Above average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Guy And Mary Felt Manor, Inc during CMS and state inspections, most recent first.
The facility failed to properly monitor psychotropic medication use for one resident and failed to ensure a PRN Hydroxyzine order for another resident had the required 14-day limit or documented rationale for extension. One resident was receiving Buspirone, Cymbalta, and Elavil, but the record did not show monitoring of individualized target behaviors such as sleep pattern or documented side effects. Another resident had a PRN order for Hydroxyzine for agitation without a stop date or physician documentation supporting continued use beyond 14 days.
Improper Food Storage and Labeling in Kitchen: The main kitchen had multiple food items stored without clear dates or labels, including snack bars, cheese, frozen chicken, frozen dessert, and items in the cooler with unclear opened, received, or expiration dates. The CDM could not confirm the meaning of several dates, and other items included a dented can of carrots, faded labeling on a bag, graham cracker crumbs with conflicting dates, and an opened can of thickening powder with a scoop left inside.
Infection control deficiencies were identified in laundry processing, hand hygiene access, and the facility’s water management program. Several residents’ soiled laundry was stored in vented hampers with untied bags, and laundry staff lacked a sink and hand hygiene supplies in the laundry room, relying instead on sanitizer or a sink in another room; paper towels near a nearby faucet were also stored openly. The facility’s water management program did not include monitoring of the water heater temperature or actions if the 140°F target was not met, and staff confirmed the heater had not been monitored.
A resident’s admission MDS incorrectly coded the resident as having natural teeth, even though social services documentation, task records, and an aide confirmed the resident wore full upper and lower dentures and did not have natural teeth. The DON, NHA, and RN assessment coordinator confirmed the dental coding was incorrect.
Failure to provide ADL assistance for two dependent residents. One resident's toenails were observed to be long and extending past the nail bed, and the DON confirmed nursing staff should have been trimming them between podiatry visits but could not show documentation of personal hygiene assistance. Another resident who used dentures was dependent for oral hygiene, but the care plan, Kardex, and task documentation did not include or show use of denture adhesive despite family concerns about denture fit.
A resident reported that her glasses were old and no longer worked, and she wanted to see an eye doctor. Her record showed an optometry consult order on admission, but the facility had no documentation that it offered ongoing ophthalmology services or vision assessments to maintain her vision abilities. Social services later confirmed the resident wanted vision care and had not been seen by eye centers in years.
Survey results were not available in the atrium binder for resident and family review, and the binder also contained deficiency letters that identified two residents by name and specific identifiers, which should have remained confidential.
Two residents experienced a decline in range of motion (ROM) that was not addressed by facility staff after discharge from physical therapy. In both cases, assessments documented new bilateral impairments, and recommended interventions such as a walk to dine program were not implemented by nursing staff, as confirmed by staff interviews.
The facility did not follow CDC guidelines for COVID-19 work exclusions and outbreak testing, failed to implement proper transmission-based and enhanced barrier precautions for residents with infections or wounds, did not communicate critical lab results after a resident's hospital stay, and handled soiled personal laundry in a manner that did not prevent infection spread. Staff returned to work before meeting return-to-work criteria, did not use required PPE, and laundry was stored in open hampers without proper containment.
Three residents were not offered updated pneumococcal vaccines in line with current CDC recommendations, despite facility policy requiring immunization review and documentation. Clinical records and staff interviews confirmed the absence of offers or documentation for PCV15, PCV20, or PCV21, and the facility's policy did not reference these newer vaccines.
Two residents had POLST forms in their physical charts indicating a desire for CPR but refusal of intubation (DNI), while their electronic medical records and active physician orders instructed staff to implement Full Code treatment without any restriction. Staff confirmed they would follow the electronic orders, which did not reflect the residents' DNI preferences, leading to inconsistent documentation and potential disregard of resident wishes.
A resident reported $80 missing from their purse after receiving money from their spouse for personal use. Despite being notified of the missing funds, facility staff did not promptly initiate or document a thorough investigation as required by policy, and necessary notifications to agencies were delayed until after the issue was raised by surveyors.
A resident reported missing funds from their purse, but the facility did not document or report the suspected misappropriation to the appropriate authorities within the required timeframe. The delay in reporting was only addressed after a surveyor became aware of the concern and notified facility leadership.
Surveyors identified that two residents did not have comprehensive care plans addressing all their needs. One resident experienced multiple falls and had significant medical conditions, including anticoagulant use and a pacemaker, which were not reflected in her care plan. Another resident with a history of MRSA urinary tract infection and on contact isolation also lacked appropriate care plan documentation for these issues.
Surveyors found that pharmacy recommendations regarding unnecessary medications and appropriate diagnoses were not properly addressed for two residents. In one case, a pharmacist's suggestion to discontinue supplements and update medication indications was not reflected in physician orders. In another, a pharmacist's request for an appropriate diagnosis for an antipsychotic was met with a physician response, but the facility did not document follow-up. These deficiencies were confirmed through record review and staff interviews.
A registered nurse failed to lock a treatment supply cart containing biologicals while performing wound care for a resident, leaving the cart unattended and unsecured in the hallway.
Two nurse aides did not receive the required 12 hours of annual in-service training, with one completing only 9.5 hours and the other 11 hours, as confirmed by review of training records and staff interviews.
A facility failed to implement necessary mobility treatment and services for a resident, as adjustments to the resident's wheelchair were not made, and physical therapy services were not documented. The resident's wheelchair seat was too high, preventing effective self-propulsion, and despite evaluations, no modifications were documented. Additionally, a physician's order for continued physical therapy was not followed, contributing to the deficiency.
Psychotropic Medication Monitoring and PRN Order Duration Deficiencies
Penalty
Summary
The facility failed to ensure that the medication regimen for two residents was free from potentially unnecessary psychotropic medications. The cited policy stated that psychotropic medications were to be used only after behavioral programming, environmental changes, or other non-pharmacological interventions had failed, and that the facility would monitor psychotropic medications for proper dose, duration, efficacy, and adverse consequences. The policy also required individualized target behaviors to be monitored each shift and documented in the clinical record. For one resident, the clinical record showed scheduled psychotropic medications including Buspirone for anxiety, Cymbalta for depression, and Elavil for depression and sleep disturbance. The care plan identified monitoring needs for mood, sleep, care participation, response to interventions, and side effects such as dry mouth, dry eyes, constipation, urinary retention, and suicidal ideations. However, the record did not include evidence that the facility monitored the resident’s individualized target behavior symptoms, such as sleep pattern, or potential side effects related to the psychotropic medications. The Nursing Home Administrator and DON confirmed these findings during interview. For another resident, the physician ordered Hydroxyzine 25 mg every 12 hours as needed for relentlessness and agitation. A consultant pharmacist noted that the PRN order was subject to the 14-day limitation and requested that the physician reassess the appropriateness of continued therapy and document the need for continuation every 14 days. The record showed that the order did not have a 14-day stop date and there was no physician progress note documenting a rationale for extending the medication beyond 14 days. The DON confirmed these findings during interview.
Improper Food Storage and Labeling in Kitchen
Penalty
Summary
The facility failed to store food in accordance with professional standards for food service safety in the main kitchen. During observation of the kitchen production area and freezer, multiple food items were found without clear dating or labeling, including fig snack bars with no receive or use-by date, a container of cheese with no date received, opened, or expiration date, an unlabeled bag of frozen grilled chicken with an illegible handwritten date, and a tray of frozen dessert that was not labeled and had no dates indicating when it was placed there or when it needed to be used by. In the walk-in cooler, a bottle of lemon juice had two dates written on it, a gallon jug of pickles had a date of April 30, 2026, and a gallon jug of salad dressing was dated May 26, 2026; the Certified Dietary Manager could not confirm which dates represented opened, received, or expiration dates. Additional items in the production area included a large dented can of sliced carrots, a zipper-style plastic bag with faded labeling and a date of April 9, 2026 that could not be explained, a bag of graham cracker crumbs with both a manufacturer’s stamped date of October 9, 2025 and a handwritten date of April 25, 2026 that could not be identified, and an opened can of thickening powder with a plastic scoop left inside.
Infection Control Deficiencies in Laundry Processing, Hand Hygiene Access, and Water Management
Penalty
Summary
The facility failed to ensure an environment free from the potential spread of infection related to laundry processing for Residents 4, 7, 22, and 26, and failed to ensure hand hygiene materials were accessible in the laundry department. During observation, Resident 22’s closet could not accommodate a clothing hamper because of too many personal possessions, so a vented hamper lined with a black bag was placed along the wall in the middle of the room; the bag was not tied. Similar observations were made in Resident 4, Resident 26, and Resident 7’s closets, where vented clothing hampers were lined with black bags that were not tied, and in Resident 4’s room the soiled laundry was visible when the vented lid was raised. Employee 4 confirmed that residents’ soiled personal laundry was stored in these hampers until laundry staff collected it. In the laundry department, the room containing the washer used to process resident personal laundry did not have a sink or handwashing materials such as soap and paper towels. Employee 6 stated she would don a gown and gloves to transfer soiled laundry, then remove them before leaving the room and use alcohol-based hand sanitizer or go to a handwashing sink in another room about 50 feet away; she also acknowledged that alcohol-based sanitizer would not be effective for C. diff spores. In the housekeeping storage room next to the laundry room, hand soap was present at a faucet with a hose sprayer, but the paper towels were stored on an open shelving unit rather than in a closed dispenser. The facility also failed to implement an effective Water Management Program for prevention and control of water-borne contaminants such as Legionella; the program only stated that the water heater should be maintained above 140 degrees Fahrenheit, but it did not include a method to monitor the water heater temperature or specify what action would be taken if the goal was not met. Employee 5 confirmed the water heater had not been monitored and that the building diagram was not used to assess areas where Legionella or other opportunistic waterborne pathogens could grow and spread.
Incorrect Dental Coding on Admission MDS
Penalty
Summary
The facility failed to ensure that an assessment accurately reflected a resident’s status for one resident reviewed. Clinical record review showed social services documentation stating that admission paperwork was completed and that the resident wore dentures. However, the admission MDS dated January 20, 2026, coded the resident as not edentulous, indicating natural teeth. Later task documentation recorded oral hygiene as full upper and lower dentures. An aide confirmed that the resident did not have natural teeth, and the DON, NHA, and RN assessment coordinator confirmed that the dental coding on the admission MDS was incorrect.
Failure to Provide ADL Assistance for Dependent Residents
Penalty
Summary
The facility failed to provide activities of daily living assistance for two dependent residents. Resident 6, who was assessed by nursing staff as dependent for personal hygiene, complained that her toenails were always long and cutting into her skin. Observation confirmed her toenails were long and extended well past the nail bed. Her record showed an order for podiatry care every 60 to 90 days, and podiatry visits occurred on several dates, including a documented refusal on one occasion. The Director of Nursing stated that nurses should be trimming Resident 6's toenails between podiatry visits, but she could not provide documentation showing that personal hygiene assistance was provided. Resident 9 was dependent on staff for oral hygiene and used dentures. Her daughter raised concerns about weight loss and the fit of the dentures, and documentation reflected a discussion about denture adhesive and that nursing staff would be updated regarding its use. However, task documentation for oral hygiene only noted full upper and lower dentures, with no indication that denture adhesive was used. The active Kardex also contained no intervention related to denture adhesive. A nurse aide confirmed that Resident 9 had no natural teeth, used dentures, had no instructions in the care plan or Kardex for adhesive use, and that she had never used denture adhesive for the resident.
Failure to Support Resident Vision Services
Penalty
Summary
The facility failed to implement treatment and assistive devices to maintain vision abilities for one resident reviewed for vision concerns. Resident 6 stated during interview that she had a pair of glasses that were old and no longer worked for her, and she wanted to see an eye doctor. The clinical record showed the resident was admitted with an order for an optometry consult and care as needed. When the surveyor asked the Nursing Home Administrator and DON for evidence that the facility had offered professional ophthalmology services since admission, the facility did not provide such evidence. Social services later documented that they reviewed the resident’s vision needs and preferences, and the resident reported wanting to be seen for her vision needs and said she had been followed by two eye centers but had not been seen in years. An interview with social services confirmed there was no further documentation showing ongoing vision assessments to maintain her vision abilities.
Survey Results Not Posted and Resident Identifiers Exposed
Penalty
Summary
The facility failed to ensure that the results of the most recent survey were posted in a place readily accessible to residents, family members, and legal representatives. During an observation in the atrium, a blue binder was found containing previous survey results and expected to include the results of the most recent standard survey and any plan of correction, but the binder did not contain the results of the survey ending June 18, 2025. Review of the binder also showed full health survey letters and complaint deficiency letters, including a deficiency letter for the survey ending June 18, 2025, that listed the names and associated specific resident identifiers for Residents 7 and 18, which should have been kept confidential to protect resident privacy. These findings were reviewed with the Nursing Home Administrator.
Failure to Maintain or Address Decline in Range of Motion for Two Residents
Penalty
Summary
The facility failed to provide appropriate services to maintain or improve range of motion (ROM) for two residents with identified ROM concerns. For one resident, initial assessments indicated no impairment in ROM, but a subsequent quarterly assessment showed a decline with bilateral impairments in both upper and lower extremities. Despite this decline, there was no evidence in the clinical record that the facility addressed the resident's decreased ROM after discharge from physical therapy. Similarly, another resident was assessed as having no ROM impairment on an annual assessment, but a later quarterly assessment documented a decline with bilateral impairments. Physical therapy discharge documentation recommended a walk to dine program for this resident, but there was no evidence that this program was implemented by nursing staff. Interviews with facility staff confirmed that the recommended interventions were not carried out for either resident.
Infection Control Failures in COVID-19 Management, Precautions, and Laundry Handling
Penalty
Summary
The facility failed to implement and maintain an effective infection prevention and control program, as evidenced by multiple deficiencies in COVID-19 management, transmission-based precautions, enhanced barrier precautions, communication of pertinent clinical information, and laundry handling. Employees who tested positive for COVID-19 returned to work before meeting CDC criteria for healthcare personnel, including the absence of required negative tests and insufficient isolation periods. The facility also did not conduct appropriate outbreak testing for staff and residents during three separate COVID-19 outbreaks, and testing logs did not align with CDC guidelines regarding timing and inclusion of vaccinated staff. Transmission-based precautions were not properly followed for a resident with a urinary tract infection caused by MRSA. Staff failed to don required personal protective equipment, such as gowns, when entering the resident's room and did not use dedicated equipment, resulting in potential contamination of shared medical equipment and surfaces. Additionally, enhanced barrier precautions were not observed during wound care for another resident, as staff did not use gowns and failed to perform hand hygiene between glove changes, contrary to facility policy and CDC recommendations. The facility also lacked a process to obtain and communicate pertinent clinical information following a resident's acute care hospital treatment for a urinary tract infection, resulting in the continued administration of an antibiotic that was not the most effective for the identified organism. Furthermore, the handling and processing of residents' personal laundry did not adhere to infection control standards, with soiled laundry stored in open, unlidded hampers and staff not using appropriate protective equipment or following manufacturer guidelines for laundry processing. These failures were confirmed through staff interviews, record reviews, and direct observations.
Failure to Offer Updated Pneumococcal Vaccines per CDC Guidance
Penalty
Summary
The facility failed to offer pneumococcal vaccines in accordance with current CDC recommendations to three of five residents reviewed for immunizations. Facility policy required that all residents receive appropriate pneumococcal vaccines unless contraindicated or refused, with immunization status determined at admission and documented in the electronic medical record. However, clinical record reviews revealed that one resident, admitted at age 83, had only received a PPSV23 vaccine prior to admission, with no evidence of being offered additional recommended pneumococcal vaccines such as PCV15, PCV20, or PCV21. Two other residents, both of whom had received PCV13 and PPSV23 prior to admission, also had no documentation indicating they were offered the newer pneumococcal vaccines as recommended by current CDC guidance. Interviews with the infection control prevention coordinator confirmed that there was no additional evidence of these residents being offered the appropriate pneumococcal immunizations. The facility's active policy did not reference the newer available vaccines (PCV15 or PCV21), and there was no documentation of offers or administration of these vaccines in the residents' medical records. These findings were based on a review of facility policies, clinical records, and staff interviews.
Inconsistent Advance Directive Documentation for Two Residents
Penalty
Summary
The facility failed to ensure that residents' wishes regarding advance directives were clearly established and consistently reflected in both the physical and electronic medical records for two of four residents reviewed. For one resident, the physical chart contained a POLST form signed by both the physician and the resident, indicating a desire for CPR but a refusal of intubation (DNI). However, the electronic medical record and active physician orders instructed staff to implement Full Code treatment without any restriction on intubation. Staff interviews confirmed that in the event of a medical emergency, they would follow the electronic orders, which did not reflect the resident's DNI preference. Similarly, another resident's physical chart included documentation that a POLST was completed with the resident and her son, designating CPR with limited interventions and a DNI order. The POLST was signed by the physician and the resident's responsible party. Despite this, the electronic medical record and active physician orders indicated Full Code treatment without any restriction on intubation. Staff confirmed that, based on the electronic orders and absence of a physical chart indicator, they would provide Full Code CPR without honoring the DNI preference. These discrepancies were reviewed with facility leadership during the survey.
Failure to Promptly Investigate and Report Alleged Misappropriation of Resident Funds
Penalty
Summary
The facility failed to thoroughly investigate and notify the appropriate agencies regarding an incident of potential misappropriation of a resident's money. A resident reported that $80 was missing from their purse, which had been given to them by their spouse for use at the beautician. The resident discovered the missing funds approximately one week prior to notifying the facility and subsequently sent the purse home with their spouse. The resident and their spouse had previously declined to set up a resident fund account or use a key-locked drawer for securing personal funds, and there was no documentation of any prior incidents involving missing funds for this resident. Upon notification of the missing money, the facility's social worker re-educated the resident and spouse about available options for securing funds, but both continued to decline these services. Despite the facility's policy requiring prompt and thorough investigation of misappropriation allegations, there was no documentation that an investigation was initiated or conducted prior to several days after the incident was reported. Documentation of required investigative steps, such as interviews and searches, was not provided until after the surveyor's request, indicating a delay in the facility's response to the reported misappropriation.
Failure to Timely Report Suspected Misappropriation of Resident Property
Penalty
Summary
The facility failed to develop and/or implement policies and procedures to ensure the timely reporting of a reasonable suspicion of a crime, specifically regarding the misappropriation of resident property. A resident reported that $80 was missing from their purse, which had been given to them by their spouse for use at the facility's beautician. The resident notified the facility of the missing funds, but there was no documentation in the clinical record of any incident or reported misappropriation at the time of notification. The facility's policy required immediate reporting of such allegations to the administrator and to the State Agency and law enforcement within 24 hours if the event did not result in serious bodily injury. Despite being notified of the missing funds, the facility did not report the reasonable suspicion of misappropriation to the Department of Health, Department of Aging, or law enforcement until almost five days after the initial notification by the resident. The required agencies were not notified until after the surveyor became aware of the concern and informed the facility. This delay in reporting was confirmed through interviews with facility leadership and review of the facility's electronic reporting system and mandatory abuse reports.
Failure to Develop Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop comprehensive care plans for two residents, resulting in deficiencies related to unmet care needs. For one resident, clinical records showed multiple falls from her wheelchair, with documented interventions after each incident instructing staff to encourage her to lie in bed when appearing sleepy. However, these interventions were not incorporated into her official care plan. Additionally, despite the resident's use of an anticoagulant and the presence of a cardiac pacemaker, her care plan did not address these significant medical factors. Another resident was admitted with a urinary tract infection caused by MRSA, requiring antibiotics and contact isolation precautions. Documentation confirmed the presence of MRSA in her urine and the implementation of contact precautions, including signage and the use of personal protective equipment by staff. Despite these measures being in place, the resident's care plan did not include her history of urinary tract infections with a multi-drug-resistant organism or the need for contact isolation. Interviews with facility leadership and staff confirmed the absence of these critical interventions and medical conditions in the residents' care plans. The lack of comprehensive and updated care plans for both residents was identified through clinical record review, observation, and staff and resident interviews.
Failure to Address Pharmacy Recommendations for Medication Use
Penalty
Summary
The facility failed to ensure that pharmacy recommendations were properly addressed by the attending physician for two residents reviewed for unnecessary medications. For one resident, the consultant pharmacist identified that daily supplements of Vitamin D and oyster shell calcium may be unnecessary and requested the physician to consider discontinuation, but there was no documented physician response. Additionally, the pharmacist requested an updated diagnosis to justify the combined use of Prozac and Zyprexa for treatment-resistant major depressive disorder. Although the physician indicated that orders were updated, the active orders continued to list previous diagnoses, and there was no evidence that the orders were revised to reflect the pharmacist's recommendation. For another resident, the consultant pharmacist noted that Risperidone was prescribed for dementia, which is not an approved diagnosis for this medication, and requested clarification. The physician later indicated the medication was for depression, but there was no documentation that the facility addressed or followed up on the physician's response to the pharmacist's recommendation. These findings were confirmed through clinical record review and staff interviews, indicating a failure to ensure that pharmacy recommendations were appropriately addressed and documented.
Unsecured Treatment Cart During Wound Care
Penalty
Summary
A registered nurse was observed gathering wound care supplies from a treatment supply cart located in the hallway and entering a resident's room to perform wound care. The nurse shut the door and began the procedure, leaving the treatment supply cart unattended and unlocked in the hallway. After completing the dressing change, the nurse confirmed in an interview that the cart had not been locked while unattended. This failure to secure the treatment cart resulted in treatment biologicals being left unsecured during the wound care process.
Failure to Provide Required Annual In-Service Training for Nurse Aides
Penalty
Summary
The facility failed to ensure that nurse aides received the required 12 hours of annual in-service training, as evidenced by a review of employee education records and staff interviews. Specifically, two out of three nurse aides reviewed did not meet the annual training requirement: one received only 9.5 hours and the other 11 hours of in-service training in the past year. During meetings with the Nursing Home Administrator and the DON, it was confirmed that there was no additional documentation to show that these nurse aides had completed the mandated training hours. This deficiency was identified through a review of training records and confirmed by staff interview.
Failure to Implement Mobility Treatment and Services
Penalty
Summary
The facility failed to implement necessary treatment and services for a resident's mobility, as evidenced by the lack of adjustments to the resident's wheelchair and the absence of physical therapy services. The resident, identified as CR1, had a physical therapy discharge summary indicating that her wheelchair seat was too high, preventing her from self-propelling. Although an outside resource assessed the situation and adjustments were pending, there was no evidence in the clinical record that these adjustments were made. Furthermore, a physician's order for continued physical therapy was not followed, as there was no documentation of therapy services being provided after a certain date. An interview with a physical therapy assistant revealed that the resident had decreased mobility and used her feet to propel her wheelchair. However, the height of the wheelchair seat caused her knees to remain bent, limiting her ability to self-propel effectively. Although a customized wheelchair was provided to stretch her legs, it reduced her feet's contact with the floor. The facility evaluated the chair again but did not document any modifications to improve the situation. The lack of documentation and follow-up on the resident's physical therapy needs contributed to the deficiency identified by the surveyors.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 23 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Emporium
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Pinecrest Manor | 18.6 mi | ★★★★★ | 3 | 0 |
| Elk Haven Nursing Home | 18.7 mi | ★★★★★ | 6 | 0 |
| Cole Place | 22.2 mi | — | 0 | 0 |
| Sweden Valley Manor | 22.2 mi | ★★★★★ | 0 | 0 |
| Sena Kean Nursing And Rehabilitation | 22.9 mi | ★★★★★ | 11 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.