Cycle 1
Health 2025-01-09 · Fire 2025-01-09
1 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
14 fire-safety deficiencies
Top issue: Emergency Preparedness (7 deficiencies)
Newtown Square, PA
Hcc At White Horse Village
5-star overall rating with 4-star inspections with 1 recent health deficiencies with 14 fire-safety deficiencies in the latest cycle
535 Gradyville Road, Newtown Square, PA
(610) 558-5044
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
55
Certified beds
Average residents
45
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1990-07-30
CMS approved date
Coverage
Medicare
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
1.72
Registered nurse staffing · state 0.78 · national 0.68
LPN hours / resident day
0.51
Licensed practical nurse staffing · state 0.91 · national 0.87
Aide hours / resident day
3.24
Nurse aide staffing · state 2.20 · national 2.35
Total nurse hours
5.47
All reported nurse hours · state 3.89 · national 3.89
Licensed hours
2.23
RN + LPN hours · state 1.69 · national 1.54
Weekend hours
5.14
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
1.50
Weekend registered nurse coverage · state 0.55 · national 0.47
Physical therapist
0.18
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
2.00
CMS adjusted RN staffing hours
Adjusted total hours
6.36
CMS adjusted total nurse staffing hours
Case-mix index
1.18
Higher values indicate more complex resident acuity
RN turnover
11%
Annual RN turnover · state 43% · national 45%
Total nurse turnover
42%
Annual nurse turnover · state 47% · national 46%
SNF VBP
Value-based purchasing
Program rank
270
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
74.90
Composite VBP score used to determine payment impact.
Payment multiplier
1.0244
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
6.32
Baseline 20.09% · Performance 18.50% · Measure score 6.32 · Achievement 6.32 · Improvement 4.68
Healthcare-associated infections
10
Baseline 5.81% · Performance 4.98% · Measure score 10 · Achievement 10 · Improvement 9
Total nurse turnover
5.36
Baseline 44.93% · Performance 41.77% · Measure score 5.36 · Achievement 5.36 · Improvement 1.07
Adjusted total nurse staffing
8.28
Baseline 4.62 hours · Performance 5.43 hours · Measure score 8.28 · Achievement 8.28 · Improvement 6.50
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.32% |
10.72%
0.4 pts better
|
No Different than the National Rate · Eligible stays 144 · Observed rate 7.64% · Lower 95% interval 7.06% |
| Discharge to community | 64.02% |
50.57%
13.4 pts better
|
Better than the National Rate · Eligible stays 127 · Observed rate 66.93% · Lower 95% interval 56.94% |
| Medicare spending per beneficiary | 0.67 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 96.23% |
95.27%
1 pts better
|
Numerator 102 · Denominator 106 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 106 |
| Discharge self-care score | 70.33% |
53.69%
16.6 pts better
|
Numerator 64 · Denominator 91 |
| Discharge mobility score | 62.64% |
50.94%
11.7 pts better
|
Numerator 57 · Denominator 91 |
| Pressure ulcers or injuries, new or worsened | 1.9% |
2.29%
0.4 pts better
|
Numerator 2 · Denominator 105 · Adjusted rate 2.46% |
| Healthcare-associated infections requiring hospitalization | 4.98% |
7.12%
2.1 pts better
|
No Different than the National Rate · Eligible stays 100 · Observed rate 0% · Lower 95% interval 2.56% |
| Staff COVID-19 vaccination coverage | 4.88% |
8.2%
3.3 pts worse
|
Numerator 6 · Denominator 123 |
| Staff flu vaccination coverage | 76.1% |
42%
34.1 pts better
|
Numerator 191 · Denominator 251 |
| Discharge function score | 63.74% |
56.45%
7.3 pts better
|
Numerator 58 · Denominator 91 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 12 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 68 · Denominator 68 |
| Resident COVID-19 vaccinations up to date | 43.75% |
25.2%
18.6 pts better
|
Numerator 21 · Denominator 48 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.8 |
1.7
0.9 pts better
|
1.9
1.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.5 · Expected 1.2 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.5 |
1.2
0.7 pts better
|
1.8
1.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.5 · Observed 0.3 · Expected 1.1 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 77.1% |
86.9%
9.8 pts worse
|
93.4%
16.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 76.5% · Q2 74.4% · Q3 77.8% · Q4 80.0% · 4Q avg 77.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
93.5%
6.5 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.8% |
3.2%
0.4 pts better
|
3.3%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.9% · Q2 2.6% · Q3 2.8% · Q4 2.9% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 2.2% |
6.5%
4.3 pts better
|
11.4%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.2% · Q2 2.6% · Q3 0.0% · Q4 0.0% · 4Q avg 2.2% |
| Percentage of long-stay residents who lose too much weight | 1.8% |
6.5%
4.7 pts better
|
5.4%
3.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.7% · Q2 0.0% · Q3 3.6% · Q4 0.0% · 4Q avg 1.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 15.9% |
19.9%
4 pts better
|
19.6%
3.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 18.5% · Q2 17.9% · Q3 10.7% · Q4 16.7% · 4Q avg 15.9% |
| Percentage of long-stay residents who received an antipsychotic medication | 4.1% |
18.7%
14.6 pts better
|
16.7%
12.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 7.7% · Q3 0.0% · Q4 4.0% · 4Q avg 4.1% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 11.8% |
19.6%
7.8 pts better
|
16.3%
4.5 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 11.8% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 21.8% |
18.3%
3.5 pts worse
|
14.9%
6.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 17.4% · Q2 30.8% · Q3 24.0% · Q4 14.8% · 4Q avg 21.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
0.9%
0.9 pts better
|
1.0%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.0% |
1.7%
1.7 pts better
|
1.7%
1.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 21.8% |
26.4%
4.6 pts better
|
19.8%
2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.6% · Q2 31.6% · Q3 11.0% · Q4 15.2% · 4Q avg 21.8% |
| Percentage of long-stay residents with pressure ulcers | 0.0% |
5.3%
5.3 pts better
|
5.1%
5.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 87.6% |
68.9%
18.7 pts better
|
81.7%
5.9 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 80.4% · Q2 85.7% · Q3 91.5% · Q4 93.4% · 4Q avg 87.6% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 9.7% |
9.8%
0.1 pts better
|
12.0%
2.3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 9.7% · Observed 8.4% · Expected 9.7% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.3% |
1.5%
0.2 pts better
|
1.6%
0.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.9% · Q3 1.8% · Q4 1.7% · 4Q avg 1.3% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 92.4% |
68.7%
23.7 pts better
|
79.7%
12.7 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 92.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 18.1% |
23.1%
5 pts better
|
23.9%
5.8 pts better
|
Short Stay · 20240701-20250630 · Adjusted 18.1% · Observed 13.7% · Expected 18.1% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-02-23 · Fire 2024-02-23
2 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
5 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cycle 3
Health 2023-04-06 · Fire 2023-04-06
0 health deficiencies
No concentrated health issue counts in this cycle.
8 fire-safety deficiencies
Top issue: Smoke (5 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-01-09
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-02-10
F · Potential for more than minimal harm
2025-01-09
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2025-02-10
E · Potential for more than minimal harm
2025-01-09
K131 · Construction Deficiencies
Fire Safety
Meet requirements for sections of health care facilities separated by fire resistive construction.
Corrected 2025-02-10
E · Potential for more than minimal harm
2025-01-09
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-02-10
E · Potential for more than minimal harm
2025-01-09
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2025-02-10
E · Potential for more than minimal harm
2025-01-09
K374 · Smoke Deficiencies
Fire Safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2025-02-10
E · Potential for more than minimal harm
2025-01-09
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E23 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for medical documentation.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E24 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for volunteers.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E26 · Emergency Preparedness Deficiencies
Fire Safety
Establish roles under a Waiver declared by secretary.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E33 · Emergency Preparedness Deficiencies
Fire Safety
Establish methods for sharing information.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E34 · Emergency Preparedness Deficiencies
Fire Safety
Provide a means of sharing information on occupancy/needs.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E35 · Emergency Preparedness Deficiencies
Fire Safety
Provide family notifications of emergency plan.
Corrected 2025-02-10
B · Minimal harm
2025-01-09
E7 · Emergency Preparedness Deficiencies
Fire Safety
Address patient/client population and determine types of services needed.
Corrected 2025-02-10
E · Potential for more than minimal harm
2024-02-23
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2024-04-29
E · Potential for more than minimal harm
2024-02-23
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2024-04-29
D · Potential for more than minimal harm
2024-02-23
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2024-05-20
D · Potential for more than minimal harm
2024-02-23
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-04-29
C · Minimal harm
2024-02-23
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-04-29
F · Potential for more than minimal harm
2023-04-06
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-07-06
E · Potential for more than minimal harm
2023-04-06
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2023-07-06
E · Potential for more than minimal harm
2023-04-06
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-06-11
E · Potential for more than minimal harm
2023-04-06
K362 · Smoke Deficiencies
Fire Safety
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Corrected 2023-06-11
E · Potential for more than minimal harm
2023-04-06
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-06-11
E · Potential for more than minimal harm
2023-04-06
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2023-06-11
E · Potential for more than minimal harm
2023-04-06
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2023-06-11
E · Potential for more than minimal harm
2023-04-06
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2023-06-11
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-01-09
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-02-07
D · Potential for more than minimal harm
2024-02-23
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-04-23
D · Potential for more than minimal harm
2024-02-23
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2024-04-23
Penalties and ownership
What sits behind the stars
Ownership
Ciechanowski, Helena
Corporate Director · Individual
Deming-Murphy, Joan
Corporate Director · Individual
Hammond, Michael
Corporate Director · Individual
Hansen, Pamela
Corporate Director · Individual
Huang, George
Corporate Director · Individual
Kassabian, Dikran
Corporate Director · Individual
Magnavita, Michael
Corporate Director · Individual
Magnavita, Michael
Corporate Officer · Individual
Mclaughlin, Marylou
Corporate Director · Individual
Miller, Alisa
Corporate Officer · Individual
Miller, Alisa
Contracted Managing Employee · Individual
Owens, Sarah
Corporate Director · Individual
Quinones, Jeanntte
W-2 Managing Employee · Individual
Siebeneich, Ursula
Corporate Director · Individual
Weiser, Len
Operational/Managerial Control · Individual
Weiser, Len
Corporate Officer · Individual
Weiser, Len
W-2 Managing Employee · Individual
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#3
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5-star overall rating with 5-star inspections
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