Kingston Center for Rehabilitation and Health Care — nursing home in West Kingston, RI

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 55 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
CMS Certification Number: 415107
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Jan 1, 1992
Ownership type: For profit - Corporation
Operator (legal business name): Shady Acres Operations Assoc LLC
CMS chain: Not part of a CMS-reported chain
Phone: (401) 295-8520
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

7

latest Jan 16, 2025

Citations

14

8 health · 6 fire

Harm or worse

0

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D5	E3	F6
Minimal	A·	B·	C·

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffingfn 23

Quality measuresNot ratedfn 2

Penalties · about the last 3 years

Fines

0

$0

Payment denials

0

Latest

—

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 415107
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 55
First approved: Jan 1, 1992
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Rhode Island.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Jan 16, 2025	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Jan 16, 2025	Health	Health Standard	0	No citations	—	Open →
Feb 7, 2024	Fire safety	Fire Safety Standard	5	Potential harm	—	Open →
Feb 7, 2024	Health	Health Complaint, Health Standard	5	Potential harm	—	Open →
Nov 14, 2023	Health	Health Complaint	1	Potential harm	—	Open →
Dec 15, 2022	Fire safety	Fire Safety Standard	1	Potential harm	—	Open →
Dec 15, 2022	Health	Health Standard	2	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

No fines or payment denials in the CMS Penalties file for this CCN.

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D5	E3	F6
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Feb 7, 2024	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Mar 7, 2024
Feb 7, 2024	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Mar 7, 2024
Feb 7, 2024	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Mar 7, 2024
Feb 7, 2024	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Mar 7, 2024
Feb 7, 2024	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Mar 7, 2024
Feb 7, 2024	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Mar 7, 2024
Feb 7, 2024	F-0761	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 Deficiencies · Medication management	D · Potential harm Isolated	Corrected Mar 7, 2024	Complaint
Feb 7, 2024	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Mar 7, 2024	Complaint
Feb 7, 2024	F-0883	Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Mar 7, 2024	Complaint
Feb 7, 2024	F-0908	Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Mar 7, 2024	Complaint
Nov 14, 2023	F-0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Dec 12, 2023	Complaint
Dec 15, 2022	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 13, 2023
Dec 15, 2022	F-0761	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 Deficiencies · Medication management	E · Potential harm Pattern	Corrected Jan 13, 2023
Dec 15, 2022	F-0921	Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Environmental Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 13, 2023

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 2.9

Health inspectionsstate 2.9

Staffingstate 3.3

Quality measuresNot ratedstate 3.2

Long-stay QMNot rated

Short-stay QMNot rated

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffingNot reported

State avg 3.78US avg 3.90

Registered nurse (RN)Not reported

State avg 0.77US avg 0.69

Licensed practical nurseNot reported

State avg 0.49US avg 0.86

Nurse aideNot reported

State avg 2.52US avg 2.35

Weekend total nurseNot reported

State avg 3.37US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: — (case-mix index —).

Staff turnover

Total nursing staff turnoverNot reported

State avg 40.0%US avg 45.3%

Registered nurse turnoverNot reported

State avg 38.8%US avg 42.5%

Administrators who leftNot reported

State avg 0US avg 1

Health survey score

Cycle 1 standard survey: Jan 16, 2025
Cycle 1 health score: 0
Total weighted score: 11

Operating entity

Shady Acres Operations Assoc LLC

CMS legal business name of the certified provider. Operates this facility only.

VerifiedLinked by exact legal name

CMS chain

Not part of a CMS-reported chain.

Ownership disclosures

Disclosures

3

Organizations

0

Individuals

3

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Jonathan Hagler	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	90%	Oct 1, 2016
Shoshana Rozenberg	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	10%	Dec 31, 2021

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Jonathan Hagler	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	90%	Oct 1, 2016
Shoshana Rozenberg	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	10%	Dec 31, 2021
Nicholas Lutzel	Individual	Managing employee	W-2 MANAGING EMPLOYEE	not provided	Oct 1, 2016

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 415 Gardner Road, West Kingston, RI 02892
ZIP: 02892
County: Washington County FIPS 44009
State: Rhode Island
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	CMS overall	Last inspection	Citations (window)	Fines
South Kingstown Nurs. & Rehab Ctr 2115 South County Trail, West Kingston, RI 02892 CCN 415054Abuse icon	8.5 km	112		May 12, 2026	181 IJ1 harm	$14k
Roberts Health Centre Inc 25 Roberts Way, North Kingstown, RI 02852 CCN 415104	10.8 km	66		May 26, 2026	102 harm	—
South County Eden Operations LLC DBA Lakeside Nurs 740 Oak Hill Road, North Kingstown, RI 02852 CCN 415071	11.1 km	120		May 18, 2026	201 IJ	$14k
Alpine Nursing Home Inc 557 Weaver Hill Road, Coventry, RI 02816 CCN 415089	11.9 km	60		Jul 13, 2026	17	—
Coventry Operations Ri LLC DBA Respiratory and Reh 10 Woodland Drive, Coventry, RI 02816 CCN 415078SFFAbuse icon	12.2 km	210	Not rated	Jun 24, 2026	9912 IJ6 harm	$372k
Saint Elizabeth Home East Greenwich 1 Saint Elizabeth Way, East Greenwich, RI 02818 CCN 415010Abuse icon	14.9 km	168		Apr 23, 2026	282 IJ	$64k
Adviniacare Scallop Shell, LLC 55 Scallop Shell Way, South Kingstown, RI 02879 CCN 415057	16.6 km	80		Nov 20, 2025	271 IJ5 harm	$19k
West View Nursing Home, Inc 239 Legris Avenue, West Warwick, RI 02893 CCN 415067	17.5 km	120		Jul 20, 2026	294 IJ6 harm	$112k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	415107	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	415107	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 415107

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction