Providence Health & Rehab Center

In the surveyor’s words

From the most serious findings on record at Providence Health & Rehab Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689May 21, 2026

  Based on review of facility policy, facility documents, clinical record review, and staff interviews, it was determined that the facility failed to ensure proper supervision for a resident (Resident R1) resulting in an elopement (resident exits to an unsupervised and unauthorized location without staff's knowledge) from the facility. This failure created an immediate jeopardy situation (IJ) for all residents identified as an elopement risk.Findings include: Review of facility policy Elopement Unauthorized Absence dated 5/4/26, indicated the facility will identify residents with potential and/or actual risk factors for elopement and protect the resident through development and implementation of safety interventions. […]

• Actual harm, isolatedF600Mar 21, 2024

  Based on review of facility policy, facility documentation and clinical record, and resident and staff interviews, it was determined that the facility failed to ensure that one of two residents reviewed (Resident R1) was free of neglect during care which resulted in actual harm of a fracture of the distal right tibia (fracture of the shin bone near the ankle). This deficiency is cited as past non-compliance. Findings include: Review of facility policy entitled Pennsylvania Resident Abuse, dated 1/19/24, indicated that the facility will not tolerate abuse, neglect, mistreatment, exploitation of residents, and misappropriation of resident property by anyone. […]

• Actual harm, isolatedF689Mar 21, 2024

  Based on review of facility policy, clinical records, facility documentation, and resident and staff interviews, it was determined that the facility failed to provide adequate supervision and implement effective transfer interventions as per physician order to promote resident safety, resulting in a preventable accident and actual harm when the resident received a fracture of the distal right tibia, one of two residents reviewed (Resident R1). This deficiency is cited as past non-compliance. Findings include: Review of facility policy entitled Incident/Accident Policy, dated 1/19/24, indicated an incident/accident is any occurrence which is not consistent with the routine care of a particular resident. […]

• Actual harm, isolatedF689Aug 22, 2022

  Based on review of facility policy and records, and staff interviews, it was determined that the facility failed to provide adequate supervision that resulted in actual harm of fractures of the right tibia and fibula (lower leg bones) for one of four residents reviewed (Resident R1). Findings include: Review of the Resident Assessment Instrument (RAI) 3.0 User's Manual effective October 2019, indicated that bed mobility is defined as how resident moves to and from lying position, turns side or side, and positions body while in bed or alternate sleep furniture. The RAI further indicated that How a resident turns from side to side, in the bed, during incontinence care, is a component of Bed Mobility and should not be considered as part of Toileting. […]

• No harm, potential for more than minimal, widespreadF812Aug 7, 2026

  Based on review of policy, observation and staff interview, it was determined that the facility failed to properly label and date food products, creating the potential for food-borne illness in the main kitchen's standing cooler rack and dry storage area.Findings include: Review of the facility's Food Preparation and Handling Policy dated 5/4/26, indicated Potentially Hazardous Foods (PHF)/Time Temperature Control for Safety Food (TCS) foods are kept refrigerated except when being handled. Refrigerated foods will be:-Covered for storage.-Cooked timely following defrosting.-Appropriately labeled and dated. Observation in the Main Kitchen on 8/3/26 at 9:20 a.m. […]