01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-04-24 | 15 | 2026-04-24 | 6 |
| Cycle 2 | 2025-04-04 | 15 | 2025-04-04 | 7 |
| Cycle 3 | 2024-05-23 | 26 | 2024-05-23 | 3 |
CMS CCN 3953642026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Edenbrook North
300 Leader Drive · Williamsport, PA 17701 · Lycoming County
Certified beds152CMS provider file
Recent citation rows72current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
72 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 17 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-24 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0692Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0726Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · HEALTHF0887Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Correction field: Deficient, Provider has date of correction · 2026-06-022026-04-24 · FIREK0100Severity C · widespread; potential for minimal harm
Construction Deficiencies
Meet other general requirements.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-04-24 · FIREK0161Severity E · pattern; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-04-24 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-04-24 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-04-24 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-04-24 · FIREK0741Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2026-06-012026-03-09 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2026-04-07 · complaint2026-03-09 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2026-04-07 · complaint2025-11-08 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2025-12-12 · complaint2025-04-04 · FIREE0004Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2025-05-282025-04-04 · FIREE0039Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-05-282025-04-04 · HEALTHF0557Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Correction field: Deficient, Provider has date of correction · 2025-05-1303 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-05-23 | Fine | $305,250 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- POLSTEIN, MORDECHAIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/01/2025
- WILLIAMSPORT NORTH SNF OPERATIONS, LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- GRAF, ANDREWIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- THOMPSON, BOBBI JOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- PA 6 INVESTORS, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- WILLIAMSPORT NORTH SNF OPERATIONS, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- GRAF, ANDREWIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- LIFSICS, CHANNIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- MAUER, DOVIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- POLSTEIN, MORDECHAIIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- STESEL, MAXIMIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2024
- THOMPSON, BOBBI JOIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
- ZARKH, GLEBIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.76per resident day
RN hours0.48per resident day
Weekend nurse hours3.47per resident day
Staff turnover47.6%CMS reported field