Below average — CMS composite of the measures below.
A standard survey is most likely before around August 2026
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 Pink Bud Home For The Golden Years during CMS and state inspections, most recent first.
The facility did not immediately report two separate allegations of staff being rough with a resident to the appropriate authorities, as required. In both cases, staff reassigned the CNAs involved but did not complete required documentation, body audits, or timely state reporting. Despite staff training on abuse reporting, the incidents were not handled according to policy, resulting in a deficiency cited at the Immediate Jeopardy level.
The facility failed to properly investigate two allegations of abuse involving a resident with intact cognition and significant care needs. In both cases, there was no documentation of resident or staff interviews, body audits, or nurse assessments, and the incidents were not reported to authorities as required. Accused staff were allowed to continue working with other residents, and the facility lacked an abuse coordinator at the time.
Surveyors found that a narcotic box containing multidose anti-anxiety medication was not permanently affixed inside an unlocked refrigerator, and expired anti-angina medication was left in a tackle-style box above the narcotic refrigerator. Staff confirmed these practices had been ongoing, and facility policy did not address the need for the narcotic box to be permanently secured.
Dietary staff did not consistently wash hands or change gloves between handling food, touching potentially contaminated surfaces, and serving residents. Staff were observed serving meals, touching residents and surfaces, and returning to food preparation without proper hand hygiene, despite facility policy and training requiring these practices to prevent cross-contamination.
A resident with moderate cognitive impairment and multiple diagnoses was allowed to self-administer a prescribed nasal spray without the required interdisciplinary assessment or formal self-administration rights. Facility policy required a mental assessment and approval before permitting self-administration, but this process was not followed, and staff allowed the resident to administer the medication themselves.
A resident with multiple health conditions reported being handled roughly by a CNA, resulting in a finger injury later identified as a questionable fracture. Staff failed to report the abuse allegation to administration or document the incident as required by policy, leading to a delay in investigation and reporting.
Staff did not wear gowns while providing wound care and repositioning a resident with an open stage II pressure wound and a leaking catheter, despite EBP signage and available PPE. The DON and CNAs acknowledged the lapse, and facility policy required gowns and gloves for such high-contact care to prevent infection transmission.
Surveyors found that a narcotic box containing multidose anti-anxiety medication was not permanently affixed inside an unlocked refrigerator, and expired anti-angina medication was left in a tackle-style box above the narcotic refrigerator. Staff confirmed the narcotic box had always been removable and that expired medication should have been disposed of, but facility policy did not address the need for the narcotic box to be permanently secured.
Dietary staff did not consistently wash hands or change gloves between handling food, touching residents, and contacting potentially contaminated surfaces during meal service. Staff acknowledged the lapses and confirmed knowledge of facility policy requiring hand hygiene and glove changes to prevent cross-contamination.
A resident with moderate cognitive impairment and multiple diagnoses was allowed to self-administer a prescribed nasal spray without the required interdisciplinary assessment or formal approval for self-administration. Facility policy required a mental assessment and medical director agreement before granting self-administration rights, but these steps were not completed, and staff were expected to administer all medications unless rights were granted.
A resident with multiple health conditions developed a questionable hand fracture after reporting that a CNA had been rough during care. Nursing staff and the ADON were aware of the resident's complaint but did not report the allegation to the Administrator or DON, nor did they document or investigate the incident as required by policy. The Administrator and DON only learned of the allegation during the survey, resulting in a delayed investigation and reporting.
Staff did not wear gowns while providing wound care and repositioning a resident with an open stage II pressure wound and a leaking catheter, despite EBP signage and available PPE. The DON and CNAs acknowledged the lapse, and facility policy required gowns and gloves for such high-contact care.
Failure to Timely Report and Investigate Alleged Abuse
Penalty
Summary
The facility failed to ensure that allegations of abuse involving a resident were reported immediately to the appropriate authorities, including the state agency, as required by regulation. Two separate incidents involving a resident and two different CNAs were not reported within the mandated timeframe. In one incident, a resident with intact cognition and multiple medical diagnoses, including Parkinson's disease and dementia, reported that a CNA had been rough with them. The incident was relayed to a registered nurse, who reassigned the CNA to another hallway but did not complete a body audit or resident interview, nor was the incident reported to the state agency until fourteen days later. In a separate incident, another CNA was also alleged to have been rough with the same resident. The CNA supervisor reassigned the CNA to another hall but did not document the incident or report it to supervisory staff or authorities. The administrator's investigation into this incident consisted of a brief two-page report, which included a statement from the CNA supervisor and a warning record for the CNA, but no body audit or nurse assessment was completed for the resident. The administrator confirmed that this allegation was not reported to the mandatory authorities or the state agency. Despite the facility's abuse and neglect policy and documented in-service training for staff, including the administrator and ADON, on the identification and reporting of abuse, the required procedures were not followed. The failure to report these allegations in a timely manner and to conduct appropriate assessments resulted in non-compliance with federal requirements and was determined to have caused, or was likely to cause, serious injury, harm, impairment, or death to residents. The deficiency was cited at the Immediate Jeopardy level.
Removal Plan
- In-service training for all staff on reporting abuse and neglect to the Administrator, the DON, and Office of Long-Term Care, ensuring all incidents are reported properly and to ensure resident safety.
- Interviewed residents regarding abuse and performed body audits on residents unable to verbalize abuse.
- Appointed the Director of Nursing (DON) to monitor, investigate, and report allegations of abuse.
- Implemented a monitoring tool for documenting and reporting of allegations.
- Appointed the DON as the Abuse and Neglect Coordinator with all corrections completed.
- Conducted staff interviews from all shifts to verify training had been completed.
- Ensured that staff not yet trained are not allowed to return to work until they have been trained.
Failure to Investigate and Report Alleged Abuse and Protect Residents
Penalty
Summary
The facility failed to thoroughly investigate two separate allegations of abuse involving a resident who required assistance with transfers and had intact cognition. In both cases, there was no evidence that a resident statement, accused staff statement, assessment of the resident, bedside staff interviews, or a police report were completed. The facility also did not document a body audit or a nurse assessment in the medical record following the allegations. The incidents were not reported to the appropriate authorities or the State Agency/Office of Long Term Care (OLTC) as required by facility policy and state regulations. When the first allegation was made that a staff member was rough with the resident, the staff member was simply reassigned to another hallway and allowed to continue working with other residents. The incident was reported to the Assistant Director of Nursing (ADON), but no formal investigation or documentation was completed at that time. The ADON did not conduct a body audit or assessment and did not know if the allegation was investigated further. The Certified Nursing Assistant (CNA) Supervisor also failed to report a separate incident involving another staff member and did not complete any write-up or formal report, only moving the accused staff member to a different hall. The Administrator later provided a minimal two-page investigation that lacked essential elements such as resident and staff interviews, body audits, and proper documentation. The Administrator admitted that the incident was not reported to mandatory authorities and that the documentation provided was the entirety of the investigation. The facility did not have an abuse coordinator at the time, and the highest-ranking person present was responsible for investigations. The Director of Nursing (DON) confirmed that the accused staff should have been separated from residents and that the incident should have been reported and investigated immediately.
Removal Plan
- Provide in-service training for all staff on reporting abuse and neglect to the Administrator, the DON, and Office of Long-Term Care.
- Report all incidents properly.
- Ensure resident safety.
- Interview residents regarding abuse and conduct body audits for residents unable to verbalize abuse.
- Appoint the DON to monitor, investigate, and report allegations of abuse.
- Implement a monitoring tool for documenting and reporting allegations of abuse.
- Appoint the DON as the Abuse and Neglect Coordinator.
- Ensure all staff complete training on reporting of abuse before returning to work.
Improper Storage and Handling of Controlled and Expired Medications
Penalty
Summary
Surveyors observed that the facility failed to ensure proper storage and labeling of drugs and biologicals in accordance with accepted professional principles. Specifically, a narcotic box containing multidose anti-anxiety medication was found inside an unlocked refrigerator in the North medication room. The narcotic box itself was locked but not permanently affixed within the refrigerator, contrary to best practices for securing controlled substances. Staff interviews confirmed that the narcotic box had never been affixed, and both the LPN and DON acknowledged this had been the practice for over two years. The facility's policy did not address the requirement for the narcotic box to be permanently affixed. Additionally, an expired bottle of anti-angina medication was discovered in a tackle-style box located in an upper cabinet above the narcotic refrigerator. The LPN stated that the medication had been left in the old emergency kit and should have been disposed of when the kit was changed out. Both the DON and the Administrator confirmed that expired medications should not have been left accessible and acknowledged that nursing staff were responsible for medication storage. The presence of expired medication and the unsecured narcotic box were both observed and confirmed through staff interviews and policy review.
Failure to Follow Hand Hygiene and Glove-Changing Protocols During Food Service
Penalty
Summary
Dietary staff failed to follow proper hand hygiene and glove-changing procedures while preparing and serving food in the facility's kitchen and dining areas. Observations revealed that one dietary employee, while wearing gloves, served food to residents, touched potentially contaminated surfaces such as tray cards and residents' shoulders, and then returned to food preparation without removing gloves or washing hands. Another dietary employee was observed handling packaged hamburger buns, removing them from the microwave and packaging, and placing them on the steam table without changing gloves or washing hands between tasks. Both employees acknowledged during interviews that they should have removed gloves and washed hands between these activities, as per facility policy and their training. Facility policy requires handwashing before food preparation, after touching potentially contaminated surfaces, and when changing tasks to prevent cross-contamination. Interviews with the Assistant Dietary Manager and Dietary Manager confirmed that staff are expected to wash hands and change gloves in these situations. The failure to adhere to these procedures was observed directly by surveyors and acknowledged by the staff involved, indicating a lapse in compliance with established infection control practices. This deficiency had the potential to affect all residents receiving food from the kitchen.
Failure to Ensure Proper Assessment Before Self-Administration of Medication
Penalty
Summary
A resident with diagnoses including seizure disorders, depression, and atrial fibrillation, and a BIMS score indicating moderate cognitive impairment, was observed self-administering a prescribed nasal spray for allergic rhinitis. The medication aide handed the nasal spray to the resident and allowed them to administer it themselves, despite not being certain if the resident had been assessed for safe self-administration. The aide also stated that the resident was sometimes resistant to taking the nasal spray but might comply when allowed to self-administer. Facility records and interviews with the Administrator and Director of Nursing confirmed that no residents had self-administration rights at the time of the incident. The facility's policy required a mini mental assessment, agreement from the Medical Director, and demonstration of capability before granting self-administration rights. However, this process had not been completed for the resident involved, and staff were expected to administer all medications, including nasal spray, unless self-administration rights were formally granted.
Failure to Report and Investigate Alleged Staff-to-Resident Abuse
Penalty
Summary
The facility failed to implement its Abuse and Neglect policy by not ensuring that an allegation of staff-to-resident abuse was reported and investigated in a timely manner. A resident with Parkinson's Disease, chronic pain, and anxiety disorder, who was non-ambulatory and required assistance with transfers and activities of daily living, was found to have swelling and pain in the fingers, later determined to be a questionable fracture. The resident reported to staff that a CNA had been rough during care, and this concern was communicated to both a nurse and the ADON. However, neither the nurse nor the ADON reported the allegation to the Administrator or the DON as required by policy, nor did they document the incident or conduct a thorough assessment at the time of the complaint. Despite the resident's complaint of rough handling and subsequent injury, the incident was not treated as a potential abuse allegation. The staff initially attributed the injury to a possible gout flare, and only after further medical evaluation was a fracture suspected. The resident's statements about being hurt by a staff member were not immediately investigated, and the required Incident & Accident report was not completed. The Administrator and DON were not made aware of the allegation until much later, after which the investigation and reporting process began. Interviews with staff revealed confusion and lack of clarity regarding the reporting process for abuse allegations. The ADON and RN involved could not recall if the incident was reported to the appropriate administrative personnel, and there was no documentation of the resident's complaint or assessment following the allegation. The facility's failure to follow its own policy resulted in a delay in recognizing, investigating, and reporting a potential abuse incident involving a resident.
Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
Staff failed to follow Enhanced Barrier Precautions (EBP) during wound care for a resident with a stage II, open moisture-associated pressure wound on the coccyx and a leaking catheter. During an observation, two CNAs and the DON provided wound care and repositioned the resident without donning gowns, despite EBP signage being present on the resident's door and PPE being available at the nurse's station. The DON and CNAs acknowledged that they should have worn gowns and gloves during the high-contact activity, and confirmed that their gloves came into contact with saturated padding under the resident. The resident involved had diagnoses including cerebral palsy, seizure disorder, depression, memory problems, and moderately impaired cognitive decision-making. The resident had a catheter in place and an unhealed pressure ulcer requiring a pressure-reducing device. Facility policy and in-service documentation specified that gowns and gloves must be worn during high-contact care such as wound care and changing briefs for residents on EBP. The DON, CNAs, Administrator, and Medical Director all confirmed the expectation that EBP should be followed to prevent infection transmission.
Improper Storage and Security of Narcotics and Expired Medication
Penalty
Summary
Surveyors observed that the facility failed to ensure proper storage and security of drugs and biologicals in the North medication room. Specifically, a narcotic box containing multidose anti-anxiety medication was found inside an unlocked refrigerator and was not permanently affixed, contrary to accepted professional standards. The box was locked, but it was removable and had never been secured to the refrigerator. Staff, including an LPN and the DON, confirmed that the narcotic box had always been removable and that the medication room and box were locked, with narcotics counted at each shift change. However, the facility's policy did not address the requirement for the narcotic box to be permanently affixed. Additionally, an expired bottle of anti-angina medication was discovered in a tackle-style box above the narcotic refrigerator. The LPN stated that the medication had been left in the old emergency kit and should have been disposed of when the kit was changed out. Both the DON and the Administrator acknowledged that the expired medication should not have been left in the storage area, as it could have been accidentally administered. The facility's policy required discontinued medications to be stored centrally for destruction, but this was not followed in this instance.
Failure to Follow Hand Hygiene and Glove Protocols During Food Service
Penalty
Summary
Dietary staff failed to follow proper hand hygiene and glove-changing procedures while preparing and serving food in the facility's kitchen and dining areas. Observations revealed that one dietary employee, while wearing gloves, served food to residents, touched potentially contaminated surfaces such as tray cards and residents' shoulders, and then returned to food preparation without removing gloves or washing hands. Another dietary employee was observed handling packaged hamburger buns, removing them from the microwave and packaging, and placing them on the steam table without changing gloves or washing hands between tasks. Both employees acknowledged during interviews that they should have removed gloves and washed hands between these activities, as per facility policy and their training. Facility policy requires handwashing and glove changes before food preparation, after touching potentially contaminated surfaces, and as often as necessary to prevent cross-contamination. Interviews with the Assistant Dietary Manager and Dietary Manager confirmed that staff are expected to wash hands and change gloves after any activity that could contaminate hands or gloves, such as touching non-food items or residents. The failure to adhere to these procedures was observed directly by surveyors and acknowledged by staff, with the potential to affect all residents receiving food from the kitchen.
Failure to Ensure Proper Assessment Before Self-Administration of Medication
Penalty
Summary
A resident with diagnoses including seizure disorders, depression, and atrial fibrillation, and a BIMS score indicating moderate cognitive impairment, was observed self-administering a prescribed nasal spray for allergic rhinitis. The medication aide handed the nasal spray to the resident and instructed them on its use, despite not being certain if the resident had been assessed for safe self-administration. The resident was known to sometimes resist taking the nasal spray but was more compliant when allowed to self-administer. Facility records and interviews with the Administrator and Director of Nursing confirmed that no residents had self-administration rights at the time of the incident. The facility's policy required a mini mental assessment, medical director approval, and demonstration of capability before granting self-administration rights. However, these steps had not been completed for this resident, and staff were expected to administer all medications, including nasal spray, unless self-administration rights were formally granted.
Failure to Report and Investigate Abuse Allegation
Penalty
Summary
The facility failed to implement its Abuse and Neglect policy regarding the reporting and investigation of an abuse allegation involving a resident with Parkinson's Disease, chronic pain, and anxiety disorder. The resident, who was non-ambulatory and required assistance with transfers and activities of daily living, developed swelling and pain in the right hand, which was later found to have a questionable fracture. Initial assessments by nursing staff and the primary care physician attributed the symptoms to a possible gout flare, and subsequent lab work and imaging were ordered. However, no incident or accident report was completed regarding the injury at the time. During interviews, it was revealed that the resident had reported to nursing staff that a CNA had been rough during care, and the resident associated the finger injury with this incident. The nurse who received the complaint instructed the CNA not to return to the resident's room and reported the allegation to the ADON. However, neither the nurse nor the ADON reported the allegation to the Administrator or DON as required by facility policy, nor did they document the assessment or initiate an investigation at that time. The ADON and RN both acknowledged being aware of the resident's complaint but did not take further action beyond informal reassignment of staff. The Administrator and DON only became aware of the abuse allegation during the survey process, several days after the initial complaint and injury. At that point, the facility began the process of investigating and reporting the allegation to the appropriate authorities. The delay in reporting and investigating the abuse allegation, as well as the lack of documentation and failure to follow established policy, constituted the deficiency identified by surveyors.
Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
Staff failed to follow Enhanced Barrier Precautions (EBP) during wound care for a resident with a stage II, open moisture-associated pressure wound on the coccyx and a leaking catheter. During an observation, two CNAs and the DON provided wound care and repositioned the resident without donning gowns, despite EBP signage being present on the resident's door and PPE being available at the nurse's station. The DON and CNAs acknowledged that they should have worn gowns and gloves during the high-contact activity, and confirmed that their gloves came into contact with saturated padding under the resident. The resident involved had diagnoses including cerebral palsy, seizure disorder, depression, memory problems, and moderately impaired cognitive decision-making. The resident had a catheter in place and an unhealed pressure ulcer requiring a pressure-reducing device. Facility policy and in-service documentation indicated that EBP requires gowns and gloves during high-contact care such as wound care and changing briefs, but this protocol was not followed during the observed incident.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 43 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Greenwood
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Ashton Place Health And Rehab, Llc | 8.1 mi | ★★★★★ | 0 | 0 |
| Brooken Hill Health And Rehab, Llc | 9.1 mi | ★★★★★ | 10 | 0 |
| Fianna Hills Nursing And Rehabilitation Center | 10.1 mi | ★★★★★ | 1 | 0 |
| Methodist Health And Rehab | 11.2 mi | ★★★★★ | 0 | 0 |
| Covington Court Health And Rehabilitation Center | 11.3 mi | ★★★★★ | 5 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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.