Glenwood Health And Rehabilitation

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

decision regarding the conclusion of the investigation had been provided to Resident R4.Review of the facility document titled, Resident Grievance/Concern/Complaint Report, dated 8/11/2025 revealed, Resident R4 voiced a grievance to the SSD regarding another resident. The document indicated the grievance was resolved and indicated the Resident/Responsible Party was notified One-to-One. The Resident Grievance/Concern/Complaint Report was signed by the SSD on 8/12/2025. The document revealed it did not indicate that a written decision regarding the conclusion of the investigation had been provided to Resident R4.Review of the facility document titled, Resident Grievance/Concern/Complaint Report, dated 9/1/2025 revealed, Resident R4 voiced a grievance to the SSD related to dietary concerns. The document indicated the grievance was resolved and indicated the Resident/Responsible Party was notified One-to-One. The Resident Grievance/Concern/Complaint Report was signed by the SSD on 9/3/2025. The document revealed it did not indicate that a written decision regarding the conclusion of the investigation had been provided to Resident R4.During an interview on 9/9/2025 at 12:30 pm, Resident R4 revealed they had filed grievances in the past that were resolved. Resident R4 stated the SSD responded verbally about the grievances the resident had filed but had not offered a written copy. Resident R4 stated they were unaware a copy could be provided, and they wanted

a copy of the grievance.During an interview on 9/10/2025 at 4:00 pm, the SSD stated she had been the Grievance Official designee for the facility since 7/22/2025. The SSD stated she was responsible for the investigation and follow-up for grievances and complaints. The SSD stated that at the conclusion of her investigations of grievances, she made in-person contact with the resident or responsible party to let them know how the grievance was resolved. The SSD stated she was not aware a written response was required. The SSD stated she had not provided a copy of grievance resolutions for grievances she had investigated since starting at the facility in July 2025. During an interview on 9/10/2025 at 5:00 pm, the Director of Nursing (DON) stated she was not aware the facility was required to provide a written response to grievances, and she expected the grievance official or designee to follow the facility policy.During an

interview on 9/10/2025 at 5:15 pm, the Administrator (ADM), stated he was not aware the facility was required to provide a written response to grievances, and he expected the grievance official or designee to follow the facility policy.

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/11/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Glenwood Health and Rehabilitation

41 North Fifth Street Glenwood, GA 30428

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many

FORM CMS-2567 (02/99) Previous Versions Obsolete

interview on 9/9/2025 at 10:47 am revealed, an uncovered 25-gallon stock pot containing green beans on

the stove, and the stove was turned off. [NAME] (3) stated she turned the pot of green beans off between 10:15 am and 10:30 am, to allow the green beans to cool before putting the green beans in a service pan and then on the steam table for the meal service.Interview on 9/9/2025 at 10:48 am with the DM revealed,

she did not notice the creamed corn was already on the steam table for hot holding. The DM stated she expected the cooks to use the oven for hot holding at a temperature of 140 degrees F instead of the steam table. The DM stated cooks should follow the guidance on the recipes regarding the temperature to hold foods hot until the meal tray line began. The DM stated the green beans should not be left on the stove with

the temperature turned off but should be transferred to a service pan, covered, and held in the oven at 140 degrees F until the meal service.2. Observation with concurrent interview of the facility's walk-in refrigerator

on 9/9/2025 at 11:05 am revealed, 12 tomatoes were stored in a cardboard box with a lid. The observation revealed the tomatoes had multiple areas of dark discoloration, and two tomatoes had white hair-like growth identified by the DM as mold. The observation also revealed two oranges stored in a cardboard box with a lid. The oranges were covered with black/white hair-like growth identified by the DM as mold. The DM stated she checked the refrigerated storage areas daily for properly stored items and removed any expired items she found. The DM stated that she had most recently checked the walk-in refrigerator that morning but stated, I missed these items.Interview with the Registered Dietician (RD) by telephone on 9/9/2025 at 2:44 pm revealed, the steam table should not be used for hot temperature holding, but hot foods should be placed in the oven and monitored to maintain a hot holding temperature of 140 degrees F. The RD stated that an oven set to 100 degrees F would not maintain hot foods of at least 140 degrees F. The RD stated that she expected hot foods to be placed on the steam table approximately 30 minutes before the meal service. The RD stated the staff should conduct daily checks of the cold food storage for expired items and remove any items that were stored past their use-by-date.Interviews with the Director of Nursing (DON) and

the Administrator (ADM) on 9/10/2025 at 5:00 pm revealed, the DON stated that the dietary staff required some education regarding kitchen sanitation and safe cooking practices. The ADM stated that he expected

the DM to check kitchen sanitation daily and oversee the cooks during meal preparation. The ADM stated

he expected the cooks to follow a food safety and certification program's cooking practices and recommendations.

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Facility ID:

If continuation sheet