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Nursing HomeMedicaid Investigative

Highland Rehabilitation and Nursing Center

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

120 Highland Avenue, Middletown, NY 1094098 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
2.9/5

based on 55 Google reviews

5
4
3
2
1
Highland Rehabilitation and Nursing Center Nursing Home in Middletown, NY — Street View
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6/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (1/5 stars)
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (14 vs median 6.0)
  • High staff turnover (54%)
  • High RN turnover (69%)

Bottom 25% in NY · Below recommended RN staffing · Worst in PERSONAL HEALTHCARE MANAGEMENT chain · No penalties on record

Source: Medicare data

What this means for your family

This facility shows a significant gap between its rehabilitation success stories and reports of neglect. If you are considering this center, you must conduct an in-person tour to verify cleanliness and ask specifically about their nurse-to-patient ratios and communication protocols for family updates.

Google Reviews

Google Reviews

55 reviews on Google
Highland Rehabilitation and Nursing Center receives highly polarized feedback, with some families praising the compassionate care and successful rehab outcomes, while others report severe neglect and hygiene issues. Common criticisms include chronic understaffing, poor communication from management, and unsanitary conditions, while supporters highlight specific staff members who provided attentive care.

Quality Themes

Tap a score for details
Food2.0Staff4.0Clean2.0Activities7.0Meds2.0Memory5.0Comms2.0ValueN/A

Strengths

  • Compassionate individual staff members
  • Effective physical therapy programs
  • Successful rehabilitation and recovery outcomes
  • Engaging recreation and activity department

Concerns

  • Chronic understaffing and slow response times (mentioned by 9 reviewers)
  • Poor facility hygiene and cleanliness (mentioned by 7 reviewers)
  • Lack of communication and inaccessible management (mentioned by 6 reviewers)
  • Neglect of basic resident needs (hygiene, medication, hydration) (mentioned by 5 reviewers)

Rating Trends

Tap a year to see what changed

234'14(1)'17(2)'19(4)'21(1)'23(5)'25(14)'26(4)

Distribution · 56 analyzed

5
23
4
4
3
2
2
2
1
25

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1Given the recent feedback regarding facility cleanliness, what specific protocols and schedules are currently in place to ensure resident living areas remain sanitized and well-maintained?
  • 2I noticed the facility has a very active recreation department; could you walk me through a typical weekly activity calendar and how you encourage residents to participate?
  • 3With staffing levels being a common point of discussion, what is your current strategy for ensuring consistent response times for call bells and daily assistance needs?
  • 4How does your leadership team facilitate regular communication with families, and what is the best way for us to get updates on our loved one's care plan?
  • 5Since physical therapy is a noted strength here, how do you coordinate between the therapy team and nursing staff to ensure a resident's progress is maintained throughout the day?
  • 6Can you explain your internal process for medication management and how you monitor for accuracy and timely administration?

Personalized based on this facility's data


Key Review Excerpts

The staff goes out of their way to tell you they'll be back in 5 minutes, then disappear never to be seen again. The facility itself is fine, but the housekeeping terrible. Floors, tables, surfaces are dirty and littered.

Family member · 2024☆☆☆☆

My mother was in her for a month or so.This place is nasty. The dirty floor and bedding. They are so understaffed. They need to be shut down. Leaving residence in dirty diapers and beds.

Family member · 2024☆☆☆☆

My Great Aunt was recently at this facility for rehab after a fall and was extremely impressed. The staff was very helpful and engaging, she loved the recreation department and all the programs offered during her stay.

Family member · 2024★★★★★
Source: 55 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.58hrs
78%
Registered nurses for medical care
Total Nursing
3.69hrs
90%
All nurses + aides combined
Staff Turnover
54%
Lower is better (< 30% = good)
RN Turnover
67%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
1/ 5
Better Than Avg

7

measures

Worse Than Avg

9

measures

Mixed Results

1

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility0.7%
Better than Avg
Here
0.7%
US
12.1%
NY
18.9%
Orange
6.2%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility83.2%
Worse than Avg
Here
83.2%
US
93.4%
NY
91.3%
Orange
98.6%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility24.0%
Worse than Avg
Here
24.0%
US
15.3%
NY
13.8%
Orange
9.6%
⚖️

Residents who lost too much weight

↓ Lower is better
This Facility16.9%
Worse than Avg
Here
16.9%
US
5.3%
NY
5.9%
Orange
4.2%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility7.8%
Better than Avg
Here
7.8%
US
19.4%
NY
20.2%
Orange
9.8%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility10.9%
Better than Avg
Here
10.9%
US
19.5%
NY
13.3%
Orange
12.8%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility28.9%
Worse than Avg
Here
28.9%
US
79.8%
NY
78.8%
Orange
94.6%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility37.4%
Worse than Avg
Here
37.4%
US
81.8%
NY
77.0%
Orange
95.4%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility2.8%
Worse than Avg
Here
2.8%
US
1.6%
NY
1.2%
Orange
1.9%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

17deficiencies
Well above state avg (7.6)
11 complaint-triggered

Families have filed multiple complaint reports, triggering 8 deficiencies across recent surveys at Highland Rehabilitation and Nursing Center. The facility shows recurring problems in resident rights and care planning, dining services, and building safety systems spanning four surveys from 2018 to 2025. While all identified deficiencies have reported correction dates, the persistent nature of issues across multiple years raises concerns about sustained quality improvements.

Feb 6, 2026Complaint
3
0580Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Jul 3, 2025Routine
17
0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0521Potential for harm · WidespreadCorrected

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

0800Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0838Potential for harm · PatternCorrected

Administration Deficiencies

Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

0887Potential for harm · PatternCorrected

Infection Control Deficiencies

Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

0761Potential for harm · PatternCorrected

Miscellaneous Deficiencies

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0759Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

0883Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Develop and implement policies and procedures for flu and pneumonia vaccinations.

0161Potential for harm · IsolatedCorrected

Construction Deficiencies

Use approved construction type or materials.

0271Potential for harm · IsolatedCorrected

Egress Deficiencies

Have exits that are accessible at all times.

0321Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0363Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0372Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0920Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

Jul 3, 2025Complaint
6
0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

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.

0677Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0561Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

0602Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from the wrongful use of the resident's belongings or money.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Aug 25, 2023Routine
8
0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0908Potential for harm · PatternCorrected

Environmental Deficiencies

Keep all essential equipment working safely.

0558Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0582Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

0623Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

0625Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0810Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Provide special eating equipment and utensils for residents who need them and appropriate assistance.

Aug 25, 2023Complaint
2
0921Potential for harm · IsolatedCorrected

Environmental Deficiencies

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Jan 31, 2020Routine
14
0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0656Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0676Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

0690Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0698Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate dialysis care/services for a resident who requires such services.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0321Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0351Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install an approved automatic sprinkler system.

0625Minimal · PatternCorrected

Resident Rights Deficiencies

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.

Ownership & Operations

Who Operates This Facility

Owner / Operator

Highland Rehabilitation and Nursing Center

Organization Type

for profit

Chain Affiliation

Chain Name

Personal Healthcare Management

Chain Size

21 facilities nationwide

Chain avg rating: 3.0/5 · Rank 18 of 19 (Worst)

Ownership & Management

Owners

Barth, Alexander

Owner

20%

Walden, Yehudah

Owner

20%

Zagelbaum, Ephraim

Owner

40%

Zalgelbaum, Pincus

Owner

10%

Key personnel

M&t Bank5% or Greater Mortgage InterestShneider, AlecW-2 Managing EmployeeZagelbaum, EphraimW-2 Managing EmployeeOstrovitsky, IsraelManagerWalden, YehudahManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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