Above average — CMS composite of the measures below.
A standard survey is most likely before 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 Paul's Run during CMS and state inspections, most recent first.
Failure to report a resident fall and bruise: A resident with CVA and right-sided hemiplegia/hemiparesis required 2-person assist for transfers, but was being transferred from a wheelchair to bed by only 1 nurse aide when the resident lost balance and fell, with a new bruise noted on the right forearm. Although the incident was documented in the facility report, there was no evidence it was reported to the State agency, and the DON confirmed the omission.
A resident with CVA and right-sided hemiplegia/hemiparesis required a 2-person assist for transfers, but was being transferred from a wheelchair to bed with only 1 nurse aide. During the transfer, the resident lost balance and fell to the floor, sustaining a new bruise on the right forearm. The DON confirmed the resident required 2 staff for the transfer.
Failure to assess significant weight loss: A resident with CHF, malnutrition, and depression had daily weight orders and a marked drop in documented weight, but the chart showed no assessment or documentation related to the significant loss. The dietitian confirmed the resident was not assessed after the weight change.
The facility failed to implement enhanced barrier precautions for residents with catheters and chronic wounds, as required by their policy. Observations and staff interviews confirmed the absence of necessary signage and PPE, indicating a lapse in infection control measures.
The facility did not complete baseline care plans within 48 hours for two residents, one with joint replacement aftercare and diabetes, and another with heart failure and dysphagia. This delay contravened the facility's policy, as confirmed by an LPN.
A resident with moderate cognitive impairment and hand tremors experienced significant weight loss and developed a pressure ulcer due to the facility's failure to implement recommended nutritional interventions. Despite a dietitian's recommendation for a supplement and a physician's order for a calorie count, these were not followed, and the resident's nutritional needs were not reassessed in a timely manner.
The facility failed to implement a complete drug regimen review for two residents. A pharmacist's recommendation to adjust Memantine dosage for a resident with dementia was not documented or acted upon. Similarly, a recommendation to administer Potassium chloride with fluid or food was not implemented. The DON confirmed the lack of documentation for these recommendations.
A facility failed to notify the State LTC Ombudsman of an emergency transfer for a resident with abdominal pain, nausea, and vomiting. The omission was confirmed by Social Services during a review of documentation and staff interviews.
Failure to Report Resident Fall and Bruise
Penalty
Summary
The facility failed to report a resident's fall incident and bruise to the local State agency as required. Resident R14 was admitted with a diagnosis that included cerebrovascular accident and hemiplegia/hemiparesis affecting the right dominant side, and the resident's MDS assessment dated August 11, 2024, indicated the resident required two or more persons for physical assistance with transfers. A nursing note dated August 18, 2025, documented that Resident R14 was in the middle of a transfer from a wheelchair to bed when the resident lost balance and fell to the floor, and a new bruise was observed on the right forearm after the fall. The resident was an assist of 2 staff but was being assisted by only 1 nurse aide at the time of the fall. The facility incident report documented the fall, but review of the facility's reported information to the State agency for August 2025 showed no evidence that the incident was reported. The DON confirmed the facility failed to report the incident to the State agency.
Inadequate Assistance During Transfer Resulted in Resident Fall
Penalty
Summary
The facility failed to ensure adequate assistance was provided during a transfer for Resident R14, resulting in a fall. Facility policy stated that residents are to receive care that keeps the environment as free from accident hazards as possible and provides adequate supervision and assistive devices to prevent accidents. Resident R14 was admitted with diagnoses including CVA and hemiplegia/hemiparesis affecting the right dominant side. The resident’s MDS assessment dated August 11, 2025, indicated transfers required two or more persons physical assists. On August 18, 2025, Resident R14 was in the middle of transferring from a wheelchair to bed when the resident lost balance and fell to the floor. The nursing progress note documented a new bruise on the right forearm after the fall. The incident report stated the resident fell during the transfer at 7:22 p.m., and the resident was being assisted by one nurse aide even though the resident required a two-person assist. The DON confirmed in interview that Resident R14 required a two-person assist at the time of transfer.
Failure to Assess Significant Weight Loss
Penalty
Summary
The facility failed to ensure a resident was assessed after a significant weight loss. Resident R75 was admitted with diagnoses including CHF, malnutrition, and depression. The resident also had a physician’s order for CHF to check weight daily, notify the doctor for a gain of 2-3 pounds in a day or 5 pounds in a week, or if heart failure symptoms were present, and to perform standing weights in the morning. The resident’s documented weights showed a drop from 175.6 pounds on 8/20/25 and 174.0 pounds on 8/21/25 to 153.6 pounds on 8/22/25, followed by additional weights in the 151.4 to 153.6 pound range through 8/28/25. Facility policy required re-weighing within 48 hours when a resident had a 5% or greater weight change from the previous month, and if the re-weigh confirmed a 5% gain or loss, the dietitian was to notify the IDT and complete documentation. Review of the clinical record found no assessment or documentation related to the resident’s significant weight loss, and the dietitian confirmed the resident was not assessed related to the documented weight loss.
Failure to Implement Enhanced Barrier Precautions
Penalty
Summary
The facility failed to implement enhanced barrier precautions for eight residents who were at risk for multidrug-resistant organisms (MDROs) due to the presence of chronic wounds and/or indwelling devices such as catheters. The facility's policy required enhanced barrier precautions during high-contact care activities for these residents, but observations and record reviews revealed that these precautions were not in place. Specifically, residents with various types of catheters, including Foley, coude, and suprapubic catheters, did not have signage indicating enhanced barrier precautions, and there was no documented evidence in their clinical records or care plans that such precautions were being followed. Interviews with staff, including a registered nurse and the infection preventionist, confirmed that enhanced barrier precautions were not being implemented for residents with catheters or those receiving wound care. Observations further revealed the absence of personal protective equipment (PPE) and transmission-based precaution signage outside the rooms of affected residents. This lack of adherence to the facility's policy on enhanced barrier precautions was evident in the care of residents with catheters and those undergoing wound treatment, indicating a systemic issue in the facility's infection prevention and control program.
Failure to Develop Timely Baseline Care Plans
Penalty
Summary
The facility failed to develop a baseline care plan within 48 hours of admission for two residents, as required by their policy. Resident R69 was admitted with diagnoses including aftercare following joint replacement surgery, major depressive disorder, urinary tract infection, and Type 2 diabetes. However, the baseline care plan for Resident R69 was not completed until three days after admission, and initially only included a focus on transitioning to long-term care after rehabilitation. This delay in completing the baseline care plan did not meet the facility's policy of ensuring continuity of care and communication among staff within the first 48 hours. Similarly, Resident R315 was admitted with heart failure, dysphagia, and hypertension, but did not have a baseline care plan that included the necessary healthcare information within the required timeframe. The care plan for Resident R315 was initiated after the 48-hour window, failing to provide the immediate care instructions needed for the resident's conditions. An interview with an LPN confirmed that the baseline care plans for both residents were not completed within the stipulated 48 hours of admission, indicating a lapse in adherence to the facility's resident care policies.
Failure to Address Nutritional Needs and Monitor Weight Loss
Penalty
Summary
The facility failed to adequately address the nutritional needs of a resident, identified as Resident R52, who had moderate cognitive impairment and a history of weight loss. The resident experienced difficulties during mealtimes due to bilateral hand tremors, which led to frustration and reduced food intake. Despite recommendations from a Registered Dietitian to provide a 4-ounce supplement to increase oral intake, there was no documented evidence that this supplement was implemented. Additionally, a physician-ordered calorie count was not completed, and there was no follow-up from the dietitian regarding this order. The resident's condition worsened with the development of a stage 2 pressure ulcer, which later progressed to an unstageable pressure ulcer. Despite these changes, the Registered Dietitian did not reassess the resident's nutritional needs to support wound healing until several weeks later. The resident experienced a significant weight loss of 10 pounds, or 6.44%, over a period of less than a month. Interviews with the Registered Dietitian confirmed the lack of implementation of the recommended supplement, absence of follow-up on the calorie count, and failure to reassess nutritional needs in response to the resident's deteriorating condition.
Deficiencies in Medication Review Process
Penalty
Summary
The facility failed to implement a complete drug regimen review process for two residents, leading to deficiencies in medication management. For Resident R6, the consultant pharmacist recommended increasing the dosage of Memantine to 10 mg twice a day for optimal response. However, the resident continued to receive only 10 mg once a day, as initially ordered in April 2024. There was no documentation in the physician's progress notes regarding the review of the pharmacist's recommendation or any action taken, leaving the recommendation unacknowledged and unimplemented. Similarly, for Resident R34, the consultant pharmacist advised administering Potassium chloride with 4 ounces of fluid or food to prevent esophageal erosion and to update the medication administration record accordingly. Despite this recommendation, there was no evidence in the clinical record that the suggestion was addressed or implemented before the resident's discharge. Interviews with the Director of Nursing confirmed the lack of documentation related to the pharmacist's recommendations for both residents, indicating a breakdown in the facility's medication review process.
Failure to Notify Ombudsman of Emergency Transfer
Penalty
Summary
The facility failed to notify the Office of the State Long-Term Care Ombudsman of a facility-initiated emergency transfer for one of the residents reviewed. Specifically, Resident R111 experienced abdominal pain, nausea, and vomiting, leading to a transfer to a local hospital emergency department for evaluation. The progress notes for this resident, dated July 20, 2024, did not indicate that the Ombudsman was informed of this transfer. An interview with Social Services, Employee E10, confirmed that the notification to the Ombudsman was not made. This oversight was identified during a review of facility documentation, clinical records, and staff interviews, highlighting a deficiency in the facility's compliance with notification requirements.
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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 Philadelphia
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Oakwood Healthcare & Rehabilitation Center | 0.7 mi | ★★★★★ | 6 | 0 |
| St John Neumann Ctr For Rehab & Healthcare | 1 mi | ★★★★★ | 10 | 0 |
| Chapel Manor | 1 mi | ★★★★★ | 21 | 0 |
| Lafayette-redeemer, The | 2.1 mi | ★★★★★ | 0 | 0 |
| Accela Rehab And Care Center At Somerton | 2.5 mi | ★★★★★ | 9 | 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.