F 0585
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must
establish a grievance policy and make prompt efforts to resolve grievances.
Based on facility policy review, observations, and resident and staff interviews, it was determined that the
facility failed to provide residents access to grievance forms on one of three units observed (Third Floor);
and failed to provide residents access to the right to file written grievances anonymously on three of three
units observed (First, Second, and Third Floor). Findings include: Review of facility policy, titled Resident
Grievances, last reviewed January 2025, read, in part, It is the policy of this facility to support each
resident's and family member's right to voice grievances without discrimination, reprisal or fear of
discrimination or reprisal. Grievances may be voiced in the following forums. Verbal complaint to a staff
member or Grievance Official. Written complaint to a staff member or Grievance Official. Written complaint
to an outside party. Verbal complaint during resident or family council meetings. Via the company toll free
Customer Service Line (if applicable). A grievance may be filed anonymously.During a group interview with
Residents 2, 6, 37, and 73 on July 23, 2025, at 9:59 AM, all four residents revealed they were not sure how
to file a grievance, including how to file one anonymously.Observation on the Second-Floor unit on July 23,
2025, at 10:18 AM, revealed some grievance forms attached to a bulletin board. There was no designated
box or folder, etc. to put the grievances in if residents would prefer to file a grievance anonymously. Another
posting detailed the information for the Grievance Official and stated, If you have any concerns, please
forward them to our social workers or contact the grievance official as listed above, thank you.Interview with
Employee 1 (Nurse Aide) on July 23, 2025, at 10:18 AM, revealed she is not aware of where residents
would put a grievance if they wanted to file anonymously but that they could bring it to Human Resources.
Observation in the First-Floor unit on July 23, 2025, at 10:27 AM, revealed some grievance forms in a folder
attached to a bulletin board. The folder had instructions on it that stated, If you have a concern, please
complete the top section of the form and return it to social services, the Registered Nurse supervisor, or at
any nurses station, thank you!During an interview with the Nursing Home Administrator (NHA) on July 23,
2025, at 10:37 AM, she revealed that the process for residents to file a grievance anonymously would be to
contact herself or a social worker privately. Observation in the Third-Floor unit on July 23, 2025, at 10:39
AM, revealed a bulletin board that did not contain grievance forms. Employee 2 (Social Worker) then went
to get blank grievance forms in a drawer in the locked nurse's station. Further observation on the unit failed
to reveal a designated box or folder, etc. to put the grievances in if residents would prefer to file a grievance
anonymously. Interview with the NHA on July 23, 2025, at 10:39 AM, revealed the forms are usually kept on
the bulletin board and she is unsure as to why they were not there. During an interview with Employee 2 on
July 23, 2025, at 10:41 AM, she revealed the process for residents to file a grievance anonymously would
be to contact herself or the grievance official, and if they wanted it to be anonymous, they would not share
who the grievance came from with other staff members; or residents can put their
(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 2
Event ID:
395786
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
395786
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pleasant View Communities
544 North Penryn Road
Manheim, PA 17545
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 0585
Level of Harm - Minimal harm
or potential for actual harm
grievance in an envelope and hand it a staff member to give to the grievance official or herself. During a
follow up interview with the NHA on July 23, 2025, at 10:54 AM, she revealed the facility was going to
purchase drop boxes for the units so that residents can file written grievances anonymously, and she would
expect residents to have the opportunity to file grievances anonymously. 28 Pa code 201.18(b)(2)(3)
Management28 Pa code 201.29(a) Resident rights
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395786
If continuation sheet
Page 2 of 2