D68

GARDEN SPRING NURSING AND REHABILITATION CENTER

Grade D 68/100 composite score

For profit - Corporation

CMS Star Ratings

Overall
2/5
Health Insp.
2/5
Quality
3/5
Staffing
2/5
RN Staffing
Not rated

Certified Beds

173

Ownership

For profit - Corporation

Total Fines

None

Last Survey

N/A

1113 NORTH EASTON ROAD, WILLOW GROVE, PA 19090
2158305400

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Staffing Hours & Turnover

Hours per Resident per Day (PBJ)

RN
0.48h
LPN
1.21h
CNA
1.99h
Total
3.68h
Facility
State Average

Turnover Rates

RN Turnover
N/A
Total Nurse Turnover
N/A
Admin Turnover
N/A

Ownership

BH OPCO HOLDCO LLC

Organization5% OR GREATER DIRECT OWNERSHIP INTERESTSince Jul 2019

100%

CHRH EQUITIES LLC

Organization5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2021

ENS HOLDINGS, LLC

Organization5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2021

THE ENS FAMILY TRUST

Organization5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2021

YMCS EQUITIES LLC

Organization5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2021

GOTTESMAN, DANIEL

Individual5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2021

HERZKA, YISROEL

Individual5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2019

KOPELOWITZ, SHAUL

Individual5% OR GREATER INDIRECT OWNERSHIP INTERESTSince Jul 2019

HERZKA, YISROEL

IndividualCORPORATE OFFICERSince Jul 2021

ARON, YEHOSHUA

IndividualW-2 MANAGING EMPLOYEESince Jul 2019

Penalties & Fines

No penalties or fines on record.

Health Inspection Deficiencies (45)

November 5, 2025Health1 deficiency1 severe
0880KImmediate jeopardy, Pattern

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Dec 9, 2025
July 11, 2025Health5 deficiencies
0677DMinimal harm, Isolated

Provide care and assistance to perform activities of daily living for any resident who is unable.

Quality of Life and Care Deficiencies

Corrected Aug 12, 2025
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected Aug 12, 2025
0686DMinimal harm, Isolated

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Quality of Life and Care Deficiencies

Corrected Aug 12, 2025
0880DMinimal harm, Isolated

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Aug 12, 2025
0921EMinimal harm, Pattern

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Environmental Deficiencies

Corrected Aug 12, 2025
October 18, 2024Health3 deficiencies
0607DMinimal harm, Isolated

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Nov 7, 2024
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected Nov 7, 2024
0623CNo harm, Widespread

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Resident Rights Deficiencies

Corrected Nov 7, 2024
October 2, 2024Health1 deficiency
0686DMinimal harm, Isolated

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Quality of Life and Care Deficiencies

Corrected Oct 30, 2024
August 8, 2024Health2 deficiencies
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected Sep 3, 2024
0759DMinimal harm, Isolated

Ensure medication error rates are not 5 percent or greater.

Pharmacy Service Deficiencies

Corrected Sep 3, 2024
July 12, 2024Health2 deficiencies
0558DMinimal harm, Isolated

Reasonably accommodate the needs and preferences of each resident.

Resident Rights Deficiencies

Corrected Jul 29, 2024
0689DMinimal harm, Isolated

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Quality of Life and Care Deficiencies

Corrected Jul 29, 2024
June 17, 2024Health1 deficiency
0559DMinimal harm, Isolated

Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.

Resident Rights Deficiencies

Corrected Jun 25, 2024
February 27, 2024Health1 deficiency
0732CNo harm, Widespread

Post nurse staffing information every day.

Nursing and Physician Services Deficiencies

Corrected Mar 13, 2024
November 16, 2023Health6 deficiencies
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected Dec 19, 2023
0688DMinimal harm, Isolated

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Quality of Life and Care Deficiencies

Corrected Dec 19, 2023
0689DMinimal harm, Isolated

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Quality of Life and Care Deficiencies

Corrected Dec 19, 2023
0699DMinimal harm, Isolated

Provide care or services that was trauma informed and/or culturally competent.

Quality of Life and Care Deficiencies

Corrected Dec 19, 2023
0761DMinimal harm, Isolated

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Pharmacy Service Deficiencies

Corrected Dec 19, 2023
0584EMinimal harm, Pattern

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Resident Rights Deficiencies

Corrected Dec 19, 2023
April 10, 2023Health2 deficiencies
0622DMinimal harm, Isolated

Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

Resident Rights Deficiencies

Corrected May 1, 2023
0695DMinimal harm, Isolated

Provide safe and appropriate respiratory care for a resident when needed.

Quality of Life and Care Deficiencies

Corrected May 1, 2023
December 2, 2022Health21 deficiencies
0850CNo harm, Widespread

Hire a qualified full-time social worker in a facility with more than 120 beds.

Administration Deficiencies

Corrected Jan 12, 2023
0698DMinimal harm, Isolated

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0677DMinimal harm, Isolated

Provide care and assistance to perform activities of daily living for any resident who is unable.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0580DMinimal harm, Isolated

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Resident Rights Deficiencies

Corrected Jan 12, 2023
0584EMinimal harm, Pattern

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Resident Rights Deficiencies

Corrected Jan 12, 2023
0609DMinimal harm, Isolated

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Jan 12, 2023
0645DMinimal harm, Isolated

PASARR screening for Mental disorders or Intellectual Disabilities

Resident Assessment and Care Planning Deficiencies

Corrected Jan 12, 2023
0656EMinimal harm, Pattern

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Resident Assessment and Care Planning Deficiencies

Corrected Jan 12, 2023
0657DMinimal harm, Isolated

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Resident Assessment and Care Planning Deficiencies

Corrected Jan 12, 2023
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0688DMinimal harm, Isolated

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0689DMinimal harm, Isolated

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0690DMinimal harm, Isolated

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0692DMinimal harm, Isolated

Provide enough food/fluids to maintain a resident's health.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0697DMinimal harm, Isolated

Provide safe, appropriate pain management for a resident who requires such services.

Quality of Life and Care Deficiencies

Corrected Jan 12, 2023
0756EMinimal harm, Pattern

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Pharmacy Service Deficiencies

Corrected Jan 12, 2023
0812FMinimal harm, Widespread

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Nutrition and Dietary Deficiencies

Corrected Jan 12, 2023
0880FMinimal harm, Widespread

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Jan 12, 2023
0623CNo harm, Widespread

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Resident Rights Deficiencies

Corrected Jan 12, 2023
0637DMinimal harm, Isolated

Assess the resident when there is a significant change in condition

Resident Assessment and Care Planning Deficiencies

Corrected Jan 12, 2023
0641EMinimal harm, Pattern

Ensure each resident receives an accurate assessment.

Resident Assessment and Care Planning Deficiencies

Corrected Jan 12, 2023

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Frequently Asked Questions

What is the CareGrader rating for GARDEN SPRING NURSING AND REHABILITATION CENTER?

GARDEN SPRING NURSING AND REHABILITATION CENTER in WILLOW GROVE, Pennsylvania has a CareGrader grade of D (Below Average), with a composite score of 67.5 out of 100. This grade is based on health inspections, staffing levels, quality measures, and penalty history from official CMS government data.

What is the CMS star rating for GARDEN SPRING NURSING AND REHABILITATION CENTER?

GARDEN SPRING NURSING AND REHABILITATION CENTER has an overall CMS star rating of 2 out of 5, a health inspection rating of 2/5, and a staffing rating of 2/5. CareGrader combines this with additional data to calculate an A-F grade.

How many health deficiencies does GARDEN SPRING NURSING AND REHABILITATION CENTER have?

GARDEN SPRING NURSING AND REHABILITATION CENTER has 45 health deficiencies on record from CMS health inspection surveys. Deficiencies are rated from A (minimal harm potential) to L (immediate jeopardy, widespread). View the full inspection timeline above for details on each deficiency.

How many beds does GARDEN SPRING NURSING AND REHABILITATION CENTER have?

GARDEN SPRING NURSING AND REHABILITATION CENTER has 173 certified beds with approximately 131 current residents (76% occupancy). The facility is located at 1113 NORTH EASTON ROAD, WILLOW GROVE, Pennsylvania 19090. It is a for profit - corporation facility.

Data Disclaimer

Inspection data, staffing levels, and star ratings are sourced from CMS Medicare Nursing Home Compare and are largely self-reported by facilities. A 2019 GAO study found that 43% of facilities under-reported falls. CareGrader provides this data for informational purposes only and is not affiliated with CMS or Medicare. Always visit facilities in person before making a decision.