General Information: NEW GOUVERNEUR HOSPITAL S N F
Nursing home name NEW GOUVERNEUR HOSPITAL S N F
Address227 MADISON STREET
NEW YORK, NY 10002
Phone number (212) 441-5000
Located within a hospital No
Type of ownership Government - City
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 210
Total number of residents 128
Perc of occupied beds 60
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints2
Number of Fines1
Total Amount of Fines$5980
Total Number of Penalties0
Total Number of Penalties1
Ratings Summary: NEW GOUVERNEUR HOSPITAL S N F
Overall rating 4
4
Nursing Home Staffing 5
5
Registered Nurses only 5
5
Health Inspections 2
2
Quality Measures 5
5
Nursing Home Staffing Info: NEW GOUVERNEUR HOSPITAL S N F
National AverageNew York AverageNEW GOUVERNEUR HOSPITAL S N F
Overall staff rating NA NA 5
5
Registered Nurses only rating NANA 5
5
Total Number of Residents NA NA 128
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 3.95 hours 5.35 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.56 hours 1.76 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.72 hours 1.18 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.84 hours 0.59 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.39 hours 3.59 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.1 hours 0.23 hours
Health Survey: NEW GOUVERNEUR HOSPITAL S N F
Heath Survey Summary on 2013-12-06
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2012-10-11
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-10-07
Total Number of Health Deficiencies 2
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Health Survey Details: NEW GOUVERNEUR HOSPITAL S N F
Inspection Results: 12/06/2013
Corrected Deficiency Scope and Severity
02/03/2014 Store, cook, and serve food in a safe and clean way. Widespread /Minimal harm or potential for actual harm
Inspection Results: 10/11/2012
Corrected Deficiency Scope and Severity
11/28/2012 Conduct initial and periodic assessments of each resident's functional capacity. Isolated/Minimal harm or potential for actual harm
10/16/2012 Give notice to the resident before a room or roommate change. Isolated/Minimal harm or potential for actual harm
12/10/2012 Allow residents to easily view the results of the nursing home's most recent inspection. Isolated/Minimal harm or potential for actual harm
Inspection Results: 10/07/2011
Corrected Deficiency Scope and Severity
12/06/2011 Make sure that doctors visit residents regularly, as required. Isolated/Minimal harm or potential for actual harm
11/18/2011 Choose a doctor to serve as the medical director to create resident care policies and coordinate medical care in the facility. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: NEW GOUVERNEUR HOSPITAL S N F
Fire Safety Survey Summary on 2013-12-06
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-10-11
Total Number of Fire SafetyDeficiencies 8
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-10-07
Total Number of Fire SafetyDeficiencies 1
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey: NEW GOUVERNEUR HOSPITAL S N F
Fire Safety Survey Results: 12/06/2013
Corrected Deficiency Severity
02/03/2014 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
02/03/2014 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
02/03/2014 Exit stairways and towers that are smoke proof. Isolated/Minimal harm or potential for actual harm
02/03/2014 An approved automatic sprinkler system connected to the fire alarm system. Isolated/Minimal harm or potential for actual harm
02/03/2014 Heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 10/11/2012
Corrected Deficiency Severity
12/10/2012 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
12/10/2012 Exits that are accessible at all times. Pattern/Minimal harm or potential for actual harm
12/10/2012 Smoke barrier doors that can resist smoke for at least 20 minutes. Pattern/Minimal harm or potential for actual harm
12/10/2012 Proper stairway enclosures and vertical shafts. Pattern/Minimal harm or potential for actual harm
12/10/2012 Properly located and lighted "Exit" signs. Isolated/Minimal harm or potential for actual harm
12/10/2012 An automatic smoke detection system in all hallways. Isolated/Minimal harm or potential for actual harm
12/10/2012 An approved automatic sprinkler system connected to the fire alarm system. Isolated/Minimal harm or potential for actual harm
12/10/2012 Noncombustible or limited-combustible interior walls. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 10/07/2011
Corrected Deficiency Severity
10/10/2011 Proper stairway enclosures and vertical shafts. Isolated/Minimal harm or potential for actual harm

Resident Complaints: NEW GOUVERNEUR HOSPITAL S N F
Date Complaint Substantiated: 08/23/2013
CorrectedCategoryDeficiencySeverity
08/23/2013Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. K
08/23/2013Make sure that the facility is administered in an acceptable way that maintains the well-being of each resident . K
Date Complaint Substantiated: 06/01/2011
CorrectedCategoryDeficiencySeverity
06/17/2011Maintain comfortable and safe temperature levels. E

Quality Measures: NEW GOUVERNEUR HOSPITAL S N F
Quality Measures National Average New York Average NEW GOUVERNEUR HOSPITAL S N F
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 14.3% 18.2%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 2.0%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 7.7% 13.6%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.3% 4.5%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 44.4% 15.5%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 2.7% 2.8%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.8% 3.1%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 11.6% 5.2%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.8% 1.4%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 2.7% 1.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 93.9% 99.3%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 96.9% 98.6%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 18.7% 15.7%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 14.6% 11.5%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.2% 0.9%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 83.1% 95.6%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 83.8% 88.0%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.4% 1.6%

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