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 The Grand Rehabilitation And Nursing At Pawling during CMS and state inspections, most recent first.
A resident with a history of diabetes, morbid obesity, and a dehisced amputation stump experienced ongoing loose stools and was not clinically monitored or tested for Clostridium Difficile as ordered by the NP. Orders for lab tests and medication adjustments were not processed or documented, and a stool softener was not held despite loose stools. The resident's condition worsened, leading to hospital transfer and a diagnosis of septic shock. Staff interviews confirmed that verbal orders were not followed, resulting in actual harm.
The facility did not maintain adequate nurse staffing as outlined in its own staffing plan, resulting in frequent care delays and unmet resident needs. Multiple residents reported missed showers, prolonged periods in soiled briefs, and extended waits for assistance with activities of daily living. Staff confirmed that units were often staffed with only one CNA or nurse, making it difficult to provide timely care. Facility leadership acknowledged the staffing shortages and challenges in hiring, and ultimately admitted that the staffing plan itself was insufficient.
Multiple residents did not receive timely incontinence care, regular showers, or assistance with getting out of bed, often due to insufficient staffing. Some residents were left soiled for extended periods, had poor grooming, and lacked consistent personal hygiene. Staff interviews and documentation revealed frequent omissions in care and incomplete records, with care tasks sometimes not performed as required by facility policy.
Multiple residents experienced unresolved maintenance issues, including non-functioning televisions and a broken closet door that was left unrepaired for over two years. Maintenance logs showed over 500 reports of malfunctioning TVs and remotes, with many not addressed promptly. A resident had to prop their closet door with a chair due to broken hinges, and there was no record of a work order for this repair. The facility lacked a formal process for auditing rooms for safety concerns.
A resident with multiple chronic conditions reported missing personal property, including a bag with identification, gift cards, cash, and clothing, but was not offered a grievance form or assistance from administration or social work. Housekeeping staff discussed the issue with the resident but did not escalate it or initiate a formal grievance, and other staff were unaware of the complaint. Facility policies required prompt investigation and documentation of grievances, but no evidence was found that these procedures were followed or that the resident's complaint was resolved.
A resident in an LTC facility reported physical and verbal abuse by a CNA, witnessed by their roommate. The resident, with a history of depression and anxiety, required assistance with daily activities and communicated via writing. An investigation confirmed inappropriate verbal conduct by the CNA, who was subsequently removed from the schedule. The facility failed to protect the resident from abuse, resulting in a deficiency.
A facility failed to implement an endocrinology consult recommendation for a resident to start Glipizide, an oral anti-diabetic medication. The resident, with a history of type 2 diabetes and chronic kidney disease, was recommended this medication to address concerns about insulin shots. However, the facility did not carry out the recommendation before the resident's discharge, as the process for handling consult recommendations was not followed.
Failure to Follow Physician Orders and Complete Clinical Monitoring for Resident with Loose Stools
Penalty
Summary
A deficiency occurred when a resident with multiple medical conditions, including diabetes, morbid obesity, and a dehisced amputation stump, experienced ongoing loose stools for several days. Despite repeated documentation of loose bowel movements and ineffectiveness of prescribed Imodium, there was no evidence that clinical monitoring or laboratory tests for Clostridium Difficile, as ordered by the nurse practitioner, were initiated. Additionally, the resident's care plan required monitoring of labs and reporting of abnormal findings, but there was no documentation that these actions were taken. Physician and nurse practitioner progress notes indicated plans to order stool tests for Clostridium Difficile, start Metamucil, and monitor the resident clinically. However, the electronic medical record did not show that these orders were processed or that the tests were completed. The medication administration record also revealed that Docusate Sodium, which was to be held for loose stools, continued to be administered on multiple days when the resident had loose stools, contrary to physician orders. There was also no evidence that Metamucil was ordered or started as planned. The resident's condition deteriorated, with increasing lethargy and slurred speech, leading to further orders for laboratory tests, intravenous hydration, and a chest x-ray. Despite these orders, there was no documentation that the laboratory tests or chest x-ray were completed. The resident was eventually transferred to the hospital and diagnosed with septic shock. Interviews with staff confirmed that orders were given verbally but not processed, and the nurse practitioner acknowledged that the lack of completed laboratory tests prevented diagnosis and treatment, resulting in actual harm to the resident.
Failure to Provide Sufficient Nursing Staff to Meet Resident Needs
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of every resident as required by its own Facility Assessment Staffing Plan. Review of nurse staffing schedules revealed that the facility did not meet its minimum staffing requirements on numerous days, including specific dates in April and May, nearly the entire month of December, most weekends from January through March, and multiple days in May and June. The staffing shortfalls were confirmed by the Staffing Coordinator, who cited frequent callouts, vacations, and a reliance on per diem staff who worked irregularly. The Administrator and Assistant Administrator acknowledged awareness of the low staffing levels and stated that hiring new staff was challenging, with little use of incentives or bonuses to fill shifts. Residents reported significant delays and omissions in care due to inadequate staffing. Multiple residents stated they did not receive showers as scheduled, sometimes going weeks without one, and experienced long waits for assistance with toileting, dressing, and transfers out of bed. One resident described being left in a soiled brief for hours, while another expressed fear of having a bowel movement due to the likelihood of remaining soiled for extended periods. Observations confirmed that some residents remained in bed late into the day and that family members had to assist with feeding due to staff shortages. Resident Council members also reported excessive wait times for care, with one noting that a roommate waited three hours for a colostomy bag to be emptied and another waiting six hours for a brief change. Staff interviews corroborated the residents' accounts, with Certified Nurse Aides and nurses stating that they were often the only staff member on a unit, making it impossible to meet all residents' care needs in a timely manner. Staff reported that nurses were unable to assist with direct care due to their medication and documentation responsibilities, and that the facility did not offer extra pay or bonuses to incentivize staff to work additional shifts. The Director of Nursing and other leaders confirmed ongoing difficulties in recruiting and retaining staff, and the Assistant Administrator ultimately acknowledged that the Facility Assessment Staffing Plan itself did not document a sufficient number of staff to provide adequate care to residents.
Failure to Provide Timely ADL Assistance and Personal Hygiene
Penalty
Summary
Surveyors identified that the facility failed to provide necessary care and assistance with activities of daily living (ADLs) for residents who were unable to perform these tasks independently. Multiple residents were not provided timely incontinence care, were not gotten out of bed as planned, and did not receive consistent showers or personal hygiene. Documentation and interviews revealed that residents often remained soiled for extended periods, sometimes from early morning until the afternoon, and that staff frequently cited insufficient staffing as the reason for not providing care as scheduled. Residents reported feelings of anxiety, depression, and frustration due to these lapses in care, particularly when unable to get out of bed for family visits or when left in soiled conditions. Observations and record reviews showed that several residents had long, dirty fingernails, soiled clothing, and noticeable urine odors, indicating a lack of regular grooming and hygiene. Certified Nurse Aide Accountability Records contained multiple omissions for ADL tasks such as showers, personal hygiene, and toileting, with some residents not receiving showers for extended periods. Staff interviews confirmed that care was often not provided as required, especially when staffing levels were low, and that documentation of care was incomplete or missing. Some staff were unaware of when certain care tasks, such as nail clipping or showers, were last performed. The facility's own policies required regular assistance with ADLs, including toileting, grooming, and hygiene, with documentation to be completed after care was provided. However, interviews with staff and management revealed that these policies were not consistently followed, and that care was sometimes prioritized over documentation, leading to gaps in both care delivery and record-keeping. The Director of Nursing acknowledged awareness of documentation omissions and inconsistent provision of showers, but was not aware of the full extent of the deficiencies. Residents' preferences for getting out of bed and receiving care were not always honored, particularly when staffing was insufficient.
Failure to Maintain Safe and Homelike Environment Due to Unresolved Maintenance Issues
Penalty
Summary
The facility failed to ensure a safe, clean, comfortable, and homelike environment for its residents, as evidenced by multiple unresolved maintenance issues. Maintenance Care Logs from January 2024 to the present documented over 500 reports of malfunctioning televisions and remote controls, with many not repaired in a timely manner and some delays lasting several days. One resident's family reported on multiple occasions that the resident did not have a functioning television in their room, and another resident stated that televisions did not work each time they moved rooms. The Director of Maintenance confirmed that television repairs were often delayed due to prioritization of other issues and limited staffing, with only maintenance staff able to replace batteries for remotes. Additionally, a resident reported that their closet door had been broken for over two years, requiring them to prop it closed with a chair to prevent it from falling. Observations confirmed the door was not attached at the hinges and was being held in place by a chair. There were no documented work orders for this repair, and the Director of Maintenance stated they had not received a recent work order for the closet door. The Director also acknowledged that routine audits of rooms for safety issues were not being conducted, and the Administrator confirmed that while maintenance and housekeeping round on units, there was no formal tool in use to audit rooms for safety.
Failure to Address Resident Grievance Regarding Missing Personal Property
Penalty
Summary
The facility failed to ensure that a resident's right to file a grievance and have it promptly addressed was honored, as required by facility policy and regulation. A resident with diagnoses including heart failure, chronic kidney disease, and lymphedema reported missing personal property, including a bag containing a license, gift cards, cash, and multiple clothing items. The resident stated that new clothing purchases were not recorded on the inventory sheet and that, despite having receipts for the missing items, they had not been offered a grievance form or seen the Social Worker or Administration regarding the missing property. The resident only discussed the issue with housekeeping staff, who did not escalate the matter or initiate a formal grievance process. Interviews with staff revealed inconsistencies and gaps in the facility's process for handling missing items and grievances. The Director of Housekeeping acknowledged repeated discussions with the resident about missing items and attempts to contact the outside launderer but did not notify the Social Worker or initiate a grievance. The Director of Social Work and the Administrator both indicated that they were unaware of the missing items and described unclear or incomplete procedures for investigating and resolving such complaints, particularly when items were not listed on the inventory form. Staff interviews also revealed confusion about documentation, notification responsibilities, and the process for reimbursement or investigation when items were missing. Documentation review confirmed that the facility's policies required prompt investigation and resolution of grievances, including written summaries and communication of outcomes to residents. However, there was no documented evidence that a grievance was filed, an investigation was conducted, or the issue was resolved for the resident's missing property. The lack of coordination among staff and failure to follow established grievance and missing item procedures resulted in the resident's complaint not being formally addressed or resolved.
Resident Abuse by Staff Member
Penalty
Summary
The facility failed to protect a resident from physical and verbal abuse by a staff member. On July 16, 2024, a resident reported that a Certified Nurse Aide (CNA) pulled their hair, hit their arm, and twisted their thumb. This incident was witnessed by the resident's roommate. Another CNA found the resident crying, and the accused CNA was heard making an inappropriate comment to the resident. The facility's policy on abuse prevention, dated January 2025, mandates that residents be free from abuse, neglect, and mistreatment. The resident involved had a history of Major Depressive Disorder, Anxiety Disorder, Dysphagia, and Cerebral Infarction. They were cognitively intact, as indicated by a BIMS score of 15/15, and required maximal assistance with personal hygiene and toileting. The resident communicated by writing on a yellow pad due to speech difficulties. The behavior care plan noted the resident's tendency to tap on the bedside table to get staff attention and included interventions to assess and report signs of abuse or neglect. Following the incident, an investigation was conducted, and it was found that the CNA did verbally respond inappropriately to the resident. The resident's thumb appeared red, and an X-ray showed no fracture. The facility notified the Sheriff's office, and the CNA was removed from the schedule pending investigation. Interviews with staff and the resident confirmed the allegations, although the accused CNA denied the abuse. The facility's failure to prevent this incident resulted in a deficiency in protecting the resident from abuse.
Failure to Implement Endocrinology Consult Recommendation
Penalty
Summary
The facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice. This deficiency was identified during an abbreviated survey, where it was found that the facility did not complete an endocrinology consult recommendation for a resident to start an oral anti-diabetic medication, Glipizide. The resident, who was admitted with diagnoses including cerebral infarction, type 2 diabetes, and chronic kidney disease, expressed concern about receiving insulin shots and was recommended by an endocrinologist to start Glipizide ER 2.5 mg daily with breakfast. However, there was no documented evidence that this recommendation was carried out before the resident was discharged. Interviews conducted during the survey revealed that the facility's process for handling consult recommendations was not followed. The Director of Nursing stated that when a resident returns from an appointment, the consult sheet is given to the Unit Manager, who is responsible for contacting the doctor and documenting the recommendations. If the Unit Manager is not available, the Supervisor is supposed to consult with the doctor and document the actions taken. In this case, the Director of Nursing acknowledged that the resident was not started on the recommended Glipizide medication after their endocrinology visit, indicating a lapse in the facility's procedure for managing and implementing medical recommendations.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 112 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Pawling
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Putnam Nursing & Rehabilitation Center | 6.8 mi | — | 0 | 0 |
| Village Crest Center For Health & Rehabilitation | 9.3 mi | — | 0 | 0 |
| Putnam Ridge | 9.4 mi | — | 6 | 0 |
| Candlewood Rehabilitation And Healthcare Center | 9.8 mi | — | 1 | 0 |
| Autumn Lake Healthcare At Glen Hill | 13.2 mi | — | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for The Grand Rehabilitation And Nursing At Pawling.
100% money-back within 48 hours.
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.