Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Greenbriar Center during CMS and state inspections, most recent first.
A cognitively intact, wheelchair‑dependent resident with paraplegia and nicotine dependence, assessed as an independent smoker and educated on the facility’s smoking policy, routinely kept smoking materials on his person despite written guidelines requiring staff to secure all smoking items and limit smoking to designated areas. One night, the resident, believing he was at home, lit a cigarette while in bed, dropped it onto his lap, and in attempting to retrieve it, ignited cologne present in the bed, causing second‑degree burns to his thigh and abdomen that required hospital evaluation and topical treatment. Multiple staff, including RNs, LPNs, and CNAs, acknowledged that although policy required staff to secure smoking materials after use, at the time of the incident residents often retained smoking items on their person or in their rooms, and another resident reported she also kept smoking items on her person until later educated by staff.
The facility did not provide enough nursing staff to meet resident needs and failed to have a licensed nurse in charge on every shift, as required.
Drugs and biologicals were not labeled according to professional standards, and medications, including controlled drugs, were not stored in locked or separately locked compartments as required.
A resident was not properly assessed or prepared for transfer or discharge, and the facility did not ensure that the process met the resident's needs and preferences, resulting in a deficiency in care planning and transition.
A resident with multiple medical conditions did not receive several ordered medications in a timely manner after admission due to a computer system issue affecting communication with the pharmacy. Although the facility had stock medications available, these were not administered as scheduled, and the resident reported a delay in receiving medications.
A facility failed to perform required pre and post dialysis assessments for a resident with end-stage renal disease, despite attending multiple dialysis sessions. The resident's medical records showed only one pre and post dialysis assessment completed, contrary to facility policy requiring assessments on each treatment day. Staff interviews confirmed the oversight.
A facility failed to ensure a resident's POA signed the admission paperwork, instead allowing the resident's son-in-law, who was not an authorized representative, to sign. The resident had severe cognitive impairment and multiple medical conditions. The Admission Director confirmed the error, which was identified during a complaint investigation.
The facility failed to ensure a call light was within reach for a resident with cognitive impairment and did not respond promptly to call light activations for two residents. One resident's call light was found on the floor, while another resident reported waiting up to 45 minutes for assistance. The facility's policy requires call lights to be accessible and answered promptly, but this was not followed.
A facility failed to mail a bed hold letter to a resident's POA during a hospital transfer. The resident had severe cognitive impairment and multiple medical conditions, requiring significant assistance with daily activities. The oversight was confirmed by both the POA and the Business Office Manager during interviews.
The facility failed to provide scheduled showers to three residents, impacting their personal hygiene. A resident with severe cognitive impairment missed several showers due to unclear 'environmental limitations.' Another resident, dependent on staff for showers, only received bed baths despite expressing a preference for showers. A third resident, who required assistance with transfers, also missed scheduled showers. The facility's policy to promote resident-centered care was not followed.
The facility failed to administer medications as ordered for two residents. One resident, with intact cognition and multiple diagnoses, did not receive Suboxone as prescribed due to delayed delivery. Another resident, with severely impaired cognition, did not receive Dronabinol for appetite stimulation, with no communication to the physician or family about its unavailability. The facility's policy requires medications to be administered as prescribed, which was not followed in these instances.
Three residents were observed smoking in a non-designated area of the facility, despite being assessed as independent smokers and having care plans that included education on designated smoking areas. The residents chose the non-smoking area due to its proximity, and the facility does not supervise smoking, allowing independent smokers to smoke at their discretion. The facility's policy aims to provide safe smoking areas and smoke-free zones, but this was not enforced.
A resident with severe cognitive impairment was allegedly verbally abused and roughly handled by a CNA during incontinence care. The incident was not reported immediately, as required by the facility's policy, allowing the accused CNA to continue working with residents. A witness observed the abuse but did not report it due to fear, leading to a delay in the facility's response.
Two residents in a facility experienced inadequate pain management due to staff failing to administer and reassess pain medication as ordered. One resident with metastatic lung cancer did not receive scheduled Morphine doses, leading to increased pain and shortness of breath. Another resident with osteoarthritis and osteonecrosis did not receive Ultram due to being asleep, resulting in severe pain. The staff's lack of understanding of routine pain medication administration contributed to these deficiencies.
A facility failed to maintain accurate medication administration records for a resident with osteoarthritis and osteonecrosis. Discrepancies were found between the MAR and the controlled drug administration record for ultram, a pain medication. The DON confirmed these inconsistencies, and an LPN admitted to forgetting to sign a form for a wasted dose, contributing to the record inaccuracies.
A resident with a physician's order to self-medicate was found to have medications stored in an unsecured manner, contrary to facility policy. The resident, with a history of diabetes, hypertension, and schizophrenia, kept medications in a cardboard box next to his bed without a lock. Interviews confirmed the lack of secure storage, violating the facility's policy requiring medications to be locked and accessible only to authorized personnel.
A resident with multiple health conditions was not properly monitored during medication administration. An LPN administered an inhaler and multiple tablets but did not ensure the resident rinsed his mouth or swallowed the pills safely. The resident struggled to take the medication due to hand contractures. The facility's policy requires nurses to remain with residents until medications are swallowed and to ensure mouth rinsing after inhaler use.
The facility failed to adhere to scheduled bathing for two residents, leading to missed baths due to issues with the bathing schedule not being printed or updated. One resident, dependent on staff for bathing, did not receive baths for a period, while another had gaps in documentation of offered baths. Staff interviews confirmed uncertainty and inconsistency in the bathing schedule, indicating non-compliance with facility policies.
Unsecured Smoking Materials and In-Room Smoking Resulting in Resident Burns
Penalty
Summary
The deficiency involves the facility’s failure to maintain a hazard‑free environment by allowing residents to keep unsecured smoking materials and to smoke in undesignated areas, including inside resident rooms. One cognitively intact, wheelchair‑dependent resident with paraplegia, COPD, nicotine dependence, bipolar disorder, and chronic pain was assessed as an independent smoker and had signed the facility’s smoking acknowledgment form and resident smoking guidelines. These guidelines required that all smoking materials be kept by staff, that smoking occur only in designated areas, and that smoking materials be returned to staff when smoking was completed. The resident’s care plan identified him as a smoker with a goal to use nicotine products safely, with interventions including a smoking evaluation, education on designated smoking areas, education on the smoking policy, and provision of safe smoking devices if required. Despite these policies and care plan interventions, the resident reported that he normally kept his smoking items on his person instead of giving them to staff to secure, even though he knew smoking materials were to be kept with staff. On the night of the incident, the resident was in bed, thought he was at home, lit a cigarette, and dropped the lit cigarette onto his lap. When he attempted to retrieve the cigarette, it came into contact with cologne that was in the bed, causing the cologne to ignite and burn his thigh and abdomen. Staff responding to the resident’s call light observed a haze, a chemical smell, and burn marks on his clothes, and noted a cologne bottle on the floor. The resident was transferred to the hospital, where he was diagnosed with partial thickness (second‑degree) burns to his right thigh and received topical antibiotic treatments. Interviews with multiple staff members, including RNs, LPNs, and CNAs, confirmed that although the policy required smoking items to be secured by staff after residents finished smoking, at the time of the incident smoking items were not always returned to staff. Staff acknowledged that some residents kept smoking materials on their person or hidden in their rooms. Another resident stated she also kept her smoking items on her person and did not return them to staff until after she was educated by staff. The facility identified a total of 22 residents who smoked, and it was known at the time of the incident that some residents maintained smoking items on their person or in their rooms, contrary to the written smoking guidelines that limited smoking to designated areas and required staff to store smoking materials when not in use.
Insufficient Nursing Staff and Lack of Licensed Nurse Coverage
Penalty
Summary
The facility failed to provide enough nursing staff each day to meet the needs of every resident and did not ensure that a licensed nurse was in charge on each shift. This deficiency was identified through observations and review of staffing patterns, which showed that staffing levels were insufficient to meet resident care needs and that there were shifts without a licensed nurse in charge. These findings indicate that the facility did not comply with requirements to maintain adequate nursing coverage and supervision for residents at all times.
Failure to Properly Label and Secure Medications
Penalty
Summary
Drugs and biologicals in the facility were not labeled in accordance with currently accepted professional principles. Additionally, all drugs and biologicals were not stored in locked compartments, and controlled drugs were not kept in separately locked compartments as required. These actions resulted in a failure to meet regulatory requirements for the proper labeling and secure storage of medications and biologicals within the facility.
Failure to Ensure Safe and Individualized Transfer/Discharge
Penalty
Summary
The facility failed to ensure that the transfer or discharge process met the resident's needs and preferences, and did not adequately prepare the resident for a safe transfer or discharge. The report identifies that the necessary steps to assess and address the resident's individual requirements and preferences during the transfer or discharge process were not followed, resulting in a deficiency related to resident care planning and transition.
Failure to Administer Medications as Ordered After Admission
Penalty
Summary
The facility failed to ensure that medications were administered as ordered in a timely manner for a newly admitted resident. Upon admission, the resident had multiple diagnoses including vesicointestinal fistula, peritoneal abscess, acute diastolic heart failure, hypothyroidism, arteriosclerotic heart disease, hypertension, and gastroesophageal reflux. Physician orders included several medications such as antibiotics, antidepressants, antihypertensives, and medications for thyroid and coronary artery disease. Despite these orders, the medication administration record showed that several medications, including fluoxetine, isosorbide, levothyroxine, metoprolol, omeprazole, and amoxicillin, were not administered as scheduled after admission. Interviews with nursing staff revealed that a computer system issue beginning two days prior to the resident's admission interfered with communication between the facility and the pharmacy regarding new medication orders. The facility's stock medication list indicated that several of the missed medications were available in the starter kit and could have been administered. The resident reported not receiving medications until several days after admission. The facility's pharmacy contract required daily delivery of prescriptions and 24/7 emergency pharmaceutical services, but these services were not effectively utilized to ensure timely medication administration for the resident.
Failure to Complete Dialysis Assessments
Penalty
Summary
The facility failed to complete pre and post dialysis assessments for a resident who required such services. The resident, who was cognitively intact and had significant diagnoses including end-stage renal disease and dependence on renal dialysis, was admitted with orders to assess the dialysis shunt for thrill or bruit every shift and to evaluate the resident following dialysis treatment. Despite these orders, the facility only completed one pre-dialysis and one post-dialysis assessment since the resident's admission, even though the resident attended multiple dialysis sessions. Interviews with facility staff confirmed that pre and post dialysis assessments were required on each dialysis treatment day, as per facility policy. The policy outlined specific evaluation criteria to be completed before and after dialysis, including checking vital signs and the condition of the dialysis access site. However, these assessments were not consistently performed, as verified by the Corporate Registered Nurse and the Medical Secretary from the dialysis center, who confirmed the resident's attendance at numerous dialysis sessions without corresponding assessments documented in the medical record.
Failure to Obtain POA Signature on Admission Paperwork
Penalty
Summary
The facility failed to ensure that the Power of Attorney (POA) for a resident signed the admission paperwork, which is a requirement for exercising the resident's rights. The resident, who had severe cognitive impairment and multiple medical conditions including aphasia, Parkinson's disease, and chronic kidney disease, was admitted with the POA designated as the resident's wife. However, the admission paperwork was signed by the resident's son-in-law, who was not an authorized representative or the POA. Interviews revealed that the POA was not given the opportunity to review and sign the admission documents. Instead, the admissions staff approached the resident's room with an iPad, requesting a family signature to complete the paperwork, leading to the son-in-law signing the documents. The Admission Director confirmed that the son-in-law, who was not the POA, signed all necessary admission paperwork, which should have been signed by the POA. This deficiency was identified during the investigation of a complaint.
Failure to Ensure Call Light Accessibility and Timely Response
Penalty
Summary
The facility failed to ensure that a call light was within reach for Resident #52, who had moderate cognitive impairment and required assistance with activities of daily living (ADLs). During an observation, the call light activation button was found on the floor and behind the nightstand, making it inaccessible to the resident. This oversight was verified by a Corporate Registered Nurse. Resident #52 had significant diagnoses including unspecified head injury, dementia, and cognitive communication deficit, and was on hospice care with scheduled toileting to promote continence. Additionally, the facility did not respond promptly to call light activations for Resident #3 and Resident #28. Resident #3, who was cognitively intact and frequently incontinent, expressed concerns during resident council meetings about the untimely response to call lights, which was acknowledged by the facility administration. Resident #28, also cognitively intact, required total assistance for toileting and reported that her call light was not answered for approximately 15 minutes, with previous wait times extending up to 45 minutes. The facility's policy stated that call lights should be within reach and answered promptly, but this was not adhered to, as evidenced by the observations and resident interviews.
Failure to Notify POA of Bed Hold for Resident
Penalty
Summary
The facility failed to ensure that a bed hold letter was mailed to the Power of Attorney (POA) for a resident who was transferred to a hospital or on therapeutic leave. This deficiency affected one resident out of three reviewed for notification of bed hold, within a facility census of 95. The resident in question had a range of medical conditions, including aphasia following cerebral infarction, Parkinson's disease, type two diabetes mellitus, chronic kidney disease, and muscle wasting and atrophy. The resident's medical record indicated severe cognitive impairment and dependency on staff for various activities of daily living. Despite these conditions, the bed hold notice was not sent via certified mail to the resident's POA, as confirmed by both the POA and the Business Office Manager during interviews. This oversight was identified during the investigation of a specific complaint.
Failure to Provide Scheduled Showers to Residents
Penalty
Summary
The facility failed to ensure that three residents received the necessary services for showers to maintain personal hygiene. Resident #56, who had severe cognitive impairment and required assistance from two staff members for personal hygiene, did not receive showers as scheduled due to 'environmental limitations,' a term that the Director of Nursing (DON) and Corporate Registered Nurse (CRN) did not understand and acknowledged should not be an option. This resident missed several scheduled showers, receiving only bed baths instead. Resident #13, who was totally dependent on staff for showers, also did not receive any showers during the review period, only bed baths. Despite having a gurney available for use in the shower room, the staff did not utilize it for this resident, who expressed dissatisfaction with only receiving bed baths and had communicated this to the administration. The DON and CRN confirmed that Resident #13 did not receive showers as per his schedule or preference. Resident #9, who was dependent on staff for transferring and shower setup, did not receive showers as scheduled. Although he preferred to shower every other day and only needed assistance with transferring and setup, he missed several scheduled showers. The DON confirmed that Resident #9 required maximum assistance with a mechanical lift for transfers and did not receive showers as scheduled. The facility's policy emphasizes promoting resident-centered care, including assisting with personal care and hygiene, which was not adhered to in these cases.
Medication Administration Failures Affect Two Residents
Penalty
Summary
The facility failed to ensure medications were administered as ordered by the physician, affecting two residents. Resident #357, who had intact cognition, was diagnosed with conditions including infective endocarditis, chronic kidney disease, and substance use disorder. The resident was prescribed Suboxone, which was not administered as ordered on multiple occasions due to the medication not being available at the facility until several days after the order. The resident expressed concern about not receiving the medication, and the facility's administration confirmed the medication was not administered as ordered. Resident #70, with severely impaired cognition and multiple diagnoses including metabolic encephalopathy and chronic kidney disease, was prescribed Dronabinol for appetite stimulation. However, the medication was not available for administration for several days, and there was no communication with the physician or the resident's family regarding its unavailability. The facility's medication administration policy emphasizes administering medications only as prescribed, highlighting a failure to adhere to this policy in these cases.
Residents Smoke in Non-Designated Area
Penalty
Summary
The facility failed to ensure that three residents, identified as Residents #53, #55, and #89, adhered to the designated smoking areas, resulting in them smoking in a non-smoking area. Resident #53, with severe cognitive impairment and requiring extensive assistance for daily activities, was assessed as an independent smoker. Despite interventions in her care plan to use nicotine products safely and be educated on designated smoking areas, she was observed smoking in a non-smoking area. Similarly, Resident #55, who had mild cognitive impairment and required moderate assistance, was also assessed as an independent smoker. Despite being reeducated on the facility's smoking policy and acknowledging understanding, he was found smoking in the non-smoking area. Resident #89, with intact cognition and requiring moderate assistance, was also observed smoking in the non-smoking area, despite his care plan interventions for safe nicotine use and education on smoking areas. The incident was observed on the facility's back patio, which was clearly marked as a no-smoking area. The residents confirmed that they chose to smoke there because the designated smoking area was too far. The Assistant Director of Nursing confirmed that the facility does not supervise smoking, and residents assessed as independent smokers are allowed to smoke in designated areas at their discretion. An interview with another resident revealed that the issue of smoking in non-designated areas was ongoing, and there was a desire for the facility to enforce its smoking policy. The facility's policy on Resident Smoking Guidelines aims to provide safe smoking areas for residents capable of safe smoking behaviors and smoke-free areas for non-smoking residents, but this was not adhered to in this instance.
Failure to Timely Report Suspected Abuse
Penalty
Summary
The facility failed to ensure timely and appropriate reporting of suspected verbal abuse and rough handling of a resident by staff. The incident involved a resident with severe cognitive impairment and multiple medical conditions, including Alzheimer's disease and dementia. The resident was dependent on staff for personal hygiene and was frequently incontinent. The alleged abuse occurred when a certified nurse aide (CNA) was reported to have verbally abused and roughly handled the resident during incontinence care. The incident was not reported immediately, as required by the facility's policy. The Director of Nursing (DON) and the Executive Director (ED) were not informed of the alleged abuse until several days later, despite the facility's policy mandating immediate reporting of such incidents. A witness, another CNA, observed the abuse but did not report it to the facility due to fear, instead confiding in a friend who reported the incident anonymously to the Ohio Department of Health. The facility's policy required all staff to report any reasonable suspicion of a crime against a resident immediately to a supervisor and the Executive Director. However, the failure to report the incident promptly allowed the accused CNA to continue working with residents. The facility's investigation revealed that the witness had received training on abuse reporting expectations but failed to act due to fear, highlighting a breakdown in the facility's abuse reporting process.
Inadequate Pain Management for Residents
Penalty
Summary
The facility failed to provide comprehensive and effective pain management for two residents, resulting in actual harm to one of them. Resident #104, diagnosed with metastatic lung cancer and chronic obstructive pulmonary disease, did not receive his scheduled Morphine Sulfate doses as ordered. The medication was supposed to be administered every four hours, but doses were missed because the resident was reportedly sleeping, which he denied. This led to increased pain, shortness of breath, and facial grimacing. The staff did not understand the importance of administering pain medication on a routine basis, even if the resident appeared to be sleeping. Resident #60, with diagnoses including osteoarthritis and osteonecrosis, also experienced inadequate pain management. An order for Ultram was in place, but the medication was not administered because the resident was sleeping, and the last dose was wasted. The resident complained of severe pain, rating it at an 11 on a scale of zero to ten, and expressed that Norco had been effective in the past. However, the staff did not reassess the resident's pain or adjust the medication regimen in a timely manner, leading to prolonged discomfort. The facility's failure to adhere to its pain management policy and ensure timely administration and reassessment of pain medication resulted in significant discomfort for both residents. The staff's lack of understanding and failure to follow through with physician orders contributed to the deficiencies observed during the survey.
Discrepancies in Medication Administration Records
Penalty
Summary
The facility failed to ensure the accuracy of medication administration records for a resident diagnosed with osteoarthritis of the hips and osteonecrosis of the left femur. An order was written for the administration of ultram, a pain medication, to be given every eight hours as needed. However, discrepancies were found between the Medication Administration Record (MAR) and the controlled drug administration record. On several occasions, the MAR indicated that ultram was administered, but there was no corresponding documentation of the medication being withdrawn from the controlled drug administration record. Additionally, there were instances where the controlled drug administration record showed withdrawals of ultram without corresponding entries on the MAR. The discrepancies were verified by the Director of Nursing, who confirmed the inconsistencies between the MAR and the controlled drug administration record. A Licensed Practical Nurse (LPN) admitted to forgetting to sign the form for a dose of ultram that was wasted, which contributed to the discrepancies. These issues affected the accuracy of the records for one resident reviewed for pain management, highlighting a failure in maintaining proper documentation and safeguarding resident-identifiable information in accordance with accepted professional standards.
Failure to Securely Store Self-Administered Medications
Penalty
Summary
The facility failed to ensure that a resident, who had an order to self-medicate, stored his medications appropriately. The resident, who was the only one in the facility self-medicating, had a medical history including type two diabetes mellitus, hypertension, and schizophrenia. The physician's order allowed the resident to keep medications at his bedside and self-administer them. An assessment indicated that the resident demonstrated secure storage for medication in his room, and the care plan included interventions to assist the resident in securing his medication and educating him on proper storage. However, during an interview, the resident revealed that he did not have a lock box for his medications and kept them in a cardboard box next to his bed. Observations confirmed that the medications were not securely stored, as they were in an unlocked drawer. Interviews with the Director of Nursing and a Regional Nurse confirmed that the medications were not locked, and the resident had removed the lock from his drawer. The facility's policy required medication storage to be accessible only to authorized personnel and locked when unattended, which was not adhered to in this case.
Failure in Medication Administration Observed
Penalty
Summary
The facility failed to administer medications to Resident #31 in accordance with professional standards of practice. Resident #31, who had intact cognition and required extensive assistance for all activities of daily living, was observed during a medication administration session. The resident had multiple diagnoses, including chronic kidney disease, type two diabetes mellitus, chronic obstructive pulmonary disease, and peripheral vascular disease. During the observation, an LPN administered two puffs of an inhaler to the resident and instructed him to rinse his mouth, but did not ensure that he did so. The LPN then handed the resident a cup containing 12 tablets and left the room, failing to observe the resident as he attempted to swallow the medications. The resident, who had hand contractures, struggled to grab his glass of water and began to cough while trying to swallow the pills. The LPN confirmed that she did not watch to ensure the resident swallowed all his pills safely and did not ensure the resident rinsed his mouth after using the inhaler. The facility's medication administration policy requires that nurses remain with the resident until the medication has been swallowed and that residents rinse their mouths after using steroid inhalers. This deficiency was identified during a complaint investigation.
Failure to Adhere to Bathing Schedules for Residents
Penalty
Summary
The facility failed to ensure scheduled bathing for two residents, Resident #55 and Resident #87, as per their care plans. Resident #55, who has multiple diagnoses including hypertension, diabetes, and hemiplegia, was dependent on staff for bathing. Despite being scheduled for baths three times a week, there was a gap in documentation indicating that Resident #55 did not receive any bathing between August 21 and September 3. Interviews with staff revealed issues with the bathing schedule not being printed or updated in the electronic records, leading to missed baths unless residents complained. Resident #87, with conditions such as lumbar fracture, COPD, and heart failure, also required assistance with bathing. The care plan indicated a need for help with ADLs due to functional deficits and pain. Documentation showed that Resident #87 refused a bath on one occasion and received bed baths on several dates, but there were periods where no bath or shower was documented as offered. Staff interviews confirmed uncertainty about Resident #87's bathing schedule, especially during a unit transfer, and acknowledged that the bathing schedule was not consistently available or updated. The facility's policy on routine resident care emphasized the importance of promoting quality of life and dignity through assistance with ADLs, including bathing. However, the lack of adherence to the bathing schedule for these residents indicates a failure to meet these standards. This deficiency was investigated under a specific complaint number, highlighting non-compliance with the facility's own policies and procedures.
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Illustrative
What surveyors actually found near you
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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.
Illustrative
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Illustrative
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Nursing homes near Boardman
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hampton Woods Nursing Center, Inc | 1.2 mi | ★★★★★ | 3 | 0 |
| Center For Rehabilitation At Hampton Woods The | 1.2 mi | ★★★★★ | 11 | 0 |
| Briarfield Place | 1.6 mi | ★★★★★ | 3 | 0 |
| Caprice Health Care Center | 2 mi | ★★★★★ | 5 | 0 |
| Shepherd Of The Valley Poland | 2.2 mi | ★★★★★ | 9 | 0 |
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