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Rose City Nursing and Rehab at Lancaster, Lancaster, PA: 2 star rating, fined $128,792 across 2 fines

Rose City Nursing and Rehab at Lancaster in Lancaster, PA is owned by Underscore Holdings LLC, is rated 2 of 5 stars by Medicare, and was fined $128,792 across 2 fines in the three years to October 1, 2026. CMS lists 47 health citations from inspections in that time, the latest survey on May 20, 2026, and 3 of them found actual harm or immediate jeopardy.

SpecStream is the live web data engine for teams and agents. It reads the CMS nursing home files every month, and this page is that reading, joined on the CMS Certification Number. Ask for the nursing homes you track by state, owner or rating and new inspection citations and fines arrive in your sheet, CRM, Slack or agent as CMS publishes them.

Watch this facility's inspections and finesGet every facility this owner runsGet nursing homes in Pennsylvania
Address
425 North Duke Street, Lancaster, PA 17602
Overall rating
2 of 5 stars
Health inspection rating
1 of 5
Staffing rating
3 of 5
Quality measure rating
5 of 5
Certified beds
124
Residents per day
108 on average
Ownership type
For profit, limited liability company
Legal business name
Keystone Nursing and Rehab of Lancaster LLC
Chain
Lme Family Holdings, 15 facilities
Fines
$128,792 across 2 fines, three years to October 1, 2026
Payment denials
0
Health citations
47, of which 3 with actual harm or immediate jeopardy
Latest survey
May 20, 2026
CMS Certification Number
395177
On Care Compare
Medicare Care Compare

Fines and payment denials

Every fine and payment denial CMS lists for this facility in the three years, newest first.

DateTypeFine amountDenial startsDenial daysSource
May 20, 2026Fine$43,002Not listeddata.cms.gov
December 1, 2023Fine$85,790Not listeddata.cms.gov

Recent health citations

Citations from health inspections, newest first.

Survey dateTagWhat CMS citedScope and severityStatusCorrected onSource
May 20, 2026F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.K: pattern, immediate jeopardyCorrectedJune 10, 2026data.cms.gov
May 20, 2026F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F880Provide and implement an infection prevention and control program.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F835Administer the facility in a manner that enables it to use its resources effectively and efficiently.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F790Provide routine and 24-hour emergency dental care for each resident.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F770Provide timely, quality laboratory services/tests to meet the needs of residents.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F698Provide safe, appropriate dialysis care/services for a resident who requires such services.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F692Provide enough food/fluids to maintain a resident's health.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
May 20, 2026F584Honor 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.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 10, 2026data.cms.gov
February 13, 2026F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.D: isolated, no actual harm, potential for more than minimal harmCorrectedMarch 30, 2026data.cms.gov
December 18, 2025F680Ensure the activities program is directed by a qualified professional.E: pattern, no actual harm, potential for more than minimal harmCorrectedJanuary 19, 2026data.cms.gov
December 3, 2025F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D: isolated, no actual harm, potential for more than minimal harmCorrectedDecember 8, 2025data.cms.gov
August 6, 2025F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.D: isolated, no actual harm, potential for more than minimal harmCorrectedAugust 20, 2025data.cms.gov
April 25, 2025F947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.F: widespread, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F761Ensure 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.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.F: widespread, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F730Observe each nurse aide's job performance and give regular training.F: widespread, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F698Provide safe, appropriate dialysis care/services for a resident who requires such services.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F692Provide enough food/fluids to maintain a resident's health.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F641Ensure each resident receives an accurate assessment.E: pattern, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F610Respond appropriately to all alleged violations.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
April 25, 2025F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.D: isolated, no actual harm, potential for more than minimal harmCorrectedJune 12, 2025data.cms.gov
August 12, 2024F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.D: isolated, no actual harm, potential for more than minimal harmCorrectedSeptember 3, 2024data.cms.gov
August 12, 2024F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.D: isolated, no actual harm, potential for more than minimal harmCorrectedSeptember 3, 2024data.cms.gov
March 15, 2024F825Provide or get specialized rehabilitative services as required for a resident.D: isolated, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F: widespread, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F759Ensure medication error rates are not 5 percent or greater.D: isolated, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F692Provide enough food/fluids to maintain a resident's health.E: pattern, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F658Ensure services provided by the nursing facility meet professional standards of quality.D: isolated, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D: isolated, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.D: isolated, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
March 15, 2024F565Honor the resident's right to organize and participate in resident/family groups in the facility.E: pattern, no actual harm, potential for more than minimal harmCorrectedMay 1, 2024data.cms.gov
January 3, 2024F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.D: isolated, no actual harm, potential for more than minimal harmCorrectedJanuary 15, 2024data.cms.gov
December 1, 2023F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.J: isolated, immediate jeopardyPast noncomplianceOctober 27, 2023data.cms.gov
December 1, 2023F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.J: isolated, immediate jeopardyCorrectedJanuary 2, 2024data.cms.gov
December 1, 2023F835Administer the facility in a manner that enables it to use its resources effectively and efficiently.E: pattern, no actual harm, potential for more than minimal harmCorrectedJanuary 2, 2024data.cms.gov
December 1, 2023F760Ensure that residents are free from significant medication errors.D: isolated, no actual harm, potential for more than minimal harmCorrectedJanuary 2, 2024data.cms.gov
December 1, 2023F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.D: isolated, no actual harm, potential for more than minimal harmCorrectedJanuary 2, 2024data.cms.gov

Owners and managers

Organizations CMS lists as owners or managers of this facility, as CMS names them. CMS also lists 4 individual or personal trusts (2 managers, 2 other disclosable parties). Their names are not shown on this page.

OrganizationRoleShareSinceSource
Underscore Holdings LLCDirect owner100%May 14, 2018data.cms.gov
Samara Holdings Company LLCIndirect owner32%January 28, 2020data.cms.gov
Strawberry Hill Holdings LLCIndirect owner32%January 28, 2020data.cms.gov
Clinical Consulting Services LLCOperational or managerial controlNot listedJanuary 1, 2019data.cms.gov
Priority Care Group LLCOperational or managerial controlNot listedJanuary 1, 2019data.cms.gov
Summation Financial Services LLCOperational or managerial controlNot listedJanuary 1, 2019data.cms.gov
GPH Lancaster LPAdditional disclosable partyNot listedMay 14, 2018data.cms.gov

Also on SpecStream

Updated November 7, 2026. Read from CMS Provider Data Catalog, nursing homes. Open data from the Centers for Medicare & Medicaid Services (US government work). Fines and citations are as CMS lists them on the date this page was read and can change after an appeal. The CMS files are joined on the CMS Certification Number. CMS gives owners no ID, so an owner page groups facilities by the owner name as CMS spells it. Names of individual owners and managers are not shown. This page uses CMS data and is not endorsed or certified by CMS. Free to reuse with credit to SpecStream under CC BY 4.0. Spot a wrong value? Write to [email protected] with the link to this page.