Symphony Square at Bala Cynwyd.

“Staff person A was hired but a criminal background check was not completed until after the hire date. Criminal history checks must be completed in accordance with the Older Adult Protective Services Act and 6 Pa. Code Chapter 15 prior to employment.”

“Staff person B did not receive required fire safety and emergency preparedness orientation on their first day of work, including evacuation procedures, staff duties during emergencies, designated meeting places, smoking safety procedures, fire extinguisher use, smoke detectors and fire alarms, and emergency notification procedures.”

“Direct care staff person B began providing unsupervised ADL services without completing required training including demonstration of job duties with supervised practice, Department-approved direct care training course, competency test, and initial direct care training on safe management techniques, ADLs/IADLs, personal hygiene, dementia care, aging, assessment implementation, nutrition, recreation, gerontology, safety, universal precautions, infection control, and mobility needs.”

“The record of direct care staff training does not include the length of training as required for documentation of training provided.”

“A resident's record did not include a current list of medications. The record included a discontinued medication and failed to include a currently prescribed medication.”

“From 11:00 PM to 7:00 AM with 44 residents present in the home, no staff person trained in first aid and certified in obstructed airway techniques and CPR was on duty. At least one such staff member is required for every 50 residents at all times.”

“Staff person D did not receive fire safety training completed by a fire safety expert or a staff person trained by a fire safety expert during the 2024 training year.”

“Resident #2 returned from hospital to find apartment in disarray with personal documents and items on the floor and table. Staff member admitted entering and moving items without legitimate reason, violating resident privacy.”

“Assignment sheets for the secured dementia care unit containing resident personal information (incontinence assistance, mobility needs, devices, and ADL assistance levels) were left unlocked, unattended, and accessible on a medication room countertop.”

“Resident #1's resident-home contract was not signed by the resident. This is a repeat violation from 07/15/2024.”

“Staff B was hired without a Pennsylvania State Police Criminal Background Check (ePatch). Staff C was rehired without a new criminal background check being requested. This is a repeat violation from 07/15/2024.”

“Two residents prescribed medications at bedtime did not receive their prescribed medications on specific dates, violating the requirement to follow prescriber's orders.”

“A resident's assessment does not include an assessment of the resident's mobility needs.”

“The medication room in the Memory Care Unit was unlocked, unattended, and accessible to all residents, violating confidentiality and security requirements for resident records.”

“A resident struck another resident in the left eye, resulting in an argument and physical altercation where the second resident punched the first resident in the face, causing them to fall and sustain a head injury with subarachnoid hemorrhage requiring hospitalization. Staff inadequately supervised residents in the secure dementia care unit common area.”

“Eucerin cream, Gain laundry detergent, toothpaste, and other poisonous materials with manufacturer labels warning to keep out of reach of children were unlocked, unattended, and accessible to residents in the medication room in the secure dementia care unit.”

“A resident does not have access to a source of light that can be turned on/off at the bedside.”

“A resident's medical evaluation did not include the medical information pertinent to diagnosis and treatment in case of an emergency, and did not document body positioning and movement stimulation for the resident.”

“A resident's prescribed medication in blister pack form had openings in the back that were taped, violating proper storage and sanitation requirements for medications.”

“A resident's medical evaluation form contained an altered date that was not properly initialed, and the original evaluation date fell outside the required 60-day prior to admission timeframe. The form also had a blank 'Date Resident Examined' field and unclear documentation of who made changes to the document.”

“A resident's support plan did not address several diagnoses listed on the resident's medical evaluation including Osteoporosis, Incontinence of Urine, Neural Hearing Loss, Osteoarthritis, Collagenous Colitis, and Depression.”

“A resident's record was missing required information including race, religious affiliation, identifying marks, and had an incorrect admission date listed in the file.”

“The home's current violation report dated 10/18/2023 was not posted in a conspicuous and public place in the home as required.”

“An incident where Resident #1 hit Resident #2 in the shoulder and Resident #2 pushed Resident #1 causing them to fall and hit their head was not reported to the Department within 24 hours as required. This was a repeated violation from 10/18/2023.”

“The resident-home contract for Resident #3 was not signed by the resident as required.”

“Resident #3's record did not contain a statement signed by the resident acknowledging receipt of a copy of the resident rights and complaint procedures.”

“Staff Member A was hired and worked without a criminal background check being completed until after their start date, contrary to requirements under the Older Adult Protective Services Act.”

“On 7/15/2024 at 9:45 A.M., trash bags were placed on top of closed dumpsters and recycling dumpsters were open and uncovered, failing to keep trash in covered receptacles that prevent insect and rodent penetration.”

“The window in bedroom 134 has blinds that are in disrepair and missing slats on the right side, failing to provide proper window coverings that are clean, in good repair, and provide privacy.”

“Three incidents were not reported to the Department within the required 24-hour timeframe: a resident who left the facility and sustained injuries (not reported), a resident fall on May 12, 2023 (reported late on May 16), and a resident death (reported late).”

“Medical evaluations for residents 1 and 4 were incomplete. Resident 1 and 4's evaluations did not include medical information pertinent to diagnosis and treatment in case of emergency (section left blank). Resident 4's evaluation did not include medication regimen, contraindicated medications, medication side effects, and ability to self-administer medications.”

“Resident 1's preadmission screening form does not include a determination if the resident has been assessed as capable of recognizing and using poisons safely. Resident 1 resides in the dementia care unit.”

“Resident 1's DME indicates a need for a no-added sodium diet, but the resident's support plan dated in 2023 was left blank for dietary needs.”

“Resident 4's support plan indicates multiple needs (toileting, bladder management, personal hygiene, managing health care, securing health care, doing laundry, making and keeping appointments, caring for personal possessions, engaging in social and leisure activities, obtaining clean and seasonal clothing, needing attendance in unfamiliar places, requiring limited physical or oral assistance to evacuate in emergency, administering medications, orientation to time/place/person, judgement, and short-term memory) but does not document how these needs will be met.”

“Resident 1's preadmission screening form does not include a determination that the needs of the resident can be met by the services provided by the home.”

“Direct care staff person A did not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry, with CNA certification expired as of 4/29/2023.”

“Resident 2 and Resident 3 participated in the development of their support plans but did not sign the support plans as required.”

“Resident 3 was admitted to the Secure Dementia Care Unit but the medical evaluation did not occur within 60 days prior to admission as required.”

“Resident 3 was admitted to the Secure Dementia Care Unit but the initial support plan was not developed and documented within 72 hours of admission as required.”