The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited July 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
Nursing home report
THORNWALD HOME
CARLISLE, PA · Medicare-certified · 83 beds
Needs attention
Non-profit
3 of 5 overall
THORNWALD HOME (CARLISLE, PA) has a 3-star overall rating, with 3 stars for health inspections and quality measures and 4 stars for staffing; reported nurse staffing is 4.31 hours per resident per day, slightly above the federal benchmark of 4.1. It also has $9,110 in fines in the last 24 months and a recent federal penalty, with recent inspection citations involving accident prevention, resident assessment, and urinary/catheter care.
Facility ratings
Health inspections
Staffing
4.3135 hrs/resident/day
Quality measures
Last inspection: December 11, 2025Penalties, last 24 months: $9,110recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.3135.
Staffing detail
- Registered nurses
- 0.88
- Licensed practical nurses
- 0.85
- Nurse aides
- 2.59
- Weekend nursing
- 3.87
Hours per resident per day.
Total staff turnover: 43%
Registered nurse turnover: 35%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
14.3%5.1%Improving
Residents with a fall causing major injury
4.1%3.8%No change
Residents with pressure ulcers (bedsores)
4.6%4.1%No change
Residents with a urinary tract infection
0%1.3%Worsening
Residents who lost too much weight
25.4%6.2%Improving
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
41.7%14.3%Improving
Residents whose ability to walk got worse
18.4%23.8%Worsening
Long-stay residents on antianxiety or sleep medication
25.7%14.7%Improving
Short-stay residents newly given an antipsychotic
—1.7%—
Residents with a long-term catheter
0%0%No change
Residents with new or worsening incontinence
42.2%39.9%Improving
Residents with depressive symptoms
0%1.5%Worsening
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—94.9%—
Long-stay residents given the pneumonia vaccine
100%88.5%Worsening
Short-stay residents given the seasonal flu vaccine
—72.4%—
Short-stay residents given the pneumonia vaccine
50%77.3%Improving
What the inspectors found
The nursing home failed to make sure each resident got an accurate assessment of their needs and condition. Cited December 2025 — limited pattern, potential for harm.
View the original federal record
F-Tag 641 — 42 CFR §483.20(g) — S/S: E
The home failed to provide proper bladder and bowel care, including catheter care and steps to prevent urinary tract infections. Cited December 2024 — limited pattern, potential for harm.
View the original federal record
F-Tag 690 — 42 CFR §483.25(e) — S/S: E
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited January 2024 — limited pattern, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: E
The home failed to make sure it did not hire anyone with a record of abuse, neglect, exploitation, or theft. Cited December 2025 — isolated incident, potential for harm.
View the original federal record
F-Tag 606 — 42 CFR §483.12 — S/S: D
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 4 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $9,110 was recorded.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 3 health deficiencies.
See what inspectors found
Penalties & enforcement
On record with Medicare: 1 fine · $9,110 in total fines.
- $9,110
Federal fine
Jul 21, 2025
Operator & ownership
- Ownership
- Non profit - Church related
- Occupancy
- 76.8 residents on an average day (93% of 83 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 36 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.