Follow Greenville Nursing and Rehabilitation on Facebook! Click Here

To see a list of frequently asked questions please Click Here

Greenville | Nursing & Rehabilitation

Latest News

Latest News

Success Story: Randy Markham

April 29, 2023

Greenville Nursing and Rehabilitation is excited to highlight resident Randy Markham’s Success Story!

Mr. Randy Markham has been a long-term Greenville Nursing and Rehabilitation resident since May 2021. He has a great sense of humor and enjoys participating in community activities. He loves to have fun, and loves good food. He enjoys being mobile in his wheelchair, going around the community and talking to caregivers and fellow residents. In the middle of December, Mr. Markham was diagnosed with COVID-19 and experienced and medical decline. He lost interest in talking to fellow residents and required increased assistance with self-feeding, required to thicken liquids. With his functional decline, he could not transfer and propel himself in his wheelchair.

Therapy evaluated Mr. Markham and devised and planned to address his decline so he could return to his prior level of function. With much encouragement and his participation in therapy, he can now perform self-feeding with set-up help only and is back on a regular liquid consistency. He can complete functional transfers with limited assistance and walk with someone assisting him utilizing a rolling walker. Mr. Markham can also propel himself within the community independently and visit with his fellow residents and caregivers, and at times you can hear him even singing! Congratulations to Mr. Markham and his Care Team on their success!

Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs)

April 25, 2023


Residents in nursing homes are at increased risk of becoming colonized and developing infection with MDROs [2]. As described further in Consideration for the Use of Enhanced Barrier Precautions in Skilled Nursing Facilities [PDF – 9 pages], more than 50% of nursing home residents may be colonized with an MDRO, nursing homes have been the setting for MDRO outbreaks, and when these MDROs result in resident infections, limited treatment options are available [1-9]. Implementation of Contact Precautions, as described in the CDC Guideline for Isolation Precautions, is perceived to create challenges for nursing homes trying to balance the use of PPE and room restriction to prevent MDRO transmission with residents’ quality of life. Thus, many nursing homes only implement Contact Precautions when residents are infected with an MDRO and on treatment.

Focusing only on residents with active infection fails to address the continued risk of transmission from residents with MDRO colonization, who by definition have no symptoms of illness. MDRO colonization may persist for long periods of time (e.g., months) [10] which contributes to the silent spread of MDROs.

With the need for an effective response to the detection of serious antibiotic resistance threats, there is growing evidence that the traditional implementation of Contact Precautions in nursing homes is not implementable for most residents for prevention of MDRO transmission.

This document is intended to provide guidance for PPE use and room restriction in nursing homes for preventing transmission of MDROs, including as part of a public health response. For the purposes of this guidance, the MDROs for which the use of EBP applies are based on local epidemiology. At a minimum, they should include resistant organisms targeted by CDC but can also include other epidemiologically important MDROs [9, 10].

Examples of MDROs Targeted by CDC include:

  • Pan-resistant organisms,
  • Carbapenemase-producing carbapenem-resistant Enterobacterales,
  • Carbapenemase-producing carbapenem-resistant Pseudomonas spp.,
  • Carbapenemase-producing carbapenem-resistant  Acinetobacter baumannii, and
  • Candida auris

Additional epidemiologically important MDROs may include, but are not limited to:

  • Methicillin-resistant Staphylococcus aureus (MRSA),
  • ESBL-producing Enterobacterales,
  • Vancomycin-resistant Enterococci (VRE),
  • Multidrug-resistant Pseudomonas aeruginosa,
  • Drug-resistant Streptococcus pneumoniae

This document is not intended for use in acute care or long-term acute care hospitals and does not replace existing guidance regarding use of Contact Precautions for other pathogens (e.g., Clostridioides difficile, norovirus) in nursing homes.

Description of Precautions

Standard Precautions are a group of infection prevention practices that apply to the care of all residents, regardless of suspected or confirmed infection or colonization status. They are based on the principle that all blood, body fluids, secretions, and excretions (except sweat) may contain transmissible infectious agents. Proper selection and use of PPE, such as gowns and gloves, is one component of Standard Precautions, along with hand hygiene, safe injection practices, respiratory hygiene and cough etiquette, environmental cleaning and disinfection, and reprocessing of reusable medical equipment. Use of PPE is based on the staff interaction with residents and the potential for exposure to blood, body fluids, or pathogens (e.g., gloves are worn when contact with blood, body fluids, mucous membranes, non-intact skin, or potentially contaminated surfaces or equipment are anticipated). More detail about Standard Precautions is available as part of the Core Infection Prevention and Control Practices for Safe Healthcare Delivery in all Settings.

Contact Precautions are one type of Transmission-Based Precaution that are used when pathogen transmission is not completely interrupted by Standard Precautions alone. Contact Precautions are intended to prevent transmission of infectious agents, like MDROs, that are spread by direct or indirect contact with the resident or the resident’s environment.

Contact Precautions require the use of gown and gloves on every entry into a resident’s room. The resident is given dedicated equipment (e.g., stethoscope and blood pressure cuff) and is placed into a private room. When private rooms are not available, some residents (e.g., residents with the same pathogen) may be cohorted, or grouped together. Residents on Contact Precautions should be restricted to their rooms except for medically necessary care and restricted from participation in group activities.

Because Contact Precautions require room restriction, they are generally intended to be time limited and, when implemented, should include a plan for discontinuation or de-escalation.

More detail about Transmission-Based Precautions, including descriptions of Droplet Precautions and Airborne Precautions are available in the CDC Guideline for Isolation Precautions. In addition, other infections (e.g. norovirus, C. difficile, and scabies) and conditions for which Contact Precautions are indicated are summarized in Appendix A – Type and Duration of Precautions Recommended for Selected Infections and Conditions of the guideline.

Enhanced Barrier Precautions expand the use of PPE and refer to the use of gown and gloves during high-contact resident care activities that provide opportunities for transfer of MDROs to staff hands and clothing [11-15]. MDROs may be indirectly transferred from resident-to-resident during these high-contact care activities. Nursing home residents with wounds and indwelling medical devices are at especially high risk of both acquisition of and colonization with MDROs [3,5,6]. The use of gown and gloves for high-contact resident care activities is indicated, when Contact Precautions do not otherwise apply, for nursing home residents with wounds and/or indwelling medical devices regardless of MDRO colonization as well as for residents with MDRO infection or colonization.

Examples of high-contact resident care activities requiring gown and glove use for Enhanced Barrier Precautions include:

  • Dressing
  • Bathing/showering
  • Transferring
  • Providing hygiene
  • Changing linens
  • Changing briefs or assisting with toileting
  • Device care or use: central line, urinary catheter, feeding tube, tracheostomy/ventilator
  • Wound care: any skin opening requiring a dressing

In general, gown and gloves would not be required for resident care activities other than those listed above, unless otherwise necessary for adherence to Standard Precautions. Residents are not restricted to their rooms or limited from participation in group activities. Because Enhanced Barrier Precautions do not impose the same activity and room placement restrictions as Contact Precautions, they are intended to be in place for the duration of a resident’s stay in the facility or until resolution of the wound or discontinuation of the indwelling medical device that placed them at higher risk.


When implementing Contact Precautions or Enhanced Barrier Precautions, it is critical to ensure that staff have awareness of the facility’s expectations about hand hygiene and gown/glove use, initial and refresher training, and access to appropriate supplies. To accomplish this:

  • Post clear signage on the door or wall outside of the resident room indicating the type of Precautions and required PPE (e.g., gown and gloves)
    • For Enhanced Barrier Precautions, signage should also clearly indicate the high-contact resident care activities that require the use of gown and gloves
  • Make PPE, including gowns and gloves, available immediately outside of the resident room
  • Ensure access to alcohol-based hand rub in every resident room (ideally both inside and outside of the room)
  • Position a trash can inside the resident room and near the exit for discarding PPE after removal, prior to exit of the room or before providing care for another resident in the same room
  • Incorporate periodic monitoring and assessment of adherence to determine the need for additional training and education
  • Provide education to residents and visitors

Note: Prevention of MDRO transmission in nursing homes requires more than just proper use of PPE and room restriction. Guidance on implementing other recommended infection prevention practices (e.g., hand hygiene, environmental cleaning, proper handling of wounds, indwelling medical devices, and resident care equipment) are available in CDC’s free online course — The Nursing Home Infection Preventionist Training. Nursing homes are encouraged to have staff review relevant modules and to use the resources provided in the training (e.g., policy and procedure templates, checklists) to assess and improve practices in their facility.

To learn more, please visit

Success Story: Lois Woodall

April 25, 2023

Greenville Nursing and Rehabilitation is excited to share resident Lois Woodall’s Success Story!

Ms. Lois Woodall was admitted to Greenville Nursing and Rehabilitation after a left-toe amputation. Upon admission, Ms. Woodall was unable to bare full weight on her left leg, causing increased difficulty with transfers. She struggled with ambulation and completing her activities of daily living. She received skilled physical and occupational therapy to address her functional decline to return home to live with her husband. While at Greenville Nursing and Rehabilitation, she had a few setbacks due to vitamin deficiency and required several infusions. Ms. Woodall did not let this deter her from her goal and she was always ready and motivated to participate in her skilled therapy, participate in facility activities, and enjoy socializing with fellow residents. She has demonstrated excellent progress, and at discharge, she completed her transfers and ambulation utilizing a rolling walker with only supervision. She was discharged home and was given a “Red Carpet” send-off. Congratulations to Ms. Woodall and her Care Team on their success!

Older Adult Fall Prevention

April 18, 2023

Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, 1 but less than half tell their doctor. 2  Falling once doubles your chances of falling again.

Falls Are Serious and Costly

  • One out of five falls causes a serious injury such as broken bones or a head injury,4,5
  • Each year, 3 million older people are treated in emergency departments for fall injuries.6
  • Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.6
  • Each year at least 300,000 older people are hospitalized for hip fractures.7
  • More than 95% of hip fractures are caused by falling,8 usually by falling sideways.9
  • Falls are the most common cause of traumatic brain injuries (TBI).10
  • In 2015, the total medical costs for falls totaled more than $50 billion.11 Medicare and Medicaid shouldered 75% of these costs.

What Can Happen After a Fall?

Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.4,5 These injuries can make it hard for a person to get around, do everyday activities, or live on their own.

  • Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
  • Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
  • Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.12

What Conditions Make You More Likely to Fall?

Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include:

  • Lower body weakness
  • Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Difficulties with walking and balance
  • Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Vision problems
  • Foot pain or poor footwear
  • Home hazards or dangers such as
    • broken or uneven steps, and
    • throw rugs or clutter that can be tripped over.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above. To learn more, please visit

Transportation Safety for Older Adult Drivers

April 11, 2023

In 2020, there were almost 48 million licensed drivers ages 65 and older in the United States. This is a 68% increase since 2000. Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a traffic crash increases as people age. Thankfully, older adults can take steps to stay safer on the roads.

Thousands of older adults are injured or killed in the United States every year in traffic crashes.

In 2020, about 7,500 older adults were killed in traffic crashes, and almost 200,000 were treated in emergency departments for crash injuries. This means that each day, 20 older adults are killed and almost 540 are injured in crashes.

Age, gender, and age-related changes are major risk factors

  • Drivers aged 70+ have higher crash death rates per 1,000 crashes than middle-aged drivers (aged 35-54). Higher crash death rates among this age group are primarily due to increased vulnerability to injury in a crash.
  • Across all age groups, males have substantially higher crash death rates than females.
  • Age-related changes in vision, physical functioning, and the ability to reason and remember, as well as some diseases and medications, might affect some older adults’ driving abilities.

Key steps to staying safe on the roads

  • The good news is that older adults are more likely to have safer driving behaviors than other age groups.
  • Taking these key steps can help adults of all ages, including older adults, stay safe on the road:
  • Always wear a seat belt as a driver or passenger
    Seat belt use is one of the most effective ways to save lives and reduce injuries in crashes.6
  • Drive when conditions are safest
    Drive during daylight and in good weather. Conditions such as poor weather7 and driving at night8 increase the likelihood of crash injuries and deaths.
  • Don’t drink and drive
    Drinking and driving increases the risk of being in a crash because alcohol reduces coordination and impairs judgment.

Additional steps to stay safe on the road

  • Use CDC’s MyMobility Plan, a plan to stay mobile and independent as you age.
  • Follow a regular activity program to increase strength and flexibility.
  • Ask your doctor or pharmacist to review medicines—both prescription and over-the counter—to reduce side effects and interactions. Read the Are Your Medicines Increasing Your Risk of a Fall or a Car Crash fact sheet to learn more.
  • Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.
  • Plan your route before you drive.
  • Find the safest route with well-lit streets, intersections with left-turn signals, and easy parking.
  • Leave a large following distance between your car and the car in front of you.
  • Avoid distractions in your car, such as listening to a loud radio, talking or texting on your phone, and eating.
  • Consider potential alternatives to driving, such as riding with a friend, using ride share services, or taking public transit.

To learn more, please visit

Patient Safety: What You Can Do to Be a Safe Patient

April 3, 2023

You go to the hospital to get well, right? Of course, but did you know that you can get infections in the hospital while you are being treated for something else?

Time in the hospital can put you at risk for a healthcare-associated infection (HAI), such as a blood, surgical site, or urinary tract infection.

Every day, patients get infections in healthcare facilities while they are being treated for something else. These infections can have devastating emotional, financial, and medical effects. Worst of all, they can be deadly.

Healthcare procedures can leave you vulnerable to germs that cause HAIs. These germs can be spread in healthcare settings from patient to patient on unclean hands of healthcare personnel or through the improper use or reuse of equipment.

These infections are not limited to hospitals. For example, in the past 10 years alone, there have been more than 30 outbreaks of hepatitis B and hepatitis C in non-hospital healthcare settings such as

5 Tips for Patients [Video – 2:32]

Protect yourself and your family from harmful germs that can cause infections

  • Keep your hands clean. Regular hand cleaning is one of the best ways to remove germs, avoid getting sick, and prevent spreading germs.
  • Take antibiotics only when your provider thinks you need them. Ask if your antibiotic is necessary. If you take antibiotics when you don’t need them, you’re only exposing yourself to unnecessary risk of side effects and potentially serious infections in the future. If you do need antibiotics, take them exactly as they’re prescribed.
  • Watch for signs of infection and its complications, like sepsis. Get care right away—don’t delay.
    • Tell your doctor if you think you have an infection, or if your infection is not getting better or is getting worse.
  • Watch out for life-threatening diarrhea caused by C. difficile. If you have been taking an antibiotic, tell your doctor if you have 3 or more diarrhea episodes in 24 hours.
  • Get vaccinated against flu and other infections to avoid complications.

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death. Learn more about sepsis.

Be a safe patient in the hospital

  • Tell your doctors if you have been hospitalized in another facility, have recently received health care outside of the United States, or have recently had an infection.
  • Ask your healthcare provider what they and the facility will do to protect you and your family from an antibiotic-resistant infection.
    • If you have a catheter, ask daily when it can be removed.
    • If you are having surgery, ask your doctor how they prevent infections. Also, ask how you can prepare for surgery to reduce your infection risk.
  • Keep your hands clean. Make sure everyone cleans their hands before touching you. Remind healthcare personnel and your visitors to clean their hands.
  • Let your doctors check you for resistant germs if needed. Hospitals need to screen patients if they’re exposed, and this helps protect you and those around you.
  • Understand that if you have a resistant bacteria, healthcare providers may use gowns and gloves when caring for you.
  • Allow people to clean your room while you’re in the hospital, even when it feels inconvenient for you.
    • Environmental services workers are the people who clean patient rooms in the hospital, and they are important members of the healthcare team.
    • Allowing them to clean and disinfect your room helps keep you safe by reducing your risk of developing an infection—don’t say, “come back later.”

To learn more, please visit