AristaCare at Meadow Springs: Care Plan Failures - PA
The man, identified in inspection records only as Resident R2, is in his later years and has lived at the facility since March 1, 2024. He cannot care for himself. His diagnoses include quadriplegia, Parkinson's disease, heart failure, chronic kidney disease, malnutrition, and a history of brain hemorrhage. He is fed through a gastrostomy tube and has difficulty swallowing. His cognitive score, recorded in the clinical file, was 99 out of 100, meaning he was fully aware of his condition and surroundings.
His family had noticed the scalp problem first.
A physician's progress note dated August 17, 2025, documented that R2's family had raised concerns about dry, flaky skin on his scalp. The following morning, a second physician placed an order for Ketoconazole shampoo, a medicated antifungal treatment, to be applied every Wednesday and Saturday until the scalp was no longer dry and flaky.
That order was written sixteen days before inspectors arrived. When they examined R2 on September 3, the yellow flakes were still visible on his oily scalp. His nails remained uncut.
Inspectors then turned to his care plan, the document that is supposed to capture every identified problem a resident has and lay out specific goals and interventions to address them. For a man with quadriplegia who cannot wash his own hair, trim his own nails, or perform any basic hygiene without assistance, that document is not a formality. It is the mechanism by which staff know what to do and when.
There was nothing in it about hair care. Nothing about nail care. No goals. No interventions. Not a single line addressing the hygiene needs of a fully dependent resident.
The director of nursing and the wound care nurse both confirmed the findings.
The violation was cited under F0655, which covers the requirement that facilities develop and implement plans addressing a resident's most immediate needs. The level of harm was recorded as minimal harm or potential for actual harm, the lower end of the federal scale, and inspectors noted only a few residents were affected. The facility was cited under Pennsylvania code governing resident care policies.
What the inspection does not answer is how long R2 had been sitting with an untreated scalp condition before his family said something. The physician's note from August 17 records the family's concern as the reason the problem came to clinical attention at all. There is no note in the record suggesting staff had identified it themselves.
The medicated shampoo order was written. The care plan was not updated to reflect it. Sixteen days passed.
AristaCare at Meadow Springs is a skilled nursing facility in Plymouth Meeting, a suburb of Philadelphia. The September 3 inspection was a complaint survey, meaning it was triggered by a report filed with regulators rather than a routine inspection cycle.
R2's care plan, as inspectors described it, was built around identifying problems and maintaining the highest level of functioning a resident can be expected to reach. For a man with quadriplegia and Parkinson's, the ceiling for independent functioning is low. The floor, what staff are responsible for providing, is correspondingly high. Every task he cannot do himself falls to them.
His family had to tell the doctor his scalp was flaking. The doctor had to write an order. And still, two and a half weeks later, the care plan had not caught up to what his own body was showing.
His nails, inspectors noted, had not been cut either. There was no order required for that. No diagnosis. No prescription. Just a dependent man, fully aware, waiting.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Aristacare At Meadow Springs from 2025-09-03 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: July 1, 2026 · Our methodology
ARISTACARE AT MEADOW SPRINGS in PLYMOUTH MEETING, PA was cited for violations during a health inspection on September 3, 2025.
The man, identified in inspection records only as Resident R2, is in his later years and has lived at the facility since March 1, 2024.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.