Glenoaks Senior Living: Aide Warned Twice Before Complaint - MN
The complaint that triggered a September 12 inspection centered on a nursing assistant identified in inspection records as NA-P. What inspectors found when they pulled her employment file was a paper trail that started in July and didn't stop.
The first entry was dated July 18, 2025, a coaching note the facility called a "teachable moment." NA-P had been using the wrong tone of voice with coworkers, the note said, and had been disrespectful and condescending toward them. It was the kind of documentation facilities generate when they want a record but aren't ready to call something a formal warning.
Two weeks later, they were ready.
A written warning dated August 1 described NA-P as harsh and rushed during resident care. Staff had complained, the warning said, about her tone and the words she used, language they described as demeaning and lacking appropriate bedside manner. The warning named the behavior. It named the impact. It was placed in her file, and NA-P remained on the floor.
Then came September 5.
The director of nursing wrote up a grievance on behalf of a resident identified in inspection records as R1. The resident had identified NA-P by name. She told the director that NA-P moved too fast during cares, that the experience was unpleasant, and that she would prefer, if possible, that NA-P not assist her going forward. She used the word "possible." She left herself a small exit from the ask, the way people do when they're not sure their complaint will be taken seriously, or when they're dependent on the people they're complaining about and don't want to make things worse.
The director of nursing, in an interview with inspectors on the morning of September 12 at 7:40 a.m., said she had gone over the grievance form with NA-P on September 5, the same day the grievance was written. She said she had asked NA-P to slow down, had encouraged her to treat residents as individuals with individual care needs, and had reminded her to provide quality care to all residents.
That was the response. A conversation.
What the inspection record doesn't show is any indication that NA-P was removed from caring for R1 after the resident asked her to be. It doesn't show a formal investigation into whether the behavior described across three separate documents over 57 days rose to the level the facility's own abuse prevention policy contemplates.
That policy, dated July 8, 2024, defines personal degradation of a dependent adult as any act or statement by a caretaker intended to shame, degrade, humiliate, or otherwise harm the personal dignity of a dependent adult, or where the caretaker knew or reasonably should have known the act or statement would cause shame, degradation, humiliation, or harm to the personal dignity of a reasonable person. It defines mental abuse as verbal or nonverbal conduct that causes or has the potential to cause a resident to experience humiliation, intimidation, fear, shame, agitation, or degradation, and it specifies that derogatory statements directed at a resident fall within that definition.
The facility wrote that policy. Inspectors cited it. The gap between what the policy describes and what the employment file documents is the finding.
Nursing aides work in close physical proximity to the people they care for. They help residents bathe, dress, use the toilet. The relationship requires trust in a way that few professional relationships do, because the person receiving care is often unable to leave, unable to easily find someone else, and sometimes unable to fully articulate what is happening to them or why it feels wrong. When a resident manages to say, clearly, that a specific person is too rough and too fast and she would prefer that person not touch her anymore, that is not a minor complaint. That is someone who found the words and used them.
R1 found the words. She said NA-P moved too fast. She said it was unpleasant. She named her.
The director of nursing's response was to have a conversation with NA-P about slowing down and treating residents as individuals. The same message, more or less, that had been delivered on July 18 and again on August 1.
The coaching note in July addressed tone and disrespect toward coworkers, not residents. The written warning in August addressed harsh and rushed care with residents and the language NA-P used around them. The grievance in September addressed the same rushed, unpleasant care, now described by a resident directly. Each document in the file describes a pattern that didn't stop after the previous document was written.
Inspectors classified the deficiency as causing minimal harm or potential for actual harm, and noted that some residents were affected. The inspection was conducted as a complaint investigation, meaning someone, a resident, a family member, or a staff member, had already contacted state authorities before inspectors arrived.
What the file shows, taken together, is a facility that documented a problem three times in less than two months and each time responded with a conversation. The written warning in August acknowledged that staff had complained about NA-P's tone and verbiage. The grievance in September showed that a resident had now said the same thing, in her own words, about her own body and her own care.
She asked for it to stop. She asked, specifically, for this person not to be the one helping her anymore.
The inspection report does not say whether that request was granted.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Glenoaks Senior Living Campus from 2025-09-12 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 22, 2026 · Our methodology
GLENOAKS SENIOR LIVING CAMPUS in NEW LONDON, MN was cited for violations during a health inspection on September 12, 2025.
The complaint that triggered a September 12 inspection centered on a nursing assistant identified in inspection records as NA-P.
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.