Barre Gardens Nursing and Rehab, LLC

In the surveyor’s words

From the most serious findings on record at Barre Gardens Nursing and Rehab, LLC, in the surveyor’s own words.

• Immediate jeopardy, widespreadF865Nov 13, 2025

  Based on interview, record review of the facility's Quality Assurance and Performance Improvement Program (QAPI), and facility policy review, the facility failed to address all systems of care in a comprehensive manner by identifying problems and opportunities for improvement in the areas of infection control, environment, and Medical Director. As a result, GAS (group A strep) spread through the facility and 12 residents developed symptoms of GAS. 2 of 3 sampled residents with symptoms of GAS were hospitalized with sepsis due to cellulitis (Residents #1 and #2). This citation is at the immediate jeopardy level as these failures put all residents at risk for serious harm and/or death. […]

• No harm, potential for more than minimal, widespreadF812Jun 17, 2026

  Based on observation and interview, the facility failed to ensure that food items were stored in accordance with professional standards, that the kitchen was kept neat and orderly, and that food service equipment were clean or dry. This is a repeat deficiency for this facility, with the violation cited during the previous three recertification surveys, dated 6/25/25, 5/9/24, and 4/26/23, and partial survey dated 11/13/25. Findings include:During a tour of the kitchen with the Kitchen Manager on 6/15/2026 at approximately 9:56 AM, the following observations were made:sandwiches on a plate in the walk-in fridge, not dated. The Kitchen Manager confirmed that they were not dated.a bag of opened chicken cutlets in freezer, not dated. […]

• No harm, potential for more than minimal, widespreadF880Jun 17, 2026

  Based on observation, interview, and record review, the facility failed to follow, maintain, implement their legionella water management plan and implement the use of personal protective equipment when required. This has the potential to impact all residents. This is a repeat deficiency for this facility, with the violation cited during a previous partial survey, dated 11/13/25. Findings include: 1. Review of the facility's Legionella Water Management Plan included an assessment to identify areas for Legionella spread and measures to prevent growth and how to monitor them. Per interview with the Maintenance Director on 6/17/26 at 10:30 AM and 1:09 PM, he was unable to provide evidence of measures to prevent Legionella growth put in place and how the facility was monitoring them. […]

• No harm, potential for more than minimal, widespreadF584Nov 13, 2025

  Based upon observation, interview, and record review, the facility failed to ensure that areas used for bathing/showering, resident rooms, and a resident gathering area were clean, safe, and homelike. This deficient practice has the potential to affect all residents residing in the facility. This is a repeat deficiency for this facility, with the violation cited during the previous two recertification surveys, dated 6/25/25 and 5/9/24, and partial survey dated 4/17/25. Findings include: During the initial tour of the facility on 11/4/25 at approximately 10:40 AM the following observations were made: Wing 1 short hall, room [ROOM NUMBER] and room [ROOM NUMBER] appeared dirty with loose debris on the floor. […]

• No harm, potential for more than minimal, widespreadF812Nov 13, 2025

  Based on observation and interview, the facility failed to ensure that all food was stored safely and to ensure that sanitary conditions for safe food handling were maintained. This has the potential to impact all residents. This is a repeat deficiency for this facility, with violations cited during the previous three recertification surveys, dated 4/26/23, 5/9/24, and 6/25/25. Findings include:A kitchen tour was conducted with a Dietary Staff Member on 11/13/25 at 11:40 AM. Per observation of the dry food storage area, the following items were found improperly stored:Gluten free pasta, (1) expired June 11, 2024, (3) expired July 20, 2024; Baking mix, expired 4/24/24; Pasta, expired May 3, 2025; Hormel Thick & Easy Clear Thickened Cranberry Juice Cocktail, dated 10/24, instructions on back… […]