Above average — CMS composite of the measures below.
The next survey window likely opens around November 2026
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 Mifflin Center during CMS and state inspections, most recent first.
A resident with adrenocortical insufficiency and peripheral vascular disease had physician orders for scheduled hydrocortisone and PRN oxycodone, but multiple doses were not administered because the medications were not available from the pharmacy. Nursing documentation noted missed hydrocortisone doses and an unavailable oxycodone dose, and the DON confirmed that the medications were not given as ordered due to lack of availability, resulting in a cited deficiency in pharmaceutical and nursing services.
A resident with a left lower leg fracture, muscle weakness, and HTN, who could communicate needs and required extensive assistance for transfers, was taken to an orthopedic appointment without documented notification to the responsible party. After returning from the appointment, the resident reported she would have liked staff to call her daughter so she could attend. Review of the clinical record showed no evidence that the responsible party was informed of the appointment, and the DON confirmed there was no documentation of such notification.
A resident with a history of left lower leg fracture, HTN, and muscle weakness was assessed via MDS/CAA as having bowel incontinence that required care plan attention, but the comprehensive care plan contained no interventions addressing this condition. Review of the clinical record and confirmation from the DON showed there was no documented evidence that bowel incontinence interventions were developed or implemented, resulting in a deficiency in required nursing services.
A resident with HTN and muscle weakness had a verbal MD order for a stool specimen to rule out C. difficile, but staff did not collect the ordered sample. Record review showed no documentation that the specimen was obtained, and the DON confirmed in interview that the stool sample was not collected as ordered, resulting in noncompliance with quality of care and nursing services requirements.
A resident with constipation, a history of paralytic ileus, and diabetes did not receive ordered bowel regimen medications when no BM was documented over several days. The MAR showed the resident was not given the ordered PEG, MOM, bisacodyl suppository, or saline enema, and the DON confirmed the orders should have been followed.
A resident with an indwelling urinary catheter, bladder obstruction, enlarged prostate, diabetes, and heart failure did not receive documented catheter care in accordance with facility policy. Although the resident had orders for daily and evening catheter care and later had the catheter reinserted after a voiding trial, no new orders were obtained and there was no documented evidence that catheter care was provided. The resident reported catheter care was not regularly provided, and the DON confirmed the lack of documentation.
A facility failed to provide food and drinks matching two residents' individualized meal selections. One resident with DM and HF was served orange juice instead of the apple juice and cinnamon roll listed on the meal ticket, and later received vegetable pizza despite requesting sausage pizza. Another resident with cirrhosis and respiratory failure, with mild cognitive impairment, was given apple juice instead of the coffee listed on the meal ticket. The Administrator stated dietary staff were expected to follow residents' weekly menu selections and provide all items listed on each meal ticket.
The facility failed to maintain proper food service and sanitary conditions in the kitchen. A dietary employee did not use a serving utensil when handling food, failed to change gloves or perform hand hygiene between tasks, and placed a container of food directly on cooked meat, violating the facility's food preparation policy.
The facility failed to implement comprehensive care plans for three residents, leading to deficiencies in addressing identified needs such as skin protection, hydration, nutrition, pain management, and functional deterioration. Observations and interviews confirmed the lack of required interventions, with the DON acknowledging the absence of documentation.
The facility failed to serve food that was palatable and at an appetizing temperature in the main dining room. Residents reported that their food was often cold and unpalatable. A test tray audit confirmed that food items were served below the required temperature, with the Dietary Director acknowledging the deficiency.
Failure to Provide Ordered Medications Due to Pharmacy Unavailability
Penalty
Summary
Surveyors identified a deficiency in pharmaceutical services when a resident’s physician-ordered medications were not available from the pharmacy and therefore were not administered as prescribed. The resident had been admitted with diagnoses including adrenocortical insufficiency and peripheral vascular disease, and the care plan included interventions for staff to administer medications as ordered by the physician. On January 17, 2026, the physician ordered hydrocortisone every eight hours and oxycodone every six hours as needed. Documentation showed that hydrocortisone doses scheduled for 6:00 a.m. and 2:00 p.m. were not given because the medication was unavailable from the pharmacy, and at 1:32 p.m. the nurse documented that oxycodone could not be administered for the same reason. In an interview, the Director of Nursing confirmed that these medications were not administered as ordered because they were not available from the pharmacy. The deficiency was cited under 28 Pa. Code 201.14(a) Responsibility of licensee, 28 Pa. Code 201.18(1)(3) Management, and 28 Pa. Code 211.12(d)(3)(5) Nursing services, based on the failure to ensure that ordered medications were available and administered to meet the resident’s needs.
Failure to Notify Responsible Party of Scheduled Medical Appointment
Penalty
Summary
The facility failed to ensure timely notification of a responsible party regarding a scheduled medical appointment for one of six sampled residents. The resident had been admitted with diagnoses including a left lower leg fracture, muscle weakness, and hypertension, and the MDS assessment indicated she was able to communicate her needs and required extensive staff assistance for transfers. A nurse’s note documented that the resident returned from an orthopedic appointment on January 23, 2026. During an interview on January 27, 2026, the resident stated she would have liked staff to call her daughter about the appointment so her daughter could have made plans to attend. Clinical record review showed no documentation that the resident’s responsible party was notified of the appointment, and in a subsequent interview the DON confirmed there was no documented evidence of such notification, constituting noncompliance with 28 Pa. Code 211.12(d)(1)(5) Nursing services.
Failure to Include Bowel Incontinence Interventions in Care Plan
Penalty
Summary
The facility failed to develop and implement care plan interventions to address a resident’s bowel incontinence. Clinical record review showed that the resident was admitted with diagnoses including a left lower leg fracture, hypertension, and muscle weakness. A Minimum Data Set (MDS) assessment and Care Area Assessment (CAA) summary dated January 15, 2026, documented that the resident had bowel incontinence and indicated that this issue was to be addressed in the care plan. However, review of the resident’s comprehensive care plan revealed no evidence that any interventions related to bowel incontinence were included. In an interview, the Director of Nursing confirmed that there was no documented evidence of bowel incontinence interventions in the resident’s care plan, resulting in noncompliance with 28 Pa. Code 211.12(d)(1)(5) regarding nursing services.
Failure to Implement Physician Order for Stool Sample Collection
Penalty
Summary
The facility failed to implement a physician’s order for a sampled resident, resulting in a missed diagnostic test. Clinical record review showed that Resident 1, who had diagnoses including hypertension and muscle weakness, had a verbal physician order dated January 23, 2026, directing staff to collect a stool sample to rule out Clostridium difficile. Review of the clinical record revealed no documented evidence that the ordered stool sample was ever collected. In an interview on January 27, 2026, at 3:15 p.m., the Director of Nursing confirmed that the stool sample had not been collected as ordered. This deficiency was cited under CFR 483.25 Quality of Care and 28 Pa. Code 211.12(d)(1)(3)(5) Nursing services, and was noted as previously cited on December 19, 2025.
Failure to Follow Bowel Regimen Orders
Penalty
Summary
The facility failed to ensure that physicians' orders were implemented for a resident with diagnoses including constipation, a history of paralytic ileus, and diabetes. The resident's MDS assessment indicated the resident was alert and oriented, always incontinent of bowel, and required substantial assistance with toileting hygiene. Physicians' orders directed staff to give polyethylene glycol as needed if there was no bowel movement in three days, milk of magnesia at bedtime on the third day without a bowel movement, a bisacodyl suppository on the shift after milk of magnesia was given, and a saline laxative enema two hours after the suppository failed to produce a bowel movement. Bowel movement tracking showed no bowel movements recorded over a five-day period, and the MAR showed the resident was not given the ordered oral medications, suppository, or enema to induce a bowel movement. The DON confirmed in interview that the physicians' orders should have been followed.
Failure to Provide Ordered Catheter Care
Penalty
Summary
The facility failed to assess and provide indwelling urinary catheter care in accordance with its policy for one resident with a catheter. The facility policy required catheter care twice per day and as needed, including inspection, assessment for signs or symptoms of infection or trauma, and routine cleaning of the catheter tubing. Resident 11 had diagnoses including bladder obstruction, enlarged prostate, diabetes, and heart failure, and was assessed as alert and oriented with an indwelling urinary catheter. A physician ordered catheter care every day and evening and as needed, but after the resident developed worsening pain and signs of trauma at the catheter site, the catheter was removed and later reinserted when the resident was unable to empty his bladder. After reinsertion, no new catheter care orders were obtained, and there was no documented evidence that catheter care was provided. The resident stated that catheter care was not regularly provided, and the DON confirmed there was no documented evidence that catheter care had been provided in accordance with facility policy.
Failure to Provide Ordered Meal Preferences
Penalty
Summary
The facility failed to provide food and drink that accommodated residents' individualized preferences for two of 25 sampled residents. Resident 14 had diagnoses including diabetes and heart failure, and the MDS indicated no cognitive impairment. On the breakfast meal ticket, the resident was to receive apple juice, scrambled egg, bacon, toast with diet jam or jelly, and one cinnamon roll, but was observed with orange juice, scrambled egg, bacon, and toast. Resident 14 stated she would have preferred a cinnamon roll and apple juice instead of orange juice. Later that day, Resident 14 was observed with vegetable pizza even though the meal ticket indicated sausage pizza and that the resident was not to be served fish. Resident 14 stated she had asked for sausage pizza and had not told anyone she was allergic to or disliked fish. Resident 28 had diagnoses including cirrhosis of the liver and respiratory failure, and the MDS indicated mild cognitive impairment. On the breakfast meal ticket, the resident was to receive coffee, scrambled egg, bacon, toast with diet jam or jelly, and one cinnamon roll, but apple juice was provided instead of coffee. Resident 28 stated that she preferred coffee. The Administrator stated that dietary staff were expected to follow residents' selections identified on the weekly menu selection form and provide all items listed on each meal ticket.
Improper Food Handling and Sanitation in Kitchen
Penalty
Summary
The facility failed to maintain proper food service and sanitary conditions in the main kitchen, as observed during a tray line service. Dietary Employee 1 (DE 1) was seen wearing gloves while operating the tray line but did not use a serving utensil when handling a smothered chicken breast. DE 1 then proceeded to open a bag of hot dog buns, open and close a drawer of utensils, and wipe food substance off her apron without changing gloves or performing hand hygiene between these tasks. Additionally, DE 1 placed a small metal container of food from the steam table directly on top of the cooked meat. These actions were in violation of the facility's policy on food preparation, which requires proper hand hygiene and glove use to prevent cross-contamination.
Failure to Implement Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop or implement comprehensive care plans for three residents, as identified in their comprehensive assessments. Resident 15, diagnosed with malignant neoplasm of the prostate and Alzheimer's disease, was at risk for skin breakdown. The care plan required the application of Geri-Sleeves to protect the skin, but observations over several days revealed that the sleeves were not applied as required. Resident 17, with diagnoses including Parkinson's disease and multiple sclerosis, had a care plan that lacked interventions for activities, dehydration/fluid maintenance, nutritional status, pain, pressure ulcer/injury, and psychosocial well-being, despite these areas being identified in the Minimum Data Set Care Area Assessment. Resident 21, diagnosed with polyneuropathy and muscle weakness, was at risk for functional deterioration. The care plan included an intervention for restorative range of motion, but there was no evidence that this intervention was developed or implemented. The Director of Nursing confirmed the absence of documented evidence addressing these care areas in the residents' current care plans. This deficiency was previously cited in December of the previous year, indicating a recurring issue with the facility's care planning process.
Failure to Serve Palatable and Appetizing Temperature Food
Penalty
Summary
The facility failed to provide food that was palatable and at an appetizing temperature in the main dining room. According to the facility's policy on Dining Service Operations, food should be palatable, attractive, and served at a safe and appetizing temperature. However, Dining Council Minutes from late September and October 2024 revealed that residents reported their food was often served cold and not palatable. During a group interview, two residents confirmed that food in the main dining room was frequently cold and unpalatable. A test tray audit conducted in November 2024 showed that a smothered chicken breast, mashed potatoes, and ravioli pasta were served at temperatures below the required 135 degrees Fahrenheit, with all items being cool to taste. The Dietary Director acknowledged that the hot food should have been served at a higher temperature.
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What surveyors actually found near you
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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 Shillington
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Highlands At Wyomissing | 1.5 mi | ★★★★★ | 0 | 0 |
| Wyomissing Health And Rehabilitation Center | 1.8 mi | ★★★★★ | 18 | 0 |
| Spruce Manor Nursing & Rehabilitation Center | 2.4 mi | ★★★★★ | 5 | 0 |
| West Reading Skilled Nursing And Rehabilitation Ce | 2.7 mi | ★★★★★ | 6 | 0 |
| Sinking Spring Skilled Nursing And Rehabilitation | 3 mi | ★★★★★ | 18 | 1 |
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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 July 2026) and official state health department websites.