Inspection Reports for
Arden Courts – ProMedica Memory Care Community (Jefferson Hills)
PA, 15025
Back to Facility Profile48 Reports
Inspection Report — Apr 30, 2026
Complaint Investigation
Date: Apr 30, 2026
Visit Reason
The inspection was conducted as a complaint investigation during an unannounced partial licensing inspection.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 52
Current Hospice Residents: 16
Residents 60 Years of Age or Older: 52
Residents with Mobility Need: 52
Total Daily Staff: 104
Waking Staff: 78
Inspection Report — Mar 10, 2026
Date: Mar 10, 2026
Visit Reason
The inspection was a partial, unannounced visit conducted due to an incident at the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Resident Support Staff: 0
Total Daily Staff: 90
Waking Staff: 68
Residents Served: 45
Hospice Current Residents: 16
Residents Age 60 or Older: 45
Residents with Mobility Need: 45
Inspection Report — Jan 30, 2026
Date: Jan 30, 2026
Visit Reason
The inspection was a partial, unannounced licensing inspection conducted due to an incident at the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 42
Residents Served in Secured Dementia Care Unit: 42
Current Residents in Hospice: 17
Inspection Report — Dec 29, 2025
Renewal
Date: Dec 29, 2025
Visit Reason
The inspection was an unannounced full renewal inspection conducted on 12/29/2025 to assess compliance with licensing requirements.
Findings
The facility had multiple deficiencies related to resident record confidentiality, sanitary conditions, medication storage, labeling, and management. All identified issues were addressed with plans of correction that were implemented by 03/25/2026.
Citations (5)
Resident records were found unlocked and unattended in a cabinet, exposing confidential information. The cabinet hinge was repaired and staff re-educated on confidentiality.
Sticky dirt and an unknown dark substance were found near the drain in the bathtub in the Garden Wing common tub room. The tub was cleaned and housekeeping staff were re-educated on sanitary conditions.
Opened insulin pens for residents were undated, contrary to manufacturer instructions. The pens were discarded and staff re-educated on proper dating of insulin pens.
Pharmacy labels for medications did not match physician orders for dosage and administration instructions. Direction change stickers were applied and staff received additional education on medication labeling.
Resident glucometers were not set to the correct time and date, and a prescribed medication was not available in the home. New glucometers were provided, medication reordered, and staff re-educated on medication storage and device use.
Report Facts
Residents Served: 49
Current Residents in Hospice: 15
Total Daily Staff: 98
Waking Staff: 74
Inspection Report — Aug 14, 2025
Date: Aug 14, 2025
Visit Reason
The inspection was a partial, unannounced visit conducted due to an incident at the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Total Daily Staff: 84
Waking Staff: 63
Residents Served: 42
Current Hospice Residents: 14
Residents 60 Years or Older: 42
Residents with Mobility Need: 42
Inspection Report — Jun 26, 2025
Date: Jun 26, 2025
Visit Reason
The inspection was conducted as a licensing inspection by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing, due to an incident.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 42
Current Residents in Hospice: 12
Total Daily Staff: 84
Waking Staff: 63
Notice — Jun 9, 2025
Date: Jun 9, 2025
Visit Reason
Response to a facility request to use the Safely You Falls Management Program to support fall detection and fall management for individuals with cognitive impairment.
Findings
The Department reviewed the submitted information and determined that the informed consent process includes voluntary participation, the right to discontinue use of cameras, and notification of residents' rights. Maintaining the outlined practices satisfies regulatory requirements around residents' right to privacy.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Theresa Hartman | Director, Bureau of Human Services Licensing | Signed the letter responding to the facility's request regarding the Safely You Falls Management Program. |
Inspection Report — Dec 19, 2024
Complaint Investigation
Date: Dec 19, 2024
Visit Reason
The inspection was conducted as a complaint and incident investigation during an unannounced partial inspection.
Complaint Details
The inspection was triggered by a complaint and incident, but no deficiencies or citations were found, indicating no substantiated issues.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 53
Current Hospice Residents: 16
Resident Support Staff: 0
Total Daily Staff: 106
Waking Staff: 80
Residents Age 60 or Older: 53
Residents with Mobility Need: 53
Inspection Report — Dec 3, 2024
Renewal
Date: Dec 3, 2024
Visit Reason
The inspection was conducted as a renewal inspection of the facility's license.
Findings
The inspection found two main deficiencies: missing battery installation dates on carbon monoxide detectors in multiple areas, and a medication administration documentation error for a resident. The facility submitted a plan of correction which was fully implemented by the report date.
Citations (2)
Battery-operated carbon monoxide detectors outside laundry rooms in multiple areas did not include dates of battery installation as required by law.
Medication administration for Resident #2 was not documented on the medication administration record despite being administered.
Report Facts
Residents Served: 55
Total Daily Staff: 110
Waking Staff: 83
Current Hospice Residents: 16
Inspection Report — May 31, 2024
Follow-Up
Date: May 31, 2024
Visit Reason
The inspection visit on 05/31/2024 was a partial, unannounced follow-up inspection related to an incident at the facility.
Complaint Details
The visit was incident-related and involved a resident-to-resident abuse event. Resident #2 was injured and transported to the hospital; Resident #1 remained hospitalized. The plan of correction included staff reeducation and monitoring to prevent recurrence.
Findings
The submitted plan of correction was determined to be fully implemented. The report details a resident-to-resident abuse incident involving two residents, with follow-up actions including staff reeducation and ongoing monitoring.
Citations (1)
Resident #1 intentionally tipped resident #2's wheelchair over causing injury, constituting abuse and neglect.
Report Facts
Residents Served: 51
Current Hospice Residents: 10
Total Daily Staff: 102
Waking Staff: 77
Resident Age 60 or Older: 51
Residents with Mobility Need: 51
Inspection Report — Jan 23, 2024
Complaint Investigation
Date: Jan 23, 2024
Visit Reason
The inspection was conducted as a complaint and incident investigation following allegations of verbal abuse by a staff member towards a resident.
Complaint Details
The complaint involved an incident where direct care staff person B verbally abused a resident by saying, 'You ever wonder why your husband leaves you here and goes home? Because he is cheating on you.' The abuse was witnessed by another staff member but was not immediately reported to the Department of Aging or the personal care home complaint hotline. Staff person B was not immediately suspended and continued working unsupervised until the end of the shift. The facility took corrective actions including suspension of the staff member and reeducation of all staff on abuse reporting requirements.
Findings
The investigation found that a direct care staff member verbally abused a resident by making inappropriate comments and failed to immediately report the incident as required by the Older Adults Protective Services Act. The staff member was not immediately suspended and continued to work unsupervised until the end of the shift. The facility submitted a plan of correction which was accepted and fully implemented.
Citations (4)
Failure to immediately report suspected verbal abuse of a resident to the Department of Aging as required by law.
Failure to immediately suspend or implement a plan of supervision for the staff member involved in the alleged abuse.
Failure to report the incident to the Department’s personal care home regional office or complaint hotline within 24 hours.
Resident was subjected to verbal abuse that was disrespectful and undignified.
Report Facts
Residents Served: 46
Current Residents in Hospice: 9
Total Daily Staff: 92
Waking Staff: 69
Inspection Report — Jan 8, 2024
Complaint Investigation
Date: Jan 8, 2024
Visit Reason
The inspection was conducted as a complaint investigation following an incident involving alleged abuse between residents.
Complaint Details
The complaint involved an incident where one resident verbally abused and physically assaulted another resident, causing bruising and requiring hospital transport. The resident responsible was removed from the community. The plan of correction included staff education on behavior management and ongoing monitoring.
Findings
The investigation found that a resident was verbally and physically abused by another resident, resulting in injury and hospitalization. A plan of correction was submitted and fully implemented.
Citations (1)
A resident was neglected, intimidated, verbally and physically abused by another resident, resulting in injury and hospitalization.
Report Facts
Residents Served: 49
Current Residents in Hospice: 10
Total Daily Staff: 98
Waking Staff: 74
Inspection Report — Dec 4, 2023
Date: Dec 4, 2023
Visit Reason
The inspection was a partial, unannounced licensing inspection conducted due to an incident.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 44
Current Residents in Hospice: 11
Residents Age 60 or Older: 44
Residents with Mobility Need: 44
Inspection Report — Nov 9, 2023
Complaint Investigation
Date: Nov 9, 2023
Visit Reason
The inspection was conducted as a complaint and incident investigation at the facility.
Complaint Details
The inspection was complaint-related, but no deficiencies were found and no follow-up was required.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 43
Current Residents in Hospice: 9
Total Daily Staff: 86
Waking Staff: 65
Inspection Report — Jun 7, 2023
Date: Jun 7, 2023
Visit Reason
The inspection was conducted as a partial, unannounced licensing inspection due to an incident at the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Total Daily Staff: 102
Waking Staff: 77
Residents Served: 51
Residents 60 Years of Age or Older: 50
Residents with Mobility Need: 51
Current Hospice Residents: 18
Inspection Report — Jan 9, 2023
Date: Jan 9, 2023
Visit Reason
The inspection was an unannounced partial licensing inspection conducted as an interim review of the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Total Daily Staff: 98
Waking Staff: 74
Residents Served: 49
Inspection Report — Oct 18, 2022
Renewal
Date: Oct 18, 2022
Visit Reason
The inspection was conducted as a renewal and incident review of the facility on 10/18/2022 and 10/20/2022.
Findings
The inspection identified multiple deficiencies including sanitary conditions, soap dispenser availability, food storage and temperature issues, medication storage and recording errors, and missing directions for key-locking devices. Plans of correction were accepted and implemented by 01/10/2023.
Citations (6)
Resident #1’s glucometer was used to measure resident #2’s blood glucose level.
No soap was found in the bathrooms of resident rooms #13, #38, and #49.
Eight undated styrofoam bowls of ice cream were found in the freezer section of the kitchen refrigerator/freezer.
Refrigerator temperature measured 45°F and freezer temperature measured 14°F, exceeding required limits.
Resident #2’s blood glucose reading was incorrectly recorded on medication administration record and separate glucose log.
Magnetically locked gates and exit doors lacked conspicuous directions for operation and posted codes were incomplete.
Report Facts
Residents Served: 55
Current Residents in Hospice: 19
Residents 60 Years or Older: 55
Residents with Mobility Need: 55
Residents with Physical Disability: 1
Inspection Report — Jun 22, 2022
Follow-Up
Date: Jun 22, 2022
Visit Reason
The inspection was a follow-up visit to verify the implementation of a previously submitted plan of correction related to a complaint investigation.
Complaint Details
The visit was complaint-related. The complaint involved neglect and abuse of resident #1, who was found incoherent, unable to sit upright, and with facial drooping. The resident was eventually hospitalized and died from a stroke. Staff member C was no longer employed at the facility as a result.
Findings
The submitted plan of correction was determined to be fully implemented. The facility addressed a serious incident involving resident abuse and neglect, including staff training on resident change of condition protocols and abuse regulations, and termination of a staff member involved.
Citations (1)
Failure to prevent neglect and abuse of resident #1, who exhibited significant change in condition and was not promptly sent to the hospital, resulting in the resident's death from a stroke.
Report Facts
Residents Served: 57
Current Hospice Residents: 11
Total Daily Staff: 114
Waking Staff: 86
Follow-Up Date: Aug 7, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff member C | Licensed Practical Nurse | Named in abuse finding and no longer employed at the facility |
Inspection Report — Jun 10, 2022
Complaint Investigation
Date: Jun 10, 2022
Visit Reason
The inspection was conducted as a complaint investigation at the facility.
Complaint Details
The inspection was complaint-related, but no deficiencies or citations were substantiated.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Residents Served: 58
Current Hospice Residents: 11
Resident Support Staff: 116
Waking Staff: 87
Inspection Report — Apr 19, 2022
Routine
Date: Apr 19, 2022
Visit Reason
The inspection was conducted as a routine licensing inspection by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Inspection Report — Jan 27, 2022
Renewal
Date: Jan 27, 2022
Visit Reason
The inspection was conducted as a licensing inspection by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing.
Findings
No regulatory citations were identified as a result of this inspection.
Inspection Report — Oct 20, 2021
Renewal
Date: Oct 20, 2021
Visit Reason
The inspection was conducted as a renewal inspection with an incident review, unannounced, on 10/20/2021 and 10/21/2021 at Arden Courts of Jefferson Hills.
Findings
The inspection identified multiple deficiencies including improper physical restraint of a resident, fire door not closing properly, unlabeled bar soap in a common shower, lack of thermometer in a refrigerator, unlocked medication cart drawer, failure to follow prescriber's orders, missing support plan signatures, and delayed completion of admission support plans. Plans of correction were accepted for all deficiencies.
Citations (8)
Physical restraint of resident #4 by staff member A holding wrists together and pinning on shoulder while changing brief.
Approximate 1/2" gap at top of fire-safe door causing it not to securely close.
Unlabeled bar of soap in the shower stall in the Country Lane common shower room.
No thermometer present in the Boat House kitchenette refrigerator.
Top drawer of medication cart unlocked and unattended containing numerous medications.
Failure to follow prescriber's orders for resident #5 with medication administered incorrectly on 10/1, 10/2, and 10/3/21.
Resident #6's most recent support plan not signed by the resident and lacks indication of reason.
Resident #4's initial support plan for secured dementia care unit admission was not completed timely (repeat violation).
Report Facts
Residents Served: 58
Current Hospice Residents: 11
Total Daily Staff: 116
Waking Staff: 87
Inspection Report — Jan 5, 2021
Date: Jan 5, 2021
Visit Reason
The inspection was a partial, unannounced licensing inspection conducted by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing, triggered by an incident.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Report Facts
Total Daily Staff: 110
Waking Staff: 83
Residents Served: 55
Residents 60 Years or Older: 54
Residents with Mobility Need: 55
Inspection Report — Dec 22, 2020
Follow-Up
Date: Dec 22, 2020
Visit Reason
The inspection was a partial, unannounced follow-up visit triggered by an incident to verify the implementation of a previously submitted plan of correction.
Findings
The submitted plan of correction was determined to be fully implemented with continued compliance required. The report details deficiencies related to delayed reporting of suspected resident abuse and failure to immediately notify the resident's designated person.
Citations (3)
2600.15a - The home failed to immediately report suspected abuse of a resident to the local Agency Area on Aging, reporting it one day late on 12/10/2020 for an incident on 12/2/2020.
2600.15d - The home failed to immediately notify the resident and the resident’s designated person of a report of suspected abuse, notifying them on 12/10/2020 after the incident on 12/2/2020.
2600.16c - The home failed to report the incident or condition to the Department’s personal care home regional office within 24 hours, reporting it on 12/10/2020 at 5:23 PM for an incident on 12/2/2020.
Report Facts
Residents Served: 56
Staff Total Daily: 112
Waking Staff: 84
Current Hospice Residents: 14
Residents Age 60 or Older: 55
Residents with Mobility Need: 56
Notice — Dec 18, 2020
Date: Dec 18, 2020
Visit Reason
The document serves as a license renewal approval and notification that the Department will conduct an annual onsite inspection within the next twelve months as required by regulation.
Findings
No inspection findings are reported in this document. It confirms issuance of a regular license following the renewal application.
Report Facts
Inspection Report — Sep 21, 2020
Renewal
Date: Sep 21, 2020
Visit Reason
The inspection was conducted as part of the licensing inspections by the Pennsylvania Department of Human Services, Bureau of Human Service Licensing, over the dates 09/21/2020 to 09/23/2020.
Findings
No regulatory citations were identified as a result of this inspection.
Inspection Report — Nov 21, 2019
Follow-Up
Date: Nov 21, 2019
Visit Reason
The visit was a follow-up review conducted by the Pennsylvania Department of Human Services, Bureau of Human Services Licensing, to verify that the submitted plan of correction was fully implemented following an incident.
Complaint Details
The inspection was triggered by an incident involving an allegation of staff-to-resident sexual abuse. The complaint was investigated and the plan of correction was approved and fully implemented.
Findings
The submitted plan of correction related to an allegation of staff-to-resident sexual abuse was found to be fully implemented. Continued compliance must be maintained.
Citations (2)
Regulation 2600.15(b): The home failed to immediately develop and implement a plan of supervision or suspend the staff person involved in an alleged resident sexual abuse incident on 11/12/19.
Regulation 2600.15(d): The designated person was not notified of the incident until November 15, 2019, despite the incident occurring on November 12, 2019.
Report Facts
Residents Served: 51
Current Hospice Residents: 10
Total Daily Staff: 103
Waking Staff: 77
Residents Age 60 or Older: 50
Residents with Mobility Need: 52
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named as administrator and signer of plan of correction documents related to the incident and follow-up. |
Notice — Oct 11, 2019
Date: Oct 11, 2019
Visit Reason
The document serves as a renewal approval for the Personal Care Home license for Arden Courts of Jefferson Hills PA LLC, confirming the facility's compliance and outlining the requirement for an annual onsite inspection within the next twelve months.
Findings
The Department has approved the renewal application and will conduct an annual inspection within twelve months to ensure compliance with Title 55, PA Code, Chapter 2600. No deficiencies or enforcement actions are noted in this document.
Report Facts
Inspection Report — Aug 30, 2019
Routine
Date: Aug 30, 2019
Visit Reason
The Department’s Bureau of Human Services Licensing conducted an inspection of Arden Courts of Jefferson Hills on August 30, 2019.
Findings
No regulatory citations with 55 Pa. Code Ch. 2600 relating to Personal Care Homes were identified as a result of this inspection.
Inspection Report — Jul 17, 2019
Annual Inspection
Date: Jul 17, 2019
Visit Reason
The visit was an annual inspection conducted by the Department's Bureau of Human Services Licensing to assess compliance with 55 Pa. Code Ch. 2600 relating to Personal Care Homes.
Findings
The inspection identified multiple violations related to resident record access, confidentiality, administrator training, locking poisonous materials, operable lighting, medication storage, and admission support plans. Plans of correction were submitted and partially implemented with adequate progress noted.
Citations (7)
Regulation 2600.5.a required immediate access to resident records upon request, but partial records were initially provided and full records for 7 residents were delayed.
Regulation 2600.17 required resident records to be confidential and inaccessible except as authorized, but behavioral care notes for residents #4, #5, and #6 were unlocked and unattended on a kitchen desk.
Regulation 2600.64.c required at least 24 hours of annual administrator training, but 19 of 24 hours completed in 2018 were online exceeding the maximum allowed of 12 hours.
Regulation 2600.82.c required poisonous materials to be locked and inaccessible, but toothpaste and mouthwash were found unlocked in residents #3 and #7 bathrooms, and some residents were not assessed capable of safe use.
Regulation 2600.101.j required an operable lamp at each resident's bedside, but resident #8's bedside light was inoperable.
Regulation 2600.183.b required medications and syringes to be locked, but anti-fungal powder and barrier cream were stored unlocked in resident #7's nightstand drawer.
Regulation 2600.234.a required a support plan within 72 hours of admission, but resident #1's support plan was incomplete and missing signatures and dates.
Report Facts
Residents served: 57
Administrator training hours completed online: 19
Maximum allowed online training hours: 12
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in relation to multiple findings and plans of correction |
Inspection Report — Jun 11, 2019
Complaint Investigation
Date: Jun 11, 2019
Visit Reason
The inspection was conducted as a result of an incident complaint involving alleged abuse at Arden Courts of Jefferson Hills.
Complaint Details
The complaint investigation was substantiated. Staff person A was suspended immediately on 5/29/2019 and terminated after the investigation. Resident #1 was assessed with no physical injury and continues to receive mental health services. The facility implemented a plan of correction including staff inservice and ongoing quality management reviews.
Findings
Staff person A was observed grabbing and pulling resident #1 aggressively, yelling profanities, and subsequently resident #1 was found holding his head and complaining of being hit. Staff person A was suspended immediately and later terminated. The facility failed to timely submit a notice of suspension to the Department. Resident #1 was assessed with no physical injury and continues to receive mental health services.
Citations (2)
Regulation 2600.15.c: The home failed to immediately submit a plan of supervision or notice of suspension of the affected staff person after the incident on 5/29/19 involving resident #1.
Regulation 2600.42.b: Resident #1 was subjected to verbal and physical abuse by staff person A, including being grabbed and pulled down a hallway and yelled at inappropriately.
Report Facts
Current Residents: 17
Total Daily Staff: 112
Waking Staff: 84
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in relation to plan of correction and staff inservice. |
Inspection Report — Apr 19, 2019
Routine
Date: Apr 19, 2019
Visit Reason
The Department’s Bureau of Human Services Licensing conducted an inspection of Arden Courts of Jefferson Hills to assess compliance with 55 Pa. Code Ch. 2600 relating to Personal Care Homes.
Findings
No regulatory citations were identified as a result of this inspection.
Inspection Report — Apr 11, 2019
Routine
Date: Apr 11, 2019
Visit Reason
The Department’s Bureau of Human Services Licensing conducted an inspection of Arden Courts of Jefferson Hills to assess compliance with 55 Pa. Code Ch. 2600 relating to Personal Care Homes.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Inspection Report — Dec 28, 2018
Routine
Date: Dec 28, 2018
Visit Reason
The Department’s Bureau of Human Services Licensing conducted an inspection of Arden Courts of Jefferson Hills to assess compliance with 55 Pa. Code Ch. 2600 relating to Personal Care Homes.
Findings
No regulatory citations were identified as a result of this inspection.
Inspection Report — Oct 19, 2018
Routine
Date: Oct 19, 2018
Visit Reason
The Department’s Bureau of Human Services Licensing conducted an inspection of Arden Courts of Jefferson Hills to assess compliance with 55 Pa. Code Ch. 2600 relating to Personal Care Homes.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Notice — Oct 16, 2018
Date: Oct 16, 2018
Visit Reason
The document serves as a renewal approval for the Personal Care Home license and notifies the facility of the requirement for an annual onsite inspection within the next twelve months.
Findings
No inspection findings are reported in this document. It confirms issuance of a regular license following the renewal application.
Inspection Report — Aug 1, 2018
Complaint Investigation
Date: Aug 1, 2018
Visit Reason
The inspection was conducted as a complaint investigation triggered by an incident involving alleged abuse by staff toward a resident.
Complaint Details
The complaint involved allegations of abuse by direct care staff dragging, pinching, and using profanity toward a resident. The allegations were investigated, staff person B was suspended and terminated, and staff training and supervision plans were implemented.
Findings
The investigation found that direct care staff persons A and B were involved in alleged abuse and unsupervised care of residents. Staff person B was suspended and no longer employed. Documentation deficiencies were also noted regarding staff orientation and training.
Citations (4)
Regulation 2600.15(a): The home failed to immediately report suspected abuse of a resident involving direct care staff person B who dragged and pinched a resident and delayed reporting to protective services.
Regulation 2600.15(b): The home failed to immediately develop and implement a plan of supervision or suspend staff person B who continued to provide unsupervised care after the alleged abuse incident.
Regulation 2600.58(a): Staff person B was observed sleeping during the work shift, violating the requirement that direct care staff be awake when residents are present.
Regulation 2600.65(i): The home lacked documentation that direct care staff persons A, B, and C received orientation within 40 scheduled working hours including emergency medical plan and reporting of reportable incidents.
Report Facts
Number of Residents Served: 20
Number of Current Hospice Residents: 8
Number of Hospice Residents in Past Year: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in multiple findings and plans of correction related to staff training, supervision, and abuse reporting. |
Inspection Report — Jul 19, 2018
Annual Inspection
Date: Jul 19, 2018
Visit Reason
The inspection was a full, unannounced visit conducted on July 19, 2018, for renewal, complaint, and incident reasons.
Findings
Multiple violations of 55 Pa. Code Chapter 2600 were found, including issues with contract signatures, ventilation fans, emergency preparedness plans, fire drill activation, medical evaluations, medication labeling, and medication administration records. Plans of correction were submitted and partially implemented as of December 27, 2018.
Citations (9)
Regulation 2600.25(b): Resident #1's contract dated 4/12/18 was not signed by the home's administrator or designee nor by the resident.
Regulation 2600.25(c)(10): Resident #2's contract change was not signed by the resident nor was there indication the resident was unable to sign.
Regulation 2600.86(b): Ventilation fans in common bathrooms in Garden Path and Cottage Place were non-operational and lacked outside windows.
Regulation 2600.123(b): Emergency preparedness plans for the home and municipality were not posted in a public and conspicuous place.
Regulation 2600.132(i): A fire drill conducted on 6/25/18 did not activate the fire alarm.
Regulation 2600.141(b)(1): Resident #2's most recent medical evaluation was completed on 8/31/16, not annually.
Regulation 2600.184(a): Resident #3's prescription label indicated Haloperidol 1 mg by mouth three times daily as needed, but the medication was prescribed as 2 mg by mouth three times daily for agitation.
Regulation 2600.185(a): Resident #4's prescribed Mupirocin 2% ointment was not available in the home at 12:30 p.m.
Regulation 2600.187(a)(13) and (14): Medication administration records for Resident #3 were not properly recorded at the time medication was administered.
Report Facts
Number of Residents Served: 58
Number of Current Hospice Residents: 7
Number of Hospice Residents in past year: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in multiple findings and plans of correction signatures throughout the report. |
Inspection Report — May 16, 2018
Routine
Date: May 16, 2018
Visit Reason
The Department's Bureau of Human Services representatives conducted an inspection of Arden Courts of Jefferson Hills on May 16, 2018.
Findings
No regulatory violations with 55 Pa. Code Ch. 2600 (relating to Personal Care Homes) were identified as a result of this inspection.
Inspection Report — Apr 11, 2018
Complaint Investigation
Date: Apr 11, 2018
Visit Reason
The inspection was conducted due to a complaint and incident investigation at Arden Courts of Jefferson Hills.
Complaint Details
The inspection was complaint-driven and incident-related. The complaint involved staff verbal abuse and failure to report the incident. The incident involved multiple falls of a resident resulting in serious injury and death. The plan of correction was partially implemented with adequate progress.
Findings
Two violations of 55 Pa. Code Chapter 2600 were found involving staff making inappropriate comments to a resident and multiple falls resulting in serious injury and death of another resident. Plans of correction were partially implemented with adequate progress noted.
Citations (2)
Regulation 2600.16(c): The home failed to report an incident where staff made inappropriate comments to a resident within 24 hours to the Department's complaint hotline.
Regulation 2600.42(b): Resident #2 fell at least 12 times between 11-19-18 and 3-26-18, sustaining serious injuries including fractures and a subdural hematoma, and later died from blunt force trauma to the head and neck.
Report Facts
Number of Residents Served: 57
Number of Falls: 12
Number of Current Hospice Residents: 13
Number of Hospice Residents in Past Year: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in relation to the plan of correction and incident reporting. |
Inspection Report — Nov 3, 2017
Routine
Date: Nov 3, 2017
Visit Reason
The Department of Human Services licensing representatives conducted an inspection of Arden Courts of Jefferson Hills facility on November 3, 2017.
Findings
No regulatory violations were identified as a result of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Larry Mazza | Acting Regional Licensing Director | Signed the inspection report letter. |
Notice — Oct 10, 2017
Date: Oct 10, 2017
Visit Reason
This document serves as a renewal notification and license issuance for Arden Courts of Jefferson Hills Personal Care Home, confirming the renewal application and outlining the requirement for an annual onsite inspection within the next twelve months.
Findings
No inspection findings are reported in this document. It confirms the issuance of a regular license and states that the Department will conduct an inspection within the next twelve months.
Report Facts
Inspection Report — Jul 11, 2017
Renewal
Date: Jul 11, 2017
Visit Reason
The inspection was conducted as part of the Department of Human Services' annual licensing renewal inspections on July 11 and July 12, 2017, for Arden Courts of Jefferson Hills.
Findings
Multiple violations of 55 Pa.Code Chapter 2600 related to Personal Care Homes were found, including issues with toilet paper availability, medical evaluations, medication labeling, medication administration, and resident assessments. Plans of correction were submitted and partially implemented with adequate progress noted.
Citations (6)
55 Pa.Code §2600.102(h) - Toilet paper was not provided for the toilet in resident #1's bathroom at 2:40 PM.
55 Pa.Code §2600.141(b)(1) - Resident #2 had a medical evaluation completed on 7/26/16, but the previous evaluation could not be located, so timeliness of the current evaluation could not be determined.
55 Pa.Code §2600.184(a) - The original container for prescription medications for residents #2 and #3 lacked accurate pharmacy labels reflecting the prescribed sliding scale and dosage instructions.
55 Pa.Code §2600.185(a) - The glucometers for residents #2 and #4 were not calibrated to the current date and time.
55 Pa.Code §2600.187(d) - Resident #2 did not receive prescribed medication (Trazodone) from 7/08/17 through 7/11/17 as the medication was not available in the home.
55 Pa.Code §2600.225(c) - Resident #2 had an assessment completed on 7/26/17, but the previous assessment could not be located, so timeliness of the current assessment could not be determined.
Report Facts
Number of Residents Served: 60
Number of Current Hospice Residents: 18
Number of Hospice Residents in past year: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Signed plans of correction and was named as legal entity representative on multiple violation report pages. |
Inspection Report — Nov 23, 2016
Complaint Investigation
Date: Nov 23, 2016
Visit Reason
The inspection was conducted as a complaint investigation triggered by an incident at the facility.
Complaint Details
The visit was complaint-related due to an incident involving mistreatment of resident #1 by direct care staff person A. The violation was substantiated and corrective actions were taken.
Findings
A violation of 55 Pa.Code Chapter 2600 was found involving direct care staff mistreating a resident with dignity and respect. The staff member was no longer employed, and a plan of correction was implemented including staff training and resident interviews.
Citations (1)
55 Pa.Code 2600.42(c) requires that a resident be treated with dignity and respect. Direct care staff person A was observed mistreating resident #1 by yelling, smearing feces on the resident, and physically pushing the resident during the incident on 11/17/2016.
Report Facts
Number of Residents Served: 60
Number of Current Hospice Residents: 17
Number of Hospice Residents in past year: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named as legal entity representative and signer of plan of correction |
Inspection Report — Oct 11, 2016
Routine
Date: Oct 11, 2016
Visit Reason
The Department of Human Services licensing representatives conducted an inspection of Arden Court of Jefferson Hills on October 11, 2016.
Findings
No regulatory violations were identified as a result of this inspection.
Inspection Report — Aug 8, 2016
Renewal
Date: Aug 8, 2016
Visit Reason
The inspection was a renewal licensing inspection conducted by the Pennsylvania Department of Human Services on August 8, 2016, for Arden Courts of Jefferson Hills.
Findings
Multiple violations of 55 Pa.Code Chapter 2600 were found, including improper use of the term 'assisted living,' incomplete medical evaluations, medication administration record deficiencies, incomplete medication administration training for staff, inadequate resident support plans, and improper use of correction fluid in resident records. Plans of correction were submitted and partially implemented.
Citations (6)
Regulation 2600.18: The home improperly used the term 'Alzheimer's Assisted Living' in their nondiscrimination policy statement, which is not allowed unless licensed as an assisted living residence.
Regulation 2600.141(a)(2): The medical evaluation for resident #1 dated 5/3/16 was incomplete, missing blood pressure, temperature, and pulse rate.
Regulation 2600.187(a): Resident #2's August 2016 medication administration record lacked a diagnosis or purpose for Nystatin cream, and resident #3's record was not initialed for administration of Buspirone and Acetaminophen.
Regulation 2600.190(a): Staff persons B and C had not completed the Department-approved medication administration practicum but administered medications to resident #2 on specified dates.
Regulation 2600.227(d): Resident #4's support plan dated 6/30/16 did not address how the home would assist the resident with a moderate problem with judgment.
Regulation 2600.251(b): Correction fluid was used in multiple areas on resident #2's assessment and support plan dated 3/13/16, including the medical needs section for diagnosis.
Report Facts
Number of Residents Served: 59
Number of Current Hospice Residents: 16
Number of Hospice Residents in Past Year: 100
Number of Residents Age 60 or Older: 58
Number of Residents with a Mobility Need: 59
Number of Residents with a Physical Disability: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Named in multiple findings related to plans of correction and oversight of medication administration and support plans. |
Inspection Report — Mar 25, 2016
Complaint Investigation
Date: Mar 25, 2016
Visit Reason
The inspection was conducted as a complaint investigation due to an incident involving suspected abuse of a resident.
Complaint Details
The complaint investigation was substantiated. The incident involved direct care staff verbally mistreating a resident during care and failure to timely report the abuse. Staff person A was suspended and no longer employed. Staff person B received training and was on leave but will be retrained before return.
Findings
The investigation found that direct care staff were involved in an incident where a resident became resistant to care and was verbally mistreated. The home failed to immediately report the suspected abuse to the local Area Agency on Aging. Staff training and suspension actions were taken, and plans for in-service training and compliance improvements were implemented.
Citations (3)
55 Pa.Code §2600.15(a) - The home failed to immediately report suspected abuse of a resident as required by regulations.
55 Pa.Code 2600.23(a) - The home did not provide assistance with activities of daily living consistent with the resident's assessment and support plan.
55 Pa.Code 2600.42(c) - A resident was not treated with dignity and respect during care, violating regulatory requirements.
Report Facts
Number of Residents Served: 52
Number of Current Hospice Residents: 19
Number of Hospice Residents in past year: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kristin Kahler | Executive Director | Signed legal entity representative on violation report and plan of correction |
| Susie Pollock | Human Services Licensing Supervisor | Signed letter approving plan of correction |
Notice — Feb 25, 2016
Date: Feb 25, 2016
Visit Reason
The document serves as a waiver approval for Arden Courts of Jefferson Hills to use an alternative cognitive preadmission screening form in lieu of the Department's standard form, relating to admission requirements under 55 Pa.Code Chapter 2600.
Findings
The waiver is granted under specified conditions and will be reviewed annually during the facility's annual inspection to ensure compliance. Failure to comply may result in termination of the waiver or other licensing actions.
Report Facts
Waiver Code Reference: 55
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Matthew Jones | Director | Signed the waiver approval letter |
Viewing
Loading inspection reports...
