Above average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Advanced Health Care Of Hanover during CMS and state inspections, most recent first.
Incomplete Annual Staff In-Service Training: The facility failed to maintain an effective staff training program requiring 12 hours of annual in-service education. Review of personnel and training records showed that five of seven staff members reviewed did not complete the required hours, with several completing only a small portion of the mandated training. The Administrator confirmed the shortfall in annual in-service training.
Failure to implement physician orders affected two residents. One resident with HTN was given amlodipine and carvedilol without documented BP checks before administration as ordered, and another resident with hypertensive heart disease and CHF did not have ordered daily weights obtained on several days. The DON confirmed the missing documentation and that the ordered assessments were not completed as required.
Improper Disposal of Trash and Refuse: During an observation of the dumpster area, more than 15 used plastic gloves, crushed carrots, a cornstarch box, a cracked medicine cup, a specimen sample cup, a glycerin swab box, used cigarettes, a smashed plastic bag with debris, used paper towels, and multiple used plastic cups were found on the ground around the dumpster.
Staff did not implement or document the use of a physician-ordered Dynasplint device for a resident with limited range of motion, despite clear orders and therapy recommendations. The resident, who was dependent on staff and had multiple medical conditions, did not receive the prescribed intervention to maintain or improve joint movement.
Surveyors found that the facility did not include required interventions in the care plans for three residents, despite their clinical assessments identifying needs such as vision, nutrition, activities of daily living, communication, dental care, and psychotropic drug use. The DON confirmed these omissions during interviews.
The facility did not consistently follow physician orders for daily weights and vital sign assessments for four residents with conditions such as heart failure, kidney disease, and high blood pressure. Required weights were not documented on multiple days, and a blood pressure medication was administered without evidence that heart rate was checked as ordered. The DON confirmed the lack of documentation for these required assessments.
Two residents who were transferred to the hospital after a change in condition did not receive written notification about the bed hold policy or the reasons for their transfer, nor was Ombudsman information provided. Documentation confirming that these notifications were given was absent, as verified by the Administrator.
A resident's Quarterly MDS assessment was not completed and electronically transmitted to CMS within the required 14-day timeframe. This deficiency was confirmed through clinical record review and interview with the DON.
A resident who was dependent on staff for personal hygiene and bathing was observed on multiple occasions with long and dirty fingernails, and there was no evidence that staff offered or provided assistance with nail care, despite the resident's request and care plan requirements. The DON confirmed that nail care should be provided during routine care.
A resident with chronic kidney disease and heart failure, who was cognitively intact, was not served her preferred breakfast items as indicated on her menu selection form. Instead of the requested pancakes and sausage, she received eggs on a tortilla, fruit, hot tea, and milk, and was observed having difficulty eating the meal. The Administrator confirmed that dietary staff were expected to follow residents' menu selections.
A resident with a recent upper arm fracture, osteoarthritis, and vision problems was not provided with the adaptive eating equipment and assistance specified in her care plan and therapy documentation. Observations showed she did not receive the required inner lip plate, was given incorrect utensils, and her food was not cut, resulting in visible difficulty managing her meals.
A resident with metabolic encephalopathy and a left BKA was admitted with documented intact skin, but later reported an unassessed and unchanged bandaged area on the right lower extremity. Staff failed to document identification or assessment of this impaired area for eight days following admission.
A facility failed to provide a resident's clinical record to their legal representative within the required timeframe. The resident was discharged, and a request for the records was made, but the facility delayed sending the information for several months, violating resident rights under 28 PA. Code 201.29(a).
A facility failed to assist a resident with mouthcare, despite the resident's need for help due to limited mobility and medical conditions such as encephalopathy and heart failure. There was no documentation of assistance or refusal, as confirmed by the DON.
A facility failed to implement a physician's order for a resident with encephalopathy, heart failure, and muscle weakness. The order required a stat urine sample for urinalysis, but there was no evidence it was obtained. The DON confirmed the lapse in following the medical directive.
A resident with chronic heart failure did not receive the prescribed medication Entresto from January 4 to January 8 due to a delay in pharmacy services. The medication was ordered to be administered twice daily starting January 3, but was not provided until January 9, highlighting a deficiency in the facility's pharmaceutical services.
The facility failed to maintain sanitary food storage conditions. Observations revealed undated baking chocolate powder, improperly stored raw chicken and shrimp, and undated raw pork and turkey. A scoop was found in direct contact with flour, and funnels and a Styrofoam bowl were in direct contact with salt and pepper. Additionally, there was no thermometer in the dry storage room, contrary to facility policy.
A facility failed to complete a Discharge MDS assessment within the required timeframe for a resident who was hospitalized. The assessment, which should have been completed and transmitted within 14 days after the resident's discharge, was delayed until July 3, 2024. This deficiency was confirmed by the Regional President of Operations.
The facility did not follow physician's orders for daily weight monitoring for two residents with chronic conditions. One resident's weight was not documented on a specific date, while another resident's weights were missing on two separate dates. The Regional President of Operations confirmed the absence of documentation.
A facility failed to monitor and document the hemodialysis access site for a resident with end-stage renal disease, as required by their policy. The policy required assessments every shift, but records showed no evidence of such assessments since late June. This was confirmed by the Regional President of Operations.
The facility did not verify the professional licenses and registrations for two newly hired staff members, a Registered Nurse and a nurse aide, before they began working. This oversight was confirmed by the Regional President of Operations and violated the facility's policies and state regulations.
Incomplete Annual Staff In-Service Training
Penalty
Summary
The facility failed to implement and maintain an effective training program so that each staff member received 12 hours of annual in-service training. Review of the facility assessment showed that staff were to be in-serviced annually on mandatory topics including resident abuse, neglect and exploitation, trauma informed care, and dementia management. During an interview, the Administrator confirmed that staff were required to complete 12 hours of in-service training each year. Review of personnel and training records showed that five of seven staff members reviewed did not complete the required annual training. Employee 6 completed 7.5 hours, Employee 8 completed 1 hour, Employee 9 completed 5.25 hours, Employee 11 completed 2.25 hours, and Employee 12 completed 2.0 hours of in-service education during the reviewed period. The Administrator confirmed that these employees had not completed the required annual in-service training.
Failure to Follow Physician Orders for BP Checks and Daily Weights
Penalty
Summary
The facility failed to ensure physicians' orders were implemented for two residents. One resident had diagnoses including hypertension, and on April 17, 2026, the physician ordered amlodipine once daily and carvedilol twice daily, with instructions not to administer both medications if the resident's systolic blood pressure was less than 100 mm Hg. Review of the April and May 2026 MARs showed the amlodipine was administered 15 times and the carvedilol 18 times without documentation that blood pressure was assessed before each administration as ordered. Another resident had diagnoses including hypertensive heart disease with congestive heart failure. On April 28, 2026, the physician ordered daily weights and to notify the physician if there was a weight gain greater than five pounds in one week or three pounds in one day. Review of the clinical record showed daily weights were not obtained on May 1, 2, and 3, 2026. The DON confirmed there was no documented evidence that the weights were obtained on those dates and no documented evidence that blood pressure was taken prior to medication administration per the physician's order.
Improper Disposal of Trash and Refuse
Penalty
Summary
The facility failed to dispose of trash and refuse properly. During observation of the dumpster area on May 5, 2026, at 11:05 a.m., more than 15 used plastic gloves, crushed carrots, a cornstarch box, a cracked medicine cup, a specimen sample cup, a glycerin swab box, used cigarettes, a smashed plastic bag with debris in it, used paper towels, and multiple used plastic cups were found on the ground around the dumpster.
Failure to Implement and Document Physician-Ordered ROM Device
Penalty
Summary
A deficiency was identified when staff failed to implement and document an orthopedic surgeon's order for a Dynasplint device to maintain or improve range of motion in a resident with heart failure, osteoarthritis of the right hand, and vision loss. The resident was alert, dependent on staff for activities of daily living, and had a limitation in range of motion in one arm. The order specified that the Dynasplint should be applied to the right elbow for 30 minutes three times daily after meals, as noted in the occupational therapy treatment plan. However, there was no documented evidence that staff ensured the Dynasplint was in place as ordered. This was confirmed by the Administrator during an interview.
Failure to Develop Comprehensive Care Plans for Multiple Residents
Penalty
Summary
The facility failed to develop comprehensive care plans that addressed all identified needs for three residents, as determined through clinical record review and staff interviews. For one resident with diabetes, lower limb cellulitis, and gastro-esophageal reflux disease, the Minimum Data Set (MDS) Care Area Assessment (CAA) summary indicated that vision, activities of daily living, dental care, and nutrition should be addressed, but there was no documented evidence that interventions for these areas were included in the care plan. Another resident with hearing loss, high cholesterol, and a recent total knee replacement had communication, nutrition, and activities of daily living identified as care areas in the MDS CAA summary, yet these were not reflected in the care plan documentation. A third resident with a diagnosis of depression was noted in the MDS CAA summary to require care plan interventions for psychotropic drug use. Review of the medication administration record showed the resident received an antidepressant over several months, but there was no documentation of interventions related to psychotropic drug use in the care plan. The Director of Nursing confirmed during interviews that the identified care areas were not addressed in the care plans for these residents.
Failure to Implement Physician Orders for Weights and Vital Signs
Penalty
Summary
The facility failed to implement physician orders for four residents, as evidenced by a review of facility policy, clinical records, and staff interviews. For three residents with diagnoses including heart failure, kidney disease, and diabetes, physician orders required daily weights and notification to the physician if specific weight gains occurred. However, the Medication Administration Records (MAR) for these residents showed multiple days where weights were not documented as obtained. Additionally, for a resident with high blood pressure, staff were ordered to check the heart rate prior to administering a blood pressure medication and to withhold the medication if the heart rate was below a certain threshold. The MAR indicated that the medication was administered on several occasions without documented evidence that the heart rate was assessed beforehand. The Director of Nursing confirmed in interviews that there was no documented evidence that the required daily weights or heart rates were obtained according to physician orders. The facility's policy on medication administration required staff to follow written physician orders and document vital signs as indicated, but this was not consistently done for the residents in question.
Failure to Provide Required Written Notification of Bed Hold Policy and Transfer
Penalty
Summary
The facility failed to provide written notification to residents and their representatives regarding the bed hold policy and the reasons for transfer, including Ombudsman information, when two residents were transferred to the hospital following a change in condition. Clinical record reviews for both residents showed no documentation that such notifications were given at the time of transfer. During an interview, the Administrator confirmed that there was no evidence that the required notices were sent to the residents or their responsible parties.
Failure to Timely Complete and Transmit MDS Assessment
Penalty
Summary
The facility failed to complete and electronically transmit the encoded Minimum Data Set (MDS) assessment data to the Centers for Medicare and Medicaid Services (CMS) within the required 14-day timeframe for one resident. Clinical record review showed that the resident had a Quarterly MDS assessment that remained incomplete and had not been transmitted as required. This was confirmed during an interview with the Director of Nursing, who acknowledged that the MDS assessment had not been completed and transmitted within the mandated period.
Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with diagnoses including heart failure and metabolic encephalopathy, who was dependent on staff for personal hygiene and bathing, was observed on two consecutive days with long and dirty fingernails. The resident's clinical record and care plan indicated a need for staff assistance with activities of daily living (ADLs), including grooming and nail care. Despite this documented need, there was no evidence that staff offered or provided assistance with trimming and cleaning the resident's nails. The resident confirmed in an interview that he would like his nails to be trimmed and cleaned and that staff had not offered to do so. The DON confirmed that nail care should be provided during routine care and as needed.
Failure to Provide Resident with Preferred Meal Items
Penalty
Summary
The facility failed to provide a resident with her preferred breakfast items as indicated on her menu selection form. The resident, who had chronic kidney disease and heart failure and no cognitive impairment, had requested pancakes and sausage for breakfast. However, she was served eggs on a tortilla, fruit, hot tea, and milk instead. Observation showed the resident had difficulty eating the meal provided and expressed a preference for the items she had originally selected. The Administrator confirmed that the dietary department was expected to follow residents' menu selections as identified on the weekly menu selection form.
Failure to Provide Required Adaptive Eating Equipment and Assistance
Penalty
Summary
A deficiency was identified when a resident with a recent upper arm fracture, osteoarthritis in the dominant hand, and vision problems was not provided with the adaptive eating equipment and assistance specified in her care plan and occupational therapy documentation. The care plan and therapy notes indicated the need for an inner lip plate, built-up utensils, visual cues, and staff assistance to cut food at every meal. Despite these documented needs, observations over multiple meals showed that the resident did not receive the required inner lip plate, was given weighted rather than built-up utensils, and her food was not cut into pieces as needed. During these observed meals, the resident was seen struggling to manage her food, having difficulty picking up and cutting items, and lacking the adaptive equipment and assistance outlined in her care plan. The NHA confirmed that the adaptive equipment should have been provided, but it was not in place during the observed meal times.
Incomplete Medical Record Documentation for Resident Skin Assessment
Penalty
Summary
The facility failed to ensure complete and accurate medical record documentation for one resident. The resident, who had a history of metabolic encephalopathy and a left below-the-knee amputation, was admitted with skin assessments indicating intact skin and no open areas. However, the resident later reported to a nurse practitioner that a bandaged area on the right lower extremity had not been changed or assessed by staff since admission. Upon assessment, a treatment was prescribed for the area. There was no documentation in the clinical record that staff had identified or assessed the impaired area from admission until eight days later.
Delayed Provision of Clinical Records
Penalty
Summary
The facility failed to provide a copy of a discharged resident's clinical record within the required timeframe. A legal representative requested a copy of the clinical record for a resident who was discharged on May 29, 2024. The request was made on August 29, 2024, but the facility did not fax the requested information until December 10, 2024. This delay was confirmed by the Nursing Home Administrator during an interview on March 4, 2025. This deficiency is a violation of 28 PA. Code 201.29(a), which pertains to resident rights, specifically the right to access or purchase copies of their records.
Failure to Assist Resident with Mouthcare
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for a resident who required help with mouthcare. The resident, who had diagnoses including encephalopathy, heart failure, and muscle weakness, was assessed as alert but with limited mobility in the right upper extremity, necessitating assistance with mouthcare. However, there was no documented evidence that the resident received this assistance, nor were there any records of the resident refusing such care. This deficiency was confirmed through a clinical record review and an interview with the Director of Nursing, who acknowledged the lack of documentation.
Failure to Implement Physician's Order for Urine Sample
Penalty
Summary
The facility failed to implement a physician's order for a resident diagnosed with encephalopathy, heart failure, and muscle weakness. The order, dated January 6, 2025, required staff to obtain a stat urine sample for urinalysis to rule out an infection. However, there was no documented evidence that the urine sample was obtained as ordered. During an interview on February 19, 2025, the Director of Nursing confirmed that the urine sample was not obtained as per the physician's order, indicating a lapse in following the prescribed medical directives.
Failure to Provide Timely Medication
Penalty
Summary
The facility failed to ensure the timely provision of physician-ordered medications for a resident. The resident, who was admitted with chronic heart failure, gout, and deconditioning, had a physician's order for the medication Entresto to be administered twice daily starting January 3, 2025. However, a review of the Medication Administration Record (MAR) for January 2025 revealed that the medication was not provided by the pharmacy until January 9, 2025. As a result, the resident did not receive the prescribed medication from January 4 through January 8, 2025. This lapse in medication administration was identified during a clinical record review, indicating a failure in the facility's pharmaceutical services to meet the needs of the resident as required by federal and state regulations.
Plan Of Correction
Corrective Action for cited Resident: Resident #1 was identified and discharged the facility on January 10th, 2025. Other Residents at Risk: An Audit was completed for patients residing in the facility for pharmacy concerns and pharmacy concerns corrected. Systemic Change: Licensed nurses educated on facility policy regarding the review of medication administration and the process to notify pharmacy and on call provider when medication is unavailable. Ongoing Monitoring: DON/designee will audit the EMAR administration record weekly x4 and monthly x2. The DON/Designee will provide in-service and training if deficient practice is noted. The DON/Designee will present the findings of these audits to the QA Committee for review and recommendations. DON is responsible for maintaining compliance.
Food Storage Sanitation Deficiency
Penalty
Summary
The facility failed to store food under sanitary conditions in the kitchen, as observed during a survey. A review of the facility's Food Storage policy, last reviewed in April 2024, indicated that a thermometer should be present in the dry storage room and that scoops should not be stored in food containers. However, during an observation in July 2024, it was found that a container of baking chocolate powder was not dated after being removed from its original package. In the walk-in refrigerator, raw chicken was stored over raw shrimp, and both were not dated with a pull date after being removed from the freezer. Similarly, raw pork and turkey were also not dated with a pull date. A scoop was found in direct contact with flour in a bulk bin, and funnels were in direct contact with salt and pepper in the dry storage room. Additionally, a Styrofoam bowl was in direct contact with salt in another container, and there was no thermometer in the dry storage room. The Director of Dietary confirmed that the items should have been dated.
Failure to Timely Complete MDS Assessment for Hospitalized Resident
Penalty
Summary
The facility failed to complete a Minimum Data Set (MDS) assessment in a timely manner for a resident who was hospitalized. According to the Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual, a Discharge assessment is required when a resident is admitted to a hospital or another care setting, and it must be completed and transmitted within 14 days after the Assessment Reference Date (ARD). In this case, the resident was admitted to the facility and later hospitalized, but the Discharge MDS was not completed until July 3, 2024, which was beyond the required timeframe. This deficiency was confirmed during an interview with the Regional President of Operations on the same day.
Failure to Implement Physician's Orders for Daily Weights
Penalty
Summary
The facility failed to implement physician's orders for two residents, leading to a deficiency. Resident 4, who was admitted with chronic kidney disease and heart failure, had a physician's order for daily weight monitoring starting June 18, 2024. However, there was no documented evidence of a weight being obtained on June 21, 2024. Similarly, Resident 25, admitted with end-stage renal disease and heart failure, had a physician's order for daily weight monitoring starting June 21, 2024. There was no documented evidence of weights being obtained on June 23 and 30, 2024. An interview with the Regional President of Operations confirmed the lack of documentation for these dates, indicating that the weights were neither obtained nor refused by the residents.
Failure to Monitor Hemodialysis Access Site
Penalty
Summary
The facility failed to provide ongoing assessment and monitoring for a resident receiving hemodialysis, as required by their policy. The policy, last reviewed in April 2024, mandates that all patients receiving hemodialysis have their access site assessed every shift for appearance, signs of infection, drainage, bleeding, and bruit and thrill, with documentation in the treatment administration record (TAR). However, a review of the clinical records for Resident 101, who was readmitted with diagnoses including end-stage renal disease and congestive heart failure, revealed no evidence of such assessments being conducted or documented since June 27, 2024. This was confirmed by the Regional President of Operations during an interview on July 3, 2024.
Failure to Verify Licenses for New Hires
Penalty
Summary
The facility failed to adhere to its policy on verifying professional licenses and registrations for new hires, leading to a deficiency. Specifically, two out of five newly hired employees, a Registered Nurse and a nurse aide, began working without their licenses or registrations being verified as required by the facility's policy. The Registered Nurse started employment on May 24, 2024, but the inquiry to the state licensure board was not completed until July 2, 2024. Similarly, the nurse aide began working on May 23, 2024, without any inquiry to the state nurse aide registry. This oversight was confirmed by the Regional President of Operations during an interview on July 3, 2024. The facility's failure to conduct these verifications was in violation of their own policies and procedures, as well as state regulations.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Bethlehem
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Kirkland Village | 0 mi | ★★★★★ | 23 | 1 |
| Country Meadows Nursing Center Of Bethlehem | 1.7 mi | ★★★★★ | 0 | 0 |
| Moravian Village Of Bethlehem | 2.6 mi | ★★★★★ | 3 | 0 |
| Northampton Post Acute | 3.2 mi | ★★★★★ | 4 | 0 |
| Bethlehem North Skilled Nursing And Rehabilitation | 3.8 mi | ★★★★★ | 20 | 0 |
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