Trenton Gardens Rehabilitation and Nursing Center

In the surveyor’s words

From the most serious findings on record at Trenton Gardens Rehabilitation and Nursing Center, in the surveyor’s own words.

• Immediate jeopardy, widespreadF812Feb 6, 2026

  Based on observations, interviews, record review, and review of facility policy, it was determine that the facility failed to ensure standard food safety practices were put in place to prevent food borne illness by ensuring a.) the dish machine and the three-compartment sink were maintained in safe operating conditions in accordance with manufacturer's specifications; b.) adherence to sanitary requirements to ensure all dishware was properly sanitized to prevent potential foodborne illness or potential exposure to hazardous chemicals; and c.) a monitoring system was in place and staff were competent to record the temperature and the chemical concentrations of the sanitizing agent. This deficient practice had the potential to affect all 185 residents. […]

• Immediate jeopardy, widespreadF689Oct 14, 2025

  COMPLAINT #2620207 Based on interviews, medical record review, and review of other pertinent facility documentation on 10/07/2025, it was determined that the facility failed to ensure a resident (Resident #2) whose smoking privileges were revoked did not have cigarettes in their possession or smoke in the facility in the presence of oxygen to prevent accidental explosion and fire from unsafe smoking. This deficient practice was identified for 1 of 3 residents (Resident #2) reviewed for accidents. During an interview with the Nursing Supervisor (NS) on 10/07/2025, she stated that while conducting her rounds on 09/16/2025, at approximately 8:00 P.M., she observed Resident #2 seated in a wheelchair, smoking a cigarette in Resident #1 and Resident #3's room. […]

• Immediate jeopardy, widespreadF835May 15, 2025

  Complaint #: NJ185458 Based on interviews, medical record reviews, and review of other pertinent facility documentation on 5/8/25, it was determined that the facility's Licensed Nursing Home Administrator (LNHA) and the administrative staff failed to ensure resident safety and well-being by failing to A) prevent illicit drugs from entering the facility and drug overdose incidents from occurring, B) ensure a thorough investigation was completed for a staff to resident sexual abuse allegation involving Resident #3 and multiple drug overdoses that occurred in the facility involving Resident #6, and C) ensure that the police and the New Jersey Department of Health (NJDOH) were notified of any drug overdoses that occurred in the facility. […]

• Immediate jeopardy, patternF610May 15, 2025

  Complaint #: NJ182907, NJ186028 Based on interviews, medical records reviews, and review of other pertinent facility documentation on 5/7/25, 5/8/25, and 5/9/25 it was determined that the facility failed to complete thorough investigations when A) Resident #15 was observed to have bruising, swelling and a scratch to her/his face. B) when a resident reported witnessing an alleged sexual abuse between another resident (Resident #3) and the Licensed Practical Nurse (LPN #1). The facility also failed to ensure its policy titled Abuse, Resident Behavior and Facility Practice was implemented for the alleged physical abuse and alleged sexual abuse allegations. 1. On 10/12/24 at approximately 8:30 P.M, the Unit Manager (UM) was notified by LPN #6 that Resident #15 had a scratch on his/her face. […]

• Immediate jeopardy, patternF689May 15, 2025

  Complaint #: NJ185458 Based on interviews, medical record reviews, and review of pertinent facility documentation on 5/8/25 and 5/9/25, it was determined that the facility failed to: A) ensure the residents' safety by failing to implement interventions to prevent drugs from entering the facility and overdose incidents from occurring while in the facility, B) conduct a thorough investigation into a resident's (Resident #6) drug overdoses, and C) notify the police and the New Jersey Department of Health (NJDOH) of the residents' drug overdoses. 1. On 2/21/25 at approximately 6:30 PM, the Infection Preventionist (IP) observed Resident #6 slumped in his/her wheelchair. Resident #6's fingertips, lips, and lower half of face were cyanotic (blue), and he/she had loud breathing. […]