Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Saint Joseph Villa during CMS and state inspections, most recent first.
A resident sustained a burn on the right shoulder due to improper monitoring during a hot pack treatment. The resident, with a history of diabetes and other conditions, requested heat therapy for shoulder pain. The PTA applied the treatment without authorization or proper documentation, and failed to monitor the resident's skin condition. The treatment was not part of the resident's care plan, and the lack of adherence to protocols led to the injury.
The facility failed to implement comprehensive care plans for two residents. One resident, post-hip surgery, was transferred by a single staff member despite needing two-person assistance. Another resident, with mobility issues, had no care plan for an ankle-foot orthotic causing discomfort. These actions indicate a lack of adherence to established care plans.
The facility failed to obtain a physician's order for an AFO for a resident experiencing discomfort and did not clarify a physician's order regarding another resident's alcohol consumption. The resident with the AFO had no documented order, and the resident allowed wine had no specified amount or frequency, with no documentation of wine administration.
The facility did not ensure proper disposal of garbage and recyclables in the receiving and dumpster area. Observations revealed the trash compactor with its door ajar, exposing trash bags, and recycling dumpsters with open doors. Additionally, wooden pallets with splintered wood, trash cans, and laundry bins filled with rainwater and trash were found scattered around. These findings were confirmed by the Dining Operations Manager.
The facility failed to maintain acceptable food storage and service practices, as observed during kitchen tours. Items in the walk-in freezer, dairy refrigerator, and dry storage room were found opened and unlabeled. Additionally, produce pasta and raw salmon were improperly stored, and ready-to-serve shrimp was not covered or dated. These observations indicate non-compliance with the facility's food and supply storage policy.
A resident with anoxic brain damage and other conditions slid off the bed and sustained injuries due to unlocked bed wheels during incontinence care. The nurse aide assumed the brakes were locked, but they were not, leading to the incident.
Failure to Monitor Resident During Heat Therapy Results in Burn Injury
Penalty
Summary
The facility failed to ensure proper monitoring and assessment of a resident during a hot pack treatment, resulting in actual harm. The incident involved a resident who sustained a burn on the right shoulder after receiving heat therapy. The facility's policy required that residents be checked every 5-10 minutes during such treatments, and that the area be inspected for any unusual signs after the treatment. However, these procedures were not adequately followed, leading to the resident's injury. The resident, who had a medical history including anemia, hyperlipidemia, hypertension, and diabetes, requested heat therapy for shoulder pain during a physical therapy session. The Physical Therapy Assistant (PTA) applied the hot pack without proper authorization or documentation, and failed to monitor the resident's skin condition during and after the treatment. The resident later reported irritation and a burn-like area was discovered on the shoulder, which was confirmed by a licensed nurse and a wound nurse. The incident was further compounded by the fact that the hot pack treatment was not part of the resident's authorized plan of care, and the PTA did not consult with a physical therapist before administering the treatment. Additionally, there was no documentation of the treatment duration or the condition of the resident's skin, which was a requirement of the therapy department. This lack of adherence to established protocols and failure to monitor the resident's condition led to the resident sustaining a burn injury.
Plan Of Correction
1. Contain elements detailing how the facility will correct the deficiency as it relates to the individual. a. The resident (R 302) wound was resolved and discharged to home instructed to apply vaseline to keep skin moist and tight. The Contracted employee of Select Rehabilitation Co (E9) was educated on 11/14/24 for not following the plan of care for treatment, as a result his employment was Terminated at St Joseph Villa. Date: Deficient Practice was resolved on 11/4/24. 2. Indicate how the facility will act to protect residents in similar situations. a. All residents were reviewed for Hot Pack treatments to ensure any contraindications, precautions, adequate supervision and monitoring for signs of skin irritation and burning, there were no other residents receiving hot packs. The use of Hot Packs were discontinued for all residents and the use of the Hydrocollator Mobile Heating Unit was discontinued on 11/14/24. Date: Deficient practice was resolved on 11/14/24. 3. Include the measures the facility will take or the systems it will alter to ensure that the problem does not recur. a. The clinical staff coordinator and director of therapy provided formal education to the nurses and therapy staff for Hot Pack treatments to ensure any contraindications, precautions, adequate supervision and monitoring for signs of skin irritation and burning on 11/14/24. Date: Deficient Practice was resolved on 11/14/24. 4. Indicate how the corrective action will be monitored to ensure that the deficient practice will not recur: a. An audit tool is in place for all residents with orders for Hot pack treatments and reviewed by the Nurse Coordinator for any contraindications and precautions prior to treatment and to ensure adequate supervision and signs of skin irritation. The audit will be reviewed weekly x 4 and then monthly, results were reviewed and discussed at Quarterly QAPI meeting. Date: Deficient Practice was resolved 11/14/24. 5. Dates of when the corrective action will be completed: a. The facility completed this plan of correction 11/14/2024.
Failure to Implement Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to implement the comprehensive care plan for two residents, leading to deficiencies in their care. Resident R306, who was admitted following a left hip surgery, had a care plan that required assistance from two staff members for transfers due to limited mobility and deconditioning. However, an observation revealed that the resident was transferred by only one staff member, Nurse Aide Employee E8, which was confirmed in an interview with the aide. This action was contrary to the care plan's specified interventions, indicating a failure to adhere to the established care plan. Resident R67, admitted with gait and mobility abnormalities, was observed wearing a brace on the right lower leg and complaining of discomfort. The resident's clinical record included a physical therapy note about irritation from the ankle-foot orthotic (AFO), but there was no care plan addressing the use of the AFO. An interview with the Director of Nursing confirmed the absence of a care plan for the AFO, highlighting a lack of comprehensive planning for the resident's needs. These findings demonstrate the facility's failure to develop and implement appropriate interventions as outlined in the comprehensive care plans for these residents.
Plan Of Correction
1. Contain elements detailing how the facility will correct the deficiency as it relates to the individual. The resident (R306) that was affected Care Plan was updated to transfer assistance with one staff member after re-evaluation with Rehab Therapist. Employees (E8) was educated and received counseling regarding reviewing the Care plan prior to delivering care. The resident (R 67) was evaluated by the Rehab Therapist and Care Plan updated to include Right Lower Leg AFO. 2. Indicate how the facility will act to protect residents in similar situations. All current residents requiring Transfer Assistance and AFO devices Care Plans have been reviewed and updated. A formal education for Comprehensive Care Planning of Transfer Assistance and AFO devices was initiated by the facility Nurse Educator for all Nursing Staff. 3. Include the measures the facility will take or the systems it will alter to ensure that the problem does not recur. To ensure that this problem does not occur in the future, the facilities will conduct a formal education for Comprehensive Care Planning of Transfer Assistance and AFO devices was initiated by the facility Nurse Educator for all Nursing Staff. 4. Indicate how it plans to monitor its performance to make sure that solutions are sustained. The Director of Nursing will perform weekly Care Plan audits x4 and then monthly for 3 months to ensure that resident Transfer Assistance Status and Residents requiring AFO devices are appropriate. Results will be submitted and reviewed at Quarterly QAPI meeting for continued compliance. 5. Provide dates when corrective action will be completed. The facility will complete this Plan of Correction_April 4, 2025.
Failure to Obtain Physician Orders for AFO and Clarify Alcohol Consumption
Penalty
Summary
The facility failed to obtain a physician's order for the use of an ankle-foot orthotic (AFO) for a resident, identified as R67, who was observed wearing a brace on the right lower leg and complaining of discomfort. The resident mentioned that the brace had been fixed with glue but preferred an older brace that fit better. A review of the resident's clinical record showed no physician order for the AFO, and the Director of Nursing confirmed the absence of such an order. This oversight indicates a failure to adhere to professional standards of practice and ensure proper treatment and care based on a comprehensive assessment. Additionally, the facility did not clarify a physician's order regarding the alcohol consumption of another resident, identified as R4. The physician's order allowed the resident to have wine but did not specify the amount or frequency. The resident reported being served wine at least once a week, but there was no documentation in the Medical Administration Record or Treatment Administration Record to track the administration of wine. An interview with a unit manager confirmed the lack of clarity in the physician's order and the need to consult the physician for further instructions.
Plan Of Correction
1. Contain elements detailing how the facility will correct the deficiency as it relates to the individual. The resident (R67) a physician order was obtained for the use of the AFO (ankle foot orthidic) that was being used on his right foot. The resident's (R4) & (302) a physician order was clarified for the residents consumption of alcohol. The pharmacy was also contacted to determine if any of the residents (R4 & R302)) current medications would interact with alcohol. 2. Indicate how the facility will act to protect residents in similar situations. All current residents requiring an AFO device medical records were reviewed to ensure that a Physician Order was obtained prior to use. All current residents that have an order for alcohol consumption, the Physician Order was clarified to indicate the specific amount of alcohol that could be served and how often the resident could have the alcohol. The facility requested that the Pharmacy Company review all the Medications of those residents that consume alcohol to ensure that the medications would interact with alcohol. 3. Include the measures the facility will take or the systems it will alter to ensure that the problem does not recur. To ensure that this problem does not occur in the future, the facility will conduct formal education for Physician Orders & Alcoholic Beverages which was initiated by the facility Nurse Educator for all Nursing Staff. 4. Indicate how it plans to monitor its performance to make sure that solutions are sustained. The Director of Nursing or designee will perform weekly audits x4 then monthly for 3 months to ensure Physician Orders for AFO's are obtained prior to use. The facility will monitor residents Alcoholic Beverage consumption to ensure that a Physician Order is obtained for the amount of alcohol and dose is in accordance with the physician order, as well as, pharmacy recommendation for medication interaction. The results will be submitted and reviewed at the Quarterly QAPI meeting for continued compliance. 5. Provide dates when corrective action will be completed. The facility will complete this Plan of Correction 4/04/2025.
Improper Disposal of Garbage and Recyclables
Penalty
Summary
The facility failed to ensure proper disposal of garbage and recyclables in the receiving and dumpster area. During a tour of the Food Service Department, it was observed that the trash compactor had its metal door ajar, leaving bags of trash exposed. Additionally, the cardboard recycling dumpster had two sliding doors open, and the can recycling dumpster had both top doors and the side sliding door open. Near the receiving door, four wooden pallets were found on the ground with broken pieces of splintered wood scattered around. Furthermore, three large grey trash cans were lying on the ground, and two large blue laundry bins were half-filled with rainwater and trash, including a broken hot holding pan warmer. These observations were confirmed in an interview with the Dining Operations Manager.
Plan Of Correction
1. Contain elements detailing how the facility will correct the deficiency as it relates to the individual. a. There were no residents affected by this deficient practice. The metal trash compactor metal door that was ajar was closed, the cardboard recycling dumpster sliding doors were closed, and the can recycling dumpster top doors and side sliding doors were closed. The wood pallets on the ground were removed, the large grey trash can laying on the ground was removed, and the blue laundry bins that were filled with rainwater and trash were removed. 2. How will you identify other residents that have the potential to be affected by the deficient practice and what corrective action will be taken: a. The Maintenance Director, Environmental Director, and Dining Manager provided immediate education to the relevant staff on the proper waste disposal of trash and recyclables. 3. What measures will be put into place or what system changes will you make to ensure that the deficient practice does not recur. a. The Maintenance Director or designee will conduct formal education and training of the facilities Dispose Garbage and Refuse Policy. 4. Include the measures the facility will take or the systems it will alter to ensure that the problem does not recur. a. The Maintenance Director or designee will conduct weekly x4 audits for 3 months to ensure that the proper disposal of garbage and refuse. 5. Indicate how it plans to monitor its performance to make sure that solutions are sustained. The Maintenance Director or designee will conduct weekly audits x4 then monthly for three months. All findings from these audits will be reviewed during the facility's Quarterly QAPI meetings to determine if further corrective actions or further monitoring is required. 6. Provide dates when corrective action will be completed: The facility will complete this Plan of Correction on 4/4/2025.
Failure to Maintain Acceptable Food Storage and Service Practices
Penalty
Summary
The facility failed to maintain acceptable practices for the storage and service of food, as observed during an initial tour of the kitchen. The walk-in freezer contained items such as frozen pies, chocolate cakes, and chicken nuggets that were opened but not labeled. The dairy refrigerator had opened cheeses and slicing meats that were only dated with one date, making it unclear if it was the opened date or expiration date. Additionally, the walk-in refrigerator had leftover pasta that was not labeled, and the dry storage room contained various items such as dry peas, rice bags, spices, and large containers of sugar, rice, flour, and thickener that were all open and not labeled with any dates. These observations were made in the presence of the facility's Dietary Manager, Employee E6, on April 23, 2024, at 9:36 a.m. Further observations on April 26, 2024, at 9:41 a.m. with Dining Manager, Employee E10, revealed that refrigerator #2 had uncovered and unlabeled produce pasta. Raw salmon packaged in a clear bag was stored on the middle shelf with veggie produce beneath it. A cart full of ready-to-serve food included a sheet of shrimp that was not covered or dated. The dry storage room continued to have items such as peppermint pieces, pasta, seafood breading mix, granola, chips, thickener, sugar, flour, and rice in large bins that were not labeled with any dates. These findings indicate a failure to adhere to the facility's policy on food and supply storage, which requires all food items to be covered, labeled, and dated to prevent contamination and ensure food safety.
Failure to Lock Bed Wheels Resulting in Resident Injury
Penalty
Summary
The facility failed to maintain an environment free from hazards related to an unlocked bed wheel brake for one resident. Resident R83, who was admitted with diagnoses including anoxic brain damage, abnormal posture, and unspecified mental disorder, required one-person physical assistance for bed mobility. During incontinence care, the resident slid down between the bed and the wall, resulting in a laceration to the left forehead. The incident occurred because the bed wheels were not locked, causing the bed to move while the nurse aide was turning the resident. The facility's investigation confirmed that the bed wheels were unlocked during the incident. The nurse aide involved assumed the brakes were locked but later discovered they were not. The Director of Nursing also confirmed that the unlocked bed wheels were the reason for the resident's fall. The resident was transferred to the hospital and returned with a laceration on the forehead and an abrasion on the left shoulder. No acute intracranial hemorrhage or mass effect was found in the CT scan conducted at the hospital.
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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 Flourtown
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Accela Rehab And Care Center At Springfield | 0.8 mi | ★★★★★ | 18 | 0 |
| Health Center At The Hill At Whitemarsh, The | 1 mi | ★★★★★ | 0 | 0 |
| Complete Care At Harston Hall Llc | 1 mi | ★★★★★ | 13 | 0 |
| Chestnut Hill Lodge Health And Rehab Ctr | 1 mi | ★★★★★ | 18 | 0 |
| Fairview Rehab And Care Center | 1.1 mi | ★★★★★ | 35 | 0 |
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