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Deficiency Records for Willow Grove Post Acute

View the most recent health deficiencies and inspection results for Willow Grove Post Acute. Stay informed about quality of care issues.

View the most recent health deficiencies and inspection results for Willow Grove Post Acute. Stay informed about quality of care issues.

Deficiency Type of Deficiency Deficiency Date Date Corrected Resulted from a Complaint?
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2026-03-17 2026-04-17 Y
Provide enough food/fluids to maintain a resident's health. Health 2026-03-17 2026-04-17 Y
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2025-12-30 2026-01-29 Y
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2025-12-30 2026-01-29 Y
Make sure that a working call system is available in each resident's bathroom and bathing area. Health 2025-12-01 2026-01-06 Y
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Health 2025-12-01 2026-01-06 Y
Conduct risk assessment and an All-Hazards approach. Fire Safety 2025-05-16 2025-07-14 N
Develop and maintain an Emergency Preparedness Program (EP). Fire Safety 2025-05-16 2025-07-14 N
Have simulated fire drills held at unexpected times. Fire Safety 2025-05-16 2025-07-14 N
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Fire Safety 2025-05-16 2025-07-14 N
Have properly installed electrical wiring and gas equipment. Fire Safety 2025-05-16 2025-07-14 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2025-05-16 2025-07-14 N
Have a complete alarm system manually initiated and initiated by fire sprinkler system connection. Fire Safety 2025-05-16 2025-07-14 N
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2025-05-16 2025-07-14 N
Properly select, install, inspect, or maintain portable fire extinguishes. Fire Safety 2025-05-16 2025-07-14 N
Establish policies and procedures for sheltering. Fire Safety 2025-05-16 2025-07-14 N
Create arrangements with other facilities to receive patients. Fire Safety 2025-05-16 2025-07-14 N
Establish roles under a Waiver declared by secretary. Fire Safety 2025-05-16 2025-07-14 N
List the names and contact information of those in the facility. Fire Safety 2025-05-16 2025-07-14 N
Provide emergency officials' contact information. Fire Safety 2025-05-16 2025-07-14 N
Meet other general requirements. Fire Safety 2025-05-16 2025-07-14 N
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Health 2025-05-16 2025-07-08 N
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Health 2025-05-16 2025-07-08 N
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Health 2025-05-16 2025-07-08 N
Assess the resident when there is a significant change in condition Health 2025-05-16 2025-07-08 N
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Health 2025-05-16 2025-07-08 N
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Health 2025-05-16 2025-07-08 N
Provide enough food/fluids to maintain a resident's health. Health 2025-05-16 2025-07-08 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2025-05-16 2025-07-08 N
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. Health 2025-05-16 2025-07-08 N
Observe each nurse aide's job performance and give regular training. Health 2025-05-16 2025-07-08 N
Dispose of garbage and refuse properly. Health 2025-05-16 2025-07-08 N
Keep all essential equipment working safely. Health 2025-05-16 2025-07-08 N
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Health 2025-05-16 2025-07-08 N
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. Health 2025-05-16 2025-07-08 N
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. Health 2025-05-16 2025-07-08 N
The resident has the right to receive notices in a format and a language he or she understands. Health 2025-05-16 2025-07-08 N
Make sure that a working call system is available in each resident's bathroom and bathing area. Health 2024-12-09 2025-01-21 Y
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Health 2024-12-09 2025-01-21 Y
Put firmly secured handrails on each side of hallways. Health 2024-09-09 2024-10-16 Y
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Health 2024-09-09 2024-10-16 Y
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Health 2024-09-09 2024-10-16 Y
Ensure that residents are fully informed and understand their health status, care and treatments. Health 2024-09-09 2024-10-16 Y
Develop and implement policies and procedures for flu and pneumonia vaccinations. Health 2024-08-15 2024-10-02 N
Implement a program that monitors antibiotic use. Health 2024-08-15 2024-10-02 N
Provide and implement an infection prevention and control program. Health 2024-08-15 2024-10-02 N
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Health 2024-08-15 2024-10-02 N
Observe each nurse aide's job performance and give regular training. Health 2024-08-15 2024-10-02 N
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Health 2024-08-15 2024-10-02 N
Provide safe, appropriate dialysis care/services for a resident who requires such services. Health 2024-08-15 2024-10-02 N
Provide for the safe, appropriate administration of IV fluids for a resident when needed. Health 2024-08-15 2024-10-02 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2024-08-15 2024-10-02 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2024-08-15 2024-10-02 N
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Health 2024-08-15 2024-10-02 N
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Health 2024-08-15 2024-10-02 N
Install resident room doors of proper design and width. Fire Safety 2024-08-15 2024-10-02 N
Inspect, test, and maintain automatic sprinkler systems. Fire Safety 2024-08-15 2024-10-02 N
Install corridor and hallway doors that block smoke. Fire Safety 2024-08-15 2024-10-02 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2024-08-15 2024-10-02 N
Ensure gas cylinders are properly stored. Fire Safety 2024-08-15 2024-10-02 N
Make sure that a working call system is available in each resident's bathroom and bathing area. Health 2024-08-15 2024-10-02 N
Develop, implement, and/or maintain an effective training program for all new and existing staff members. Health 2024-08-15 2024-10-02 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2024-08-15 2024-10-02 Y
Ensure medication error rates are not 5 percent or greater. Health 2024-08-15 2024-10-02 Y
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Health 2024-06-10 2024-07-30 Y
Plan the resident's discharge to meet the resident's goals and needs. Health 2024-05-07 2024-07-06 Y
Provide enough food/fluids to maintain a resident's health. Health 2024-04-27 2024-06-24 Y
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2024-03-06 2024-04-23 Y
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2024-01-19 2024-03-02 Y
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Fire Safety 2024-01-19 2024-03-02 Y
Have proper medical gas storage and administration areas. Fire Safety 2023-11-08 2024-01-19 N
Use approved construction type or materials. Fire Safety 2023-11-08 2024-01-19 N
Keep aisles, corridors, and exits free of obstruction in case of emergency. Fire Safety 2023-11-08 2024-01-19 N
Provide properly protected cooking facilities. Fire Safety 2023-11-08 2024-01-19 N
Have approved installation, maintenance and testing program for fire alarm systems. Fire Safety 2023-11-08 2024-01-19 N
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Fire Safety 2023-11-08 2024-01-19 N
Install smoke barrier doors that can resist smoke for at least 20 minutes. Fire Safety 2023-11-08 2024-01-19 N
Meet other general requirements. Fire Safety 2023-11-08 2024-01-19 N
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. Health 2023-11-08 2024-01-04 N
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Health 2023-11-08 2024-01-04 N
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Health 2023-11-08 2024-01-04 N
Provide safe, appropriate pain management for a resident who requires such services. Health 2023-11-08 2024-01-04 N
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Health 2023-11-08 2024-01-04 N
Provide appropriate treatment and care according to orders, resident?s preferences and goals. Health 2023-11-08 2024-01-04 N
Provide care and assistance to perform activities of daily living for any resident who is unable. Health 2023-11-08 2024-01-04 N
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Health 2023-11-08 2024-01-04 N
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Health 2023-11-08 2024-01-04 N
Ensure each resident receives an accurate assessment. Health 2023-11-08 2024-01-04 N
Respond appropriately to all alleged violations. Health 2023-11-08 2024-01-04 N
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Health 2023-11-08 2024-01-04 Y
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Health 2023-08-25 2023-09-15 Y

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