Rockland County, New York · Nursing home
Tolstoy Foundation Rehabilitation And Nrsg Center
1 of 5 overall from CMS
100 Lake Road, Valley Cottage, NY 10989
At a glance
- Overall rating 1 of 5 Below the state average of 3.0
- Nurse time per resident, per day Not reported
- Nursing staff who left in a year 35.5% Below the state average of 40.3%
- Health citations, last 3 inspection cycles 45 2 at the harm level or above
- Fines in 3 years $126,926 1 fine
- Certified beds in use 60.0% of 96 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Tolstoy Foundation Rehabilitation And Nrsg Center is a 96-bed nursing home in Valley Cottage, New York (Rockland County). CMS rates it 1 of 5 stars overall as of Sep 2026. CMS lists 1 fine totaling $126,926 in the past three years.
- Certified beds
- 96
- Residents per day (average)
- 57.6
- Certified since
- 1970 (56 yrs)
Non profit - Corporation Participates in Medicare and MedicaidCMS Special Focus: SFF Candidate
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
- Special Focus candidate. CMS lists this home as a candidate for its Special Focus Facility program: its inspection record qualifies it for the program, but it has not been selected. What a Special Focus Facility is
These labels are shown as CMS publishes them. They describe the inspection record, not what has changed since.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Tolstoy Foundation Rehabilitation And Nrsg Center
Chosen from this home's public data.
- CMS lists this home as a candidate for its Special Focus Facility program, which means it qualifies but has not been selected. What has changed since the inspections behind that listing?Special Focus status in CMS data
- CMS lists 1 fine totaling $126,926 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 14 health deficiencies in the latest inspection cycle (the standard inspection on Sep 2, 2025 plus complaint and infection-control inspections); the New York average is 8.1. Which have been corrected?Inspection results in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 1 of 5 New York average 3.0
- Health inspections 1 of 5 New York average 2.7
- Staffing 1 of 5 New York average 2.8
- Quality measures 3 of 5 New York average 3.8
The vertical line marks the New York average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff Not reported New York average 3.63
- Nurse aides Not reported New York average 2.15
- Licensed practical nurses Not reported New York average 0.76
- Registered nurses Not reported New York average 0.71
- All staff, weekends Not reported New York average 3.18
How much nurse staffing is enough? All bars share one scale, 0 to 12 hours. The vertical line marks the New York average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover35.5%
- New York average40.3%
- Registered nurse turnover62.5%
- New York average39.8%
- Administrators who left1
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the New York and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | New York | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 22.5% | 14.1% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 13.6% | 5.8% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.8% | 0.5% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.5% | 1.3% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 23.1% | 19.5% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.2% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 2.9% | 3.1% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.6% | 91.5% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 25.5% | 12.5% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 26.0% | 13.2% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 80.9% | 95.3% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 12.9% | 6.5% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 10.8% | 19.5% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 17.9% | 13.7% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 2.01 | 1.70 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 0.85 | 1.36 | 1.78 |
Short-stay residents
| Measure | This home | New York | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 75.8% | 77.4% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 5.2% | 1.2% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 74.4% | 78.8% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 22.1% | 20.6% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 11.2% | 9.6% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 45 health deficiencies in the three most recent inspection cycles. Of these, 2 were at the immediate jeopardy level; the rest were graded as no actual harm. 14 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Sep 2, 2025: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Sep 2, 2025 | 14 | 13 |
| Jun 4, 2024 | 20 | 13 |
| Jun 15, 2021 | 11 | 17 |
New York homes averaged 8.1 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (45)
-
LImmediate jeopardy, widespread
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights · Deficient, Provider has date of correction (Oct 23, 2025)
-
LImmediate jeopardy, widespread
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Quality of Life and Care · Deficient, Provider has date of correction (Oct 23, 2025)
-
FPotential for more than minimal harm, widespread
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services · Deficient, Provider has date of correction (Oct 23, 2025)
-
FPotential for more than minimal harm, widespread
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration · Deficient, Provider has date of correction (Oct 23, 2025)
-
FPotential for more than minimal harm, widespread
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.
Administration · Deficient, Provider has date of correction (Oct 23, 2025)
Show 25 more
-
EPotential for more than minimal harm, pattern
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.
Resident Rights · Deficient, Provider has date of correction (Oct 23, 2025)
-
EPotential for more than minimal harm, pattern
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights · Deficient, Provider has date of correction (Oct 23, 2025)
-
EPotential for more than minimal harm, pattern
Make sure that a working call system is available in each resident's bathroom and bathing area.
Environmental · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
Ensure that residents are free from significant medication errors.
Pharmacy Service · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
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.
Pharmacy Service · Deficient, Provider has date of correction (Oct 23, 2025)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Oct 23, 2025)
-
EPotential for more than minimal harm, pattern
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Respond appropriately to all alleged violations.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Dec 3, 2025)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Sep 27, 2024)
-
DPotential for more than minimal harm, isolated
Respond appropriately to all alleged violations.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Sep 27, 2024)
-
EPotential for more than minimal harm, pattern
Observe each nurse aide's job performance and give regular training.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Jul 19, 2024)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Jul 19, 2024)
-
EPotential for more than minimal harm, pattern
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.
Infection Control · Deficient, Provider has date of correction (Jul 19, 2024)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights · Deficient, Provider has date of correction (Jul 19, 2024)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights · Deficient, Provider has date of correction (Jul 19, 2024)
-
DPotential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Jul 19, 2024)
-
DPotential for more than minimal harm, isolated
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights · Deficient, Provider has date of correction (Jul 19, 2024)
Showing the 30 most recent of 45.
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Sep 2, 2025 | Fine | $126,926 |
New York homes averaged 0.5 fines and $23,070 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within New York
- Size476 of 593 by certified beds
- New York average residents per day168.0
- ChainNone listed
- Resident or family councilResident
- Homes in Rockland County10
Common questions
What is the CMS star rating for Tolstoy Foundation Rehabilitation And Nrsg Center?
Tolstoy Foundation Rehabilitation And Nrsg Center has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 1, staffing is 1 and quality measures is 3.
How many beds does Tolstoy Foundation Rehabilitation And Nrsg Center have?
Tolstoy Foundation Rehabilitation And Nrsg Center has 96 certified beds. It averages 57.6 residents per day, about 60.0% of its certified beds.
Has Tolstoy Foundation Rehabilitation And Nrsg Center been fined?
Yes. CMS lists 1 fine totaling $126,926 in the past three years.
Does Tolstoy Foundation Rehabilitation And Nrsg Center accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 1 of 5 Nyack Ridge Rehabilitation and Nursing Center 160beds 95.4%in use 3.32nurse hours a day
- 2 of 5 Northern Manor Geriatric Center Inc 231beds 98.6%in use 3.62nurse hours a day
- 3 of 5 Tarrytown Hall Care Center 120beds 93.9%in use 3.55nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Rockland County
Who to call in New York
These offices serve residents of every nursing home in New York.
- Long-term care ombudsman New York State Long Term Care Ombudsman Program 1-855-582-6769 An advocate for residents and their families.
- File a complaint about a nursing home Nursing Home Complaint and Discharge Appeal Hotline 1-888-201-4563 (staffed 8:30 a.m. to 4:45 p.m. on weekdays) The state agency that inspects nursing homes.
New York staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 335311. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.