Inspection Reports for
The Villa St. Elizabeth

The inspection included a complaint investigation component; however, the complaint was contested and ultimately provided no corrective action.

The inspection identified multiple violations including failure to post the current license inspection summary, missing influenza poster, furniture and equipment disrepair, snow and ice obstructing exits, improperly conducted fire drills, unclear exit signage, unlocked medications, and incomplete medication administration training for staff. All violations had accepted plans of correction and were implemented by April 20, 2026.

The visit was complaint-related as stated under Inspection Information with reason 'Complaint'. The facility disputed the finding and submitted a plan of correction.

The facility was found to have not followed a resident's diet order change from a mechanical soft diet to a regular diet starting 1/31/25, continuing the mechanical soft diet until discharge. The facility disputed the violation, citing compliance with medical evaluations and orders from the resident's primary care providers.

The complaint involved a resident's unpaid payment due to a Social Security Administration error discontinuing the facility as the resident’s representative payee. The facility disputed the finding of failure to make reasonable documented efforts to obtain payment, providing extensive documentation of attempts to resolve the issue.

The facility was found to have multiple deficiencies including missing window coverings in a resident room, an overdue annual fire safety inspection and drill, unlocked medication cart, missing PRN medication in the cart, incorrect medication record documentation, and disputed grounds for resident discharge related to payment issues. All deficiencies had plans of correction submitted and were marked as implemented by 03/05/2025.

The visit was complaint-related and unannounced. The complaint triggered the inspection on 08/29/2024. The submitted plan of correction was fully implemented and accepted.

Two deficiencies were found: a violation of resident privacy during medical procedures where blood sugar checks and insulin administration were performed at the dining table, and failure to post the weekly menu for the following week in a timely manner. Both deficiencies were corrected with plans of correction implemented by 10/15/2024.

The inspection was complaint-related, but no deficiencies were found and the complaint was not substantiated.

No regulatory citations or deficiencies were identified as a result of this inspection.

The visit was complaint-related and the submitted plan of correction was fully implemented as of the inspection date.

The inspection found a violation related to obstructed egress where the main exit door was blocked by a velvet rope attached to metal stands. The issue was immediately corrected by moving and then removing the stanchions to ensure unobstructed emergency exits.

Multiple deficiencies were identified related to facility safety and sanitation, including uncovered trash receptacles, obstructed egress routes, missing first aid kit items, snow obstructing outdoor steps, improper soap dispenser use, and missing fire extinguisher inspection tags. All deficiencies were corrected immediately or shortly after the inspection, with plans of correction accepted and implemented.

The visit was complaint-related with the reason explicitly stated as 'Complaint'. The facility disputes the finding, asserting no violation occurred and providing a detailed corrective action plan and supporting documentation.

The report details a disputed deficiency regarding Resident #1's support plan not being updated to reflect certain behaviors and care coordination needs. The facility strongly contests the violation, providing extensive documentation and a plan of correction to ensure ongoing compliance.

The inspection was complaint-related as explicitly stated under Inspection Information with Reason: Complaint. No deficiencies or citations were found.

No regulatory citations or deficiencies were identified as a result of this complaint investigation inspection.

The inspection found three deficiencies related to emergency exit lighting, unobstructed egress, and medication storage. All deficiencies were corrected immediately during the inspection or shortly thereafter, and the submitted plan of correction was fully implemented.

The inspection was complaint-related, but no deficiencies or citations were substantiated.

No regulatory citations or deficiencies were identified as a result of this inspection.

No regulatory citations or deficiencies were identified as a result of this inspection.

The inspection identified several deficiencies including a resident privacy violation due to unredacted information on a posted inspection summary, incomplete medical evaluations for residents, medication administration training lapses for staff, improper storage of medications, and errors in medication administration records. All deficiencies had plans of correction accepted and were implemented.

No inspection findings are reported in this document. It confirms issuance of a regular license and outlines the requirement for a future annual inspection to ensure compliance.

The complaint involved the immediate eviction of Resident 1 due to use of racial slurs towards a staff member. The eviction did not comply with the required 30-day notice protocol. The facility's plan of correction was accepted and implemented.

The facility was found to have violated regulations by issuing an immediate eviction notice to a resident without the required 30-day written notice, contradicting PA Code 55 chapter 2600 regulations. The resident was evicted due to use of racial slurs towards a staff member, creating a harmful environment. The facility submitted a plan of correction which was later fully implemented.

No regulatory citations were identified as a result of this inspection.

No inspection findings are reported in this document. It confirms the issuance of a regular license following the renewal application.

No regulatory citations were identified as a result of this inspection.

No regulatory citations were identified as a result of this inspection.

No inspection findings are reported in this document. It serves as a license renewal confirmation and notification of future annual inspection requirements.

The inspection identified violations including missing emergency telephone numbers, outdated food items, and incomplete first aid kit contents. The facility submitted plans of correction and was working on compliance.

The document does not report any inspection findings but confirms the issuance of a regular license renewal for the facility with a capacity of 92 residents.

The inspection identified several violations related to carbon monoxide detector installation, hot water temperature, medication storage and administration, and medication record keeping. Plans of correction were submitted and partially implemented with adequate progress noted.

The complaint was substantiated. The resident fell while walking in the community and died at the hospital. The home failed to report the incident within 24 hours as required.

The facility failed to submit a Reportable Incident form within 24 hours after a resident passed away due to a fall outside the facility. The violation was due to a misunderstanding by the Administrator about the reporting requirement.

The Department of Human Services has approved the renewal application and issued a regular license for the facility. The Department will conduct an onsite inspection within the next twelve months as required by regulation.

Multiple violations of 55 Pa.Code Chapter 2600 were found, including improper placement of carbon monoxide alarms, incomplete staff training, nonfunctional bedside lighting, improper food labeling, and medication administration record errors. Plans of correction were submitted with partial implementation progress noted.

The inspection was triggered by a complaint and incident, as noted on page 2. The violations were substantiated as detailed in the violation report.

Multiple violations of Pennsylvania Code Chapter 2600 were found, including failure to follow emergency procedures during a smoke incident, incomplete fire safety inspections and drills, and inadequate documentation and care planning for residents' incontinence needs.

The inspection was complaint-driven as stated on page 2. The facility disputed several findings with documentation and submitted plans of correction. The complaint involved medication administration errors and failure to evacuate a resident during a fire alarm.

Multiple violations of 55 Pa.Code Chapter 2600 were found, including medication administration errors, failure to evacuate a resident during a fire alarm, and inadequate documentation of residents' ability to self-administer medications. The facility submitted plans of correction and disputed some findings with supporting documentation.

Multiple violations of 55 Pa.Code Chapter 2600 were found, including issues with resident privacy, staff qualifications, orientation and training, medication management, and resident record keeping. Plans of correction were submitted and partially implemented at the time of the report.

No inspection findings are reported in this document. It states that an onsite inspection will be conducted within the next twelve months as required by regulation.

The inspection was complaint-driven. The violation was substantiated and attributed to a clerical error in the resident contract reproduction.

A violation was found related to the resident contract not including exact written information on resident rights due to a clerical typing error. The facility committed to correcting the error and preventing future occurrences by using a PDF template and ensuring accuracy in contract content.

The complaint was an anonymous allegation received on January 6, 2016, involving suspected resident-to-resident abuse. The surveyor's investigation found no corroboration or evidence of abuse. The facility disputed the findings and submitted a plan of correction. The complaint was ultimately determined to be unfounded.

The investigation found that the facility failed to report a suspected resident-to-resident abuse incident that occurred approximately one and a half months prior. However, the surveyor determined that the complaint was unfounded and no violations of abuse occurred.