Inspection visit
Health inspection
2 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 2 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0610
Respond appropriately to all alleged violations.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on a
review of clinical records, the facility's abuse prohibition policy and information provided by the facility it was
determined the facility failed to conduct an investigation into an injury of an unknown source to rule out
abuse and/or neglect and failed to implement corrective actions, and submit the results of the completed
investigation to the State Survey Agency within five working days of the incident as evidenced by one of 18
residents reviewed (Resident 44). Findings included:A review of the facility's Pennsylvania Resident Abuse
Policy last reviewed by the facility on October 21, 2025, indicated that it was the facility's policy to
investigate all allegations, suspicions, and incidents of abuse, neglect, involuntary seclusion, intimidation,
exploitation of residents, misappropriation of resident property and injuries of unknown source. The facility
classified an injury as an injury of an unknown source when the source of the injury was not observed by
any person, or the source of the injury could not be explained by the resident and if the injury was
suspicious because of the extent of the injury, the location of the injury, the number of injuries observed at
one particular point in time, or the incidence over time. Further review of the facility's abuse policy indicated
all allegations of abuse, neglect, injuries of an unknown source, etc. must be reported immediately to the
Nursing Home Administrator (NHA), Director of Nursing (DON), and to the applicable State Agency. If the
event that caused the allegation involves an allegation of abuse or serious bodily injury, it should be
reported to the Department of Health (DOH) immediately, but not later than two hours after the allegation is
made. All serious incidents involving a resident will be reported to the DOH field office within twenty-four
hours. Once the NHA and DON are notified, an investigation of the allegation or suspicion will be
conducted, and the investigation must be completed within five working days from the alleged occurrence.
Investigating injuries of an unknown source should include talking with both the shift on duty when the
injury was discovered and prior shifts. Additionally, the investigation should include witness statements,
obtain all medical reports and statements from physician and/or hospitals, and review the resident's record.
Evidence of the investigation should be documented, and the final report will be submitted to the applicable
State agency, after the investigation is completed, but no later than five working days from the occurrence.
A review of Resident 44's clinical record revealed the resident was admitted to the facility on [DATE], with
diagnoses that included unspecified dementia (a term that encompasses various neurological disorders
characterized by cognitive decline, memory loss, and changes in behavior and mental health), unspecified
fracture (a break in a bone) of lower end of left femur (thigh bone) with routine healing, left acute impact to
left distal femur fracture, and presence of unspecified artificial knee joint. A review of Resident 44's
Quarterly Minimum Data Set Assessment (MDS, a federally mandated standardized assessment process
conducted periodically to plan resident care) dated March 26, 2025, the resident could not complete the
BIMS (Brief Interview for Mental Status). The BIMS is a standardized interview used to assess memory and
thinking skills. Because the resident was unable
Residents Affected - Few
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 5
Event ID:
395067
Printed: 05/15/2026
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
395067
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Green Ridge Care Center
2741 Boulevard Avenue
Scranton, PA 18509
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 0610
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
to participate in the interview, the BIMS was coded as 99, meaning the assessment could not be
conducted. The MDS documented severe cognitive impairment and a need for total assistance of two or
more staff for bed mobility and transfers. A progress note completed by Employee 1 (LPN) on April 8, 2025,
at 6:45 AM, documented that the resident's left knee was noted to be swollen and painful during routine foot
care. Vital signs were within normal limits, and the supervisor was notified. A progress note completed by
Employee 2 (LPN) on April 8, 2025, at 12:35 PM, documented that the Certified Registered Nurse
Practitioner (CRNP) assessed the resident and ordered an x-ray (medical imaging using radiation to create
internal images) of the left knee. New orders included acetaminophen (a non-opioid pain reliever) 1000 mg
orally every eight hours as needed for mild pain, and tramadol (an opioid pain reliever for moderate to
severe pain) 50 mg orally twice daily for pain rated 7-10. The responsible party was notified.A progress note
completed by Employee 2 (LPN) on April 8, 2025, at 12:35 PM, indicated that the Certified Registered
Nurse Practitioner (CRNP) assessed the resident and ordered an x-ray (medical imaging using radiation to
create internal images) of the left knee. New orders included acetaminophen (a non-opioid pain reliever)
1000 mg orally every eight hours as needed for mild pain, and tramadol (an opioid pain reliever for
moderate to severe pain) 50 mg orally twice daily for pain rated 7-10 (pain scale ratings indicate 0 least
amount of pain and 10 being worst amount of pain). The responsible party was notified. A review of the
April 8, 2025, x-ray report, timed 10:19 AM, revealed a new but subacute angulated fracture (a bone break
where it comes out of alignment, and tilts at an angle) of the distal left femur with partial healing. The report
noted possible insufficiency fracture (a stress-related fracture occurring in weakened bone), moderate
osteopenia (medical definition for bone density loss), degenerative joint disease (osteoarthritis most
common type of arthritis and can occur in any joint, it usually affects the hands, knees, hips or spine), mild
soft tissue swelling, and no significant joint effusion (joint swelling). Clinal correlation was suggested and
follow up radiographs to confirm healing. The facility was unable to provide documentation that an
investigation into this injury of unknown source was conducted, including interviews, review of shifts prior to
discovery, or completion of the required investigation report. The facility was also unable to provide
evidence that investigation results were submitted to the State Survey Agency within five working days as
required by the facility's abuse policy.During an interview with the Director of Nursing on November 13,
2025, at 1:30 PM, it was stated that an investigation was not initiated because the facility's CRNP
determined the swelling was related to an old fracture. During an interview with the Nursing Home
Administrator on November 14, 2025, at 10:10 AM, the above information was reviewed. The Nursing Home
Administrator indicated that an investigation should have been completed due to the presence of an injury
of unknown source, in accordance with the facility's policy to rule out potential abuse or neglect.28 Pa.
Code 201.14 (a) Responsibility of licensee.28 Pa. Code 201.18(e)(1) Management.28 Pa. Code
201.29(a)(c) Resident Rights.28 Pa. Code 211.10(d) Resident care policies.28 Pa. Code 211.12(c)(d)(5)
Nursing Services
Event ID:
Facility ID:
395067
If continuation sheet
Page 2 of 5
Printed: 05/15/2026
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
395067
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Green Ridge Care Center
2741 Boulevard Avenue
Scranton, PA 18509
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a
licensed pharmacist.
Based on a review of select facility policy. controlled sub stance shift to shift count records, and staff
interview, it was determined the facility failed to implement procedures to promote accurate controlled
medication records on three of three medication carts observed. Findings include: A review of facility policy
entitled Inventory Control of Controlled Substances (a controlled substance is a medication regulated by
federal or state law because it has a risk for abuse, diversion which is misuse for non-medical purposes, or
addiction).last reviewed by the facility on October 21, 2025, revealed the facility is to maintain separate
individual controlled substance records on all Schedule II medications and any medication with a potential
for abuse or diversion in the form of a declining inventory using the Controlled Substances Declining
Inventory Record. The policy further revealed that the facility should ensure the incoming and outgoing
nurse count all Schedule II controlled substances and other medications with a risk of abuse or diversion at
the change of each shift. A review of the facility Shift Verification of Controlled Substances Count record
from the 500-unit medication cart revealed the following:August 27, 2025, the second shift on coming nurse
failed to sign that the narcotic count was completed and correct.August 31, 2025, the first shift off going
nurse failed to sign that the narcotic count was completed and correct.August 31, 2025, the third shift off
going nurse failed to sign that the narcotic count was completed and correct.September 1, 2025, the first
shift off going nurse failed to sign that the narcotic count was completed and correct.September 1, 2025,
the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.September 1, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.September 2, 2025, the second shift on coming nurse failed to sign that the narcotic
count was completed and correct.September 2,2025, the second shift off going nurse failed to sign that the
narcotic count was completed and correct.September 2, 2025, the third shift on coming nurse failed to sign
that the narcotic count was completed and correct.September 4, 2025, the second shift on coming nurse
failed to sign that the narcotic count was completed and correct.September 4, 2025, the second shift off
going nurse failed to sign that the narcotic count was completed and correct.September 9, 2025, the night
shift on coming nurse failed to sign that the narcotic count was completed and correct.September 9, 2025,
the night shift off going nurse failed to sign that the narcotic count was completed and correct.September
12, 2025, the night shift off going nurse failed to sign that the narcotic count was completed and
correct.September 14, 2025, the second shift on coming nurse failed to sign that the narcotic count was
completed and correct.September 14, 2025, the second shift off going nurse failed to sign that the narcotic
count was completed and correct.September 17, 2025, the second shift on coming nurse failed to sign that
the narcotic count was completed and correct.September 17, 2025, the second shift off going nurse failed
to sign that the narcotic count was completed and correct.September 22, 2025, the second shift off going
nurse failed to sign that the narcotic count was completed and correct.September 24, 2025, the third shift
on coming nurse failed to sign that the narcotic count was completed and correct.September 24, 2025, the
third shift off going nurse failed to sign that the narcotic count was completed and correct.September 27,
2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.October 1, 2025, the third shift on coming nurse failed to sign that the narcotic count was completed
and correct.October 1, 2025, the third shift off going nurse failed to sign that the narcotic count was
completed and correct.October 4, 2025, the first shift off going nurse failed to sign that the narcotic count
was completed and correct.November 9, 2025, the third shift off going nurse failed to sign that the narcotic
count was completed and correct.November
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395067
If continuation sheet
Page 3 of 5
Printed: 05/15/2026
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
395067
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Green Ridge Care Center
2741 Boulevard Avenue
Scranton, PA 18509
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
13, 2025, the first shift on coming nurse failed to sign that the narcotic count was completed and correct.An
interview completed on November 13, 2025, at 08:25AM with employee 4 (Licensed Practical Nurse)
revealed she did not complete the shift-to-shift narcotic count with the off going night shift nurse. Employee
6 stated she forgot to sign the book, then proceeded to sign the shift-to-shift narcotic count sheet without
completing a complete count of the controlled medications stored in 500 Hall Cart. A review of the facility
Shift Verification of Controlled Substances Count record from the 500 Private Hall medication cart revealed
the following:August 15, 2025, the first shift off going nurse failed to sign that the narcotic count was
completed and correct.August 17, 2025, the first shift off going nurse failed to sign that the narcotic count
was completed and correct.August 19, 2025, the third shift off going nurse failed to sign that the narcotic
count was completed and correct.August 22, 2025, the first shift off going nurse failed to sign that the
narcotic count was completed and correct.August 23, 2025, the first shift off going nurse failed to sign that
the narcotic count was completed and correct.August 24, 2025, the second shift on coming nurse failed to
sign that the narcotic count was completed and correct.August 24, 2025, the second shift off going nurse
failed to sign that the narcotic count was completed and correct.August 25, 2025, the first shift off going
nurse failed to sign that the narcotic count was completed and correct. August 25, 2025, the second shift off
going nurse failed to sign that the narcotic count was completed and correct.August 30, 2025, the third shift
on coming nurse failed to sign that the narcotic count was completed and correct.August 30, 2025, the third
shift off going nurse failed to sign that the narcotic count was completed and correct.September 2, 2025,
the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.September 2, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.September 4, 2025, the second shift off going nurse failed to sign that the narcotic
count was completed and correct.September 6, 2025, the first shift off going nurse failed to sign that the
narcotic count was completed and correct.September 7, 2025, the first shift off going nurse failed to sign
that the narcotic count was completed and correct.September 8, 2025, the second shift on coming nurse
failed to sign that the narcotic count was completed and correct.September 8, 2025, the second shift off
going nurse failed to sign that the narcotic count was completed and correct.September 12, 2025, the first
shift on coming nurse failed to sign that the narcotic count was completed and correct.September 12, 2025,
the first shift off going nurse failed to sign that the narcotic count was completed and correct.September 15,
2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.September 15, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.September 16, 2025, the first shift off going nurse failed to sign that the narcotic
count was completed and correct.September 16, 2025, the second shift on coming nurse failed to sign that
the narcotic count was completed and correct.September 16, 2025, the second shift off going nurse failed
to sign that the narcotic count was completed and correct.September 23, 2025, the first shift on coming
nurse failed to sign that the narcotic count was completed and correct.September 23, 2025, the first shift off
going nurse failed to sign that the narcotic count was completed and correct.September 23, 2025, the
second shift on coming nurse failed to sign that the narcotic count was completed and correct.September
23, 2025, the second shift off going nurse failed to sign that the narcotic count was completed and
correct.September 24, 2025, the second shift on coming nurse failed to sign that the narcotic count was
completed and correct.September 24, 2025, the second shift off going nurse failed to sign that the narcotic
count was completed and correct.September 24, 2025, the third shift on coming nurse failed to sign that the
narcotic count was completed and correct.September 24,
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
395067
If continuation sheet
Page 4 of 5
Printed: 05/15/2026
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
395067
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Green Ridge Care Center
2741 Boulevard Avenue
Scranton, PA 18509
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
2025, the third shift off going nurse failed to sign that the narcotic count was completed and correct.October
2, 2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.October 2, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.October 3, 2025, the second shift on coming nurse failed to sign that the narcotic
count was completed and correct.October 3, 2025, the second shift off going nurse failed to sign that the
narcotic count was completed and correct.October 13, 2025, the second shift on coming nurse failed to
sign that the narcotic count was completed and correct.October 13, 2025, the second shift off going nurse
failed to sign that the narcotic count was completed and correct.October 15, 2025, the second shift on
coming nurse failed to sign that the narcotic count was completed and correct.October 15, 2025, the
second shift off going nurse failed to sign that the narcotic count was completed and correct.October 17,
2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.October 17, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.October 22, 2025, the first shift off going nurse failed to sign that the narcotic count
was completed and correct.October 22, 2025, the second shift off going nurse failed to sign that the
narcotic count was completed and correct.October 23, 2025, the first shift off going nurse failed to sign that
the narcotic count was completed and correct.October 23, 2025, the second shift off going nurse failed to
sign that the narcotic count was completed and correct.October 24, 2025, the first shift on coming nurse the
second shift off going nurse failed to sign that the narcotic count was completed and correct.October 25,
2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.October 25, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct.October 28, 2025, the second shift off going nurse failed to sign that the narcotic
count was completed and correct.October 28, 2025, the third shift on coming nurse failed to sign that the
narcotic count was completed and correct.October 29, 2025, the second shift on coming nurse failed to
sign that the narcotic count was completed and correct.October 29, 2025, the second shift off going nurse
failed to sign that the narcotic count was completed and correct.November 3, 2025, the second shift on
coming nurse failed to sign that the narcotic count was completed and correct.November 3, 2025, the
second shift off going nurse failed to sign that the narcotic count was completed and correct.November 7,
2025, the second shift on coming nurse failed to sign that the narcotic count was completed and
correct.November 7, 2025, the second shift off going nurse failed to sign that the narcotic count was
completed and correct. A review of the facility Shift Verification of Controlled Substances Count record from
the 200-unit medication cart revealed the following:November 12, 2025, the first shift off going nurse failed
to sign that the narcotic count was completed and correct.During an interview on November 13, 2025, at
08:05 AM, Employee 3 (Licensed Practical Nurse) confirmed that the count on the 200-unit cart for the
above date was incomplete. On November 13, 2025, at 12:45 PM, the surveyor reviewed the above findings
with the Nursing Home Administrator and the Director of Nursing.28 Pa Code 211.9 (c)(k) Pharmacy
services28 Pa Code 211.12 (c)(d)(1)(3)(5) Nursing service28 Pa Code 211.10 (c) Resident care policies.28
Pa Code 211.5(f)(x) Clinical records
Event ID:
Facility ID:
395067
If continuation sheet
Page 5 of 5
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Back to topCitations
2 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F610 - In response to allegations of abuse, neglect, exploitation, or mistreatment, the
Respond appropriately to all alleged violations.
F755 - Pharmacy Services
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
FAQ · About this visit
Common questions about this visit
What happened during the November 14, 2025 survey of GREEN RIDGE CARE CENTER?
This was a inspection survey of GREEN RIDGE CARE CENTER on November 14, 2025. The surveyor cited 2 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at GREEN RIDGE CARE CENTER on November 14, 2025?
Yes, 2 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Respond appropriately to all alleged violations."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.