Tolstoy Foundation Rehabilitation And Nrsg Center in Valley Cottage, NY has a 1-star overall rating, with 1-star health inspection and staffing ratings and a 3-star quality measures rating. It is a special focus facility/SFF candidate, has had $126,926 in fines in the last 24 months, and its staffing is 1 star.
Last inspection: September 2, 2025Penalties, last 24 months: $126,926special focus facility
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports not reported.
Staffing detail
Total staff turnover: 36%
Registered nurse turnover: 63%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Last yrNowTrend
Long-stay residents on antipsychotic medication
20.9%14.6%Improving
Residents with a fall causing major injury
7.3%0%Improving
Residents with pressure ulcers (bedsores)
14.2%13.8%No change
Residents with a urinary tract infection
1.9%0%Improving
Residents who lost too much weight
11.8%17%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
28.6%17.9%Improving
Residents whose ability to walk got worse
21%28.4%Worsening
Long-stay residents on antianxiety or sleep medication
29.6%20.8%Improving
Short-stay residents newly given an antipsychotic
2.6%8%Worsening
Residents with a long-term catheter
1%3.5%Worsening
Residents with new or worsening incontinence
6.5%9.4%Worsening
Residents with depressive symptoms
21.6%10.2%Improving
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Last yrNowTrend
Long-stay residents given the seasonal flu vaccine
—80.9%—
Long-stay residents given the pneumonia vaccine
96.4%100%Improving
Short-stay residents given the seasonal flu vaccine
—74.4%—
Short-stay residents given the pneumonia vaccine
60.7%90.9%Improving
What the inspectors found
The home failed to honor residents’ choices about treatment, research participation, and advance care instructions. Cited September 2025 — widespread issue, immediate jeopardy to residents.
View the original federal record
F-Tag 578 — 42 CFR §483.10 — S/S: L
The home failed to ensure staff provided basic life support, including CPR, before emergency medical personnel arrived. Cited September 2025 — widespread issue, immediate jeopardy to residents.
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F-Tag 678 — 42 CFR §483.24(a)(3) — S/S: L
The home failed to provide enough nursing staff each day and ensure a licensed nurse was in charge on every shift. Cited September 2025 — widespread issue, potential for harm.
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F-Tag 725 — 42 CFR §483.35 — S/S: F
The home failed to run its operations effectively and efficiently using its available resources. Cited September 2025 — widespread issue, potential for harm.
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F-Tag 835 — 42 CFR §483.70 — S/S: F
The home failed to have a responsible governing body to set and carry out policies and properly manage the facility. Cited September 2025 — widespread issue, potential for harm.
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F-Tag 837 — 42 CFR §483.70 — S/S: F
Recent history
PENALTY
A federal fine of $126,926 was recorded.
STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
PENALTY
A federal fine of $126,470 was recorded.
STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
PENALTY
A federal fine of $124,527 was recorded.
INSPECTION
Health inspection found 14 health deficiencies.
See what inspectors found
INSPECTION
Health inspection found 7 health deficiencies.
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INSPECTION
Health inspection found 2 health deficiencies.
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Penalties & enforcement
On record with Medicare: 1 fine · $126,926 in total fines.
Federal fine
Sep 2, 2025
$126,926
Operator & ownership
Ownership
Non profit - Corporation
Occupancy
57.6 residents on an average day (60% of 96 beds)
Resident voice
Resident council
Medicare history
Certified for 56 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.