Above average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Greenbrier Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to secure medications on two medication carts, one treatment cart, and in a medication room. An LPN left a medication bubble pack on an unlocked cart and the medication room door propped open, allowing an unlicensed CNA access. Another LPN left a cart unsecured near a resident. Both LPNs acknowledged the risk of unsecured medications.
The facility failed to maintain proper food safety and hygiene practices, affecting all residents. The Dietary Manager and aides were observed not washing hands or changing gloves between tasks, handling expired food, and not sanitizing surfaces properly. These actions risked cross-contamination and compromised resident safety.
A facility failed to maintain aseptic technique during IV medication administration for a resident with a PICC line, as an LPN did not perform hand hygiene and improperly opened alcohol pads. Additionally, the facility did not implement Enhanced Barrier Precautions (EBP) for three residents with medical devices and chronic wounds, despite their risk of infection. Interviews revealed inconsistencies in staff understanding and implementation of EBP.
A resident with severe cognitive impairment was not dressed in clean clothes daily or after showering, as required by their care plan. Despite the expectation for daily clothing changes, the resident was observed wearing the same clothes for several days. A CNA admitted to not providing a clean shirt after a shower, and the DON was unsure of a specific policy on clothing changes.
A resident's MDS assessment inaccurately reported no tobacco use, despite nursing assessments and care plans indicating the resident used tobacco products and could smoke with supervision. Facility staff interviews confirmed the oversight, as the information was not communicated to the MDS Coordinator for inclusion in the MDS.
A facility failed to accurately document a resident's tobacco use in their care plan. Despite assessments indicating the resident used tobacco and could smoke with supervision, the care plan lacked focus, goals, or interventions for tobacco use. Observations showed a CNA assisting the resident with smoking, and interviews revealed communication gaps among staff in updating the care plan. The care plan was eventually updated but backdated, highlighting a delay in accurately reflecting the resident's needs.
Failure to Secure Medications in Facility
Penalty
Summary
The facility failed to ensure the secure storage of medications on two medication carts, one treatment cart, and in one medication room. During an observation, the medication room on the 500-Hall was found with its door propped open by a trash can, despite a sign indicating it should be closed at all times. An LPN prepared medication for a resident and left the medication bubble pack on top of an unlocked medication cart while attending to the resident, leaving an unlicensed CNA unattended with access to the unsecured medication room and cart. The LPN acknowledged the risk of theft or accidental ingestion due to the unsecured medications. Additionally, a treatment cart at the main nurse's station was found unsecured, containing prescriptions and medicated creams that could be ingested by residents. Another LPN left a medication cart unsecured and unattended on the 100-Hall while in a resident's room, with a resident sitting in a wheelchair next to the cart. The LPN admitted the cart was left unsecured and should have been locked, highlighting a repeated failure to secure medications properly.
Food Safety and Hygiene Deficiencies
Penalty
Summary
The facility failed to ensure proper food safety and hygiene practices, affecting all 74 residents who receive food services. During an observation, the Dietary Manager was seen touching the inside of an ice machine without washing her hands after handling the dumpsters outside. This ice machine was used to provide beverages for all residents. Additionally, Dietary Aide #1 did not change gloves or wash hands after wiping down a kitchen countertop before handling clean dishes. Expired food items were also found in the dry food storage area, with breakfast cereals past their expiration dates not being discarded. Further observations revealed that Dietary Aide #3 did not sanitize kitchen countertops between tasks and failed to change gloves or wash hands before handling clean containers. Dietary Aide #4 also neglected to change gloves or perform hand hygiene after touching potentially contaminated surfaces before preparing food. Lastly, Dietary Aide #2 placed a suction plate lifter on a dirty surface and used it on clean plates without sanitizing it. These actions demonstrate a lack of adherence to food safety protocols, potentially leading to cross-contamination and affecting the health of the residents.
Failure to Maintain Aseptic Technique and Implement Enhanced Barrier Precautions
Penalty
Summary
The facility failed to maintain aseptic technique during the administration of intravenous (IV) medication via a Peripherally Inserted Central Catheter (PICC) line for one resident. During an observation, an LPN did not perform hand hygiene before putting on gloves and proceeded to handle various items and perform tasks with the same pair of gloves, including opening alcohol pads with her teeth, which compromised the aseptic technique. The LPN acknowledged the lapse in hand hygiene and the improper method of opening alcohol pads during an interview. Additionally, the facility did not implement Enhanced Barrier Precautions (EBP) for three residents who were at risk of infection due to medical conditions and devices. One resident with a PICC line and a history of severe sepsis was not placed on EBP despite having a physician's order for it. Another resident with a diabetic foot ulcer and severe cognitive impairment was not indicated to be on EBP, and a nurse was observed assessing the ulcer without wearing a gown, which is part of EBP. Similarly, a third resident with an unstageable pressure injury and a diabetic foot ulcer was not placed on EBP, and there was no indication to staff that EBP was required. Interviews with facility staff, including the Infection Preventionist and the Director of Nursing, revealed inconsistencies in the understanding and implementation of EBP. The facility's in-service training materials and policies did not align with the observed practices, leading to a failure to protect residents with indwelling devices and chronic wounds from potential infections.
Failure to Dress Resident in Clean Clothes
Penalty
Summary
The facility failed to maintain or enhance the quality of life for a resident by not ensuring they were dressed in clean clothes daily and after showering. The resident, who had severe cognitive impairment due to Alzheimer's disease, required assistance with dressing. Despite this need, the resident was observed wearing the same clothes for several days, as confirmed by a family member and multiple observations. The resident's care plan indicated the need for assistance with activities of daily living, including dressing, but this was not consistently followed. Interviews with staff revealed that the resident's clothes were supposed to be changed daily and after showers. However, a CNA admitted to not dressing the resident in a clean shirt after a shower due to forgetting to bring one to the shower room. The CNA acknowledged that she could have used the call light to request assistance or changed the shirt once back in the resident's room. The Director of Nursing confirmed the expectation for daily clothing changes but was unsure of a specific facility policy regarding this practice.
Inaccurate MDS Assessment for Resident's Tobacco Use
Penalty
Summary
The facility failed to ensure the Minimum Data Set (MDS) assessment was accurately completed for a resident, specifically regarding the resident's tobacco use. The resident was admitted with diagnoses including nicotine dependence and heart disease, and the admission MDS indicated the resident was not a tobacco user. However, the resident's care plan and nursing smoking assessments indicated the resident used traditional tobacco products and could smoke with supervision. Despite this, the MDS did not reflect the resident's tobacco use. Interviews with facility staff revealed that the initial nursing assessment, which included tobacco use, was supposed to be communicated to the MDS Coordinator for inclusion in the MDS. The Licensed Practical Nurse (LPN) and MDS Coordinator acknowledged that the resident's tobacco use should have been documented in the MDS. The Director of Nursing (DON) and the Administrator confirmed the process for completing the MDS, but the tobacco use information was not accurately captured, leading to the deficiency.
Failure to Accurately Document Tobacco Use in Resident's Care Plan
Penalty
Summary
The facility failed to ensure a comprehensive care plan was accurately completed for a resident with nicotine dependence and other nicotine-induced disorders. The resident's admission record indicated nicotine dependence, but the Minimum Data Set (MDS) assessment incorrectly documented that the resident was not a tobacco user. The resident's care plan, revised several months after admission, did not include any focus, goals, or interventions related to tobacco use. Despite assessments indicating the resident used traditional tobacco products and could smoke with supervision, the care plan section of these assessments was left blank. Observations revealed that a CNA assisted the resident to the smoking area and helped light a cigarette, indicating the resident was indeed a smoker. Interviews with facility staff, including an LPN, MDS Coordinator, and CP Coordinator, revealed a lack of communication and follow-through in updating the care plan to reflect the resident's tobacco use. The CP Coordinator eventually updated the care plan during an interview, but it was backdated to reflect an earlier date. The Director of Nursing and the Administrator confirmed that the initial assessment should have been used to complete an accurate care plan, but this was not done in a timely manner.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Greenbrier
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Heritage Living Center | 10.1 mi | ★★★★★ | 5 | 0 |
| The Blossoms At Conway Rehab & Nursing Center | 11.1 mi | ★★★★★ | 0 | 0 |
| Superior Health & Rehab, Llc | 11.3 mi | ★★★★★ | 6 | 0 |
| Conway Healthcare And Rehabilitation Center | 11.5 mi | ★★★★★ | 8 | 0 |
| Salem Place Nursing And Rehabilitation Center, Inc | 11.5 mi | ★★★★★ | 5 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.