide Bed Hold Policy to Resident During Hospital Transfer
Penalty
Summary
The facility failed to provide Resident 13 or his representative with written information regarding the facility's bed hold policy when the resident was transferred to the hospital. This deficiency was identified during a review of the resident's clinical record, which lacked evidence of the bed hold policy being provided at the time of transfer. The facility's bed hold policy, revised in 2017, mandates that a written notice specifying the duration of the bed hold be given at the time of a resident's transfer for hospitalization or therapeutic leave. However, Administrative Staff A confirmed that the resident had not received this information upon transfer. Resident 13 had a diagnosis of benign prostatic hyperplasia and was at risk for urinary tract infections due to an indwelling urinary catheter. The resident's care plan included specific instructions for catheter care to prevent complications. Despite these medical needs, the facility's oversight in not providing the bed hold policy placed the resident at risk of not being permitted to return and resume residence in the nursing facility. Observations noted the resident in a wheelchair with clear urine in the catheter tubing, indicating ongoing management of the resident's condition.
Failure to Assess Resident's Smoking Ability
Penalty
Summary
The facility failed to assess Resident 10's ability to smoke safely, which placed the resident at risk for injury during smoking. Resident 10 had a complex medical history, including chronic obstructive pulmonary disease, peripheral vascular disease, congestive heart failure, a right femur fracture, dementia, major depressive disorder, and a personal history of nicotine and alcohol dependence. Despite these conditions, the facility did not conduct a current smoking assessment upon the resident's recent admission, relying instead on an outdated assessment from a previous admission. Observations and interviews revealed that Resident 10 exhibited behaviors such as verbal outbursts, rejection of care, and agitation regarding smoking rules. The resident's care plan indicated that smoking supplies were kept locked, and the resident was allowed to smoke with supervision during designated smoke breaks. However, the resident often became upset about the smoking schedule and rules, and there were instances where the resident extended smoking times beyond the set limits. Staff were required to remind the resident of the smoking time frames and were present during smoking sessions. The facility's smoking policy required a smoking assessment to be completed for residents who expressed a desire to smoke, with reassessments conducted quarterly or upon significant changes in the resident's condition. Despite this policy, the facility did not complete a smoking assessment for Resident 10 upon their recent admission, as confirmed by an administrative nurse. This oversight in following the facility's smoking policy contributed to the deficiency identified by the surveyors.
Failure to Obtain Stop Dates for PRN Ativan Orders
Penalty
Summary
The facility failed to obtain a stop date from the physician for the continued use of Ativan, an antianxiety medication, as needed (PRN) for two residents, placing them at risk for complications related to unnecessary psychotropic medications. Resident 30, who had diagnoses including generalized anxiety disorder, convulsions, sleep apnea, obsessive-compulsive disorder, and insomnia, was prescribed Ativan PRN for anxiety without a specific stop date. The care plan for Resident 30 indicated that the resident often became anxious, leading to behaviors such as fast-talking and restlessness, and directed staff to administer Ativan if needed. However, the physician's order for Ativan was indefinite, lacking a required stop date. Similarly, Resident 188, diagnosed with an anxiety disorder, was also prescribed Ativan PRN for anxiety without an end date. The care plan for Resident 188 instructed staff to monitor for reactions to medications with black box warnings and to leave the resident alone when angry or agitated. Despite these instructions, the physician's order for Ativan did not include a stop date, contrary to the facility's policy that PRN orders for psychoactive medications should be limited to 14 days unless extended by the physician with documented rationale. The facility's failure to adhere to its Psychoactive Medication policy, which mandates a 14-day limit on PRN orders for antianxiety medications unless extended with proper documentation, resulted in the absence of stop dates for Ativan prescriptions for both residents. This oversight was confirmed by Administrative Nurse D, who acknowledged the lack of stop dates for the PRN Ativan orders for both residents, highlighting a deficiency in the facility's medication management practices.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Manhattan
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Via Christi Village Manhattan, Inc | 1.4 mi | — | 1 | 1 |
| Meadowlark Hills | 2.9 mi | — | 0 | 0 |
| Leonardville Nursing Home | 16.6 mi | — | 0 | 0 |
| Good Samaritan Society - Valley Vista | 16.7 mi | — | 0 | 0 |
| Westy Community Care Home | 16.8 mi | — | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.