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Nursing Home Oversight


Nursing homes are commonly referred to as nursing care facilities or long term care facilities.  Nursing homes are inspected annually by the Pennsylvania Department of Health (Department). The Department of Health has been given the responsibility of inspecting Pennsylvania’s nursing homes by the Centers for Medicare and Medicaid Services, a branch of the federal government.  These inspections are called surveys. The Department of Health conducts surveys in nursing homes to make sure they are following state and federal regulations (rules). Nursing homes that have a history of serious problems are inspected more frequently. 


Nursing Home Inspection Process


Survey Team Selection

The team includes a registered nurse (RN) and may include a nutritionist or social worker. The composition of the team is unique to each facility and is determined by the facility history regarding past problems at the nursing home.  All surveyors, no matter what their professional background, have been trained as generalists.  This means that any of the team members have the skill to determine how well the nursing home provides services from all professions.

Survey Team Evaluation 

Surveys usually cover several days and can take place at any time of the day or night.  Surveys are not announced in advance so nursing homes do not know when a survey might happen. The team does the following:

  • examines how well the nursing home ensures that its residents feel “at home.”
  • evaluates how well the nursing home provides care to its residents by meeting minimum regulatory standards, including the following needs:
    • medical;
    • nursing;
    • social;
    • psychological;
    • nutritional;
    • emotional;
    • spiritual; and
    • physical.
  • uses tools to determine the quality of care and quality of life of nursing home residents, including checklists and forms that guide what the surveyor observes, reads and participates in while at the nursing home.

If you are at a nursing home while a survey is in process, you might see surveyors doing some of the following:

  • observing how the staff and residents talk and interact with each other;
  • watching how the staff provides nursing care to residents;
  • interviewing residents and family to see how they feel about the care they are receiving;
  • reviewing resident charts to see if necessary services are identified and provided;
  • touring the facility to see if the environment is comfortable and safe for the residents;
  • observing meals to assure the food is nutritionally balanced, attractive, the right temperature and tastes good;
  • observing nurses giving medications and providing treatment to residents; 
  • meeting with groups of residents such as resident councils to determine if there are widespread problems in the nursing home; and 
  • meeting with staff and administrators to see if they have developed ways of solving problems in the nursing home.  

Survey Team Results
When the surveyors have made enough observations to complete the survey tasks, they will talk to the administrator, staff and residents before leaving the facility and discuss areas of concern that were identified while they were at the facility. The surveyors then return to their office to write the official report of their observations. For every problem that they identify, the surveyors must decide how serious the problem is for the residents. This is called “assigning scope and severity.” It reflects both how serious and how often a problem occurs in the nursing home. The surveyors write a description of the problems, which is then called a “statement of deficiencies.” They send a copy of their report to the nursing home requesting that it submit a plan to correct the problems. The nursing home must submit in writing its proposed solutions to the problems; this is called a “plan of correction.” You can ask to see a copy of this report at any nursing home. Nursing homes must have notices posted to tell you where the survey results are kept. You can also view these reports on the Department of Health’s website.  

Depending on the seriousness of the deficiencies, different consequences may be given to the nursing home, which are referred to as enforcement actions.
The following are examples of enforcement actions:
  • impose a ban on admissions and/or re-admissions;
  • issue a provisional license;
  • revoke a nursing facility's license;
  • have the facility lose its right to participate in federal Medicare or state Medicade programs; or
  • civil money penalty.
By providing nursing homes with consequences for quality of care and quality of life problems, the Department of Health strives to protect the health and safety of our valued citizens. The survey process lets nursing homes know what they need to do to make sure residents are receiving care and services to maintain their functional abilities in their “home.”   
Nursing care facilities sanction information for the most recent month may not reflect all sanctions issued that month due The Department of Health, Division of Nursing Care Facilities’ (DNCF) responsibility to ensure that the facility is aware of the sanction prior to posting sanctions on the website.
Nursing care facilities have the right to appeal a sanction up to 30 days from the sanction issue date.  Nursing care facilities sanction information for the most recent month may not reflect whether or not the facility is appealing the sanction.  Sanctions that are appealed may be changed or eliminated depending on the appeal result. 
Nursing care facility sanction information for all months is updated each month with the most current data available to DNCF at the time of posting.


Want to File a concern or Complaint?

Speak Up. We're Listening.
If you have a concern or complaint, call 800-254-5164 or complete a Nursing Home Complaints form.