Hermitage, PA

Hermitage Nursing And Rehabilitation

4-star overall rating with 4-star inspections with 3 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle

500 Clarksville Road, Hermitage, PA

(724) 981-6610

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

4 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

105

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Embassy Healthcare

Operator or chain grouping

Approved since

1968-03-11

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

37 facilities

Chain averages 3 overall / 2 health / 2 staffing / 5 quality stars

Changed ownership

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

0.44

Registered nurse staffing · state 0.78 · national 0.68

LPN hours / resident day

0.93

Licensed practical nurse staffing · state 0.91 · national 0.87

Aide hours / resident day

1.96

Nurse aide staffing · state 2.20 · national 2.35

Total nurse hours

3.32

All reported nurse hours · state 3.89 · national 3.89

Licensed hours

1.36

RN + LPN hours · state 1.69 · national 1.54

Weekend hours

3.07

Weekend nurse staffing · state 3.51 · national 3.43

Weekend RN hours

0.30

Weekend registered nurse coverage · state 0.55 · national 0.47

Physical therapist

0.02

Reported PT staffing · state 0.10 · national 0.07

Adjusted RN hours

0.49

CMS adjusted RN staffing hours

Adjusted total hours

3.69

CMS adjusted total nurse staffing hours

Case-mix index

1.23

Higher values indicate more complex resident acuity

RN turnover

33%

Annual RN turnover · state 43% · national 45%

Total nurse turnover

48%

Annual nurse turnover · state 47% · national 46%

SNF VBP

Value-based purchasing

Program rank

5,105

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

37.39

Composite VBP score used to determine payment impact.

Payment multiplier

0.9906

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

4.13

Baseline 17.11% · Performance 19.52% · Measure score 4.13 · Achievement 4.13 · Improvement 0

Healthcare-associated infections

7.36

Baseline 6.01% · Performance 5.64% · Measure score 7.36 · Achievement 7.36 · Improvement 3.21

Total nurse turnover

2.20

Baseline 58.54% · Performance 54.67% · Measure score 2.20 · Achievement 2.20 · Improvement 0.65

Adjusted total nurse staffing

1.27

Baseline 3.37 hours · Performance 3.44 hours · Measure score 1.27 · Achievement 1.27 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	11.22%	10.72% 0.5 pts worse	No Different than the National Rate · Eligible stays 85 · Observed rate 12.94% · Lower 95% interval 7.68%
Discharge to community	52.69%	50.57% 2.1 pts better	No Different than the National Rate · Eligible stays 83 · Observed rate 45.78% · Lower 95% interval 42.74%
Medicare spending per beneficiary	0.78	1.02 0.2 pts better
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 73 · Denominator 73
Falls with major injury	1.37%	0.77% 0.6 pts worse	Numerator 1 · Denominator 73
Discharge self-care score	36.84%	53.69% 16.8 pts worse	Numerator 21 · Denominator 57
Discharge mobility score	36.84%	50.94% 14.1 pts worse	Numerator 21 · Denominator 57
Pressure ulcers or injuries, new or worsened	4.11%	2.29% 1.8 pts worse	Numerator 3 · Denominator 73 · Adjusted rate 3.66%
Healthcare-associated infections requiring hospitalization	5.64%	7.12% 1.5 pts better	No Different than the National Rate · Eligible stays 44 · Observed rate 0% · Lower 95% interval 3.35%
Staff COVID-19 vaccination coverage	2.88%	8.2% 5.3 pts worse	Numerator 3 · Denominator 104
Staff flu vaccination coverage	11.5%	42% 30.5 pts worse	Numerator 13 · Denominator 113
Discharge function score	47.37%	56.45% 9.1 pts worse	Numerator 27 · Denominator 57
Transfer of health information to provider	100%	95.95% 4 pts better	Numerator 43 · Denominator 43
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 10 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	12.5%	25.2% 12.7 pts worse	Numerator 5 · Denominator 40

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	98.3%	86.9% 11.4 pts better	93.4% 4.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 97.3% · Q4 96.2% · 4Q avg 98.3%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	98.8%	93.5% 5.3 pts better	95.5% 3.3 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 98.8%
Percentage of long-stay residents experiencing one or more falls with major injury	4.6%	3.2% 1.4 pts worse	3.3% 1.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 4.2% · Q3 6.7% · Q4 5.1% · 4Q avg 4.6% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	0.0%	6.5% 6.5 pts better	11.4% 11.4 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 who lose too much weight	5.6%	6.5% 0.9 pts better	5.4% 0.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 6.9% · Q2 4.4% · Q3 6.9% · Q4 4.0% · 4Q avg 5.6%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	9.0%	19.9% 10.9 pts better	19.6% 10.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 6.9% · Q2 8.8% · Q3 11.0% · Q4 9.3% · 4Q avg 9.0%
Percentage of long-stay residents who received an antipsychotic medication	27.4%	18.7% 8.7 pts worse	16.7% 10.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 21.8% · Q2 28.6% · Q3 28.3% · Q4 30.5% · 4Q avg 27.4% · 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	8.3%	19.6% 11.3 pts better	16.3% 8 pts better	Long Stay · 2024Q4-2025Q3 · Q1 10.3% · Q2 9.5% · Q3 3.0% · Q4 10.2% · 4Q avg 8.3% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	5.2%	18.3% 13.1 pts better	14.9% 9.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 6.0% · Q2 4.8% · Q3 5.8% · Q4 4.2% · 4Q avg 5.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.5%	0.9% 0.4 pts better	1.0% 0.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 0.0% · Q3 0.0% · Q4 0.8% · 4Q avg 0.5% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	1.0%	1.7% 0.7 pts better	1.7% 0.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 1.4% · Q3 0.0% · Q4 1.3% · 4Q avg 1.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	27.2%	26.4% 0.8 pts worse	19.8% 7.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 24.8% · Q2 21.2% · Q3 37.2% · Q4 25.3% · 4Q avg 27.2%
Percentage of long-stay residents with pressure ulcers	7.8%	5.3% 2.5 pts worse	5.1% 2.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 10.9% · Q3 7.6% · Q4 4.6% · 4Q avg 7.8% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	41.5%	68.9% 27.4 pts worse	81.7% 40.2 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 44.4% · Q2 39.3% · Q3 41.6% · Q4 40.6% · 4Q avg 41.5%
Percentage of short-stay residents who had an outpatient emergency department visit	9.3%	9.8% 0.5 pts better	12.0% 2.7 pts better	Short Stay · 20240701-20250630 · Adjusted 9.3% · Observed 9.1% · Expected 11.0% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	1.5%	1.5% About the same	1.6% 0.1 pts better	Short Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 3.1% · Q3 0.0% · Q4 0.0% · 4Q avg 1.5% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	63.1%	68.7% 5.6 pts worse	79.7% 16.6 pts worse	Short Stay · 2024Q3-2025Q2 · 4Q avg 63.1%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	19.0%	23.1% 4.1 pts better	23.9% 4.9 pts better	Short Stay · 20240701-20250630 · Adjusted 19.0% · Observed 16.4% · Expected 20.5% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-12-04 · Fire 2025-12-04

3 health deficiencies

Top issue: Nursing and Physician Services (1 deficiency)

2 fire-safety deficiencies

Top issue: Emergency Preparedness (1 deficiency)

Cycle 2 Health 2024-11-15 · Fire 2024-11-15

4 health deficiencies

Top issue: Resident Rights (3 deficiencies)

4 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 3 Health 2023-12-21 · Fire 2023-12-21

14 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

5 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Fire safety

Fire-safety citations

C · Minimal harm 2025-12-04

E36 · Emergency Preparedness Deficiencies

Fire Safety

Establish emergency prep training and testing.

Corrected 2026-01-14

C · Minimal harm 2025-12-04

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2026-01-14

F · Potential for more than minimal harm 2024-11-15

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2024-12-31

E · Potential for more than minimal harm 2024-11-15

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2024-12-31

D · Potential for more than minimal harm 2024-11-15

K912 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have power receptacles that are properly grounded.

Corrected 2024-12-31

C · Minimal harm 2024-11-15

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2024-12-31

F · Potential for more than minimal harm 2023-12-21

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2024-02-13

F · Potential for more than minimal harm 2023-12-21

K761 · Miscellaneous Deficiencies

Fire Safety

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

Corrected 2024-02-13

F · Potential for more than minimal harm 2023-12-21

K914 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

Corrected 2024-02-13

E · Potential for more than minimal harm 2023-12-21

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-02-13

C · Minimal harm 2023-12-21

E39 · Emergency Preparedness Deficiencies

Fire Safety

Conduct testing and exercise requirements.

Corrected 2024-02-13

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-12-04

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 2025-12-05

D · Potential for more than minimal harm 2025-12-04

F947 · Nursing and Physician Services Deficiencies

Health

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Corrected 2025-12-05

D · Potential for more than minimal harm 2025-09-18

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-10-13

D · Potential for more than minimal harm 2024-11-15

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-12-31

B · Minimal harm 2024-11-15

F623 · Resident Rights Deficiencies

Health

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

Corrected 2024-12-31

B · Minimal harm 2024-11-15

F625 · Resident Rights Deficiencies

Health

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Corrected 2024-12-31

D · Potential for more than minimal harm 2024-03-21

F585 · Resident Rights Deficiencies

Health

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.

Corrected 2024-04-17

E · Potential for more than minimal harm 2024-02-07

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-03-06

E · Potential for more than minimal harm 2023-12-21

F679 · Quality of Life and Care Deficiencies

Health

Provide activities to meet all resident's needs.

Corrected 2024-01-30

D · Potential for more than minimal harm 2023-12-21

F690 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-01-30

D · Potential for more than minimal harm 2023-12-21

F758 · Pharmacy Service Deficiencies

Health

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Corrected 2024-01-30

D · Potential for more than minimal harm 2023-12-21

F761 · Pharmacy Service Deficiencies

Health

Corrected 2024-01-30

D · Potential for more than minimal harm 2023-12-21

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 2024-01-30

B · Minimal harm 2023-12-21

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2024-01-30

E · Potential for more than minimal harm 2023-08-08

F584 · Resident Rights Deficiencies

Health

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.

Corrected 2023-10-07

E · Potential for more than minimal harm 2023-08-08

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-10-07

D · Potential for more than minimal harm 2023-08-08

F725 · Nursing and Physician Services Deficiencies

Health

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Corrected 2023-10-07

D · Potential for more than minimal harm 2023-06-02

F660 · Resident Assessment and Care Planning Deficiencies

Health

Plan the resident's discharge to meet the resident's goals and needs.

Corrected 2023-07-17

E · Potential for more than minimal harm 2023-04-10

F584 · Resident Rights Deficiencies

Health

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.

Corrected 2023-05-01

E · Potential for more than minimal harm 2023-04-10

F678 · Quality of Life and Care Deficiencies

Health

Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.

Corrected 2023-05-01

B · Minimal harm 2023-03-14

F625 · Resident Rights Deficiencies

Health

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Not marked corrected

Penalties and ownership

What sits behind the stars

Ownership

Embassy Pa Tentant Holdings LLC

5% Or Greater Direct Ownership Interest · Organization

100% 2 facilities 2020-05-01

2020 Gsr Dynasty LLC