Eden Village Care Center

In the surveyor’s words

From the most serious findings on record at Eden Village Care Center, in the surveyor’s own words.

• Actual harm, isolatedF689Dec 8, 2022

  Based on interview and record review, the Facility failed to ensure continued assistance with ambulation to prevent resident injury for 1 of 4 residents (R1) reviewed for falls, in the sample of 4. This failure resulted in R1 sustaining a fractured femur from falling while unattended. Findings include: R1's Care Plan dated 5/27/2022 documents, I am at risk for falls due to dementia diagnosis, confusion, forgetfulness, severe impairment. I am up with assist using a walker or I use a wheelchair. I have tried to walk unassisted at times. R1's Minimum Data Set (MDS) dated [DATE] documents R1 required limited assistance for transfers and ambulation. R1's Care Plan dated 11/4/2022 documents, I am at risk for pain and have exhibited signs of pain related to left hip fracture. […]

• No harm, potential for more than minimal, widespreadF812Feb 6, 2025

  Based on observation, interview, and record review, the facility failed to label food items in the refrigerator with use by dates and dispose of outdated food items in the refrigerator. This failure has the potential to affect all 52 residents residing at the facility. Findings include: On 02/03/24 at 8:06 AM, The initial tour of the kitchen was completed. During inspection of the walk-in refrigerator, it contained the following items: 1. A metal container of Chopped bacon, a metal container of diced tomatoes, a metal container of chopped onions, a metal container of shredded cheese, a metal container of cut up eggs, a metal container of pickle spears, and a metal container of shredded lettuce all of them covered with cling wrap with perpetration (prep) date of 2/2 and no date listed on… […]

• No harm, potential for more than minimal, widespreadF812Jan 20, 2023

  Based on observation, interview, and record review, the Facility failed to ensure food was stored and prepared in a manner which prevents potential contamination. This has the potential to affect all 59 residents living in the Facility. Findings include: On 1/17/23 at 7:33 AM, the walk in freezer had a small amount of ice on the bottom of the fan. There was a box on a shelf labeled stew vegetables. The plastic bag inside the box was open and not sealed with vegetables exposed to the air. There was no date on the package to denote when it was opened. On 1/17/23 at 7:35 AM, the fan in the walk in refrigerator had a significant amount of dust. There were 3 stainless steel containers of food that were dated, but none were labeled to identify the contents inside. […]

• No harm, potential for more than minimal, widespreadF812Dec 3, 2021

  Based on observation, interview and record review the facility failed to ensure food was stored and prepared in a manner which prevents potential contamination. This has the potential to affect all 62 residents living in the facility. Findings include: On 11/30/21 at 9:24 AM during the kitchen tour, in the dry storage area, there was a large industrial box of chips sitting directly on the floor. On the shelf there was a package of opened spaghetti. Approximately a pound of spaghetti was still in the box and it was not covered, dated, or labeled and the spaghetti was exposed to the air. Near the doorway of the dry storage area was a large rack that contained 2 buckets with potatoes in them. […]

• No harm, potential for more than minimal, patternF690Feb 6, 2025

  Based on observation, interview, and record review, the facility failed ensure timely and complete incontinent care was done for 4 of 4 residents (R3, R4, R41, and R52) reviewed for incontinent care in a sample of 30. Findings Include: 1. R3's Face Sheet, current admitted [DATE], documented R3 has diagnoses of but not limited to Urinary tract infection, Unspecified urinary incontinence, Full incontinence of feces, and Severe sepsis with septic shock. R3's Minimum Data Set (MDS), dated [DATE], documented R3 is severely cognitively impaired and is dependent on staff for toileting hygiene, bed mobility, and transfers. R3's Care Plan, last review date of 11/18/2024, documented R3 has been incontinent of bowel and bladder, and she doesn't know when she is wet or soiled. […]