The Springs of Red Oak

In the surveyor’s words

From the most serious findings on record at The Springs of Red Oak, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Feb 8, 2024

  Based on observation, record review, and interview, the facility failed to ensure transportation provider safely off-loaded a resident in a wheelchair from the facility transportation van to prevent potential injury for 1 (Resident #1) of 2 (Residents #1 and #2) sampled residents who required transport in a wheelchair on the transportation provider's van. The failed practice had the potential to affect 46 residents that resided in the facility per census received 2/7/2024. This failed practice resulted past Immediate Jeopardy, which caused or could have caused serious harm, injury, or death to Resident #1, who rolled out of the van in a manual wheelchair and fell on the lift that was ground level resulting in a back injury. […]

• No harm, potential for more than minimal, widespreadF812May 14, 2026

  Based on observation, interview, and facility policy review, it was determined that the facility failed to ensure food preparation and serving pieces were washed, dried, and stored in sanitary conditions for one of one kitchen. Based on observation, interview, and facility policy review, it was determined that the facility failed to ensure food preparation and serving dishware were washed, dried, and stored in sanitary conditions for one of one kitchen that served 35 residents with regular diets, 11 with mechanical soft diets, and two with pureed diets. The findings include: During an observation and concurrent interview on 05/16/2026 at 11:25 AM, the Dietary Manager (DM) retrieved pans that were stored on a shelf under the serving table. Five quarter sheet pans were observed. […]

• No harm, potential for more than minimal, widespreadF880Feb 23, 2024

  Based on record review and interview, the facility failed to develop and/or implement a water management program with measures to minimize the risk for Legionella and other waterborne opportunistic pathogens to reduce the risk for potential infections. This failed practice had the potential to affect 38 residents who resided in the facility. The findings are: 1. On 2/22/24 at 2:06 PM, the Maintenance Supervisor was asked, Do you handle water management here? The Maintenance Supervisor stated, No, I'm not sure what you mean. The Surveyor asked, If the water system has to be tested or checked here, would you be the one doing that? The Maintenance Supervisor stated, Well I'm sure I would be involved in that. […]

• No harm, potential for more than minimal, widespreadF812Dec 8, 2022

  Based on observation, record review and interview, dietary staff (failed to) wash their hands between dirty and clean tasks and before handling clean equipment or food items to prevent potential for cross contamination; the facility failed to ensure foods stored in the refrigerator were sealed to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; expired dry food products were promptly removed/discarded on or before the expiration or use by date to prevent the growth of bacteria; and failed to ensure 1 of 2 ice machines was maintained in a clean and sanitary condition to prevent potential contamination for residents who received meals from 1 of 1 kitchen. […]

• No harm, potential for more than minimal, widespreadF812Jul 6, 2022

  Based on observation, record review and interview, the facility failed to ensure hot foods were held at 135 Fahrenheit (F) or higher on the steam table to prevent the potential for food-borne illness. This failed practice had the potential to affect in 37 residents who received a meal tray during the evening meal on 7/5/22 as documented on a list provided by the Secretary on 7/6/22 at 9:55 a.m. The findings are: 1. The facility policy Food Temperatures, provided by the Administrator on 7/6/22 at 10:15 a.m. documented, .hot foods may not fall below 135 degrees after cooking . food preparation and service areas will follow these methods: .hold foods . at or above 135 degrees F for hot foods (to keep food out of the temperature danger zone) . 2. […]