Based on review of facility documentation, and interview with staff it was determined that the facility did not notify the state mental health authority or state intellectual disability authority, promptly after a significant change in the mental condition for three of thirty-three residents reviewed. (R4, R53, R56).Findings Include: Review of Resident R4's psychiatry note from September 2, 2025 stated, [Resident R4] with noted history of schizoaffective disorder in electronic health records system and past psychology note. Resident R4 does not answer appropriately assessment questions and is a poor historian. [Resident R4] was previously prescribed Haldol, but medication was discontinued in 2024, after discontinuation, pt displayed no signs of psychosis. …
F646 citations in Pennsylvania
Resident Assessment and Care Planning Deficiencies
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Pennsylvania cites F646 less often than its own record predicts
0.46 times the national share — cited less often here than elsewhere.
Of every deficiency written in Pennsylvania in 2025, this is the portion that was F646.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Pennsylvania surveyors wrote
F646 findings written in Pennsylvania, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
The short window
Recent years
| Year | Share of Pennsylvania citations | vs expected |
|---|---|---|
| 2024 | 0.03% | 0.56× |
| 2025 | 0.03% | 0.46× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Pennsylvania surveyors cite →
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