Highland Rehabilitation and Nursing Center

Name: Highland Rehabilitation and Nursing Center
Address: 120 Highland Avenue, Middletown, NY, 10940, US
Telephone: 8453421033

120 Highland Avenue, Middletown, NY 10940 · Orange County · 98 certified beds · avg 90 residents/day · certified since Jul 1, 1976

Part of chain: PERSONAL HEALTHCARE MANAGEMENT (21 facilities, chain avg rating 2.9★)

1/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

3.34

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (39)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Feb 6, 2026	D · Potential for harm, one-off	The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint
Feb 6, 2026	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint
Feb 6, 2026	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint
Jul 3, 2025	E · Potential for harm, repeated	The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint
Jul 3, 2025	E · Potential for harm, repeated	The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint
Jul 3, 2025	E · Potential for harm, repeated	The facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs.
Jul 3, 2025	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Jul 3, 2025	E · Potential for harm, repeated	The facility did not conduct and document a facility-wide assessment of what staff, supplies, and resources it needs to care for its residents properly — during everyday operations, nights, weekends, and emergencies.
Jul 3, 2025	E · Potential for harm, repeated	The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status.
Jul 3, 2025	D · Potential for harm, one-off	The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. · from a complaint
Jul 3, 2025	D · Potential for harm, one-off	The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint
Jul 3, 2025	D · Potential for harm, one-off	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint
Jul 3, 2025	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Jul 3, 2025	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint
Jul 3, 2025	D · Potential for harm, one-off	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
Jul 3, 2025	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Jul 3, 2025	D · Potential for harm, one-off	The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations.
Aug 25, 2023	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Aug 25, 2023	E · Potential for harm, repeated	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not provide special eating equipment and utensils — like adaptive cups or easy-grip silverware — for residents who need them, along with appropriate help at meals.
Aug 25, 2023	D · Potential for harm, one-off	The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. · from a complaint
Aug 25, 2023	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint
Jan 31, 2020	D · Potential for harm, one-off	The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required.
Jan 31, 2020	D · Potential for harm, one-off	The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Jan 31, 2020	D · Potential for harm, one-off	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Jan 31, 2020	B · Minimal risk, repeated	The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave.

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (9 → 14).

Year	Citations	Worst severity that year
2020	12	D
2023	10	E
2025	14	E
2026	3	D

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	New York avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	3.34	3.58	3.95	bottom 46% in New York; bottom 28% in the U.S.
Registered Nurse hours	0.54	0.68	0.69	bottom 45% in New York; bottom 44% in the U.S.
Weekend total nurse staffing	2.69	3.13	3.50	bottom 29% in New York; bottom 16% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.25	0.48	0.48	bottom 27% in New York; bottom 21% in the U.S.
Total nursing staff turnover (%)	53.7	40.3	45.8	bottom 19% in New York; bottom 28% in the U.S.
RN turnover (%)	78.9	39.8	42.9	bottom 3% in New York; bottom 6% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.44, RN 0.56, weekend 2.78. Staffing rating: 2/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 2/5 · long-stay residents: 2/5 · short-stay residents: 1/5

Who owns this facility

For profit - Limited Liability company

Owner / manager	Type	Role	Stake	Since
Barth, Alexander	Individual	5% or Greater Direct Ownership Interest	20%	11/20/2012
Walden, Yehudah	Individual	5% or Greater Direct Ownership Interest	20%	11/20/2012
Zagelbaum, Ephraim	Individual	5% or Greater Direct Ownership Interest	40%	11/20/2012
Zalgelbaum, Pincus	Individual	5% or Greater Direct Ownership Interest	10%	11/20/2012
M&t Bank	Organization	5% or Greater Mortgage Interest	NOT APPLICABLE	02/01/2013
Ostrovitsky, Israel	Individual	Operational/Managerial Control	NOT APPLICABLE	07/26/2024
Shneider, Alec	Individual	W-2 Managing Employee	NOT APPLICABLE	01/01/2024
Walden, Yehudah	Individual	Operational/Managerial Control	NOT APPLICABLE	11/20/2012
Zagelbaum, Ephraim	Individual	W-2 Managing Employee	NOT APPLICABLE	11/20/2012
Zagelbaum, Ephraim	Individual	Operational/Managerial Control	NOT APPLICABLE	11/20/2012

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"If my family member falls or their condition changes, exactly when and how will I be notified?"
"Who completes resident assessments here, and how do you check them for accuracy?"
"What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
"Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
"How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
"Can I see a sample menu, and how do you handle special diets like low-sodium or diabetic meals?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"How do you decide you have enough staff and resources for your resident population, including nights and weekends?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Middletown Park Rehab & Health Care Center	2.0 mi	Middletown, NY	★★★★☆	3/5
Sapphire Nursing and Rehab at Goshen	6.8 mi	Goshen, NY	★★★★★	4/5
Glen Arden INC	7.0 mi	Goshen, NY	★★★☆☆	2/5
Campbell Hall Rehabilitation Center INC	7.2 mi	Campbell Hall, NY	★☆☆☆☆	1/5	abuseSFF
The Valley View Center for Nursing Care and Rehab	7.3 mi	Goshen, NY	★★☆☆☆	1/5
Montgomery Nursing and Rehabilitation Center	11.2 mi	Montgomery, NY	★★☆☆☆	2/5
Schervier Pavilion	13.6 mi	Warwick, NY	★★★☆☆	3/5
St Josephs Place	15.6 mi	Port Jervis, NY	★★★★☆	3/5
Delaware Valley Skilled Nursing & Rehabilitation C	16.5 mi	Matamoras, PA	★☆☆☆☆	3/5
Sapphire Nursing at Meadow Hill	18.3 mi	Newburgh, NY	★★★★☆	3/5

Compare this facility with the 3 closest →

All facilities in Middletown →

Facility data as of CMS processing date 2026-08-01. CCN 335526.

The Care File

Visit checklist — Highland Rehabilitation and Nursing Center

120 Highland Avenue, Middletown, NY 10940 · 8453421033

Health inspection rating 1/5 · CMS overall 1/5· Fines (3y): $0

Questions for the administrator:

☐ "If my family member falls or their condition changes, exactly when and how will I be notified?"
☐ "Who completes resident assessments here, and how do you check them for accuracy?"
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
☐ "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
☐ "Can I see a sample menu, and how do you handle special diets like low-sodium or diabetic meals?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "How do you decide you have enough staff and resources for your resident population, including nights and weekends?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 335526 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)