Nursing HomeInspections

The Grand Rehabilitation and Nrsg at Guilderland

Nursing home in Altamont, NY

Medicare & Medicaid certified1★ overall (CMS)SFF candidate (CMS)

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Public-record details

Address
428 State Route 146, Altamont, NY 12009
Phone
(518) 861-5141
Listed under
For-profit
Medicare CCN
335540
Overall star rating
1 of 5 ★☆☆☆☆
Health inspection rating
1 of 5
Staffing rating
1 of 5
Quality measures rating
1 of 5
Certified beds
127
Average residents per day
123
Ownership
For-profit, limited Liability company
Legal business name
Guilderland Operator LLC
Chain
The Grand Healthcare (16 facilities)
Certified for
Medicare and Medicaid
First approved by Medicare/Medicaid
Sep 1, 1976
Changed ownership in last 12 months
No
Continuing care retirement community
No
Located inside a hospital
No
Resident or family council
Resident council
Sprinklers in all required areas
Yes

CMS certification number 335540. Source: CMS Nursing Home Provider Information, Health Deficiencies and Penalties (record). Data as of 2026-11-07.

Inspection record

Most recent standard health inspection: Mar 7, 2025. CMS lists 56 health citations for this facility across its last three standard inspection cycles and complaint inspections (Aug 23, 2021 to Mar 7, 2025): 15 from complaint inspections, 1 at the “actual harm” level or higher, including 1 at “immediate jeopardy”. CMS lists this facility as a candidate for its Special Focus Facility program.

InspectionCitationSeverity
Mar 7, 2025Allow residents to self-administer drugs if determined clinically appropriate.
Resident Rights		D
Potential for more than minimal harm, isolated
Mar 7, 2025Honor 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.
Resident Rights		D
Potential for more than minimal harm, isolated
Mar 7, 2025Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation		D
Potential for more than minimal harm, isolated
Mar 7, 2025Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights		D
Potential for more than minimal harm, isolated
Mar 7, 2025Notify 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.
Resident Rights		D
Potential for more than minimal harm, isolated
Mar 7, 2025PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning		D
Potential for more than minimal harm, isolated
Mar 7, 2025Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care · complaint inspection		D
Potential for more than minimal harm, isolated
Mar 7, 2025Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care		D
Potential for more than minimal harm, isolated
Mar 7, 2025Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care · complaint inspection		D
Potential for more than minimal harm, isolated
Mar 7, 2025Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services · complaint inspection		D
Potential for more than minimal harm, isolated
Mar 7, 2025Ensure medication error rates are not 5 percent or greater.
Pharmacy Service		D
Potential for more than minimal harm, isolated
Mar 7, 2025Ensure 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…
Pharmacy Service		D
Potential for more than minimal harm, isolated

Showing the 12 most recent of 56. Full inspection reports are on Medicare Care Compare.

Severity letters follow CMS's scope-and-severity grid: A–C potential for minimal harm, D–F potential for more than minimal harm, G–I actual harm, J–L immediate jeopardy. Most citations are corrected; a citation is what inspectors found on that date. Source: CMS Health Deficiencies file, processed Oct 1, 2026.

Fines and payment denials

CMS records 1 fine totalling $40,937 in the last three years.

Mar 7, 2025Fine: $40,937

Source: CMS Penalties file, processed Oct 1, 2026. Amounts are as CMS reports them and may reflect later reductions or appeals.

Staffing

Total nurse staffing per resident per day
2.70 hours
Registered nurse (RN) time per resident per day
0.32 hours
Nurse aide time per resident per day
1.45 hours
Total nurse staffing on weekends
2.24 hours
Nursing staff turnover (yearly)
57%
RN turnover (yearly)
63%
Administrators who left in the past year
1

From payroll-based staffing data the facility submits to CMS. Hours are per resident per day.

A citation is what inspectors found on one date; most are corrected within weeks. Look for patterns — the same problem cited in several inspections — and for anything at the G–L level (actual harm or immediate jeopardy). The full inspection narrative (Form CMS-2567) is linked from Medicare Care Compare, and your state long-term care ombudsman can tell you about complaints.

Public record, not an endorsement. This listing was compiled from public records as of 2026-11-07 and may be incomplete or out of date. Nursing Home Inspections does not vet, employ, recommend or guarantee nursing homes; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Nursing Home Inspections is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error