Lifequest Nursing Center
Inspection history, citations, penalties and survey trends for this long-term care facility in Quakertown, Pennsylvania.
- Location
- 2450 John Fries Highway, Quakertown, Pennsylvania 18951
- CMS Provider Number
- 395735
- Inspections on file
- 20
- Latest survey
- April 15, 2025
- Citations (last 12 mo.)
- 0
Citation history
Health deficiencies cited at Lifequest Nursing Center during CMS and state inspections, most recent first.
Surveyors found that food and equipment were not stored or maintained under sanitary conditions in the kitchen and on one nursing unit. Issues included lack of hand soap at a handwashing station, uncovered and overflowing garbage cans near food prep areas, expired food items in storage, improper storage of gloves and clean mugs near garbage, dirty equipment, and uncovered or improperly sealed food in refrigerators and freezers. Additionally, a microwave on a nursing unit was found to be dirty and corroded.
The facility did not complete MDS assessments within the required time frames for two residents. One resident's quarterly assessment was not completed by the due date, and another resident's admission assessment remained incomplete past the required period, as confirmed by the Administrator.
A resident with dementia and hemiplegia, identified as being at risk for falls and requiring staff assistance for mobility, was observed in bed multiple times without the prescribed floor mats in place, despite a care plan specifying their use. The DON confirmed the mats should have been present.
Staff did not attempt or document non-pharmacological pain interventions before administering as-needed tramadol to two residents with dementia and chronic pain, despite facility policy requiring such steps. The DON confirmed the lack of documentation for these interventions in the medication administration records.
A resident with hypertension, congestive heart failure, and chronic kidney disease did not receive care as per physician's orders. Elastic stockings were not applied as scheduled, and daily weights were not recorded on multiple occasions. The DON confirmed these deficiencies.
The facility failed to document the rationale for continued PRN psychotropic medication use for four residents with dementia, major depressive disorder, and Alzheimer's. Orders for medications like lorazepam, Ativan, and trazodone lacked time frames for use beyond 14 days, and the medications were administered multiple times without appropriate documentation. The DON confirmed the absence of time frames for these medications.
A resident with spastic hemiplegia, cerebral palsy, and muscle weakness did not receive podiatry care since admission, despite being alert and oriented. The resident expressed the need for toenail cutting, and the facility administrator confirmed the lack of scheduled podiatrist visits, indicating a deficiency in nursing services.
The facility did not act on pharmacy recommendations for two residents prescribed Seroquel without appropriate diagnoses. A pharmacist identified the need for diagnosis changes to justify the medication use, but the physicians failed to document these changes. The DON confirmed the oversight.
Failure to Maintain Sanitary Food Storage and Preparation Conditions
Penalty
Summary
Surveyors observed multiple failures to maintain sanitary conditions in the facility's kitchen and on one nursing unit. In the main kitchen, there was no hand soap at a handwashing station, and an uncovered garbage can was placed next to a food preparation surface. Garbage was overflowing and in contact with a table top can opener. The vent cover to the ice machine was dusty, and the top of the ice machine had debris, rust, and water. In dry storage, a dented can of pumpkin was found, along with containers of cereal and cous cous that were past their use by dates. At the beverage station, an uncovered garbage can was present with boxes of gloves stored above it, and clean gloves were hanging out of the boxes and touching the garbage can. Clean mugs used for resident trays were stored next to the uncovered garbage can. There was also a brown substance on the flour bin cover, and in the walk-in refrigerator, a pan of pickles was left uncovered. In the walk-in freezer, opened packages of turkey bacon and ground beef patties were not resealed and left exposed to air. On the DEF nursing unit, the microwave was found to have an accumulation of splatter from unknown substances on the inside of the door and walls, and the top of the inside was discolored, chipped, and corroded. These observations indicate that food and equipment were not stored, prepared, or maintained in accordance with professional standards, as required by regulations.
Failure to Complete MDS Assessments Within Required Time Frames
Penalty
Summary
The facility failed to complete Minimum Data Set (MDS) assessments within the federally required time frames for two residents. According to the Resident Assessment Instrument (RAI) user manual, admission MDS assessments must be completed within 13 days of entry, and quarterly assessments must be completed every quarter. Clinical record review showed that one resident did not have a quarterly MDS assessment completed by the required reference date, and another resident's admission MDS assessment was still in progress and not completed within the specified time frame. The Administrator confirmed that these assessments were not completed as required.
Failure to Implement Fall Prevention Interventions
Penalty
Summary
The facility failed to implement required safety interventions for a resident with dementia and hemiplegia who was assessed as being at risk for falls. Clinical records showed that the resident required staff assistance for bed mobility and transfers and had a history of multiple falls, as documented in progress notes over several months. The resident's care plan specified that the bed should be kept in a low position with floor mats on both sides while the resident was in bed. However, during multiple observations over three days, the resident was found in bed without the floor mats in place. The DON confirmed that the mats should have been present according to the care plan.
Failure to Attempt Non-Pharmacological Pain Interventions Prior to PRN Medication
Penalty
Summary
The facility failed to follow its pain management policy, which required staff to attempt non-pharmacological interventions before administering as-needed pain medication. For two residents with dementia and chronic pain conditions, clinical record reviews showed that staff administered tramadol on multiple occasions without any documented evidence that non-pharmacological methods were tried first. There were also no records indicating that the residents refused such interventions. Specifically, one resident with dementia, mobility issues, and pain in the right arm and left lower leg received tramadol as needed for moderate pain, but the medication administration records for two months showed no documentation of attempted non-pharmacological interventions prior to medication administration. Another resident with dementia, weakness, and low back pain also received tramadol as needed for all levels of pain, with similar lack of documentation for non-pharmacological interventions. The Director of Nursing confirmed that such interventions should have been documented but were not.
Failure to Implement Physician's Orders for Resident Care
Penalty
Summary
The facility failed to implement physician's orders for a resident with diagnoses including hypertension, congestive heart failure, and chronic kidney disease. A physician's order required the application of elastic stockings to the resident's lower extremities every morning for fluid retention, scheduled for 6:00 a.m. On October 1, 2024, the resident was observed without the stockings, and she confirmed that staff had not offered or applied them for some time. The nurse aide also confirmed the stockings were not in place. Additionally, physician's orders required daily weight monitoring for the resident. However, the treatment administration record for September 2024 showed no evidence of weight being obtained on several specified dates, with no indication of resident refusal. The Director of Nursing confirmed the failure to apply the stockings and obtain daily weights as ordered.
Failure to Document PRN Psychotropic Medication Use
Penalty
Summary
The facility failed to document the rationale and justification for the continued use of as-needed (PRN) psychotropic medications for four residents who had orders for anti-psychotic medications. Resident 4, diagnosed with dementia, had a physician's order for lorazepam every four hours PRN for anxiety, but the order lacked a time frame for continued use beyond 14 days. The medication was administered three times over three months without appropriate documentation. Similarly, Resident 10, also diagnosed with dementia, had an order for Ativan every six hours PRN for anxiety, with no time frame for continued use beyond 14 days, and the medication was administered once in April 2024. Resident 16, with major depressive disorder and anxiety, had a PRN order for trazodone at night for insomnia, again lacking a time frame for continued use beyond 14 days. Resident 77, diagnosed with Alzheimer's disease, had an order for Ativan every six hours PRN for agitation/restlessness, with no time frame for continued use beyond 14 days. The medication was administered multiple times from December 2023 to April 2024. The Director of Nursing confirmed the absence of a time frame for the continued use of these PRN psychotropic medications.
Failure to Provide Timely Podiatry Care
Penalty
Summary
The facility failed to provide adequate and timely podiatry care for a resident diagnosed with spastic hemiplegia, cerebral palsy, and muscle weakness. The resident, who was alert and oriented, expressed on May 7, 2024, that he had not received any foot care from a podiatrist since his admission. A review of the clinical records confirmed the absence of documented podiatry visits since the resident's admission. The facility administrator acknowledged on May 9, 2024, that the resident had not been scheduled for any monthly podiatrist visits, confirming the deficiency in providing necessary nursing services as per 28 Pa. Code 211.12(d)(1)(5).
Failure to Act on Pharmacy Recommendations for Anti-Psychotic Medication Use
Penalty
Summary
The facility failed to ensure timely action on pharmacy recommendations for two residents. According to the facility's policy, a consultant pharmacist is required to perform a medication regimen review (MRR) for each resident receiving medication and report any irregularities to the attending physician. For Resident 10, who was diagnosed with dementia and prescribed Seroquel for generalized anxiety disorder, the pharmacist noted that the diagnosis did not justify the use of an anti-psychotic medication. The pharmacist recommended changing the diagnosis to one that would justify the use of Seroquel. Although the physician acknowledged the MRR, there was no documented evidence that the diagnosis was changed as recommended. Similarly, Resident 85, who was prescribed Seroquel for behaviors, lacked an allowable diagnosis to support its continued use. The pharmacist recommended using the diagnosis of depression with psychotic features to justify the medication. The physician acknowledged the MRR but did not respond to the recommendation, and there was no documented evidence of a diagnosis change. The Director of Nursing confirmed that the diagnoses for both residents had not been updated to reflect the pharmacist's recommendations.
Latest citations in Pennsylvania
Surveyors identified that a fire-rated separation door between building levels did not meet NFPA 101 multiple occupancy requirements. Initially, the basement separation door had holes where panic hardware had been removed and only a turning knob remained, compromising the door’s fire-rated function. On revisit, although panic hardware had been installed, the door still failed to latch properly in the frame due to friction. Facility leadership and maintenance staff acknowledged these door deficiencies.
Surveyors found that the facility’s Emergency Preparedness Plan was not compliant with regulatory requirements because it lacked a documented community-based all-hazards risk assessment and the facility-based hazard vulnerability analysis had not been updated on an annual basis. During document review and an interview with the Maintenance Director, it was confirmed that the community-based HVA was missing from the plan and that the existing facility-based assessment had last been updated in 2024, leaving the plan without current, comprehensive all-hazards risk assessments.
Surveyors observed that stair towers used as exits were not properly maintained, as multiple stair landings were being used for storage. Chairs were found stored on landings in several stairwells on one floor, and the Maintenance Director confirmed that these items were being kept within the stair towers.
Surveyors found that the common area soiled linen room on the second floor, classified as a hazardous area in a sprinklered location, had a door that failed to positively latch when tested. This door is required to self-close and latch to maintain proper separation for hazardous areas. The issue was confirmed with the Maintenance Director during the survey.
Surveyors found that oxygen storage requirements were not maintained when a freestanding oxygen cylinder was observed unsecured in a third-floor room and the C-Hall oxygen storage room door failed to close and latch due to a coordinator malfunction. The Maintenance Director confirmed these oxygen storage deficiencies during the survey exit interview.
Surveyors found that the facility failed to review and update its emergency preparedness policies and procedures on an annual basis. During document review, the facility could not provide a community-based HVA, which is required to inform updates to the emergency preparedness plan, and the facility-based HVA had not been updated as required. In an interview, the Maintenance Director confirmed both the missing community-based HVA and the lack of an annual update to the facility-based HVA.
Surveyors found that the facility’s Emergency Preparedness Plan lacked required policies and procedures for tracking the location of on-duty staff and sheltered patients during and after an emergency. The plan also did not include a method to document the specific name and location of any receiving facility or other site if staff and patients were relocated. During the exit interview, the Maintenance Director confirmed that these tracking and documentation procedures were not present in the plan, affecting the entire facility.
Surveyors found that the facility failed to develop and maintain required arrangements with other facilities and providers to receive patients if operations were limited or ceased. Document review showed that transfer agreements were missing, and this absence of formal arrangements to ensure continuity of services was confirmed by the Maintenance Director during the exit interview.
Surveyors determined that the facility’s emergency preparedness communication plan did not include any method for sharing appropriate information from the emergency plan with residents and their families or representatives. During document review and staff interviews, it was confirmed that the written plan lacked a defined process for communicating emergency planning information to residents and their representatives, and this omission affected the entire facility.
Two residents receiving PRN anti‑anxiety medications were not protected from potential chemical restraints when PRN lorazepam/Ativan orders lacked required 14‑day stop dates and physician re‑evaluation. One resident with schizoaffective disorder, dementia, and anxiety had a PRN Ativan order without a stop date that was administered multiple times over several months. Another resident with metabolic encephalopathy, heart failure, and peripheral vascular disease had a PRN lorazepam order without a stop date that was still being administered weeks later, with no documented physician reassessment. The DON confirmed that these PRN psychotropic orders should have included 14‑day limitations but did not.
Noncompliant Fire-Rated Separation Door Between Multiple Occupancies
Penalty
Summary
The facility failed to meet NFPA 101 multiple occupancy construction type requirements by not maintaining a compliant fire-rated separation door between building levels. During an observation in the basement, surveyors found that the building separation door had holes where the fire exit (panic) hardware had been removed, and the only remaining hardware was a turning knob, compromising the integrity of the fire-rated door. In a subsequent onsite revisit, surveyors observed that although panic hardware had been installed on the same fire-rated door, the door failed to latch properly in the frame due to friction. The administrator and maintenance staff confirmed the presence of the holes in the fire-rated door and later confirmed that the door continued to have a deficiency because it did not latch.
Plan Of Correction
The Facility submits this Plan of Correction under procedures established by the Department of Health in order to comply with the Department's directive to change conditions which the Department alleges is deficient under State and/or Federal Long Term Care Regulations. This Plan of Correction should not be construed as either a waiver of the facility's right to appeal or challenge the accuracy or severity of the alleged deficiencies or an admission of past or ongoing violation of State and Federal regulatory requirements. Please accept this plan of correction as the facility's written credible allegation of compliance such that all alleged deficiencies cited have been or will be corrected by the date or dates indicated. To remain in compliance with all federal and state regulations, the facility has taken or will take the actions set forth in the following plan of correction. 1. The correct fire rated hardware was ordered and will be installed on the basement building separation door. 2. Results will be shared with the Quality Assurance Performance Improvement Committee with corrections made as needed.
Failure to Maintain Current All-Hazards Emergency Preparedness Risk Assessments
Penalty
Summary
The deficiency involves the facility’s failure to maintain an Emergency Preparedness Plan that was based on and included both a documented facility-based and community-based risk assessment utilizing an all-hazards approach. During document review, surveyors found that the Emergency Preparedness Plan did not contain a documented community-based risk assessment. The plan therefore lacked the required community-based hazard vulnerability analysis (HVA) component that should identify and address community-level emergency events. Surveyors also determined that the facility-based risk assessment within the Emergency Preparedness Plan had not been updated annually as required. The last update to the facility-based HVA was documented in 2024, indicating that it was not current at the time of review. During the exit interview, the Maintenance Director confirmed both the absence of the community-based HVA and that the facility-based HVA had not received the required annual update.
Plan Of Correction
4.1. The facility will update the facility assessment to include the All Hazards Assessment annually. 4.2. The Director of Maintenance or designee Services will monitor bi-annually to meet compliance with E-006. Completion Date: 06/30/2026 Status: APPROVED Date: 06/09/2026
Improper Storage of Chairs in Exit Stair Towers
Penalty
Summary
Surveyors found that stairways and smokeproof enclosures used as exits were not properly maintained as required by NFPA 101. On one of five levels, multiple stair tower landings were being used for storage. During observations on May 4, 2026, chairs were stored on the landings of stair #2 on the third floor C-wing at 11:30 a.m., stair #3 on the third floor B-wing at 11:40 a.m., and stair #4 on the third floor A-wing at 11:50 a.m. In an exit interview on the same day at 1:30 p.m., the Maintenance Director confirmed the presence of this storage within the stair towers.
Plan Of Correction
4.1. The chairs were permanently removed from the third floor C-wing, stair # 2, the third floor B-wing, stair # 3, and the third floor A-wing, stair # 4 on Tuesday, May 5th, 2026. 4.2. The maintenance staff will be in-serviced on importance of verifying that stairwells are cleared Stairways and smokeproof enclosures used 4.3. The maintenance staff will perform monthly audits to confirm that stairwells are cleared. Audits will be completed for 6 months. 4.4. The maintenance director will monitor to meet the compliance
Soiled Linen Room Door Failed to Latch in Hazardous Area
Penalty
Summary
Surveyors identified a deficiency related to NFPA 101 hazardous area enclosure requirements when observing the soiled linen room on the second floor. During the survey, the common area soiled linen room door was tested and found to fail to positively latch. This room qualifies as a hazardous area in a sprinklered location, and the door is required to self-close and latch to maintain proper separation. The deficiency was confirmed during an exit interview with the Maintenance Director, who acknowledged the door problem. No residents or specific patient conditions were mentioned in the report, and no additional contributing actions or events beyond the failed latching mechanism of the soiled linen room door were described.
Plan Of Correction
K 03214.1. On the second floor, the common area soiled utility room door latch was repaired on May 4th, 2026. 4.2. The maintenance staff will be in-serviced to meet compliance requirements of K-0321; NFPA 101 Hazardous areas - enclosures. 4.3. The maintenance staff will perform monthly audits to meet compliance requirements of K-0321 to November 30th, 2026. 4.4. The maintenance director will monitor to meet the compliance requirements of K-0225. Completion Date: 06/30/2026 Status: APPROVED Date: 06/09/2026
Failure to Maintain Required Oxygen Cylinder Storage and Secured Storage Room
Penalty
Summary
Surveyors identified deficiencies in the facility’s compliance with NFPA 101 and NFPA 99 requirements for gas equipment cylinder and container storage. During observation on the third floor, surveyors found a freestanding oxygen cylinder in room 5352 at 11:30 a.m. This cylinder was not described as being secured or stored in accordance with the specified oxygen storage requirements, which include proper enclosure and handling precautions for cylinders available for immediate use in patient care areas. Further observation at 11:40 a.m. revealed that the C-Hall oxygen storage room door failed to close and latch due to a malfunctioning door coordinator. This condition meant the designated oxygen storage room was not being properly secured as required. During the exit interview on the same day at 1:30 p.m., the Maintenance Director confirmed the oxygen storage deficiencies observed by the surveyors.
Plan Of Correction
Completion Date: 06/30/2026 Status: APPROVED Date: 06/09/2026 4.1. The empty freestanding oxygen cylinder on the 3rd floor rom 5352 was removed & placed into the proper oxygen storage room on May 4th, 2026. The corridor malfunction identified on the c hall oxygen storage door will be repaired to ensure proper closure. 4.2. The maintenance staff will be in-serviced to meet compliance requirements of K-0923; NFPA 101 Gas equipment - Cylinder & container storage. 4.3. The maintenance staff will perform monthly audits to meet compliance requirements of K-0923 to November 30th, 2026. 4.4. The maintenance director will monitor to meet the compliance requirements of K-0923.
Failure to Annually Update Emergency Preparedness Policies and Risk Assessments
Penalty
Summary
The deficiency involves the facility’s failure to ensure that its emergency preparedness policies and procedures were reviewed and updated at least annually, as required. Surveyors cited that the facility did not have an emergency preparedness plan community-based risk assessment available for review. This community-based Hazard Vulnerability Analysis (HVA) is one of the required components used to update the facility’s emergency preparedness policies and procedures each year. During document review, surveyors found that the facility could not provide the community-based HVA and also confirmed that the facility-based HVA had not been updated annually as required. In an exit interview, the Maintenance Director acknowledged the absence of the community-based HVA and the missing annual update to the facility-based HVA, confirming that the emergency preparedness policies and procedures were not properly updated based on the emergency plan and risk assessment.
Plan Of Correction
4.1. The facility will update the emergency preparedness to include the community based risk assessment 4.2. The Director of Maintenance or designee Services will monitor bi-annually to meet compliance with E-013.
Missing Emergency Tracking System for Staff and Patients
Penalty
Summary
Surveyors identified a deficiency related to the facility’s Emergency Preparedness Plan, specifically the absence of required policies and procedures for tracking on-duty staff and sheltered patients during an emergency. During document review, the surveyor examined the facility’s Emergency Preparedness Plan and found that it did not contain a system to track the location of on-duty staff and sheltered patients in the facility’s care during an emergency. The review further showed that the plan lacked provisions to document the specific name and location of any receiving facility or other location if on-duty staff and sheltered patients were relocated during an emergency. In an exit interview, the Maintenance Director confirmed that these policies and procedures were missing from the Emergency Preparedness Plan, affecting the entire facility.
Plan Of Correction
4.1. The facility will update the emergency preparedness plan to include a system to track the location of on-duty staff and sheltered patients in the facility's care during an emergency; the specific name and location of the receiving facility or other location of on-duty staff and sheltered patients are relocated during an emergency. 4.2. The Director of Maintenance or designee will monitor bi-annually to meet compliance with E-0018.
Lack of Emergency Transfer Arrangements With Other Facilities
Penalty
Summary
The deficiency involves the facility’s failure to develop and maintain arrangements with other facilities and providers to receive patients if the facility experiences limitations or cessation of operations. During document review, surveyors determined that the facility did not have the required transfer agreements or documented arrangements in place as mandated under the emergency preparedness regulations, which require policies and procedures to ensure continuity of services to patients. On the date of the survey, at a specified time in the morning, the surveyor’s review of facility documentation showed that these arrangements were missing. In an exit interview later that day, the Maintenance Director confirmed that the transfer agreements were not in place, corroborating the surveyor’s findings that the facility lacked the necessary arrangements to ensure continuity of services in an emergency situation.
Plan Of Correction
4.1. The facility will update the emergency preparedness plan to provide arrangements with other facilities and other providers to receive patients in the event of limitations or cessation of operations to maintain the continuity of services to facility patients. 4.2. The Director of Maintenance or designee will monitor bi-annually to meet compliance with E-0025. Completion Date: 07/07/2026 Status: APPROVED Date: 06/09/2026
Failure to Include Resident/Family Communication Method in Emergency Plan
Penalty
Summary
Surveyors found that the facility failed to maintain and update an emergency preparedness communication plan that included a method for sharing information from the emergency plan with residents and their families or representatives. During document review and interview on May 4, 2026, at 8:30 a.m., the surveyor determined that the written emergency communications plan lacked any described process or method for communicating appropriate portions of the emergency plan to residents and their families or representatives, affecting the entire facility. In an exit interview with the Maintenance Director on the same day at 1:30 p.m., the Maintenance Director confirmed that the emergency communications plan did not include such a method for sharing information from the emergency plan with residents and their families or representatives. No specific residents, medical histories, or clinical conditions were identified in the report, and the deficiency pertained to the facility-wide emergency preparedness communication plan documentation and content.
Plan Of Correction
4.1. The facility will update the emergency communications plan to include a method of sharing information from the emergency plan with the residents and their families or representatives, affecting the entire facility. 4.2. The Director of Maintenance or designee will monitor bi-annually to meet compliance with E-0035.
Failure to Limit and Re‑Evaluate PRN Psychotropic Medications
Penalty
Summary
The deficiency involves the facility’s failure to ensure that residents were free from potential chemical restraints by not complying with federal requirements for PRN psychotropic medications. For one resident with schizoaffective disorder bipolar type, dementia, and anxiety disorder, the MDS showed cognitive impairment and the care plan identified mood problems, yelling out, and anxiety/restlessness. A physician ordered PRN Ativan for anxiety with no stop date specified. The MAR showed the PRN Ativan was administered multiple times over several months, including in January, March, and April 2026, without a 14‑day limitation or documented stop date. The DON stated that the PRN order was supposed to have a 14‑day stop date, confirming that the order did not meet regulatory requirements. For another resident with metabolic encephalopathy, heart failure, and peripheral vascular disease, a physician ordered PRN lorazepam every four hours for anxiety, again without a specified stop date. The MAR documented administration of lorazepam nearly a month after the order was written, with no evidence that the physician had re‑evaluated the continued use of the PRN anti‑anxiety medication beyond 14 days. The DON confirmed that no stop date had been added to this order. These omissions resulted in PRN psychotropic medications being available and used beyond 14 days without required time limitations or documented physician re‑evaluation, constituting a failure to ensure residents were free from potential chemical restraints and unnecessary drugs.
Plan Of Correction
Pharmacist will send out a re-education to all the providers regarding PRN psychotropics and end dates by May 4, 2026. Resident records for all residents receiving psychotropics were checked on April 30, 2026- no other orders were missing stop dates. New psychotropic orders added to Point Click Care dashboard on May 1, 2026- listing shows new orders and stop dates. Interdisciplinary team will review dashboard during clinical meeting for stop dates- any missing stop dates will be added. Charge nurses will audit order listing report for new psychotropic orders- 5 residents will be audited x 4 weeks, then 2 residents per week for 4 weeks, then random residents monthly. Audits will be added to quality indicators and reviewed at QAPI.
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