Edgewood Manor: Infected Wound Left Untreated - OH
Federal inspectors found the facility failed to implement ordered wound care from August 9 through August 11, despite receiving hospital discharge paperwork that included laboratory results confirming the toe wound tested positive for Staphylococcus aureus.
The resident, identified as #53 in inspection records, had been hospitalized and received a physician's order for Sulfamethoxazole-Trimethoprim antibiotics — 800-160 milligrams twice daily by mouth, with eight doses remaining when discharged back to the nursing home on August 9.
Hospital records showed the wound had been cultured during the resident's stay and determined to contain S. aureus, a potentially serious bacterial infection. The discharge paperwork provided to Edgewood Manor included these laboratory results.
Yet no wound care orders existed in the facility's medical records for the infected toe from the day of discharge through August 11.
The resident, admitted to Edgewood Manor in April, carried multiple medical diagnoses including anxiety, kidney injury, altered mental status, osteoarthritis, asthma, bipolar disorder, cellulitis, chronic kidney disease, COPD, depression, and suicidal ideations. His most recent assessment on August 5 showed he remained cognitively intact with a mental status score of 14.
On August 11 at 3:19 PM, federal inspectors interviewed both the facility's Administrator and Director of Nursing. Both confirmed that no wound care or dressing change orders were in place for the resident's infected toe during the two-day period following his hospital return.
The facility's own wound care policy, dated September 2021, states its purpose is "to care for the wounds to promote healing."
Inspectors reviewed medical records for three residents as part of their wound care investigation at the 62-bed facility. Of those three residents, only one — resident #53 — experienced failures in timely wound care implementation.
The inspection was conducted in response to a complaint filed with state health officials, assigned complaint number 1385721.
Staphylococcus aureus infections require prompt treatment, particularly in elderly residents with multiple health conditions. Left untreated, such infections can spread to deeper tissues, bones, or bloodstream, potentially causing life-threatening complications.
The resident had been discharged from the community hospital on August 9 with specific instructions for continued antibiotic treatment. The hospital had already initiated the medication regimen, leaving eight doses for the nursing home to administer upon his return.
Federal inspectors classified the violation as causing "minimal harm or potential for actual harm" to the resident. The deficiency fell under federal regulation F 0686, which requires nursing homes to "provide appropriate pressure ulcer care and prevent new ulcers from developing."
The inspection found that few residents were affected by the wound care failures, indicating the problem was isolated rather than systemic across the facility's operations.
Edgewood Manor's failure to implement the hospital's wound care orders represented a breakdown in the transition of care between the hospital and nursing facility. The resident returned with clear medical documentation, laboratory results confirming infection, and specific treatment instructions, yet received no wound care for 48 hours.
The facility is required to submit a plan of correction to continue participating in Medicare and Medicaid programs. Under federal rules, nursing home deficiency findings and correction plans become public 14 days after the documents are made available to the facility.
The August inspection was completed on August 13, just four days after the resident's hospital discharge and two days after inspectors confirmed the wound care orders were missing from facility records.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Edgewood Manor Rehabilitation & Healthcare Center from 2025-08-13 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 21, 2026 · Our methodology
EDGEWOOD MANOR REHABILITATION & HEALTHCARE CENTER in PORT CLINTON, OH was cited for violations during a health inspection on August 13, 2025.
Hospital records showed the wound had been cultured during the resident's stay and determined to contain S.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.