Philadelphia's affluent suburbs have some of PA's worst memory care records
Chester and Montgomery counties — among Pennsylvania's wealthiest — rank in the top five statewide for memory care deficiencies per facility. Chester County's 26 facilities average 80 deficiencies each, and outpace Pittsburgh's Allegheny County on IJ findings per facility despite having 40% fewer homes.
Deficiencies per facility — top 10 PA counties (5+ facilities)
| Category | avg deficiencies per facility |
|---|---|
| Philadelphia | 87.6 |
| Chester | 80.1 |
| Montgomery | 75.6 |
| Lackawanna | 75.6 |
| Delaware | 75.4 |
| Berks | 72.7 |
| Bucks | 62.8 |
| Lehigh | 62.1 |
| Erie | 60.7 |
| Clearfield | 60 |
Philadelphia collar counties (Chester, Montgomery, Bucks, Delaware) highlighted in rust. n = publishable facilities per county.
Source: PA DHS OLTL · inspection record 2002–2026 · Data as of 2026-06-07 · Counties with ≥5 publishable facilities only
Chester County vs. Allegheny County: a telling comparison
Allegheny County (Pittsburgh) has 44 publishable memory care facilities and 136 total immediate-jeopardy findings on record — 3.1 IJ findings per facility.
Chester County, with 26 facilities — roughly 40% fewer than Allegheny — has accumulated 109 IJ findings: 4.2 per facility. Chester has a higher per-facility IJ rate than Pennsylvania's largest urban county despite operating in one of the state's wealthiest markets.
The relationship between price and inspection record does not run in the direction families typically assume. Several Chester County facilities have strong records; several have the worst in the state. Sorting by inspection grade, not zip code, is the only way to separate them.
Source: PA DHS OLTL · inspection record 2002–2026 · Refreshed 2026-06-07
What county data does and doesn't tell you
County averages locate you in the right search area, but the within-county variance is large. Chester County contains facilities with 0 IJ findings and facilities with 10+. The aggregate rate flags that the county warrants scrutiny — it doesn't identify which facilities to avoid or which to trust.
Suburb and price point are poor proxies for inspection quality. The data is public, free, and sortable on every county hub and facility profile on StarlynnCare.
Frequently asked questions
Which Pennsylvania counties have the most memory care deficiencies per facility?
Based on PA DHS OLTL inspection records through mid-2026, Philadelphia (87.6 deficiencies/facility), Chester (80.1), Lackawanna (75.6), Delaware (75.4), and Montgomery (75.4) counties have the highest rates among counties with 5 or more publishable memory care facilities. Note that Philadelphia's rate is based on only 7 facilities — a small sample that inflates the average — while Chester and Montgomery represent much larger samples of 26 and 48 facilities, respectively.
Why do wealthy suburban counties rank so high for memory care deficiencies?
A few structural factors contribute. Chester and Montgomery counties have high concentrations of large-capacity facilities — larger facilities accumulate more total deficiency findings across inspection cycles. Wealthier suburban markets attract more facility investment, which increases the number of inspection targets. PA DHS OLTL also responds to family complaints; more engaged families means more complaint-triggered inspections on top of routine surveys. None of that cancels the finding. The per-facility rate controls for facility count, and Chester still outpaces Allegheny on IJ findings per facility.
How does Allegheny County (Pittsburgh) compare to the Philadelphia collar counties?
Allegheny County has 44 publishable memory care facilities and 136 total immediate-jeopardy findings on record. Chester County has 26 facilities and 109 IJ findings — roughly 40% fewer facilities, but accumulating IJ findings at a rate of 4.2 per facility versus Allegheny's 3.1 per facility. This means Chester County's facilities collectively have a higher per-facility IJ rate than Pittsburgh-area facilities, despite being a smaller and wealthier suburban market.
What is a 'collar county' in the context of Pennsylvania memory care?
The collar counties — Chester, Montgomery, Bucks, and Delaware — are the four counties that border Philadelphia County. They are part of the greater Philadelphia metropolitan area and among the highest-income counties in Pennsylvania. For memory care, they represent a densely competitive market with many large facilities, which may partially explain their higher aggregate deficiency counts.
Sources
PA DHS OLTL Human Services Provider Directory — inspection and deficiency records for licensed Personal Care Homes and Assisted Living Residences.