Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
WEST CHESTER REHABILITATION AND HEALTHCARE CENTER
WEST CHESTER, PA · 180 certified beds · Last Life Safety survey October 3, 2024
CMS Certification Number 395740 · first certified July 1987
Ownership
Operated by MARQUIS HEALTH SERVICES · For profit - Limited Liability company
- Ownership changed October 7, 2022 (change of ownership)from 800 WEST MINER STREET OPERATIONS LLC
Position within PA
6 citations — more than 31% of the 656 certified nursing homes in PA. Compared within PA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated
The latest survey found 1 citation; the earlier surveys on file averaged 2.5. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
Well past the typical window (August 2025 to October 2025), and past the point by which nine in ten PA facilities have been surveyed. This facility’s last Life Safety survey was October 2024. Facilities in PA are typically surveyed 11–12 months after the last one (median 11), measured over 1,101 consecutive surveys in the last two years of CMS records.
A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to about three years in Virginia. How the window is measured
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Physical environment (health survey)
1 physical-environment citation on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 6 Life Safety citations above. The Physical Environment Index
- F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
How that compares
Compared with the median facility in PA, and nationally. Surveyors differ markedly between states, so the PA figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 6 |
| Median facility in PA | 10 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| June 16, 2023 | 0 |
| May 6, 2024 | 5 |
| October 3, 2024 | 1 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0100 | Meet other general requirements. | 1 | 2024-05-06 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 1 | 2024-05-06 |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | 1 | 2024-10-03 |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 1 | 2024-05-06 |
| K-0932 | Meet other general requirements. | 1 | 2024-05-06 |
| K-0291 | Install emergency lighting that can last at least 1 1/2 hours. | 1 | 2024-05-06 |
What the citations cover
- Smoke Deficiencies 2
- Gas, Vacuum, and Electrical Systems Deficiencies 1
- Egress Deficiencies 1
- Construction Deficiencies 1
- Other 1
| Category | Citations |
|---|---|
| Smoke Deficiencies | 2 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 1 |
| Egress Deficiencies | 1 |
| Construction Deficiencies | 1 |
| Miscellaneous Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
October 3, 2024 — 1 citation
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has date of correction (October 6, 2024) |
May 6, 2024 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0100 | Meet other general requirements. | Deficient, Provider has date of correction (May 5, 2024) |
| K-0291 | Install emergency lighting that can last at least 1 1/2 hours. | Deficient, Provider has date of correction (May 5, 2024) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (May 5, 2024) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (May 5, 2024) |
| K-0932 | Meet other general requirements. | Deficient, Provider has date of correction (May 5, 2024) |
Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.