Highgate at Paoli Pointe.

“The home failed to submit an incident report to the Department within 24 hours after staff de-escalation attempts were unsuccessful, law enforcement was contacted, and a resident was removed from the home.”

“A resident-home contract was not signed by the resident as required.”

“A resident's record did not contain a signed statement from the resident acknowledging receipt of resident rights and complaint procedures information.”

“Crest Toothpaste with a poison control warning label was left unlocked, unattended, and accessible to residents in a bathroom. Not all residents were assessed as capable of safely recognizing and using poisonous materials. This was a repeat violation.”

“Snow blocked egress from the home's dining room onto the patio and to the exit gate from the patio, obstructing emergency exit routes.”

“A resident admitted to the Secure Dementia Care Unit lacked documentation showing that the resident and designated person have not objected to the admission. This was a repeat violation.”

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

“Resident has an enabler that is not properly attached to their bedframe, creating a 10-inch gap between the enabler and the mattress, which is a repeat violation.”

“The home's record of direct care staff training does not include content of course, training source, and length of the courses.”

“Multiple residents' most recent assessments were not completed within the required annual timeframe.”

“Multiple instances of prescribed medications not being administered as prescribed, including missing tablet administration, spray administration, pain medication, insulin administration at incorrect dose, and missing doses. This is a repeat violation.”

“There is no bedside table or shelf beside a resident's bed in their bedroom.”

“The refrigerator in the Memory care unit had multiple red sticky stains in the interior, failing to maintain sanitary conditions.”

“A resident does not have access to a source of light that can be turned on/off at bedside, which is a repeat violation.”

“There was an unlabeled, undated container of peaches in the memory care refrigerator, violating the requirement that outdated or spoiled food may not be used.”

“A resident's medical evaluation did not include medical diagnosis including physical or mental disabilities, medical information pertinent to diagnosis and treatment in case of emergency, immunization history, or special health or dietary needs.”

“The home's current license was not posted in a conspicuous and public place in the home.”

“On 5/22/2025, a resident left a water faucet running overnight causing water damage to bedrooms below and requiring resident relocation; the facility did not report this incident to the department until 6/20/2025. Additionally, a power outage caused exit doors in the Memory Care Unit to malfunction and remain unlocked all night, which was never reported to the department.”

“On 6/18/25, there was no toilet paper in resident 2's bathroom as it was kept out of reach on top of the bathroom cabinet based on the resident's history of clogging the toilet, which does not respect the resident's dignity and right to bathroom access.”

“Staff Member A and Staff Member B do not have criminal background checks in accordance with the Older Adult Protective Services Act. Staff Members C and D had delays between their hire dates and when criminal background checks were completed.”

“Direct care staff persons C, D, E, F, and G do not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry. This is a repeat violation from 11/26/2024.”

“Staff person B did not receive orientation on evacuation procedures, staff duties and responsibilities during fire drills and emergency evacuation, designated meeting place, smoking safety procedures and smoking policy, location and use of fire extinguishers, smoke detectors and fire alarms, and telephone use and notification of emergency services. Staff person G also did not receive orientation on evacuation procedures and related emergency preparedness topics.”

“The 1st floor laundry room is missing two fluorescent tube lights.”

“The medication station where residents' records are stored was unlocked, unattended, and accessible to all residents on the Memory Care Unit.”

“Germ-X hand sanitizer with a manufacturer's label indicating it should be kept out of reach of children was unlocked, unattended, and accessible to residents in the Memory Care Unit medication station. Not all residents have been assessed as capable of recognizing and using poisons safely.”

“Multiple leaks throughout the building including open ceiling tiles in the Terrace Level activity room, hallway, and Main Dining Room with water leaking into trash cans, and a hole in the ceiling of the 1st floor laundry room above the dryer with water leaking into a trash can.”

“The exit door leading to the dumpsters in the Personal Care Unit at the rear of the building has a ramp that is missing a well-secured handrail.”

“A fire alarm box near the memory care unit's rear exit door was missing its transparent plastic cover, exposing the wire.”

“The rear exit from the Terrace Level that leads to the exterior of the building has a white plastic drainpipe that rises from the ground in the center of the walkway, which is approximately 3" to 4" above ground level, creating a tripping hazard.”

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

“Multiple cardboard boxes were stored behind and near the boilers, creating a fire hazard by locating combustible materials near heat sources.”

“The air-conditioning system of the home was inoperable with outside temperature reaching a high of 84 degrees Fahrenheit.”

“All residents of the Secured Dementia Care Unit were denied access to their bedrooms at approximately 1:15pm when staff locked each bedroom door.”

“The furnace had not been inspected as required; the last inspection date was not current. Professional furnace inspection and documentation must be maintained annually.”

“Three staff members did not have complete criminal background checks on file. Staff A had no criminal background documentation available. Staff B attested to not being a Pennsylvania resident for two years but had not completed FBI clearance and PA criminal background check. Staff C moved to Pennsylvania but had not completed FBI clearance.”

“Three staff members (C, D, and E) did not receive required first-day fire safety and emergency preparedness orientation, including evacuation procedures, staff duties during emergencies, designated meeting places, smoking safety procedures, fire extinguisher use, smoke detectors/fire alarms, and emergency services notification. This is a repeat violation from 9/17/2024.”

“Three staff members (B, C, and D) did not complete required 40-hour orientation training including resident rights, emergency medical plan, mandatory reporting of abuse and neglect, and reporting of reportable incidents and conditions by the time they completed their 40th scheduled work hour. This is a repeat violation from 11/26/2024 and 9/17/2024.”

“Direct care staff member C began providing unsupervised ADL services but did not have documentation of completing and passing the Department-approved direct care training course and competency test in their personnel file.”

“Direct care staff person B received 0 hours of required annual training in 2024. Direct care staff person C received 0 hours of required annual training in 2024.”

“Staff person A was hired without a timely criminal background check request.”

“Staff person A did not receive required first-day fire safety and emergency preparedness orientation covering evacuation procedures, staff duties during emergencies, designated meeting places, smoking safety, fire extinguishers, smoke detectors, fire alarms, and emergency services notification. This is a repeat violation from 9/17/2024 and 7/2/2024.”

“Direct care staff person B did not receive training in medication self-administration, resident needs assessment, dementia care, infection control, personal care services, safe management techniques, or mental illness/intellectual disability care during 2024. Direct care staff person C did not receive training in medication self-administration, resident needs assessment, dementia care, personal care services, safe management techniques, or mental illness/intellectual disability care during 2024. This is a repeat violation from 11/26/2024, 9/17/2024, and 7/2/2024.”

“No ServSafe certified staff were present in the kitchen during meal preparation and service on September 7, 2024, and September 17, 2024 from 4:00 PM to 7:00 PM. The PA Department of Agriculture Food Employee Certification Act requires one food manager certification to be available during all hours of operation.”

“Resident #2 and Resident #3 did not have signed resident-home contracts. The contract must be signed by the resident, administrator or designee, and the payer if different from the resident.”

“No ServSafe certified staff were present in the kitchen during meal preparation and service on September 7, 2024, and September 17, 2024 from 4:00 PM to 7:00 PM. The PA Department of Agriculture Food Employee Certification Act requires one food manager certification to be available during all hours of operation.”

“Resident #2 and Resident #3 did not have signed resident-home contracts. The contract must be signed by the resident, administrator or designee, and the payer if different from the resident.”

“No ServSafe certified staff were present in the kitchen during meal preparation and service on September 7, 2024, and September 17, 2024 from 4:00 PM to 7:00 PM. The PA Department of Agriculture Food Employee Certification Act requires one food manager certification to be available during all hours of operation.”

“Resident #2 and Resident #3 did not have signed resident-home contracts. The contract must be signed by the resident, administrator or designee, and the payer if different from the resident.”

“A resident-to-resident incident involving physical contact (hitting and pushing) was observed by staff and reported to staff person A, but was not reported to the local area agency on aging as required under the Older Adult Protective Services Act.”

“Direct care staff person B does not have a high school diploma, GED, or active registry status on the Pennsylvania nurse aide registry, which is a required qualification for direct care staff.”

“Staff person B did not receive required first-day orientation on fire safety and emergency preparedness topics including evacuation procedures, staff duties during emergencies, designated meeting places, smoking safety, fire extinguishers, smoke detectors, and emergency notification procedures. This is a repeat violation from 11/27/2023.”

“Staff person B completed their 40th scheduled work hour but had not yet completed required orientation training within 40 hours on resident rights, emergency medical plan, mandatory reporting of abuse and neglect under the Older Adult Protective Services Act, and reporting of reportable incidents and conditions. This is a repeat violation from 11/27/2023.”

“Direct care staff person B began providing unsupervised ADL services before completing and passing the Department-approved direct care training course and passing the competency test.”

“A resident requiring two-person assistance for care fell out of a wheelchair when only one staff member was providing care, resulting in a head injury requiring hospital treatment. Staff were aware of the resident's need for two-person assistance.”

“On one date, 72 hours of direct care were required but only 68 hours were provided during waking hours. On another date, 72 hours were required but only 63 hours were provided during waking hours, falling below the 75% waking hours requirement.”

“A sticky substance that looked and smelled like urine was found on the bathroom floor in one bedroom, and a yellow and brown stain that looked like feces was found on the bathroom floor in another bedroom.”

“Floor tile at the bathroom entry for a resident had some missing pieces, creating a hazard.”

“A lamp cover in a bedroom was broken, creating a potential hazard.”

“A resident in a bedroom did not have access to a source of light that could be turned on or off at bedside.”

“Medical evaluations for residents were incomplete: one evaluation dated 11/27/2023 did not include the medication list; one dated 2/14/2023 lacked medical information pertinent to diagnosis and emergency treatment; one dated 5/16/2023 lacked both emergency medical information and the medication list.”

“Deficiency related to fire safety orientation for direct care staff, ancillary staff, substitute personnel, and volunteers prior to or during first work day.”

“Medication omission was not documented on resident medication record, and the home did not report this medication error to the Department within 24 hours as required.”

“The home submitted initial and final incident reports of financial exploitation by a staff member but did not complete, document, or keep a record of an internal investigation or submit findings to the Department.”

“After validating financial exploitation of a resident by staff, the home did not inform other residents who could potentially be harmed or their designated persons immediately following investigation conclusion.”

“Resident was financially exploited when staff member A cashed checks from resident's account without authorization; resident's signature was forged on at least one check. Additionally, agency staff member B roughly handled a resident with dementia by pulling them off bed onto floor during care, and both staff members left resident undressed and uncovered.”

“The home could not provide a current list of all staff including agency staff, as required to be maintained by the administrator.”