Inspection visit
Health inspection
4 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 4 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0553
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Allow resident to participate in the development and implementation of his or her person-centered plan of
care.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
staff and resident's responsible party interview and review of clinical records, it was determined that the
facility failed to ensure that advanced notice was provided to the resident and his emergency contact of
care plan meetings and failed to ensure that care plan meetings were held in a timely manner for 3 out of 3
residents reviewed (Resident R1, R2 and R3).
Findings include:
Review of Resident R1's person-centered plan of care indicated that the resident had impaired thought
processes related to diagnosis of dementia.
Review of a nursing note dated November 22, 2024 at 7:27 a.m. documented that the resident was
disoriented and required cues. Review of a nursing note dated November 22, 2024, at 11:33 p.m.
documented that the resident was confused and required cues. The note also documented that the resident
had a wander guard (a device that is placed on an individual's wrist or ankle, who has been identified as an
elopement risk, and alerts staff when the resident is an area that is not safe) on his left ankle.
Review of a note dated November 26, 2024 at 11:35 a.m. by the facility's physiatrist nurse practitioner
(physiatrist- medical doctor who can diagnosis the cause of pain and develop a comprehensive treatment
plan) providing treatment to the resident at that [NAME] documented that the resident was pleasantly
confused during the visit.
During an interview on January 6, 2024 at 9:12 a.m. the resident's emergency contact reported that
Resident R1 received care at the facility, but that was never any meeting held that she was invited to
regarding his care. The resident's emergency contact reported that the only update that she received was
when she would visit the resident after work in the evening and they would tell her, he had a good day, or
he took all his medications. The emergency contact reported that she asked the nurses on several
occasions to have the Medical Director (Employee E5) so that she can get an updated on how he was
doing, but that the physician never call The emergency contact reported that at one point, she contacted
the therapy department, had a meeting and training with the therapy department and the Social worker
(Employee E8) regarding his progress, and schedule his discharge date was set for December 24, 2024.
Review of the resident's nursing notes indicated that on November 24, 2024, at 10:23 a.m. indicated that
the resident's care plan meeting took place, and that the resident, social services and the nurse unit
manger were present. Continued review of the care plan note and clinical notes did not
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 9
Event ID:
395342
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0553
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
indicate that the resident's emergency contact was notified of the meeting or had the opportunity to
participate.
During an interview with the social worker (Employee E8) on January 8, 2024 at 2:00 p.m. the social worker
reported that care plan meeting are held on Tuesdays and Thursday and that he contacts the responsible
parties for the care plan meetings only if the resident is not alert or oriented. The social worker was asked
how far in advance does he contact the responsible party regarding the care plan meeting, and reported
that if he does not have time he contacts them the day before the care plan meeting is scheduled to occur.
The social worker reported that if the resident is alert and oriented, he meets with the resident in their
room. He reported that he does not ask the alert and oriented resident if there is someone that he/she
wanted to invite to their meeting. It was discussed during the interview that there was no evidence that
resident R1's emergency contact was invited to the care plan meeting on November 27, 2024.
Review of the clinical record for Resident R2 included a social services note dated January 7, 2025 at 1:16
p.m. that plan of care meeting was held on January 7, 2025. Continued review of the clinical record for the 2
prior care plan meeting that the resident should have had showed no evidence that the facility conducted
those meetings.
Review of thee clinical record for Resident R3 included a social services note dated May 2, 2024 at 11:02
a.m. indicating that a care plan meeting took place. Continued review of the clinical reecord included no
additonal care plan meeting conducted by the facility for the resident since that date. During an interview
with the resident on January 9, 2024 at 1:58 p.m. the resident reported that she had not had a care plan
meeting in a while, and that she did not remember the last time that she had one.
During an interview with the social worker (Employee E8) on January 8, 2024 at 2:00 p.m. the social worker
reported that there are care plan meetings that are late, and have not been held.
During an interview with the Regional Nurse, Nursing Home Administrator and the Director of Nursing on
January 9, 2024 at 5:15 p.m. it was confirmed by the Regional Nurse that no additional informaition can be
produced to show evidence that care plan meetings were being held for residents in a timely manner.
28 Pa. Code 201.29(c.3)(1) Resident rights
28 Pa Code 211.11(d) Resident care plan
28 Pa. Code 211.12(c(1) )Nursing services
28 Pa. Code 211.12(d)(1) Nursing services
28 Pa. Code 211.12(d)(5) Nursing services
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 2 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0559
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice
before a change is made.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
staff and resident's emergency contact interviews, review of faciltiy policy and review of clinical records, it
was determined that the facility failed to ensure that documented room change notifications to the resident
and emergency contact were provided for 1 out of 7 residents reviewed (Resident R1).
Findings include:
Review of the facility policy, Room Changes, with a revision date of January 25, 2024, indicated that
Notification of room change of new roommate will be provided within reasonable/required time when
necessary. Continued review of the policy also indicated that social services or designee will process and
coordinate all request for room changes in accordance with state and federal guidelines. Continued review
of the policy indicated that if the room change is patient initiatived, the facility will discuss the move request
with the patient and/or patient representative and appropriate staff.
Review of the December 2024 physician orders for Resident R1 indicated that the resident was admitted
into the facility on November 21, 2024 with diagnoses of history of falling; heart failure (the heart muscles
don't pump as much blood as they should); atrial fibrillation (an irregular and very rapid heart rhythm;
diabetes (a condition in which the body has high blood sugars for prolonged periods of time); dementia
(group of symptoms affecting memory, thinking and social abilities; cognitive communication deficit
(impaired functioning with attention, memory, organizations, problems solving and reasoning);
post-traumatic stress disorder (PTSD-a mental health condition caused by an extremely stressful or
terrifying event); psychotic disturbance (mental health illness characterized by being diassociated from
reality) and mood disturbance (a mental health condition that can cause persistent and intense sadness,
elation and or anger).
Review of the resident person-centered plan of care indicated that the resident had impaired thought
processes related to his diagnosis of dementia.
Review of a nursing note dated November 22, 2024 at 7:27 a.m. documented that the resident was
disoriented and required cues. Review of a nursing note dated November 22, 2024, at 11:33 p.m.
documented that the resident was confused and required cues. The note also documented that the resident
had a wander guard (a device that is placed on an individual's wrist or ankle, who has been identified as an
elopement risk, and alerts staff when the resident is an area that is not safe) on his left ankle.
During an interview with the resident's emergency contact on January 6, 2025 at 9:12 a.m. the emergency
contacted reported that the resident's room was changed from room [ROOM NUMBER] (2nd floor) to room
[ROOM NUMBER] (3rd floor), and that she was not notified of the room change. The emergency contact
reported that she came to visit the resident in room [ROOM NUMBER] on the date that the room change
occurred, did not see him in his room, and was told that he had been transferred to another floor due to a
female resident using the bathroom that he used.
Review of nursing noted dated November 27, 2024 at 1:38 p.m. indicating that a room transfer took place
for the resident.
During a discussion with the Regional Nurse (Employee E3) and the Nursing Home Administrator (NHA)
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 3 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0559
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
on January 8, 2025 at 3:19 p.m. the reason as to why the resident' room was changed could not be
provided by the facility, as various reasons were provided during the interview (e.g. he was moved because
the resident was long term care; he was moved so that he could have a roommate that was more
compatible). It was also discussed during the above referenced interview that there was no indication that
the resident and his emergency contact were provided with written prior notification of the room change
explaining why the room change needed to take place, in addition to other required procedures/steps took
place prior to a room change occurring.
28 Pa. Code 201.14(a) Responsibility of licensee
28 Pa. Code 201.29(c.3) (1) Resident rights
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 4 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0660
Plan the resident's discharge to meet the resident's goals and needs.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
staff interviews, review of facility policy and review of the clinical record, it was determined that the facility
failed to develop and implement an effective discharge planning process for 1 out of 2 residents reviewed
for this care area (Resident R1).
Residents Affected - Few
Findings include:
Review of the facility policy Discharge Planning Process, with a revision date of November 15, 2022
indicated that the facility must implement an effective discharge planning process that focuses on the
patient's/resident's/ discharge goals, the preparation of patients to be active partners and effectively
discharge them to post-discharge care, and the reduction of factors leading to the reduction of factors
leading to preventable readmissions.
Continued review of the policy indicated that the facility's discharge planning process will include, involving
the patient and resident representative in order to establish goals of care and treatment preferences;
recommending options for the continuing care of the patient; referring the patient to programs or services
that meet the patient's assessed needs and preferences; ensuring that there is documentation that the
resident has been asked about his/her interest in receiving information about returning to the community
and if interested, documenting any referrals to local contact agencies or other appropriate entities made for
this purpose and also updating a patient's care plan and discharge plan as appropriate in response to
information received from referrals to local contact agencies of appropriate entities,
Review of Resident R1's person-centered plan of care indicated that the resident had impaired thought
processes related to his diagnosis of dementia.
Review of a nursing note dated November 21, 2024 at 11: 28 p.m. indicated that the resident was admitted
into the facility on the above referenced date for rehabilitation services. Review of a nursing note dated
December 24, 2024, at 7:11 p.m. indicated that the resident was discharged from the facility and
transported back to his home.
Review of the December 2024 physician orders included a physician's orders for Bumetanide 1 milligram
tablet by mouth once a day for heart failure, Metoprolol Succinate ER Tablet Extended Release 24, for heart
failure and hypertension and Haloperidol 0.5-1 milligram tablet by mouth every 12 hours for anxiety and
delusions, and Ferrous Sulfate (a supplement used to treat iron deficiency anemia) as a supplement 1-325
milligram tablet by mouth 2 times a day.
During an interview with the emergency contact on January 6, 2024 at 9:12 a.m. The emergency contact
reported that the resident was scheduled to be discharged on December 24, 2024, and that when he was
discharged , the resident needed prescriptions for the medications that he was ordered to take, but that a
physician was not available to write prescriptions for those medications, and the facility did not have any
medication samples to give her so that the resident could take until a prescription could be fulfilled.
Review of the resident's discharge documents, indicated that the resident was discharged without a
prescription for the medications that he needed to take.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 5 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0660
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
During an interview with a unit manager (Employee E4) who worked on December 26, 2024, the unit
manager reported that the resident's emergency contact called and reported that she still did not have all of
the resident's medication, or any prescriptions for the resident and that he was discharged on December
24, 2024 . During the interview, the Unit manager reported that the physician (Employee E4) was at the
facility on December 26, 2024 so she contacted him to let him know that the prescriptions needed to be
written for the resident's.
During an interview with the Medical Director (MD, Employee E5) on January 8, 2025 at 3:00 p.m., he MD
reported that he did not know that the resident was scheduled for discharge on [DATE]. The MD reported
that he received a call at approximately 5:00 p.m. from the facility on December 24, 2024 requesting that he
write prescriptions for the medications that the resident was on, and explained that he could not write those
prescriptions at that time. The MD reported that he came in on December 26, 2024, wrote all the
prescriptions and nursing faxed them over to the pharmacy that he was instructed to send them to.
28 Pa. Code 211.12(c)(1) )Nursing services
28 Pa. Code 211.12(d)(1) Nursing services
28 Pa. Code 211.12(d)(5) Nursing services
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 6 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observations, staff interviews and review of facility documentation, it was determined that the facility failed
to ensure that an effective pest control program and a pest free environment.
Residents Affected - Some
Findings include:
Review of the facility's contract with a local pest control company which began May 13, 2024 indicated that
the pest control company services will cover mice, ants, all species of roaches, and stinging insects up to
15 ft high. The pest control company indicated that the services in the contract do not include bed bugs,
termites and wildlife.
Continued review of the pest control contract indicated that the company will provide services to the facility
twice monthly, and that the company will inspect, monitor and treat as needed for the above primary
targeted pests, in addition to servicing resident rooms by request, check and date the pest log book in
kitchen, and all nursing stations, in addition to other listed tasks during their visit.
During an interview with the emergency contact for Resident R1 on January 6, 2025 at 9:12 a.m. that she
observed bugs running around the resident's bathroom on several occasions when she would visit.
Review of pest control logs on the 2nd floor indicated the following:
--November 1, 2024 a bunch of roaches running around
--November 15 roaches noted was written, and the floor pantry in addition to a named hall on the floor were
listed as the locations of the roaches.
--November 17, 2024 water bugs and roaches all around 221 D Big ones little bugs.
Review of the pest control logs on the 3rd floor indicated the following:
--November 6, 2024 2 black bugs
--December 21, 2024 2 black roaches
--December 29, 2024 2 black roaches
Review of pest reports from the pest control company from October 30, 2004 through January 2025
indicated that the company provided pest control services to the facility on November 1, 2024; November
15, 2024; and December 6, 2024, and indicated the following:
--room [ROOM NUMBER] .clutter near nightstand, poor sanitation. Will lead to increase activity for pest.
--room [ROOM NUMBER] .observed trash and debris under radiator
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 7 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0925
--room [ROOM NUMBER] .cluttered perimeter
Level of Harm - Minimal harm
or potential for actual harm
During an observation in room [ROOM NUMBER] on January 9, 2025 at 1:50 p.m. Resident R4's side of
the room near the door (221 D) was observed as being covered with food items that consisted of ketchup, a
bottle of pancake syrup with the cap half on, in addition to mustard and hot sauce, candy handing out of the
night stand drawer, in addition to other items on the residents night stand on the left side of the resident's
bed (when facing the resident's bed) and on the residents. The resident's bedside table had food items on it
in addition to about 2 cans of soda. The floor in the resident's room appeared soiled.
Residents Affected - Some
During an observation in room [ROOM NUMBER] for Resident R5 and Resident R6 on January 9, 2025 at
10:34 a.m. several bugs were observed flying throughout the room, debris under the radiator was observed.
During an observation on January 9, 2025, at 2:13 p.m. in room [ROOM NUMBER] approximately 20-30
deceased brown roaches/bugs were observed in a mouse trap that was on the left side of the toilet near the
wall. During an observation on Resident R7's side of the room, 2 open milk cartons, coffee creamers and a
container of food and other items on the left of his bed (when facing his bed), in addition to 4 Styrofoam
cups that were from other dates (one from 12/20) with what appeared to be stains on the tops of the lids
that were on them. There was another opened milk carton and a closed one on the bed side table. A bowl
of uncored peaches was also on the bedside table, in addition to an opened container of what looked like a
dried up container of what could have been chocolate ice cream in a small Styrofoam container. In addition,
about 5-7 empty plastic cups were also observed on the resident's bedside table. About 4-5 more
Styrofoam cups were observed on the resident's night stand that was on the right corner of his room next to
his bed (when stand facing the resident's bed), in addition to other items on the night stand. Resident had
addition items covering his windowsill and heating unit that made the area appear cluttered, in addition to a
plastic container filled with various items (books/papers) next to the heating/cooling unit was also observed.
Additional styrofoam cups that appeared to be filled with beverage items at one point were observed on the
floor on the right of the resident's bed. Two styrofoam cups that were closer to the wall appeared to be filled
with a liquid. Other items were also on the floor. There was a smell/stench when you entered the resident's
room and the resident's floor was soiled. Resident R7 reported that he sees roaches in his room all of the
time, especially in the bathroom.
Observations in the above referenced rooms showed now evidence that the recommendations/comments
made during the visit on December 6, 2024 were implemented by the facility to ensure a pest free
environment for residents.
Review of pest control logs on the 2nd floor indicated the following:
--November 1, 2024 a bunch of roaches running around
--November 15 roaches noted was written, and the floor pantry in addition to a named hall on the floor were
listed as the locations of the roaches.
--November 17, 2024 water bugs and roaches all around 221 D Big ones little bugs.
Review of the pest control logs on the 3rd floor indicated the following:
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 8 of 9
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
395342
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/09/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Hopkins Center
8100 Washington Lane
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0925
--November 6, 2024 2 black bugs
Level of Harm - Minimal harm
or potential for actual harm
--December 21, 2024 2 black roaches
--December 29, 2024 2 black roaches
Residents Affected - Some
During an interview with the Regional Nurse, Nursing Home Administrator (NHA) and the Director of
Nursing on January 9, 2024 at 5:15 p.m. it was discussed that from the obervations made in the above
referenced room recommendations/comments that the pest control company left after their visit
28 Pa Code 201.14(a) Responsibility of licensee
28 Pa Code 201.18(b)(3) Management
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395342
If continuation sheet
Page 9 of 9
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Back to topCitations
4 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F553 - The right to participate in the development and implementation of his or her
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
F559 - The right to share a room with his or her spouse when married residents live
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
F660 - Quality of life
Plan the resident's discharge to meet the resident's goals and needs.
F925 - Maintain an effective pest control program so that the facility is free of
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
FAQ · About this visit
Common questions about this visit
What happened during the January 9, 2025 survey of HOPKINS CENTER?
This was a inspection survey of HOPKINS CENTER on January 9, 2025. The surveyor cited 4 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at HOPKINS CENTER on January 9, 2025?
Yes, 4 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Allow resident to participate in the development and implementation of his or her person-centered plan of care."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.