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Nursing HomeMedicaid Investigative

The Grand Rehabilitation and Nrsg at Guilderland

On Medicare Special Focus status, a serious quality warning. Visit in person and ask tough questions before deciding.

428 State Route 146, Altamont, NY 12009127 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
2.5/5

based on 78 Google reviews

5
4
3
2
1
The Grand Rehabilitation and Nrsg at Guilderland Nursing Home in Altamont, NY — Street View
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9/ 10
critical Risk

Quality Concerns Identified

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

  • Special Focus Facility (under heightened CMS scrutiny)
  • Low overall rating (1/5 stars)
  • Low staffing rating (1/5 stars)
  • Above-median deficiencies (29 vs median 6.0)
  • High staff turnover (57%)
  • High RN turnover (82%)

Bottom 25% in NY · Critically understaffed (RN) · Worst in THE GRAND HEALTHCARE chain · $40,937 in fines · Special Focus Facility (CMS)

Source: Medicare data

What this means for your family

While the rehabilitation therapy team is frequently praised, the facility faces persistent, severe allegations regarding patient neglect, hygiene, and communication. We strongly advise families to conduct an unannounced visit and specifically observe the cleanliness of the hallways and the responsiveness of staff to call bells before making a decision.

Google Reviews

Google Reviews

78 reviews on Google
The Grand Rehabilitation and Nursing at Guilderland receives highly polarized feedback, with a significant number of families reporting severe neglect, poor hygiene, and understaffing. While some reviewers praise the rehabilitation therapy team and individual staff members, these positive experiences are frequently overshadowed by reports of residents left in soiled linens, unaddressed medical needs, and poor communication from management. Families considering this facility should be aware of the recurring, serious allegations regarding patient safety and cleanliness.

Quality Themes

Tap a score for details
Food2.0Staff3.0Clean1.0Activities5.0Meds1.0MemoryN/AComms2.0ValueN/A

Strengths

  • Effective rehabilitation therapy team
  • Some individual staff members are described as compassionate
  • Welcoming and professional front desk staff
  • Easy check-in process for visitors

Concerns

  • Severe understaffing leading to neglect (mentioned by 14 reviewers)
  • Poor hygiene and persistent odors of urine/feces (mentioned by 9 reviewers)
  • Unresponsive management and poor communication (mentioned by 7 reviewers)
  • Residents left in soiled linens for extended periods (mentioned by 6 reviewers)
  • Frequent falls and inadequate supervision (mentioned by 5 reviewers)

Rating Trends

Tap a year to see what changed

234'16(2)'18(2)'20(3)'22(13)'24(43)'26(3)

Distribution · 107 analyzed

5
41
4
3
3
2
2
5
1
56
14 reviews posted between Nov 3, 2024Nov 7, 2024 · 14 were 5-star

How They Respond to Reviews

70%response rate

This facility actively engages with reviewer feedback.

Questions for Your Tour

  • 1Given that the facility has a high volume of residents, could you walk me through your current staffing protocols to ensure that residents receive timely assistance with hygiene and personal care?
  • 2I noticed that management is very active in responding to feedback online; how do you utilize that communication loop to resolve specific concerns raised by families regarding daily care?
  • 3Could you describe the specific steps your team takes to maintain a clean and fresh environment throughout the facility, particularly in common areas and resident rooms?
  • 4How does your rehabilitation therapy team coordinate with the nursing staff to ensure that residents are safely supervised and supported when moving between their rooms and therapy sessions?
  • 5What is the process for ensuring that residents receive their medications accurately and on time, and how is this monitored given the current staffing levels?
  • 6What does a typical social or activity-based day look like for a resident here, and how do you encourage participation for those who may need extra assistance?

Personalized based on this facility's data


Key Review Excerpts

The staff at the grand especially nurse Caylan was absolutely wonderful to my grandfather at the end of his life. The therapist Dan and Amanda the night supervisor were advocates for him and ensured comfort for him.

Memory care family member · 2024★★★★★

My father was sent to the grand nursing home on June 25th 2024 for rehab he fell out of bed on June 29th with no phone call and was told when we got there that he stood up and put himself on the floor

Rehab patient's family · 2025☆☆☆☆

My daughter had surgery on her entire leg, she was sent here and she was highly neglected, she is diabetic and she wasn't giving her insulin,and they left her in soiled linen

Rehab patient's family · 2024☆☆☆☆
Source: 78 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.35hrs
47%
Registered nurses for medical care
Total Nursing
3.01hrs
73%
All nurses + aides combined
Staff Turnover
55%
Lower is better (< 30% = good)
RN Turnover
79%
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
2/ 5
Better Than Avg

8

measures

Worse Than Avg

5

measures

Mixed Results

4

measures

Long-Stay Residents
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility47.3%
Worse than Avg
Here
47.3%
US
93.4%
NY
91.3%
Albany
91.7%
😔

Residents with depression symptoms

↓ Lower is better
This Facility3.3%
Mixed vs Avgs
Here
3.3%
US
12.1%
NY
18.9%
Albany
2.9%

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

💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility11.8%
Better than Avg
Here
11.8%
US
19.5%
NY
13.3%
Albany
14.5%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility24.8%
Worse than Avg
Here
24.8%
US
19.4%
NY
20.2%
Albany
22.3%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility10.1%
Better than Avg
Here
10.1%
US
15.3%
NY
13.8%
Albany
15.4%
⚖️

Residents who lost too much weight

↓ Lower is better
This Facility2.5%
Better than Avg
Here
2.5%
US
5.3%
NY
5.9%
Albany
4.5%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility29.5%
Worse than Avg
Here
29.5%
US
81.8%
NY
77.0%
Albany
79.4%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility40.5%
Worse than Avg
Here
40.5%
US
79.7%
NY
78.8%
Albany
80.4%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.7%
Mixed vs Avgs
Here
1.7%
US
1.6%
NY
1.2%
Albany
2.2%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

26deficiencies
1penalties
Well above state avg (7.6)
15 complaint-triggered
$40,937 in fines

This facility has received 15 complaint-triggered deficiencies, indicating families have filed reports about care concerns. The most recurring problems involve medication management, nursing staffing adequacy, and safety systems. While most issues appear corrected, medication errors and nursing staff shortages have persisted across multiple surveys spanning 2021-2025, suggesting ongoing challenges in these critical care areas that warrant careful consideration during your visit.

Mar 7, 2025Complaint
13
0760Immediate jeopardy · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0725Potential for harm · WidespreadCorrected

Nursing and Physician Services Deficiencies

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

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.

0684Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0711Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

0837Potential for harm · PatternCorrected

Administration Deficiencies

Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.

0755Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0698Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0726Potential for harm · IsolatedCorrected

Nursing and Physician Services Deficiencies

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.

0808Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

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.

0770Potential for harm · IsolatedCorrected

Administration Deficiencies

Provide timely, quality laboratory services/tests to meet the needs of residents.

0773Potential for harm · IsolatedCorrected

Administration Deficiencies

Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.

Mar 7, 2025Routine
37
0004Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Develop and maintain an Emergency Preparedness Program (EP).

0006Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Conduct risk assessment and an All-Hazards approach.

0007Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Address patient/client population and determine types of services needed.

0015Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Address subsistence needs for staff and patients.

0018Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Establish procedures for tracking staff and patients during an emergency.

0041Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Implement emergency and standby power systems.

0291Potential for harm · WidespreadCorrected

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

0293Potential for harm · WidespreadCorrected

Egress Deficiencies

Have properly located and lighted "Exit" signs.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0711Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Provide a written emergency evacuation plan.

0781Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have restrictions on the use of portable space heaters.

0915Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper power supply for life support equipment.

0918Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0921Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure that testing and maintenance of electrical equipment is performed.

0211Potential for harm · PatternCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0222Potential for harm · PatternCorrected

Egress Deficiencies

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

0271Potential for harm · PatternCorrected

Egress Deficiencies

Have exits that are accessible at all times.

0281Potential for harm · PatternCorrected

Egress Deficiencies

Install proper backup exit lighting.

0522Potential for harm · PatternCorrected

Services Deficiencies

Have an externally vented heating system.

0550Potential for harm · PatternCorrected

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 · PatternCorrected

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 · PatternCorrected

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.

0842Potential for harm · PatternCorrected

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 · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0241Potential for harm · IsolatedCorrected

Egress Deficiencies

Have correct number of accessible exits for each story.

0912Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have power receptacles that are properly grounded.

0554Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Allow residents to self-administer drugs if determined clinically appropriate.

0585Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0609Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

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.

0645Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

PASARR screening for Mental disorders or Intellectual Disabilities

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

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.

0812Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

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

0814Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Dispose of garbage and refuse properly.

Jan 30, 2024Routine
14
0511Potential for harm · Widespread

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0918Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0921Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure that testing and maintenance of electrical equipment is performed.

0324Potential for harm · PatternCorrected

Smoke Deficiencies

Provide properly protected cooking facilities.

0341Potential for harm · PatternCorrected

Smoke Deficiencies

Install a fire alarm system that can be heard throughout the facility.

0814Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Dispose of garbage and refuse properly.

0867Potential for harm · PatternCorrected

Administration Deficiencies

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0577Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0791Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide or obtain dental services for each resident.

0812Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

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

Jan 30, 2024Complaint
2
0725Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

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.

Aug 23, 2021Routine
22
0921Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure that testing and maintenance of electrical equipment is performed.

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.

0656Potential for harm · PatternCorrected

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.

0725Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

0756Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0761Potential for harm · PatternCorrected

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.

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.

0813Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Have a policy regarding use and storage of foods brought to residents by family and other visitors.

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0925Potential for harm · PatternCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

0211Potential for harm · IsolatedCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0363Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0916Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have a battery powered remote alarm panel in a location accessible by operating personnel.

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.

0609Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

0760Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

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.

Federal Penalties

Fine

Mar 7, 2025

$40,937

Ownership & Operations

Who Operates This Facility

Owner / Operator

The Grand Rehabilitation and Nrsg at Guilderland

Organization Type

for profit

Chain Affiliation

Chain Name

The Grand Healthcare

Chain Size

16 facilities nationwide

Chain avg rating: 1.8/5 · Rank 10 of 16 (Worst)

Ownership & Management

Owners

Strauss Ventures LLC

Owner · Organization

98%

Strauss, Jeremy

Owner (parent company)

93%

Key personnel

Rogers, EricW-2 Managing EmployeeRogers, EricOfficer / DirectorStern, SamuelOfficer / DirectorStrauss, JonathanOfficer / DirectorStrauss Ventures LLCManager
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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