Village House Nursing & Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Village House Nursing & Rehabilitation Center, in the surveyor’s own words.

• Actual harm, isolatedF689Aug 6, 2024

  Based on record review and staff interview, it has been determined that the facility failed to ensure that the resident's environment remains as free from accident hazards as possible, relative to the implementation of an intervention indicated on the Safe Resident Handling document, for 1 of 2 residents reviewed who had sustained a fracture while in the facility, Resident ID #1. Findings are as follows: According to an article published by STATPEARLS found in the National Library of Medicine National Center for Biotechnology Information titled, Avulsion Fractures, last updated on 8/7/2023, states in part, .Pathophysiology .An avulsion fracture occurs when a ligament or other soft tissue attachment to bone overcomes the stress capacity of the bony attachment and tears off a portion of the… […]

• No harm, potential for more than minimal, widespreadF812Mar 12, 2026

  Based on surveyor observation, record review, and staff interview, the facility failed to ensure that food is stored, served, and distributed, in accordance with professional standards for food service safety, relative to the main kitchen.Findings are as follows:1. Review of the Food and Drug Administration (FDA) Food Code 2022 Edition, Section 5-202.13 states in part, An air gap between the water supply inlet and the flood level rim of the PLUMBING FIXTURE .may not be less than 25mm [millimeter] (1 inch).During a surveyor observation on 3/9/2026 at approximately 9:30 AM, of the main kitchen during the initial walk through, in the presence of Cook, Staff H, the ice machine did not have a one-inch air gap, as required.During a surveyor interview immediately following the above observation… […]

• No harm, potential for more than minimal, widespreadF812Jan 9, 2025

  Based on surveyor observation, record review, and staff interview, it has been determined that the facility failed to prepare, store, and distribute food according to professional standards of food service safety, relative to the main kitchen and 1 of 2 nourishment areas observed. Findings are as follows: 1. Review of the Rhode Island Food Code, 2018 Edition, section ,d+[DATE].17 states in part, .(B) .refrigerated, ready-to-eat time/temperature control for safety food .shall be clearly marked, at the time the original container is opened in a food establishment .and: (1) the day the original container is opened in the food establishment shall be counted as Day 1; and (2) The day or date marked by the food establishment may not exceed a manufacturer's use-by date . […]

• No harm, potential for more than minimal, widespreadF812Dec 14, 2022

  Based on surveyor observation, record review, and staff interview, it has been determined that the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety relative to the main kitchen. Findings are as follows: Review of The State of Rhode Island Food Code 2018 edition, titled 4-601.11 Equipment, Food-Contact Surfaces, Non-Food-Contact Surfaces, and Utensils states in part, .(C) Nonfood-contact surfaces of equipment shall be kept free of an accumulation of dust . Review of the facility's policy titled, Food Storage states in part, .Leftover food is used within 3 days or discarded .All refrigerator units are kept clean .at all times .All foods should be .labeled and dated. […]

• No harm, potential for more than minimal, patternF760Mar 12, 2026

  Based on clinical record review and staff interview, the facility failed to ensure that residents are free of any significant medication errors for 1 of 1 resident reviewed who was treated with antibiotics for infected heel wounds, Resident ID #3.Findings are as follows:1. According to Mosby's 4th Edition, Fundamentals of Nursing, page 314 states in part, The physician is responsible for directing medical treatment. Nurses are obligated to follow physician's orders unless they believe that the orders are in error or would harm the clients.Record review revealed the resident was readmitted to the facility in January of 2026 with diagnoses including, but not limited to, pressure ulcer of the right and left heels.a. […]