Woodbriar Nursing Home

In the surveyor’s words

From the most serious findings on record at Woodbriar Nursing Home, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812May 6, 2022

  Based on observation and interview, the facility failed to ensure food items in the refrigerator were dated when pulled from the freezer and placed in the refrigerator to ensure they were used within 14 days once thawed and failed to ensure equipment was maintained in clean condition and failed to ensure 1 (500 Hall) of 2 ice machines was regularly cleaned to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. The failed practices had the potential to affect 63 (total census: 66) residents who receive meals from the kitchen and 18 residents who received ice from the 500 hall ice machine based on a list provided by the Dietary Employee #1 on 05/05/22. The findings are: 1. […]

• No harm, potential for more than minimal, widespreadF812Mar 11, 2021

  Based on observation and interview, the facility failed to ensure food items stored in the refrigerator and dry storage were covered and sealed and expired food was promptly removed from stock and discarded in 1 of 1 facility. These failed practices had the potential to affect 43 residents who received meals from the kitchen (total census:45), as documented on the Diet List provided by the Dietary Manager on [DATE] at 8:39 am. The facility also failed to ensure 1 of 2 ice machines were maintained in clean condition to prevent potential contamination. This failed practice had the potential to affect 16 residents who resided on the 500 Hall according to the list provided by the Director of Nursing (DON) on [DATE] at 3:19 pm. The findings are: 1. […]

• No harm, potential for more than minimal, patternF641Apr 9, 2026

  Based on observations, record review, interview and facility policy review, it was determined that the facility failed to ensure the Minimum Data Set (MDS) was accurate and complete to facilitate the ability to plan and provide necessary care and services for three (Residents #4, #17 and #64) of three residents reviewed. The findings include:Resident #4Review of an admission Record indicated the facility admitted Resident #4 with diagnoses that included atherosclerotic heart disease (a buildup of fats and cholesterol in the artery walls, leading to narrowed or hardened arteries) and cerebral infarction (a stroke caused by blockage in an artery supplying blood to the brain).Review of a quarterly MDS with an Assessment Reference Date (ARD) of 02/09/2026 for Resident #4 revealed that the… […]

• No harm, potential for more than minimal, patternF695Aug 18, 2023

  Based on observation, interview, and record review the facility failed to ensure residents received oxygen therapy at the physician ordered flow rate. This failed practice affected 2 (Resident #17, #19) of 3 (Resident #17, #19, #34) sampled residents, residing on the 200 Hall who had orders for oxygen, according to a list provided by the Administrator on 08/17/2023 at 10:48 AM. The findings are: 1.The following observations were made of Resident #17: a. On 08/14/23 at 3:09 PM Resident #17 was sitting in her room in her wheelchair. Her oxygen was set at 1.5 liters per minute. b. On 08/16/23 at 8:42 AM Resident #17 was sitting at bedside in a wheelchair, with oxygen off. Concentrator on and set on 1.5 liters, nasal cannula in a bag dated, 08/13/23. I usually have that oxygen on. […]

• No harm, potential for more than minimal, patternF880Aug 18, 2023

  Based on observation, interview and policy and procedure review, the facility failed to prevent the potential for infection and cross contamination in the facility laundry processing area as evidenced by staff placing half consumed food and drinks on the laundry folding table next to clean, folded resident linens. This failed practice had the potential to effect 18 (Resident #1, #3, #4, #5, #8, #16, #17, #19, #20, #26, #34, #37, #39, #40, #46, #51, #54 and #59) sampled residents, and 62 residents who have their laundry done in the facility based on a list provided by the Administrator on 08/18/23 at 8:41 AM. The findings are: a. […]