Edgewood Manor of Wellston

In the surveyor’s words

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

• Actual harm, isolatedF697Jul 31, 2024

  Based on record review, review of a facility fall report, policy review and interview, the facility failed to provide timely and necessary pain management (including the administration of effective pain medication) for Resident #23 following the identification of an injury to the resident's hip/leg. Actual Harm occurred on 05/19/24 when direct care staff identified Resident #23, who was severely cognitively impaired had increased incontinence (not his baseline) and verbal and non-verbal signs of pain including facial grimacing and grabbing his right leg during care resulting in unrelieved pain. On 05/19/24 at 11:16 A.M. nursing staff received an order for Ultram for pain. However, the medication was not administered on this date until 4:05 P.M. […]

• Actual harm, isolatedF760May 9, 2024

  Based on closed record review, policy review, and interview, the facility failed to ensure Resident #22 was free from significant medication errors. This affected one resident (#22) of four residents reviewed for unnecessary medications. The facility census was 44. Actual Harm occurred on 11/27/23 and continued through 01/29/24 when the facility failed to clarify medication orders with Resident #22's referring hospital and include the resident in an admission care plan meeting, resulting in chemotherapy medication being administered in error to Resident #22. […]

• No harm, potential for more than minimal, isolatedF605Sep 4, 2025

  Based on record reviews and staff interview, the facility failed to ensure as needed psychotropic medications were not prescribed for longer than 14 days without being re-ordered by the physician or discontinued. This affected two residents (#37 and #42) out of the five residents reviewed for unnecessary medications during the annual survey. The facility census was 40. Findings include:1.Record review for Resident #37 revealed the resident was admitted to the facility on [DATE] and had diagnoses which included anxiety disorder, depression, and acute respiratory failure with hypoxia.Review of the admission Minimum Data Set (MDS) assessment, dated 05/23/25, revealed the resident was assessed to have impaired cognition.Review of the physicians order, dated 05/27/25, revealed an order to… […]

• No harm, potential for more than minimal, isolatedF656Sep 4, 2025

  Based on medical record review, staff interview, and facility policy review, this facility failed to ensure a care plan was in place for a resident diagnosis with Post-Traumatic Stress Disorder (PTSD) This affected one (Resident #3) of the one resident reviewed for accurate PTSD care planning. The facility census was 40. Findings include: Review of the medical record for Resident #3 revealed an initial admission date of 09/10/2024 and a re-entry date of 04/08/2025. Diagnoses included major depressive disorder, anxiety disorder, bipolar disorder, PTSD, and schizoaffective disorder. […]

• No harm, potential for more than minimal, isolatedF685Sep 4, 2025

  Based on interview and record review the facility failed to ensure a referral appointment was made timely with ophthalmology for Resident #11. This affected one (Resident #11) of two residents reviewed for communication and sensory. The facility census was 40. Review of the medical record for Resident #11 revealed a readmission date of 04/10/25 with diagnoses including heart failure, chronic obstructive pulmonary disorder, atrial fibrillation, diabetes mellitus type two, peripheral vascular disease, dementia and bilateral cataracts.Review of the physician orders revealed an order written on 04/11/25 for audiology, dental, vision and podiatry ancillary services per 360 as needed. […]