The Grand Rehabilitation and Nrsg at Guilderland
428 State Route 146 · Altamont, NY · 12009 · 5188615141
127 certified beds For profit - Limited Liability company Chain: The Grand Healthcare
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results are getting worse cycle over cycle, not better.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
Special Focus Facility candidate
CMS lists this facility as a candidate for its Special Focus program for persistently poor inspection performance.
1 immediate-jeopardy citation in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 1 of 5 Quality measures: 2 of 5
| Total nurse hours / resident-day | 3.01 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.35 | 0.55–0.75 |
| Weekend hours / resident-day | 2.60 | ≈ weekday level |
| Nursing turnover / year | 55% | median 45% |
| Fines (3-yr window) | 1 · $40,937 |
Inspection citations (56 in the current record)
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Immediate jeopardy · J March 7, 2025 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected April 28, 2025 · Pharmacy Service
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Potential for harm · E March 7, 2025
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · D March 7, 2025
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · D March 7, 2025
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · D March 7, 2025
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected April 28, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 7, 2025
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · D March 7, 2025
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · D March 7, 2025
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected April 28, 2025 · Resident Assessment and Care Planning
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Potential for harm · E March 7, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected April 28, 2025 · Resident Assessment and Care Planning
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Potential for harm · E March 7, 2025
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected April 28, 2025 · Resident Assessment and Care Planning
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Potential for harm · D March 7, 2025
Provide safe and appropriate respiratory care for a resident when needed.
Corrected April 28, 2025 · Quality of Life and Care
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Potential for harm · D March 7, 2025
Ensure medication error rates are not 5 percent or greater.
Corrected April 28, 2025 · Pharmacy Service
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Potential for harm · D March 7, 2025
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected April 28, 2025 · Pharmacy Service
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Potential for harm · D March 7, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected May 19, 2025 · Nutrition and Dietary
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Potential for harm · D March 7, 2025
Dispose of garbage and refuse properly.
Corrected April 28, 2025 · Nutrition and Dietary
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Potential for harm · E March 7, 2025
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 28, 2025 · Resident Assessment and Care Planning
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Potential for harm · E March 7, 2025
Provide and implement an infection prevention and control program.
Corrected April 28, 2025 · Infection Control
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Potential for harm · E March 7, 2025 · found via complaint
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected April 28, 2025 · Resident Rights
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Potential for harm · E March 7, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected April 28, 2025 · Quality of Life and Care
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Potential for harm · D March 7, 2025 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected April 28, 2025 · Quality of Life and Care
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Potential for harm · D March 7, 2025 · found via complaint
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected April 28, 2025 · Quality of Life and Care
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Potential for harm · E March 7, 2025 · found via complaint
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Corrected April 28, 2025 · Nursing and Physician Services
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Potential for harm · F March 7, 2025 · found via complaint
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected April 28, 2025 · Nursing and Physician Services
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Potential for harm · D March 7, 2025 · found via complaint
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected April 28, 2025 · Nursing and Physician Services
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Potential for harm · D March 7, 2025 · found via complaint
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Corrected April 28, 2025 · Nutrition and Dietary
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| March 7, 2025 | Fine | $40,937 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 335540 · certified since September 1, 1976. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.