Crawford Care Center

In the surveyor’s words

From the most serious findings on record at Crawford Care Center, in the surveyor’s own words.

• Immediate jeopardy, patternF880Aug 2, 2024

  Based on observations, review of facility policies and documentation, and staff interviews, it was determined that the facility failed to maintain an infection prevention and control program by failing to follow infection control guidelines from the Pennsylvania Department of Health (PA DOH) to reduce the spread of infections and prevent cross-contamination during the COVID-19 pandemic. This failure placed the facility in an Immediate Jeopardy situation for 20 of 20 residents reviewed (Residents R1, R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, R16, R17, R18, R19, and R20). […]

• Immediate jeopardy, isolatedF689May 28, 2026

  Based on review of facility policies, clinical records, facility documents, observations, and staff interview, it was determined that the facility failed to implement sufficient monitoring and supervision to prevent elopement (when a resident leaves a safe care setting without staff knowledge) and failed to adequately implement search procedures related to an elopement. This failure placed residents at the facility in an Immediate Jeopardy situation for one of one residents reviewed (Resident R1). Findings include: Review of facility policy entitled Elopements and Wandering Residents dated 1/22/26, indicated This facility ensures that residents who exhibit wandering behavior and/or are at risk for elopement receive adequate supervision. […]

• Actual harm, isolatedF689Jun 15, 2023

  Based on review of facility policy, clinical records, and facility documentation and resident and staff interviews, it was determined that the facility failed to provide necessary precautionary measures to maintain resident safety and prevent injury during transport in a wheelchair resulting in actual harm of a fractured tibia for one of 18 residents reviewed (Resident R9). Findings include: Review of facility policy entitled Assistive Devices and Equipment dated 1/18/23, indicated, Residents, family, and visitors are trained, as indicated, on the safe use of equipment and devices and Staff practices-staff are required to demonstrate competency on the use of devices and equipment and are available to assist and supervise residents as needed. […]

• No harm, potential for more than minimal, widespreadF812Apr 17, 2025

  Based on observations, review of facility policies and International Plumbing Code, and staff interviews it was determined that the facility failed to safely store food containers, and prepare, serve and store food in a safe and sanitary manner in the main kitchen; failed to prevent the potential for cross contamination (transfer of harmful substances or disease-causing organisms to food from unclean hands or objects) during food preparation; and failed to maintain safe storage of ice for residents for one of one ice machines located in the kitchen. […]

• No harm, potential for more than minimal, patternF628Apr 30, 2026

  Based on review of facility policies, clinical records, and staff interview it was determined that the facility failed to provide the resident and/or resident representative with a written notice of the facility bed-hold policy (explanation of how long a bed can be held during a leave of absence and the cost per day), and failed to make certain that the necessary resident information was communicated to the receiving health care provider upon transfer to the hospital for five of five residents reviewed (Residents R2, R3, R5, R7, and R56). […]