Greentree Health and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Greentree Health and Rehabilitation Center, in the surveyor’s own words.

• Actual harm, isolatedF689Apr 23, 2025

  Based on staff and resident interview and record review, the facility did not ensure 1 resident (R) (R86) of 1 sampled resident was transferred appropriately and in accordance with the facility's policy. On 4/5/25, Certified Nursing Assistant (CNA)-K transferred R86 without a gait belt. R86 fell during the transfer and sustained a head injury that required 3 staples. Findings include: The facility's Safe Resident Handling/Transfers Policy, revised 12/2024, indicates: It is the policy of this facility to ensure residents are handled and transferred safely to prevent or minimize risks for injury and provide and promote a safe, secure, and comfortable experience for the resident while keeping employees safe in accordance with current standards and guidelines .All residents require safe… […]

• No harm, potential for more than minimal, widespreadF801Jul 15, 2026

  Based on interview and record review, the facility did not designate a person to serve as the director of food and nutrition services who was a certified dietary manager, a certified food service manager, had a national certification for food service management and safety from a national certifying body, or had an associate's or higher level degree in food service management or hospitality. This practice had the potential to affect all 32 residents residing in the facility. Findings include: During an initial kitchen tour on 7/13/26 that began at 8:18 AM, Dietary Manager (DM)-C indicated they had not received their Dietary Manager certification. DM-C stated they were currently enrolled in classes, but had not completed them. […]

• No harm, potential for more than minimal, widespreadF812Feb 15, 2023

  Based on observation, staff interview and record review, the facility did not ensure food was handled, stored and prepared in a sanitary manner. The practice had the potential to affect 39 of 39 residents. The facility did not monitor and document food holding and food cooling temperatures. The facility did not ensure food was stored in a clean, dry location not exposed to splash, dust or contamination. The facility did not have a working handwashing sink separate from sinks used for food prep, warewashing and eye washing. Dietary staff did not wait two minutes to take microwave reheated food temperatures to ensure food was heated evenly. […]

• No harm, potential for more than minimal, widespreadF812Feb 23, 2022

  Based on observation, staff interviews, and record review, the facility did not ensure food was prepared, stored, and served under sanitary conditions. The practices had the potential to affect all 36 residents. The facility did not ensure: - monitoring of warewashing machine (dishwasher) temperatures - time and temperature controlled foods and beverages were dated and discarded as required - ice maker was free of discoloration on ice curtain - meat slicer and reach-in refrigerator were clean Findings include: On [DATE] at 12:19 PM, Director of Nursing (DON)-B indicated the facility kitchen utilized the Food and Drug Administration (FDA) Food Code to guide its practices. […]

• No harm, potential for more than minimal, widespreadF880Mar 24, 2021

  Based on observations and staff interviews, the facility did not ensure staff performed proper hand hygiene during meal pass which had the potential to affect all 28 residents in the facility. Additionally, the facility did not ensure staff performed proper hand hygiene for 1 Resident (R) (R18) of 2 residents observed during provision of cares. 1. Dietary Aide (DA)-E did not perform appropriate hand hygiene after touching resident room items during lunch meal pass on 3/22/21. This had the potential to affect all 28 residents in the facility. 2. Certified Nursing Assistant (CNA)-F did not perform appropriate hand hygiene during R18's provision of morning cares on 3/23/21. Findings include: On 3/22/21 at 11:52 AM, Surveyor observed DA-E exit dining room with a cart of five meals. […]