COMPLETE CARE AT BURLINGTON WOODS, LLC
Open-data reference.
COMPLETE CARE AT BURLINGTON WOODS, LLC is a for profit - limited liability company facility in BURLINGTON, NJ with 215 certified beds and a 3-star overall CMS rating. The facility has 22 deficiency records on file. Total penalties: $63K.
115 SUNSET ROAD, BURLINGTON, NJ 08016
Phone: 6093873620
Overall Rating
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 315050
- Ownership
- For profit - Limited Liability company
- Provider Type
- Medicare and Medicaid
- Beds
- 215
- Residents
- 171
- In Hospital
- No
- County
- Burlington
- Last Inspection
- Jun 4, 2025
Staffing Data
- RN Hours
- 0.58 (nat'l avg: 0.68)
- LPN Hours
- 0.81
- CNA Hours
- 2.09
- Total Nursing Hours
- 3.48 (nat'l avg: 3.89)
- PT Hours
- 0.04
- Nursing Turnover
- 35.5%
- RN Turnover
- 20.0%
What the CMS Record Reveals About COMPLETE CARE AT BURLINGTON WOODS, LLC
COMPLETE CARE AT BURLINGTON WOODS, LLC operates 215 certified beds in BURLINGTON, NJ with approximately 171 residents currently in care, and carries a CMS overall rating of 3 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (3★), staffing levels (3★), and quality measures (4★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
The inspection file contains 22 deficiency records from recent surveys, of which 1 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 1 penalty totaling $63K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 3.48 total nursing hours per resident day (national average 3.89), with RN coverage at 0.58 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.
Classified as "For profit - Limited Liability company" ownership and operating as a "Medicare and Medicaid" provider, COMPLETE CARE AT BURLINGTON WOODS, LLC falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 35.5%, within a range generally associated with stable care teams. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.
Deficiency History (22 most recent)
Ensure services provided by the nursing facility meet professional standards of quality.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jul 11, 2025
Post nurse staffing information every day.
Category: Nursing and Physician Services Deficiencies
Corrected: Jul 11, 2025
Provide safe and appropriate respiratory care for a resident when needed.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 11, 2025
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
Category: Quality of Life and Care Deficiencies
Corrected: Jan 26, 2024
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jan 26, 2024
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.
Category: Resident Rights Deficiencies
Corrected: Jan 26, 2024
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Category: Nutrition and Dietary Deficiencies
Corrected: Jan 26, 2024
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Category: Nursing and Physician Services Deficiencies
Corrected: Jan 26, 2024
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Category: Quality of Life and Care Deficiencies
Corrected: Jan 26, 2024
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: Jan 26, 2024
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.
Category: Resident Rights Deficiencies
Corrected: Jan 26, 2024
Put firmly secured handrails on each side of hallways.
Category: Environmental Deficiencies
Corrected: Jan 26, 2024
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Category: Administration Deficiencies
Corrected: Jan 26, 2024
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Category: Administration Deficiencies
Corrected: Jan 26, 2024
Have a plan that describes the process for conducting QAPI and QAA activities.
Category: Administration Deficiencies
Corrected: Jan 26, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Jan 26, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Jan 5, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Aug 30, 2021
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: Aug 30, 2021
Provide enough food/fluids to maintain a resident's health.
Category: Quality of Life and Care Deficiencies
Corrected: Aug 30, 2021
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Aug 30, 2021
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.
Category: Resident Rights Deficiencies
Corrected: Aug 30, 2021
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 3.3% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 1.3% | No |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.1% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.0% | Yes |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 19.3% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.1% | Yes |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 96.4% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 89.7% | No |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 1.4% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 3.4% | Yes |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 22.5% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 99.4% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | 96.6% | No |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 6.0% | Yes |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 18.1% | No |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 17.3% | Yes |
Penalty History 1 penalties totaling $63K
| Date | Type | Amount |
|---|---|---|
| Dec 13, 2023 | Fine | $63K |
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County Health Data
Health outcomes, access, and quality metrics for Burlington on PlainHealth
Frequently Asked Questions
What is the overall CMS rating for COMPLETE CARE AT BURLINGTON WOODS, LLC?
What are the staffing levels at COMPLETE CARE AT BURLINGTON WOODS, LLC?
How many beds does COMPLETE CARE AT BURLINGTON WOODS, LLC have?
Does COMPLETE CARE AT BURLINGTON WOODS, LLC have any deficiencies on record?
Has COMPLETE CARE AT BURLINGTON WOODS, LLC received any fines or penalties?
Who owns COMPLETE CARE AT BURLINGTON WOODS, LLC?
When was COMPLETE CARE AT BURLINGTON WOODS, LLC last inspected?
What quality measures are tracked for COMPLETE CARE AT BURLINGTON WOODS, LLC?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.
Read our methodology — how this data is sourced, computed, and verified.