Home / Pennsylvania / Palmyra
Kadima Rehabilitation & Nursing at Palmyra
341 North Railroad St., Palmyra, PA 17078 · Lebanon County · (717) 838-3011
39 certified beds, about 34 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1981
Special Focus Facility: CMS's list of homes with a history of serious problems Certified for Medicaid Certified for Medicare
Overall
Not rated
CMS note: This facility is not rated due to a history of serious quality issues and is included in the special focus facility program.
Health inspections
Not rated
CMS note: This facility is not rated due to a history of serious quality issues and is included in the special focus facility program.
Staffing
Not rated
CMS note: This facility is not rated due to a history of serious quality issues and is included in the special focus facility program.
Quality measures
Not rated
CMS note: This facility is not rated due to a history of serious quality issues and is included in the special focus facility program.
CMS Care Compare ratings, data as of September 1, 2026 · CCN 395506 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on March 5, 2026, inspectors cited 12 health deficiencies (the Pennsylvania average is 10, the national average 9.2).
Of 73 health citations since November 2023, 2 were rated as actual harm or immediate jeopardy to residents (2 immediate jeopardy).
CMS lists 1 fine totaling $31,346 in the last three years; the largest was $31,346, and the latest is dated July 3, 2025.
Nurses and nurse aides worked 3.61 hours per resident per day, against 3.89 across Pennsylvania and 3.86 nationally. Registered nurses accounted for 1.04 of those hours.
63.0% of nursing staff left within the year CMS measured (Pennsylvania average 44.5%).
CMS links it to Kadima Healthcare Group, an affiliated group of 14 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
211/23
112/23
112/23
102/24
103/24
304/24
2008/24
102/25
103/25
104/25
105/25
2507/25
202/26
1203/26
106/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 73 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
2L
Actual harm
0G
0H
0I
Potential for more than minimal harm
40D
13E
10F
Potential for minimal harm
0A
2B
6C
June 1, 2026Complaint inspection · 1 citation
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review, observation, and staff interview, it was determined that the facility failed to ensure that physician prescribed medications were administered as ordered to three of six sampled residents. (Residents 1, 2, 6)
March 5, 2026Standard inspection, Complaint inspection · 12 citations
- E Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on facility policy review, clinical record review, facility documentation review, and staff interview, it was determined that the facility failed to investigate falls to prevent accident hazards for three of 14 sampled residents. (Residents 3, 7, and 10)
- D Honor the resident's right to organize and participate in resident/family groups in the facility.
Inspectors wroteBased on facility policy review, resident group interviews, and a review of facility resident council meeting minutes, it was determined that the facility failed to address grievances voiced by the resident group.
- D Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to establish clear advance directives for one of 14 sampled residents. (Resident 4)Findings Include: Review of the facility policy entitled, Advance Directives, dated [DATE], revealed that all residents shall be presumed as having consented to cardiopulmonary resuscitation (CPR) unless there is documentation in the medical record that the resident has specified that a do not resuscitate (DNR) order be written. An advance directive must be accompanied by a physician's order documented in the resident's medical record. Clinical record review revealed that Resident 4 was admitted to the facility on [DATE], with diagnoses that included pressure ulcer of the left buttock, severe protein-calorie malnutrition, and schizophrenia. [...]
- D Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Inspectors wroteBased on facility policy review, clinical record review, observation, and staff interview, it was determined the facility failed to assess a resident for a physical restraint and conduct an ongoing assessment of a restraint for one of 14 sampled residents. (Resident 10)
- D Respond appropriately to all alleged violations.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to thoroughly investigate an injury of unknown origin for one of 14 sampled residents. (Resident 7)
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to implement physicians' orders for two of 14 sampled residents. (Residents 7, 37)
- D Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Inspectors wroteBased on clinical record review, observation, and staff interview, it was determined that the facility failed to implement interventions to prevent further decline and/or improve range of motion for one of one sampled residents with limited range of motion (a permanent tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff). (Resident 7)
- D Provide enough food/fluids to maintain a resident's health.
Inspectors wroteBased on clinical record review, observations, and staff interview, it was determined that the facility failed to provide adequate hydration for one of 14 sampled residents. (Resident 2)
- D Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that a physician supervised care in a timely manner for one of 14 sampled residents. (Resident 35)
- 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.
Inspectors wroteBased on review of facility policy, observation, and staff interview, it was determined that the facility failed to ensure that medications/biologicals were securely stored per facility policy in a medication cart on one of one nursing units.
- D Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on facility documentation review and staff interview, it was determined that the facility failed to ensure that all required staff persons were in attendance at quarterly Quality Assurance and Performance Improvement (QAPI) committee meetings for one of two quarters reviewed.
- D Make sure that a working call system is available in each resident's bathroom and bathing area.
Inspectors wroteBased on clinical record review and observation, it was determined that the facility failed to provide a working call bell for one of 14 sampled residents. (Resident 10)
February 4, 2026Complaint inspection · 2 citations
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that recommendations from a consultant physician were implemented for one of four sampled residents. (Resident 1)
- D Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that physician ordered medication was available from the pharmacy for one of four sampled residents. (Resident 2)
July 3, 2025Standard inspection · 25 citations
- L Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Inspectors wroteBased on clinical record review and observation, it was determined that the facility failed to employ sufficient support personnel who were competent to carry out the functions of dietary services which included safe food preparation for all resident meals, proper sanitation of resident dishes and cookware, and proper preparation of a mechanically altered diet for one of 16 sampled residents. (Resident 17) This failure resulted in an Immediate Jeopardy situation for all residents.
- L Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, review of facility documentation, and staff interview, it was determined that the facility failed to serve food under sanitary conditions in the kitchen. This failure resulted in an Immediate Jeopardy situation for all residents. Additionally, the facility failed to prepare and store food under sanitary conditions in the kitchen and dry storage areas.
- F Provide enough food/fluids to maintain a resident's health.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to adequately monitor and assess the nutritional status of six of six sampled residents at nutritional risk. (Residents 2, 9, 15, 19, 20, and 28)
- F Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspectors wroteBased on group interview, and review of facility documentation, it was determined that the facility failed to provide sufficient nursing staff to meet resident needs.
- F Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Inspectors wroteBased on interview, it was determined that the facility failed to employ a qualified dietitian or clinically qualified nutrition professional to provide frequently scheduled consultations in the absence of a full-time qualified dietitian or clinically qualified nutrition professional.
- F Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Inspectors wroteBased on observation, group interview, and staff interview, it was determined that the facility failed to accommodate resident preferences on the nursing unit.
- F Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Inspectors wroteBased on observations and staff interview, it was determined that the facility failed to employ nutrition and physical therapy staff to promote the wellbeing of it's residents.
- F Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Inspectors wroteBased on review of the facility's assessment, facility provided documentation, and staff interview, it was determined that the facility failed to conduct and document a facility-wide assessment, using evidence-based methods, which identified the specific resources necessary to care for it's specific resident population.
- F Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on review of facility documentation and staff interview, it was determined that the facility's Quality Assurance Committee failed to meet on a quarterly basis.
- E Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on facility policy review, clinical record review, observation, resident and staff interview, and group interview it was determined that the facility failed to provide care and services in a manner that respected the resident's dignity and preferences to promote quality of life for three of 16 sampled residents (Residents 9, 24, and 35).
- E Ensure residents have reasonable access to and privacy in their use of communication methods.
Inspectors wroteBased on resident interview and staff interview, it was determined that the facility failed to provide reasonable access to mail services as available in the community to all residents of the facility.
- E Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to notify the resident and the resident's representative of the bed hold and transfer, including the reasons for the move, and Ombudsman information, in writing upon transfer from the facility for five of six sampled residents who were transferred to the hospital. (Residents 12, 20, 28, 32, 33)
- E Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased in facility policy review, clinical record review, observation, review of facility documentation, and staff interview, it was determined that the facility failed to develop and implement interventions to prevent accident hazards for two of 16 sampled residents. (Residents 16 and 17)
- E Provide safe, appropriate dialysis care/services for a resident who requires such services.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to ensure that staff provided services consistent with professional standards, including monitoring, for one of two sampled residents receiving dialysis (process of removing excess toxins and water from the blood). (Resident 28)
- E Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to ensure that pharmacy recommendations were reviewed by the physician in a timely manner for five of five sampled residents. (Residents 15, 17, 20, 21, 32)
- D Ensure that residents are fully informed and understand their health status, care and treatments.
Inspectors wroteBased on clinical record review, staff interview, and a confidential interview, it was determined that the facility failed to inform a resident's responsible party of treatment options that may affect the resident's well being for one of 16 sampled residents. (Resident 17)
- D Honor the resident's right to organize and participate in resident/family groups in the facility.
Inspectors wroteBased on a review of facility resident council meeting minutes and resident interview, it was determined that the facility failed to address grievances voiced by the resident group.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to implement physician's orders for one of 16 sampled residents. (Resident 17)
- D Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on facility policy review, clinical record review, and staff interview, it was determined that the facility failed to provide treatment and services to promote healing and prevent pressure ulcers for one of 16 sampled residents. (Resident 16)
- D Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on facility policy review, clinical record review, and observation, it was determined that the facility failed to ensure that adequate catheter care was provided for one of 14 sampled residents. (Resident 20)
- D Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Inspectors wroteBased on clinical record review, observation, and staff interview, it was determined that the facility failed to provide enteral nutrition (delivery of nutrition by a feeding tube) in accordance with resident needs for one of one sampled resident who received enteral nutrition. (Resident 35)
- D Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that a physician supervised care in a timely manner for one of 14 sampled residents. (Resident 15)
- D Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Inspectors wroteBased on clinical record review, observation, and staff interview, it was determined that the facility failed to serve food in a form that meets the residents needs for two of 16 sampled residents. (Resident 17 and 21)
- D Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Inspectors wroteBased on clinical record review, observation, and staff and resident interview, it was determined that the facility failed to ensure that adaptive equipment was provided for one of two sampled residents who required adaptive equipment for meals. (Resident 12)
- D Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on clinical record review and staff interview it was determine the facility failed to maintain clinical records that were complete and accurate for three of 11 sampled residents. (Residents 1, 9, 11)
May 30, 2025Complaint inspection · 1 citation
- D Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Inspectors wroteBased on clinical record review, staff interview, and review of hospital records, it was determined that the facility failed to readmit a resident after a transfer to the hospital for one of three sampled residents. (Resident 1)
April 4, 2025Complaint inspection · 1 citation
- C Post nurse staffing information every day.
Inspectors wroteBased on observation it was determined that the facility failed to post current nurse staffing information.
March 1, 2025Complaint inspection · 1 citation
- C Post nurse staffing information every day.
Inspectors wroteBased on observation it was determined that the facility failed to post current nurse staffing information.
February 14, 2025Complaint inspection · 1 citation
- E Provide and implement an infection prevention and control program.
Inspectors wroteBased on facility policy review, clinical record review, and observation, it was determined that the facility failed to follow policies and procedures to prevent the spread of infection for three of four sampled residents. (Residents 2, 3, and 4)
August 9, 2024Standard inspection · 20 citations
- F Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Inspectors wroteBased on staff interview, it was determined that the facility failed to employ a full-time qualified dietary services manager in the absence of a full-time qualified dietitian.
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation and review of facility policy, it was determined that the facility failed to store food under sanitary conditions in the kitchen.
- F Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Inspectors wroteBased on policy review and staff interview, it was determined that the facility did not have a credentialed Infection Preventionist (IP).
- E Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on observation, it was determined that the facility failed to ensure that a dignified environment and services were provided to promote quality of life on the nursing unit.
- 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.
Inspectors wroteBased on observation, it was determined that the facility failed to ensure that a safe, clean, and comfortable environment was maintained on one of one nursing units.
- E Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, policy review, and staff interview, it was determined that the facility failed to ensure that licensed nurses (a licensed practical nurse) maintained professional standards of quality care in the administration of medications set forth in the Pennsylvania Code Title 49, Professional and Vocational Standards for one of two medication carts. (West hall)
- E 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.
Inspectors wroteBased on facility policy review and observation, it was determined that the facility failed to ensure that medications/biologicals were securely stored in one of two medication carts on the nursing unit. (East cart)
- D Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on review of facility policy, personnel file review, and staff interview, it was determined that the facility failed to provide abuse training upon hire as per facililty policy for one of five sampled employees. (Employee 3)
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observation, clinical record review, facility policy review, and staff interview, it was determined that the facility failed to store respiratory equipment appropriately for one of 14 sampled residents. (Resident 12)
- D Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that the pharmacist's recommendations were acknowledged by the physician for one of 14 sampled residents. (Residents 12)
- D Provide or obtain dental services for each resident.
Inspectors wroteBased on clinical record review, and resident and staff interviews, it was determined that the facility failed to offer routine annual dental services and emergency dental care for one of 14 sampled residents. (Resident 25)
- D Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
Inspectors wroteBased on clinical record review, observations, and resident interview, it was determined that the facility failed to provide sufficient and fresh fluids consistent with resident needs and preferences for four of 14 sampled residents. (Residents 1, 8, 10, 12)
- D Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Inspectors wroteBased on clinical record review, observation, and resident and staff interview, it was determined that the facility failed to provide therapeutic diets as ordered by the physician for two of 14 sampled residents. (Residents 8, 12)
- D Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Inspectors wroteBased on clinical record review and observation, it was determined that the facility failed to provide adaptive equipment to assist with eating meals for one of 14 sampled residents. (Resident 12)
- C The resident has the right to receive notices in a format and a language he or she understands.
Inspectors wroteBased on observation and the resident group interview, it was determined that the facility failed to post contact information in the facility for regulatory and advocacy group including (but not limited to) the State Survey Agency and State Long-Term Care Ombudsman.
- C Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Inspectors wroteBased on observation it was determined that the facility failed to make Department of Health survey results available to all residents.
- C Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to notify the resident and the resident's representative(s) of transfer(s), including the reasons for the moves, and Ombudsman information, in writing upon transfer from the facility for five of five sampled residents who were transferred to the hospital. (Residents 25, 30, 31, 33, 39)
- C Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on facility documentation review and staff interview, it was determined that the facility Quality Assurance and Performance Improvement (QAPI) committee failed to meet at least quarterly. Additionally, the facility failed to ensure that all required staff persons were in attendance at quarterly QAPI committee meetings for four of four quarters reviewed.
- B Honor the resident's right to organize and participate in resident/family groups in the facility.
Inspectors wroteBased on a review of facility resident council minutes, and resident and staff interviews, it was determined that the facility failed to address grievances voiced by the resident group. (Residents 1, 4, 8, 10, 22, 23, 27, 29, 30, 32)
- B Keep residents' personal and medical records private and confidential.
Inspectors wroteBased on observation, it was determined that the facility failed to maintain confidentiality in regards to residents' health information on the nursing unit.
April 27, 2024Complaint inspection · 3 citations
- E Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on observation and resident interview, it was determined that the facility failed to provide a safe, sanitary, and comfortable environment in nine of 16 resident rooms on the nursing unit. (Rooms 104, 106, 107, 108, 114, 115, 116, 117, 118)
- D Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.
Inspectors wroteBased on clinical record review, facility policy review, and staff interview, it was determined that the facility failed to provide necessary equipment to a resident on admission for one of five sampled residents. (Resident CL1)
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that physician's orders were implemented for one of five sampled residents. (Resident CL1 )
March 7, 2024Complaint inspection · 1 citation
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on clinical record review, and staff interview, it was determined that the facility failed to implement care planned interventions for two of three sampled residents. (Residents 1, 3)
February 25, 2024Complaint inspection · 1 citation
- D Provide safe, appropriate dialysis care/services for a resident who requires such services.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to develop and implement a care plan, and to provide ongoing assessment and monitoring for one of two sampled residents receiving dialysis (process of removing excess toxins and water from the blood). (Resident 1)
December 19, 2023Complaint inspection · 1 citation
- D Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on clinical record review, staff and resident interview, and observation, it was determined that the facility failed to provide wound treatments for one of four sampled residents. (Resident 1)
December 10, 2023Complaint inspection · 1 citation
- D Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Inspectors wroteBased on clinical record review and observation, it was determined that the facility failed to provide services to maintain adequate grooming and personal hygiene for residents who need assistance with activities of daily living for two of four sampled residents. (Residents 1, 2)
November 19, 2023Complaint inspection · 2 citations
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to ensure that physician's orders were implemented for one of five sampled residents. (Resident 1)
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical record review and staff interview, it was determined that the facility failed to follow safety measures for one of five sampled residents. (Resident 3)
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| July 3, 2025 | Fine | $31,346 |
| July 3, 2025 | Payment Denial | 20 days from August 6, 2025 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Pennsylvania | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.61 | 3.89 | 3.86 |
| Registered nurses | 1.04 | 0.79 | 0.69 |
| All nursing staff on weekends | 3.32 | 3.53 | 3.42 |
| Nurse aides | 2.00 | ||
| Licensed practical nurses | 0.58 | ||
| Nursing staff turnover (share who left in a year) | 63.0% | 44.5% | 45.8% |
| Registered nurse turnover | 76.5% | 39.9% | 42.9% |
| Administrators who left | 3 |
CMS expects 4.55 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.74 on weekdays and 3.32 on weekends, 11% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.70 in April to June 2025 to 3.61 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.61 | 1.04 | 3.74 | 3.32 | 0.0% | 0 of 90 | 34 |
| Oct to Dec 2025 | 3.50 | 1.02 | 3.64 | 3.14 | 0.0% | 0 of 92 | 35 |
| Jul to Sep 2025 | 3.60 | 1.08 | 3.81 | 3.07 | 0.0% | 0 of 92 | 37 |
| Apr to Jun 2025 | 3.70 | 1.08 | 3.88 | 3.26 | 0.0% | 0 of 91 | 37 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Pennsylvania, Jan to Mar 2026 | 3.69 | 0.65 | 3.82 | 3.34 | 11.3% | 0.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Pennsylvania | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 23.5 | 16.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.9 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.6 | 1.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 8.7 | 3.1 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 4.4 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 13.8 | 17.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 7.5 | 4.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 11.1 | 17.7 | 15.4 |
Owners and operators
Legal business name: PALMYRA REHABILITATION & NURSING LLC. CMS links this home to Kadima Healthcare Group, a group of 14 nursing homes averaging 1.9 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Cibc Bank USA | 5% or greater mortgage interest | Organization | 08/06/2025 | |
| Cibc Bank USA | Operational/managerial control | Organization | 08/06/2025 | |
| Kadima Healthcare Group Inc | Operational/managerial control | Organization | 08/29/2018 | |
| Pinnacle Healthcare Solutions Inc | Operational/managerial control | Organization | 11/01/2024 | |
| Harkins, Andrea | Operational/managerial control | Individual | 09/15/2025 | |
| Lowden, Thomas | Operational/managerial control | Individual | 10/01/2025 | |
| Morris, Daniel | Operational/managerial control | Individual | 08/29/2018 | |
| Rivera, Zenaida | Operational/managerial control | Individual | 10/27/2025 | |
| Rosen, Jacob | Operational/managerial control | Individual | 07/29/2025 | |
| Strauss, Jonathan | Operational/managerial control | Individual | 08/29/2018 | |
| Kadima Healthcare Group Inc | Adp of the SNF | Organization | 11/25/2025 | |
| Martin Friedman Cpa PC | Adp of the SNF | Organization | 01/01/2025 | |
| Palmyra Property Management LLC | Adp of the SNF | Organization | 08/29/2018 | |
| Pinnacle Healthcare Solutions Inc | Adp of the SNF | Organization | 11/25/2025 | |
| Harkins, Andrea | Adp of the SNF | Individual | 09/15/2025 | |
| Lowden, Thomas | Adp of the SNF | Individual | 10/01/2025 | |
| Morris, Daniel | Adp of the SNF | Individual | 08/29/2018 | |
| Pearlstein, Robert | Adp of the SNF | Individual | 01/01/2021 | |
| Rivera, Zenaida | Adp of the SNF | Individual | 10/27/2025 | |
| Rosen, Jacob | Adp of the SNF | Individual | 07/29/2025 | |
| Strauss, Jonathan | Adp of the SNF | Individual | 08/29/2018 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 21 problems in this area, most recently on June 1, 2026: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 16 problems in this area, most recently on March 5, 2026: "Honor the resident's right to organize and participate in resident/family groups in the facility."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 11 problems in this area, most recently on July 3, 2025: "Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service."
- How many nurses and aides work each shift, nights and weekends included?Inspectors cited 5 problems in this area, most recently on March 5, 2026: "Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.32 hours per resident per day, below the Pennsylvania average of 3.53.
- How long has the current administrator been here?CMS counts 3 administrators who left in the period it measured.
Other nursing homes nearby
- Lebanon Valley Brethren Home Palmyra, 1.4 mi · 5 of 5 stars · 1 citation
- Kadima Rehabilitation & Nursing at Campbelltown Palmyra, 2.5 mi · 1 of 5 stars · 75 citations
- Lebanon Valley Home the Annville, 5.1 mi · 3 of 5 stars · 3 citations
- Alpine Valley Post Acute and Healthcare Center Lebanon, 9.3 mi · 5 of 5 stars · 8 citations
- Lebanon Skilled Nursing and Rehabilitation Center Lebanon, 9.5 mi · 1 of 5 stars · 48 citations
- Oak Hill Center for Rehabilitation and Nursing Middletown, 10.1 mi · 2 of 5 stars · 59 citations
- Mt Hope Nazarene Retirement Community Manheim, 10.2 mi · 5 of 5 stars · 14 citations
- Cornwall Manor Cornwall, 10.6 mi · 5 of 5 stars · 2 citations
Pennsylvania contacts for a concern about a nursing home
These are the official offices in Pennsylvania. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Pennsylvania Department of Health, Division of Nursing Care Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Pennsylvania Long-Term Care Ombudsman Program, Department of Aging, 717-783-8975. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Pennsylvania Department of Health Nursing Care Facility Locator, where Pennsylvania publishes its own records on licensed homes.
Common questions
- What is Kadima Rehabilitation & Nursing at Palmyra's Medicare star rating?
- CMS does not give Kadima Rehabilitation & Nursing at Palmyra an overall star rating in the data as of September 1, 2026.
- How many deficiencies did Kadima Rehabilitation & Nursing at Palmyra get at its last inspection?
- 12 health deficiencies at the standard inspection on March 5, 2026. The Pennsylvania average is 10.
- Has Kadima Rehabilitation & Nursing at Palmyra been fined?
- Yes. CMS lists 1 fine totaling $31,346 in the last three years.
- Does Kadima Rehabilitation & Nursing at Palmyra accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Kadima Rehabilitation & Nursing at Palmyra?
- CMS lists 21 owners and managers, and links the home to Kadima Healthcare Group. Legal business name: PALMYRA REHABILITATION & NURSING LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.