Federal inspection record · CMS data as of October 1, 2026
Silver Stream Rehabilitation And Nursing Center
905 Penllyn Pike, Spring House, PA · (215) 646-1500
- Cited for abuse (CMS abuse icon)
- Certified beds
- 120
- Residents per day
- 107
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 1, 1977
1
How this home got 2 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Pennsylvania.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
This home carries CMS's abuse icon, which caps its inspection rating at 2 stars and so its overall rating at 4.
2
Where it sits among Pennsylvania homes
Silver Stream Rehabilitation And Nursing Center carries 74 inspection points. That is fewer than 37% of Pennsylvania's 652 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Pennsylvania: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–8 pts
- 4★ 8–33 pts
- 3★ 33–65 pts
- 2★ 65–128 pts
- 1★ over 128 pts
Bars show every rated home in Pennsylvania by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
53 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Quality of Life and Care16D
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide or obtain dental services for each resident.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate foot care.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Provide safe and appropriate respiratory care for a resident when needed.
Resident Rights7E
- D
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.
- E
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.
- D
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
- D
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- D
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Assessment and Care Planning7D
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Provide care by qualified persons according to each resident's written plan of care.
- D
Plan the resident's discharge to meet the resident's goals and needs.
- D
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
- D
Assure that each resident’s assessment is updated at least once every 3 months.
- D
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Pharmacy Service7D
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
Ensure that residents are free from significant medication errors.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Freedom from Abuse, Neglect, and Exploitation4E
- E
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Environmental3F
- D
Make sure that a working call system is available in each resident's bathroom and bathing area.
- F
Keep all essential equipment working safely.
- D
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Nutrition and Dietary3F
- D
Dispose of garbage and refuse properly.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Dispose of garbage and refuse properly.
Infection Control3E
- D
Provide and implement an infection prevention and control program.
- D
Implement a program that monitors antibiotic use.
- E
Implement a program that monitors antibiotic use.
Nursing and Physician Services3E
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
- D
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Inspection history
2026-01-23
16 health deficiencies · 6 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
2024-12-12
14 health deficiencies · 1 fire-safety deficiencies
Top issue: Pharmacy Service (4 deficiencies)
2024-02-27
23 health deficiencies · 5 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 37 min of nursing staff time a day, 22 min of it from a registered nurse.
This home
3 h 37 min
Pennsylvania average
3 h 54 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 59% of nursing staff and 75% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days1.1 pts worse | 2.6 | 1.5 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts worse | 1.6 | 1.1 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine7.4 pts worse | 80.4% | 87.8% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.4 pts worse | 91.3% | 93.7% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injuryAbout the same | 3.1% | 3.1% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms11.3 pts better | 2.5% | 13.8% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.1 pts better | 5.9% | 6.0% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication4.9 pts better | 15.2% | 20.1% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication6.7 pts worse | 24.3% | 17.6% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened12.2 pts better | 3.2% | 15.4% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased10.6 pts better | 5.8% | 16.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.2 pts better | 0.4% | 0.6% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.4 pts better | 0.0% | 1.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.2 pts worse | 25.2% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.9 pts better | 3.8% | 4.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine48.9 pts worse | 21.9% | 70.8% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit3.1 pts worse | 12.6% | 9.5% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.1 pts worse | 1.5% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine26.5 pts worse | 44.4% | 70.9% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission10.7 pts worse | 32.7% | 22.0% | 23.4% |
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Who owns and runs it
6 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Lichtschein, Raphael | 5% Or Greater Direct Ownership Interest · Individual | 32% | 2 facilities |
| Muller, Martin | 5% Or Greater Direct Ownership Interest · Individual | 28% | 1 facilities |
| Lichtschein, Aaron | 5% Or Greater Direct Ownership Interest · Individual | 15% | 1 facilities |
| Gewirtzman, Yehudah | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Lichtschein, Raphael | Corporate Officer · Individual | 0% | 2 facilities |
| Lichtschein, Raphael | Operational/Managerial Control · Individual | 0% | 2 facilities |
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Fire safety
12 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4F
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Install corridor and hallway doors that block smoke.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- C
Inspect, test, and maintain automatic sprinkler systems.
Egress2E
- E
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.
- E
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
Emergency Preparedness2C
- C
Conduct testing and exercise requirements.
- C
Conduct testing and exercise requirements.
Services1E
- E
Have properly installed electrical wiring and gas equipment.
Construction1E
- E
Install a two-hour-resistant firewall separation.
Miscellaneous1F
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Gas, Vacuum, and Electrical Systems1C
- C
Have generator or other power source capable of supplying service within 10 seconds.
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Other homes nearby
-
Artman Lutheran Home
Ambler, PA
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 5 h 17 min
- Fines
- $0
-
Willowbrooke Court-Spring Hous
Lower Gwynedd, PA · Acts Retirement-Life Communities
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 4 h 12 min
- Fines
- $0
-
Ambler Extended Care Center
Ambler, PA · Saber Healthcare Group
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 25 min
- Fines
- $13,070