Greentree of Hubbell Rehabilitation and Health

In the surveyor’s words

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

• Immediate jeopardy, isolatedF689Nov 1, 2022

  This Deficient Practice Statement (DPS) has two parts: A and B. A This deficiency is related to Intake #MI 574. Based on observation, interview, and record review, the facility failed to provide adequate supervision to prevent an elopement from the facility resulting in Immediate Jeopardy (IJ) for one Resident (R54), of one resident reviewed for elopement. This deficient practice resulted in Immediate Jeopardy (IJ), with the likelihood of serious harm, injury, or death when R54's location was identified and reported being on a State Highway by an unidentified passing motorist. Findings include: During interviews conducted on 10/25/22 with Certified Nurse Aide (CNA) N, CNA P, CNA Q, Maintenance Director (Staff) B, and CNA P at 11:17 a.m., 11:26 a.m., 12:08 p.m., 12:09 p.m., and 12:26 p.m. […]

• Actual harm, isolatedF887Mar 3, 2026

  Based on interview and record review, the facility failed to administer covid vaccinations for six Residents (#49, #7, #14, #28, #43, and #45) of nine residents reviewed for covid vaccinations. This deficient practice resulted in death for Resident #49 (R49) from Covid-19 after the facility failed to administer the Covid-19 vaccine as requested.Findings include:Resident #49 (R49) Review of progress notes revealed the following: [DATE] at 2:57 a.m., read in part [R49] observed to be lethargic and not of one self from CNA (Certified Nurse Aide). Vitals revealed 80/49 (blood pressure) p (pulse) 61R (respirations) 18. [DATE] at 5:05 p.m., Patient is covid positive. […]

• Actual harm, isolatedF689Sep 16, 2025

  This citation pertains to Intake# 2561427.Based on observation, interview, and record review, the facility failed to provide adequate supervision in 2 of 4 residents (Resident #4 and Resident #5), reviewed for accidents and hazards, resulting in R5 sustaining a 2nd-3rd degree burn when hot liquid hazards were left unattended.Findings include: Per the Bureau of Health Systems Burn Hazards Related to Heated Surfaces in Long Term Care Facilities ALERT dated 5/12/1999, Sustained skin contact with surfaces of equipment that have temperatures in excess of 107 degrees Fahrenheit can cause burns. […]

• Actual harm, isolatedF686Dec 19, 2023

  Based on observation, interview, and record review, the facility failed to provide treatment and services to prevent new pressure ulcers from developing for two Residents (#22 and #29) of three residents reviewed for pressure ulcer care. This deficient practice resulted in multiple newly facility acquired pressure injuries which subsequently required debridement, use of antibiotics and the use of a wound vac. Findings include: Resident #22 (R22) On 12/18/23 at 8:45 AM, an interview was conducted with R22 who was observed lying in her bed wearing a hospital gown and covered with a white bed sheet. R22 was observed with a wound vac on the left side of her bed on the floor which was connected to her lower abdominal area. […]

• Actual harm, isolatedF689Feb 9, 2022

  Intake# MI 185 Based on observation, interview, and record review, the facility failed to provide adequate supervision, physician ordered assistive devices, and properly maintained medical equipment (anti-rollback wheelchair) to prevent two falls with major injuries involving Residents #2 and Resident #3 of three residents reviewed for falls. This deficient practice resulted in harm for Resident #2 with fracture, hospitalization , increased pain, and decreased mobility. Findings include: Resident #2 Review of Resident #2's Minimum Data Set (MDS) assessment, 11/13/21, reflected the following diagnoses: diabetes, chronic [CONDITION(S)] (low sodium), dementia, and alcoholic [CONDITION(S)]. […]