Edgewood Manor of Greenfield

In the surveyor’s words

From the most serious findings on record at Edgewood Manor of Greenfield, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 14, 2022

  Based on medical record review, review of the fall investigation, observation, staff, resident, and family interview, review of the fall list, and policy review, the facility failed to ensure appropriate interventions were implemented and maintained to ensure residents remained free from burns. This resulted in Immediate Jeopardy and serious life-threatening harm and/or injuries when Resident #45, whose bed had been positioned adjacent to an electric baseboard wall heater, rolled out of the bed, and sustained second degree burns (this type of burn affects both the epidermis and the second layer of skin the dermis and pain can be severe) to her back and right shoulder from the electric baseboard wall heater. This affected one resident (#45) of five residents reviewed for falls. […]

• No harm, potential for more than minimal, widespreadF585Jan 23, 2025

  Based on resident and staff interview, review for the facility grievance log, and review of a facility policy, the facility failed to make prompt efforts to resolve dietary grievances. This had the potential to affect all 50 residents residing in the facility. The facility census was 50. Findings include: Review of the October 2024 grievance log revealed the facility received four grievances regarding dietary services and the quality of the food. The resolutions listed included to educate on tray line and availability and will cook the food longer. Review of the November 2024 grievance log revealed the facility received two grievances regarding dietary services, the quantity of food, and the quality of the food. […]

• No harm, potential for more than minimal, widespreadF803Jan 23, 2025

  Based on observation, staff interview, review of menu spreadsheets, and review of a facility policy, the facility failed to ensure menus were followed during meal service. This affected all 50 residents residing in the facility. The facility census was 50. Findings include: Review of the menu spreadsheet dated 01/22/25 revealed residents on a regular diet were to receive one country fried steak with mushroom gravy, four ounces of carrots, four ounces of potatoes, and a square of cornbread, and residents on mechanical soft diets were to receive a four ounce scoop of ground country fried steak with mushroom gravy, four ounces of carrots, four ounces of potatoes, and a square of cornbread. Observation of meal service on 01/22/25 at 4:45 P.M. […]

• No harm, potential for more than minimal, widespreadF812Jan 23, 2025

  Based on observation, staff interview, review of a dishwasher operation manual, and facility policy review, the facility failed to ensure food was served in a safe and sanitary manner, failed to ensure the kitchen was properly cleaned, and failed to ensure the dishwasher was appropriately functioning. This affected all 50 residents residing in the facility. The census was 50. Findings include: 1. Observation of the kitchen on 01/21/25 at 8:50 A.M. revealed staff were actively using the dishwasher. The dishwasher had a wash temperature of 111 degrees Fahrenheit (F) and a rinse temperature of 146 degrees F. Dietary Manager (DM) #410 was observed testing the chemical sanitizer in the dishwasher and the dishwasher tested at 200 parts per million (ppm). […]

• No harm, potential for more than minimal, widespreadF921Jan 23, 2025

  Based on observation, medical record review, and staff interview, the facility failed to maintain a clean, sanitary, and homelike environment. This had the potential to affected all 50 residents residing at the facility. The facility census was 50. Findings include: 1. Interview and observation with the Administrator on 01/23/25 at 9:25 A.M. confirmed the light over the nurses' station when walking onto the unit from the front door did not have a cover and had exposed florescent lighting. The light to the left of the main nurses' station when walking onto the unit was missing a light cover and had exposed florescent lighting. The [NAME] Court hallway had four missing light covers with exposed bulbs. […]