St Joseph's Manor
Inspection history, citations, penalties and survey trends for this long-term care facility in Meadowbrook, Pennsylvania.
- Location
- 1616 Huntingdon Pike, Meadowbrook, Pennsylvania 19046
- CMS Provider Number
- 395006
- Inspections on file
- 22
- Latest survey
- January 9, 2026
- Citations (last 12 mo.)
- 9
Citation history
Health deficiencies cited at St Joseph's Manor during CMS and state inspections, most recent first.
St. Joseph's Manor failed to notify the responsible parties of two residents about significant weight loss, contrary to their "Weight Management Guidelines." One resident with Alzheimer's dementia and dysphagia lost six percent of their weight in a month, while another resident with similar conditions lost 5.4 percent over two months. The facility's Administrator confirmed the lack of notification documentation.
The facility failed to follow physicians' orders for two residents with hypertension, administering medications outside prescribed blood pressure parameters. One resident received lisinopril despite low blood pressure, and another received metoprolol tartrate when their systolic blood pressure was below the specified limit. The administrator confirmed these errors.
St. Joseph Manor was found non-compliant with food safety standards, failing to store and serve food in a sanitary manner. Observations included debris in the ice cream freezer, improperly stored dry goods with scoops inside bins, and unlabeled and undated food items. The Director of Dietary Dining Services acknowledged the facility's policy violations.
The facility failed to maintain an adequate inventory of food and beverages for emergencies, as required by its facility-wide assessment and emergency preparedness plan. Observations and interviews revealed that the necessary food items were not available, and the dietary department confirmed the deficiency.
Failure to Notify Responsible Parties of Significant Weight Loss
Penalty
Summary
St. Joseph's Manor was found to be non-compliant with federal and state regulations regarding the notification of changes in resident conditions. Specifically, the facility failed to notify the responsible parties of two residents about significant weight loss. According to the facility's policy titled "Weight Management Guidelines," nursing staff are required to report unexplained significant weight changes to the family or responsible party. However, this protocol was not followed for two residents, identified as CL1 and 3, who experienced notable weight loss over a period of time. Resident CL1, who had Alzheimer's dementia and dysphagia, experienced a six percent weight loss from February to March 2025, dropping from 178.6 lbs to 167.8 lbs. Similarly, Resident 3, also diagnosed with dementia and dysphagia, lost 5.4 percent of their body weight between January and February 2025, with the weight loss persisting into March. Despite these significant changes, there was no documented evidence that the families or responsible parties of these residents were informed, as confirmed by the facility's Administrator during an interview.
Plan Of Correction
*What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice? It has always been our policy and practice to notify families of significant change. In this case, the family was here each day with the resident and was up to date on the resident's condition. However, the nursing staff interacted with them verbally on a daily basis and they did not write nursing notes about those interactions. The patient is no longer at the center, so no further follow-up is needed for the resident. *How will you identify other residents having the potential to be affected by the same deficient practice and what corrective action will be taken? No other resident notification needs were identified during the recent audit. *What measures will be put into place or what system changes will you make to ensure that the deficient practice does not recur? Staff in-service is being provided regarding: when to notify families, what constitutes a change in condition, and how to document those notifications. *How the corrective action will be monitored to ensure that the deficient practice will not recur, i.e., what quality assurance programs will be established? RNACS send out change of status (sig change notice) and other change of condition would be identified on shift reports. We will ask unit managers to monitor those and assure family is notified. DON or her designee will also monitor changes in condition and assure family was notified during morning clinical meeting.
Failure to Follow Medication Administration Parameters
Penalty
Summary
The facility failed to adhere to physicians' orders for two residents, resulting in the administration of medication outside the prescribed parameters. Resident 3, diagnosed with hypertension, had a physician's order to receive lisinopril once daily, provided their blood pressure was not below 110/65 mm/Hg. However, the medication administration records (MARS) indicated that the medication was given once in March and twice in April when the resident's blood pressure was below the specified threshold. Similarly, Resident 5, also diagnosed with hypertension, was prescribed metoprolol tartrate twice daily, with the condition that it should not be administered if the systolic blood pressure was below 100 mm/Hg. Despite this, the MARS showed that the medication was administered four times in April when the resident's systolic blood pressure was below the prescribed limit. The facility's administrator confirmed these discrepancies during an interview.
Plan Of Correction
*What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice? No negative signs or symptoms related to medications provided outside parameters were identified. Physician will be notified of these occurrences. Med errors will be reported in QAPI. Nurses who were non-compliant will be coached or disciplined. *How will you identify other residents having the potential to be affected by the same deficient practice and what corrective action will be taken? An audit of medications with parameters will be completed to assure no additional residents received medications outside the parameters ordered. *What measures will be put into place or what system changes will you make to ensure that the deficient practice does not recur? All licensed nursing staff will be in-serviced to pay attention to medication parameters when administering medications and to follow those orders. All parameters are included on the MAR to assure they are easily visible to nurses to comply with at time of medication administration. *How the corrective action will be monitored to ensure that the deficient practice will not recur; i.e., what quality assurance programs will be established? DON and Unit Managers or their designee will complete audits of residents with medications containing parameters monthly. These will be completed for the next 4 months to assure nursing is consistent with the following parameters. Pharmacy consultant will also be asked to randomly audit the MAR for medication parameter compliance. Any noncompliance identified will be addressed with coaching and or disciplinary action.
Non-Compliance with Food Safety Standards
Penalty
Summary
St. Joseph Manor was found to be non-compliant with food safety requirements as per 42 CFR Part 483, Subpart B, and the 28 Pa. Code. The facility failed to store and serve food in a sanitary manner, which could potentially lead to foodborne illness. During a kitchen tour, debris was observed at the bottom of the stand-up ice cream freezer. Additionally, four bins containing dry goods such as white rice, flour, thickened liquid product, sugar, and brown rice had scoops stored inside them, directly on top of the dry goods. A container of whipped cream in the refrigerator was neither labeled nor dated. In the dry goods storage room, several food items were found opened and re-sealed without proper labeling or dating, including a bag of cereal, spaghetti, penne pasta, long grain rice, and tortilla chips. A box of kosher salt was opened and stored unsealed and undated on a shelf, alongside a container of Old Bay seasoning that was opened, without a lid, and undated. The Director of Dietary Dining Services confirmed that all opened food should be re-sealed, labeled, and dated, and that scoops should not be stored inside the dry storage bins.
Plan Of Correction
All food items will be properly sealed, stored, labeled and dated. Food service staff will be in-serviced on proper food storage, labeling, and dating of food. Each food service worker will sign the in-service training form to acknowledge their understanding of the policies and procedures for food storage and handling. Director of Dining Services or designee will audit all food storage areas at least weekly to assure compliance of food storage and handling. The audit results will be retained by Dining Service Director for review by QAPI and NHA. The audit forms will be submitted to the QAPI committee for the next six months. Any compliance challenges identified in this area will be immediately addressed by the Dining Service Director. A compliance book will be created and will hold: - Copies of staff training on food storage, labeling and dating - Food storage area audit sheets - Weekly (one audit sheet for each area, each week) - Report for monthly QAPI meeting reflecting ongoing compliance
Inadequate Emergency Food Supply Inventory
Penalty
Summary
The facility failed to implement its facility-wide assessment to ensure an adequate inventory of resources, specifically sustenance, food, and beverages, in the event of an emergency or disaster. The facility assessment dated January 22, 2025, indicated that the facility was responsible for maintaining a documented inventory of resources necessary for emergencies. However, upon review, it was found that the facility did not adhere to this requirement as outlined in their emergency preparedness plan. The emergency preparedness plan required the facility to ensure adequate sustenance needs for residents and staff during emergencies. Additionally, the facility's "Food and Nutrition Disaster Plan," last reviewed on March 8, 2024, outlined procedures for preparedness, including maintaining an inventory of both perishable and non-perishable food supplies. This inventory was supposed to cover all current service points and additional staff and visitors. During an observation in the kitchen on February 11, 2025, and a review of facility documentation, it was revealed that the required number of food items listed in the facility's par listing were not available. Interviews with the general manager of the dietary department and the Administrator confirmed that the facility did not have the necessary food and beverage supplies on hand as per the facility assessment, emergency preparedness plan, and dietary policy and procedure.
Plan Of Correction
A 4-day disaster menu will be maintained. All food items needed to implement the emergency menu will be kept in the food storage areas. The facility always keeps 7-days of food in house in the main kitchen. Additionally, a 3-day emergency stock specific to the emergency menu is kept in designated areas of the food storage. All foods required to feed staff and residents of the facility for 3 days is available on premises at all times. A food inventory sheet with required par level/ portions will be updated weekly as stock is rotated and ordered by the Head Chef or designee. Each week the inventory sheets will be signed, dated and retained by the Dining Service Director. The Dining Service Director will be responsible to assure emergency food supplies are always adequate for the facility staff and residents. Training will be provided to the Food and nutrition general services manager, head chef, dining services managers and other key managers regarding the emergency supplies requirements and process. Each month the inventory levels will be reported to the QAPI team for the next six months. A compliance book will be created and will hold: - 4-day Emergency Menu - Emergency Food Inventory- Weekly - Training for key administrative staff on emergency supplies - Report for monthly QAPI meeting reflecting ongoing compliance
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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