Inspection Reports for Country Meadows of Bethlehem V
4025 GREEN POND ROAD,, PA, 18020
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Renewal
Census: 61
Capacity: 126
Deficiencies: 6
Feb 13, 2025
Visit Reason
The inspection was conducted as a renewal visit to review the facility's compliance with licensing requirements.
Findings
The facility was found to have several deficiencies related to fire safety drills, combustible storage, annual medical evaluations, and medication storage procedures. All deficiencies had plans of correction submitted and were determined to be fully implemented as of the follow-up date.
Deficiencies (6)
| Description |
|---|
| A sock was found alongside the back of the dryer on the floor, violating combustible storage requirements. |
| The facility did not have an unannounced fire drill completed in August 2024. |
| Fire drill records were incomplete, missing critical details such as time of day, evacuation time, exit route, number of residents and staff participating, and alarm status. |
| The home failed to conduct a fire drill during sleeping hours within the required six-month timeframe. |
| Resident #1's annual medical evaluation was missing information about the ability to self-administer medications. |
| Medication count for Resident #2 was inaccurate due to failure to adjust the narcotics book after administration. |
Report Facts
Total Daily Staff: 75
Waking Staff: 56
License Capacity: 126
Residents Served: 61
Current Hospice Residents: 3
Residents 60 Years or Older: 61
Residents with Mobility Need: 14
Residents with Physical Disability: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Associate Director of Nursing | Associate Director of Nursing | Responsible for monitoring ongoing procedure of counting narcotics by Medication Associates and Nurses. |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 126
Deficiencies: 0
Nov 19, 2024
Visit Reason
The inspection was conducted as a complaint investigation with an unannounced partial inspection on 11/19/2024.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Complaint Details
The inspection was complaint-related, but no deficiencies or citations were found, indicating no substantiated issues.
Report Facts
Total Daily Staff: 78
Waking Staff: 59
Residents Served: 61
License Capacity: 126
Current Residents - Hospice: 2
Residents Age 60 or Older: 61
Residents with Mobility Need: 17
Inspection Report
Census: 62
Capacity: 126
Deficiencies: 0
Sep 17, 2024
Visit Reason
The inspection was conducted as a licensing inspection triggered by an incident, with an unannounced partial inspection type.
Findings
No regulatory citations or deficiencies were identified during the inspection.
Report Facts
Resident census: 62
Total licensed capacity: 126
Staffing hours: 81
Waking staff hours: 61
Residents with mobility need: 19
Residents age 60 or older: 62
Residents with physical disability: 2
Residents with supplemental security income: 0
Residents diagnosed with mental illness: 0
Residents diagnosed with intellectual disability: 0
Hospice residents: 1
Inspection Report
Renewal
Census: 59
Capacity: 126
Deficiencies: 1
Dec 12, 2023
Visit Reason
The inspection was conducted as a renewal inspection of the facility's license.
Findings
The submitted plan of correction related to discontinued medications was found to be fully implemented. Two bottles of unused medications were previously noted but were removed on the day of inspection, and staff training and audits were planned and/or completed to ensure ongoing compliance.
Deficiencies (1)
| Description |
|---|
| Two bottles of unused medications, Memantine HCL 14mg and Levothyroxine 50mcg prescribed for Resident #1, were found in the medication cart and had not been discarded as required. |
Report Facts
License Capacity: 126
Residents Served: 59
Total Daily Staff: 75
Waking Staff: 56
Current Residents in Hospice: 1
Residents with Mobility Need: 16
Residents with Physical Disability: 1
Inspection Report
Complaint Investigation
Census: 83
Capacity: 126
Deficiencies: 0
Aug 16, 2023
Visit Reason
The inspection was conducted as a complaint investigation during an unannounced partial licensing inspection of the facility.
Findings
No regulatory citations or deficiencies were identified as a result of this inspection.
Complaint Details
The inspection was complaint-related, but no deficiencies or citations were found, indicating no substantiated issues.
Report Facts
Residents Served: 83
License Capacity: 126
Current Residents in Hospice: 6
Residents Age 60 or Older: 63
Residents Diagnosed with Mental Illness: 1
Residents with Mobility Need: 16
Inspection Report
Complaint Investigation
Census: 83
Capacity: 126
Deficiencies: 2
Feb 15, 2023
Visit Reason
The inspection was conducted as a complaint investigation following an unannounced partial inspection on 02/15/2023.
Findings
Two deficiencies were identified: a resident's wheelchair was found very dirty with food crumbs and grime, and a resident's bedroom carpet had heavy black staining requiring cleaning or replacement. Both issues were corrected promptly with cleaning and scheduled audits to ensure ongoing compliance.
Complaint Details
The inspection was triggered by a complaint and was an unannounced partial inspection.
Deficiencies (2)
| Description |
|---|
| Resident #1's wheelchair was very dirty with a buildup of food crumbs, dirt and grim along the seat and wheels. |
| Resident #1's bedroom carpet had heavy black staining and needed cleaning or replacement. |
Report Facts
License Capacity: 126
Residents Served: 83
Current Residents in Hospice: 5
Residents Age 60 or Older: 63
Residents with Mobility Need: 16
Total Daily Staff: 99
Waking Staff: 74
Inspection Report
Plan of Correction
Census: 70
Capacity: 126
Deficiencies: 1
Jan 6, 2023
Visit Reason
The inspection was conducted as a complaint and incident investigation with multiple review dates including on-site and off-site visits between 01/06/2023 and 02/03/2023.
Findings
The report found that four residents experienced delays of more than half an hour on multiple occasions before staff responded to their call bells for assistance with activities of daily living. A plan of correction was submitted and fully implemented by 02/27/2023.
Complaint Details
The visit was complaint-related and incident-based. The plan of correction was accepted and fully implemented, indicating compliance with corrective actions.
Deficiencies (1)
| Description |
|---|
| Four residents indicate that it takes staff more than a half an hour on multiple occasions before a staff member responds to their call bell to assist them with their ADLs. |
Report Facts
Residents served: 70
License capacity: 126
Current residents in hospice: 5
Residents with mobility need: 17
Residents age 60 or older: 79
Residents indicating delayed call bell response: 4
Staff total daily: 87
Staff waking: 65
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing | Re-educated care staff on call bell timing and needs of residents as part of plan of correction |
Inspection Report
Renewal
Census: 81
Capacity: 126
Deficiencies: 3
Sep 7, 2022
Visit Reason
The inspection was conducted as a renewal inspection of the facility's license, with an unannounced full inspection on 09/07/2022 and 09/08/2022.
Findings
The submitted plan of correction was found to be fully implemented. Deficiencies related to medication labeling, storage procedures, and following prescriber's orders were identified and corrected with education and process improvements.
Deficiencies (3)
| Description |
|---|
| Resident #1's PRN albuterol HFA inhaler and Resident #2's PRN glucagon kit did not have a pharmacy label attached. |
| Resident #3's PRN Tylenol 325mg was not available at the time of the inspection. |
| Resident #4 had an order for digoxin .125mg tablet daily, hold for pulse rate less than 60. On 8/26/22 the pulse rate was 60, the medication was held and should have been administered. |
Report Facts
License Capacity: 126
Residents Served: 81
Current Hospice Residents: 5
Resident Mobility Need: 18
Resident Physical Disability: 6
Resident Age 60 or Older: 81
Inspection Report
Routine
Deficiencies: 0
May 23, 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
Routine
Deficiencies: 0
Mar 1, 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
Complaint Investigation
Census: 61
Capacity: 126
Deficiencies: 5
Feb 10, 2022
Visit Reason
The inspection was conducted as a complaint and incident investigation following reports of resident abuse and medication errors.
Findings
The investigation found multiple violations including failure to immediately report suspected resident abuse, improper treatment of a resident, medication administration errors involving incorrect medications given to a resident, and improper medication storage with medications found in a resident's room without current prescriptions. Plans of correction were accepted and staff retraining was mandated.
Complaint Details
The complaint involved alleged abuse of resident #1 by staff person A, who reportedly threw the resident face down on the bed. The incident was not reported immediately as required. Additionally, medication errors involving resident #2 were investigated, including incorrect medication administration and improper medication storage.
Deficiencies (5)
| Description |
|---|
| Failure to immediately report suspected abuse of resident #1 to the Area Agency on Aging and Department’s regional office. |
| Resident #1 was thrown face down on the bed by staff person A rather than being given time to turn and pivot, causing distress. |
| Resident #2 had a weekly pill storage box with several pills stored in different compartments despite being unable to self-administer medications. |
| Staff person B incorrectly administered 5 medications to resident #2 that were prescribed to another resident. |
| Medications found in resident #2’s room were not current prescriptions and staff could not identify all pills in the pill box. |
Report Facts
License Capacity: 126
Residents Served: 61
Current Hospice Residents: 4
Residents with Mobility Need: 19
Residents with Physical Disability: 2
Medications Incorrectly Administered: 5
Staffing Hours: 80
Waking Staff Hours: 60
Inspection Report
Renewal
Capacity: 126
Deficiencies: 0
Dec 8, 2021
Visit Reason
The document is related to the renewal application and issuance of a license to operate the Personal Care Home 'Country Meadows of Bethlehem V'. The Department will conduct an onsite inspection within the next twelve months as required by regulation.
Findings
A regular license is being issued in response to the renewal application. The Department advises that an annual inspection will be conducted within the next twelve months and enforcement action will be taken if noncompliance is found.
Report Facts
Maximum capacity: 126
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jamie L. Buchenauer | Deputy Secretary | Signed letter regarding renewal application and licensing |
Inspection Report
Renewal
Census: 62
Capacity: 126
Deficiencies: 3
Oct 19, 2021
Visit Reason
The inspection was conducted as a renewal visit for the facility's license.
Findings
The inspection found three deficiencies related to uncovered trash receptacles, lack of thermometer in a refrigerator, and incomplete updates to a resident's support plan reflecting hospice care. All deficiencies were corrected promptly with plans of correction accepted and implemented.
Deficiencies (3)
| Description |
|---|
| The home had a large trash container in the main dining room that did not have a lid. |
| The GE brand refrigerator located in the country kitchen activity room did not have a thermometer. |
| Resident #1's Resident Support Plan was not updated to reflect the change to hospice care in a timely manner. |
Report Facts
License Capacity: 126
Residents Served: 62
Staffing Hours: 79
Waking Staff: 59
Hospice Residents: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Chris Swope | Administrator | Named as facility administrator |
| Ann O'Haire | Lead Inspector | Lead inspector for the renewal inspection |
| Michele Moskalczyk | Human Services Licensing Supervisor | Reviewer and licensing supervisor involved in follow-up and document submission |
Inspection Report
Renewal
Deficiencies: 0
Oct 1, 2021
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
Renewal
Deficiencies: 0
Jul 23, 2021
Visit Reason
The inspection was conducted as part of the Pennsylvania Department of Human Services, Bureau of Human Service Licensing licensing inspections on 07/23/2021 and 07/30/2021.
Findings
No regulatory citations were identified as a result of this inspection.
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