Cycle 1
Health 2025-07-31 · Fire 2025-07-31
1 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Warminster, PA
Masonic Village At Warminster
5-star overall rating with 5-star inspections with 1 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
850 Norristown Road, Warminster, PA
(215) 672-2500
Overall
5 / 5
CMS overall stars
Health inspections
5 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
43
Certified beds
Average residents
38
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1998-10-01
CMS approved date
Coverage
Medicare + Medicaid
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
0.95
Registered nurse staffing · state 0.78 · national 0.68
LPN hours / resident day
0.94
Licensed practical nurse staffing · state 0.91 · national 0.87
Aide hours / resident day
2.55
Nurse aide staffing · state 2.20 · national 2.35
Total nurse hours
4.44
All reported nurse hours · state 3.89 · national 3.89
Licensed hours
1.89
RN + LPN hours · state 1.69 · national 1.54
Weekend hours
3.94
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
0.88
Weekend registered nurse coverage · state 0.55 · national 0.47
Physical therapist
0.26
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
1.07
CMS adjusted RN staffing hours
Adjusted total hours
4.99
CMS adjusted total nurse staffing hours
Case-mix index
1.22
Higher values indicate more complex resident acuity
RN turnover
30%
Annual RN turnover · state 43% · national 45%
Total nurse turnover
44%
Annual nurse turnover · state 47% · national 46%
SNF VBP
Value-based purchasing
Program rank
1,917
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
53.05
Composite VBP score used to determine payment impact.
Payment multiplier
1.0077
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
5.18
Baseline 22.93% · Performance 19.58% · Measure score 5.18 · Achievement 4 · Improvement 5.18
Healthcare-associated infections
3.46
Baseline 5.86% · Performance 6.80% · Measure score 3.46 · Achievement 3.46 · Improvement 0
Total nurse turnover
7.42
Baseline 25.64% · Performance 33.33% · Measure score 7.42 · Achievement 7.42 · Improvement 0
Adjusted total nurse staffing
5.15
Baseline 3.52 hours · Performance 4.54 hours · Measure score 5.15 · Achievement 5.15 · Improvement 4.04
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.49% |
10.72%
1.2 pts better
|
No Different than the National Rate · Eligible stays 69 · Observed rate 5.8% · Lower 95% interval 6.27% |
| Discharge to community | 50.33% |
50.57%
0.2 pts worse
|
No Different than the National Rate · Eligible stays 65 · Observed rate 47.69% · Lower 95% interval 39.66% |
| Medicare spending per beneficiary | 0.75 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 89.74% |
95.27%
5.5 pts worse
|
Numerator 35 · Denominator 39 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 39 |
| Discharge self-care score | 72.22% |
53.69%
18.5 pts better
|
Numerator 26 · Denominator 36 |
| Discharge mobility score | 63.89% |
50.94%
13 pts better
|
Numerator 23 · Denominator 36 |
| Pressure ulcers or injuries, new or worsened | 2.56% |
2.29%
0.3 pts worse
|
Numerator 1 · Denominator 39 · Adjusted rate 2.89% |
| Healthcare-associated infections requiring hospitalization | 6.8% |
7.12%
0.3 pts better
|
No Different than the National Rate · Eligible stays 38 · Observed rate 5.26% · Lower 95% interval 3.78% |
| Staff COVID-19 vaccination coverage | 2.44% |
8.2%
5.8 pts worse
|
Numerator 2 · Denominator 82 |
| Staff flu vaccination coverage | 96.94% |
42%
54.9 pts better
|
Numerator 95 · Denominator 98 |
| Discharge function score | 69.44% |
56.45%
13 pts better
|
Numerator 25 · Denominator 36 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 27 · Denominator 27 |
| Resident COVID-19 vaccinations up to date | 30% |
25.2%
4.8 pts better
|
Numerator 6 · Denominator 20 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
86.9%
13.1 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| 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 | 6.3% |
3.2%
3.1 pts worse
|
3.3%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.3% · Q2 5.4% · Q3 6.1% · Q4 8.6% · 4Q avg 6.3% · 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 | 2.6% |
6.5%
3.9 pts better
|
5.4%
2.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.3% · Q3 3.6% · Q4 3.8% · 4Q avg 2.6% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 19.8% |
19.9%
0.1 pts better
|
19.6%
0.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.6% · Q2 19.4% · Q3 17.9% · Q4 21.4% · 4Q avg 19.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 14.5% |
18.7%
4.2 pts better
|
16.7%
2.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 18.8% · Q2 16.7% · Q3 13.3% · Q4 8.0% · 4Q avg 14.5% · 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 | 27.5% |
19.6%
7.9 pts worse
|
16.3%
11.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 40.7% · Q2 32.1% · 4Q avg 27.5% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 23.9% |
18.3%
5.6 pts worse
|
14.9%
9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 42.4% · Q2 26.7% · Q3 11.1% · Q4 11.1% · 4Q avg 23.9% · 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 | 21.5% |
26.4%
4.9 pts better
|
19.8%
1.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 33.3% · Q2 22.5% · Q3 15.8% · Q4 12.8% · 4Q avg 21.5% |
| Percentage of long-stay residents with pressure ulcers | 4.2% |
5.3%
1.1 pts better
|
5.1%
0.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 2.8% · Q3 5.5% · Q4 5.6% · 4Q avg 4.2% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.3% |
68.9%
30.4 pts better
|
81.7%
17.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 97.4% · Q4 100.0% · 4Q avg 99.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 14.8% |
9.8%
5 pts worse
|
12.0%
2.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 14.8% · Observed 12.5% · Expected 9.4% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.5%
1.5 pts better
|
1.6%
1.6 pts better
|
Short 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 who were assessed and appropriately given the seasonal influenza vaccine | 100.0% |
68.7%
31.3 pts better
|
79.7%
20.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 21.0% |
23.1%
2.1 pts better
|
23.9%
2.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 21.0% · Observed 15.6% · Expected 17.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-08-14 · Fire 2024-08-14
0 health deficiencies
No concentrated health issue counts in this cycle.
1 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Cycle 3
Health 2023-09-07 · Fire 2023-09-07
0 health deficiencies
No concentrated health issue counts in this cycle.
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-07-31
E6 · Emergency Preparedness Deficiencies
Fire Safety
Conduct risk assessment and an All-Hazards approach.
Corrected 2025-11-06
C · Minimal harm
2025-07-31
E13 · Emergency Preparedness Deficiencies
Fire Safety
Develop Emergency Preparedness policies and procedures.
Corrected 2025-11-06
C · Minimal harm
2025-07-31
E4 · Emergency Preparedness Deficiencies
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2025-11-06
B · Minimal harm
2024-08-14
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2024-09-05
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-12-30
F806 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected 2026-01-13
Penalties and ownership
What sits behind the stars
Ownership
Masonic Villages Of The Grand Lodge Of Pennsylvania
5% Or Greater Direct Ownership Interest · Organization
Bahney, Thomas
Corporate Director · Individual
Baker, Lynn
Corporate Director · Individual
Brink, Robert
Corporate Director · Individual
Cepielik, Robert
Corporate Director · Individual
Downs, Eric
Corporate Director · Individual
Formica, Pamela
Operational/Managerial Control · Individual
Formica, Pamela
Corporate Officer · Individual
Heese, Adam
Corporate Director · Individual
Kingsbury, William
Corporate Officer · Individual
Kraus, Peter
Corporate Director · Individual
Miller, Glenn
Corporate Director · Individual
Ockovic, Todd
Corporate Director · Individual
Roup, Paul
Corporate Director · Individual
Saidi, Firas
Operational/Managerial Control · Individual
Saylor, Stanley
Corporate Director · Individual
Snyder, Robert
Corporate Director · Individual
Spence, Brenda
Corporate Director · Individual
Weaver, Kelly
Operational/Managerial Control · Individual
Wheeler, Frederic
Corporate Director · Individual
Nearby options
Other facilities in reach
#1
Christ's Home Retirement Community
Warminster, PA
5-star overall rating with 5-star inspections with 2 recent health deficiencies
#2
Ann's Choice
Warminster, PA
5-star overall rating with 4-star inspections with 4 recent health deficiencies
#3
Luther Woods Nursing And Rehabilitation Center
Hatboro, PA
4-star overall rating with 3-star inspections with 10 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
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