St Anne's Retirement Community
st anne's retirement community in COLUMBIA, PA — inspection on December 24, 2025.
Found 3 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Review of Resident 9's progress note of October 20, 2025, indicated resident was found on the floor in the bathroom. 911 was called to transport the resident to the hospital.
Review of information submitted October 21, 2025, to the
(back of the head or skull) region of the scalp.
Laceration was stapled and resident returned to the facility.
Interview with licensed staff E3 on December 22, 2025, at 1:30 p.m. revealed that the laceration was coded as a major injury because it involved the head. 28 Pa.
Code 211.12(d)(1)(5) Nursing services Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
395806 12/24/2025
St Anne's Retirement Community 3952 Columbia Avenue Columbia, PA 17512
Review of Resident 1 physician's orders dated December 15, 2025, revealed an order for ?Oxycodone HCl Oral Tablet 5 MG (Oxycodone HCl) Give 1 tablet by mouth every 6 hours as needed for severe pain'.
Review of Resident 1's care plan revealed the resident has chronic pain with interventions for staff to ?identify other factors that may enhance pain such as body position, tight clothing, anxiety or other emotional issues, etc.
Provide relief as able'.
Review of the Medication Administration Records for December 2025, revealed that the Resident 1 received the as needed narcotic (Oxycodone HCl) on December 5, 2025, to December 22, 2025, without documented evidence that non-pharmacological interventions were attempted prior to administration.
During an interview on December 24, 2025, at 10:30am., the Assistant Director of Nursing confirmed that the Oxycodone HCl was administered to Resident 1 and failed to provide documentation to support that non-pharmacological interventions for pain had been provided prior to the administration of as needed pain medication. 28 Pa.
Code 211.12(d)(1)(5) Nursing services.
395806 12/24/2025
St Anne's Retirement Community 3952 Columbia Avenue Columbia, PA 17512
Review of Resident 2's physician's orders revealed that the resident was receiving an enteral feed (tube feeding - soft tube which delivers liquid nutrition directly into the gastrointestinal tract).Interview with licensed staff Employee E4 on December 24, 2025, at 10:05 a.m. confirmed that Resident 2 would meet the criteria for EBP due to the tube feeding and that EBP was not in place for Resident 2.28 Pa.
Code 211.10(d) Resident care policies28 Pa.
Code: 211.12(d)(1)(5) Nursing services
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.