Nursing home in Middletown, Orange County
Highland Rehabilitation and Nursing Center
120 Highland Avenue, Middletown, NY 10940 · (845) 342-1033
Highland Rehabilitation and Nursing Center is a 98-bed for-profit nursing home in Middletown, Orange County. It is one of 10 certified nursing homes in Orange County. Medicare rates it 1 out of 5 stars overall (1 for health inspections, 2 for staffing and 2 for quality measures). That overall rating is below the Orange County average of 2.9 stars. Inspectors issued 39 health citations across 4 inspections in the current federal reporting period. CMS lists no federal fines or payment denials for the facility in the past three years. Residents receive about 3.4 hours of total nursing care per day on average, and nursing staff turnover is 54%.
Medicare star ratings
Overall Medicare rating
1 / 5
Medicare's summary rating combining inspections, staffing and quality measures.
Health inspection rating
1 / 5
Based on findings from state health inspections and complaint investigations.
Staffing rating
2 / 5
Based on reported nurse and aide staffing hours per resident.
Quality measures rating
2 / 5
Based on resident outcomes such as falls, pressure ulcers and hospitalizations.
Staffing
- Total nurse hours per resident per day
- 3.44
- RN hours per resident per day
- 0.56
- Nursing staff turnover
- 53.7%
- RN turnover
- 78.9%
Staffing hours are self-reported payroll data published by CMS. Ask the facility about current staffing, including weekends.
Facility facts
- Address
- 120 Highland Avenue, Middletown, NY 10940
- County
- Orange
- Phone
- (845) 342-1033
- Certified beds
- 98
- Average residents per day
- 90
- Ownership type
- For profit - Limited Liability company
- Legal business name
- Hrnc Operating, LLC
- Chain affiliation
- Personal Healthcare Management (21 facilities)
- In Medicare/Medicaid since
- 1976
- CMS Certification Number (CCN)
- 335526
- Most recent standard inspection
- July 3, 2025
Location and getting there
Highland Rehabilitation and Nursing Center is located at 120 Highland Avenue in Middletown, Orange County, in the Hudson Valley (ZIP 10940). The nearest hospital is Garnet Health Medical Center, about 2.8 miles away. Distances are straight-line estimates; confirm travel routes before visiting.
Open in Google MapsInspection record
- Inspections on record
- 4
- Total health citations
- 39
- Serious citations (harm or immediate jeopardy)
- 0
- Immediate jeopardy citations
- 0
Inspection history
| Inspection date | Type | Citations | Most serious finding | Official report |
|---|---|---|---|---|
| February 6, 2026 | Complaint investigation | 3 | Potential for harm (isolated) | View CMS report |
| July 3, 2025 | Standard health inspection | 14 | Potential for harm (pattern) | View CMS report |
| August 25, 2023 | Standard health inspection | 10 | Potential for harm (pattern) | View CMS report |
| January 31, 2020 | Standard health inspection | 12 | Potential for harm (isolated) | View CMS report |
Federal penalties
No federal fines or payment denials are listed for this facility in the CMS penalty data we compiled. Penalties are only one indicator; review the inspection reports below for cited deficiencies.
Complaints to the New York State Department of Health
- Complaints received
- 57
- Complaints per 100 beds
- 65.1
- Statewide average per 100 beds
- 57.1
- On-site complaint inspections
- 10
NYS DOH complaint data through July 31, 2026.
Owners and managers reported to CMS
| Name | Role reported to CMS |
|---|---|
| Alexander Barth | Direct owner (5% or greater) — 20% (since 11/20/2012) |
| Yehudah Walden | Direct owner (5% or greater) — 20% (since 11/20/2012) |
| Ephraim Zagelbaum | Direct owner (5% or greater) — 40% (since 11/20/2012) |
| Pincus Zalgelbaum | Direct owner (5% or greater) — 10% (since 11/20/2012) |
| Alec Shneider | Managing employee (since 01/01/2024) |
| Ephraim Zagelbaum | Managing employee (since 11/20/2012) |
| Israel Ostrovitsky | Operational/managerial control (since 07/26/2024) |
| Yehudah Walden | Operational/managerial control (since 11/20/2012) |
| Ephraim Zagelbaum | Operational/managerial control (since 11/20/2012) |
Official reports and records
These links open official and independent records for CCN 335526. Read several inspections, not only the most recent, to see whether problems repeat.