Inspection Reports for
Altamaha Healthcare Center
1311 WEST CHERRY STREET, JESUP, GA, 31545
Back to Facility ProfileDeficiencies (last 9 years)
Deficiencies (over 9 years)
6.2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
27% worse than Georgia average
Georgia average: 4.9 deficiencies/yearDeficiencies per year
36
27
18
9
0
Occupancy
Latest occupancy rate
89% occupied
Based on a November 2024 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Deficiencies: 2
Date: Aug 9, 2025
Visit Reason
The inspection was conducted to assess compliance with safety standards related to accident hazards and supervision in the nursing home, including investigation of incidents involving resident falls and unsafe smoking practices.
Findings
The facility failed to ensure an environment free from accident hazards for two residents, resulting in a fall with injury and unsafe smoking practices involving supplemental oxygen. Staff failed to provide required two-person assistance during care, and a resident was allowed to smoke with oxygen equipment, leading to staff termination.
Deficiencies (2)
F 0689: The facility failed to ensure an environment free from accident hazards and provide adequate supervision to prevent accidents. A resident fell from bed during a bed bath when two-person assistance was not used as required, resulting in a head laceration and emergency room transfer.
F 0689: The facility allowed a resident to smoke with supplemental oxygen despite policies prohibiting oxygen use in smoking areas. This placed residents in danger and resulted in termination of the responsible CNA.
Report Facts
Residents sampled: 42
Residents affected: 2
Length of laceration: 4
Oxygen flow rate: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA12 | Certified Nursing Assistant | Named in fall incident involving resident R51 |
| CNA15 | Certified Nursing Assistant | Named in unsafe smoking incident with resident R6 and subsequent termination |
| Director of Nursing | Director of Nursing | Provided interviews and education related to fall incident and smoking policies |
| Administrator | Administrator | Provided interviews and reported on staff education and termination related to incidents |
| Licensed Practical Nurse Unit Manager | LPN Unit Manager | Interviewed regarding fall incident and resident care requirements |
| Activities Director | Activities Director | Signed witness statement regarding smoking incident |
Inspection Report
Re-Inspection
Census: 55
Deficiencies: 0
Date: Nov 25, 2024
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the July 31, 2024 Recertification with Complaint Survey.
Findings
All deficiencies cited in the previous survey were found to be corrected during this revisit survey.
Inspection Report
Routine
Census: 23
Deficiencies: 2
Date: Oct 10, 2024
Visit Reason
The inspection was conducted to evaluate infection control practices related to glucometer use and COVID testing procedures at Altamaha Healthcare Center.
Findings
The facility failed to properly disinfect and store glucometers after use, with multiple observations of nurses not sanitizing equipment or surfaces appropriately. Additionally, infection control practices during COVID testing were inadequate, including improper handling and placement of used test materials and equipment.
Deficiencies (2)
Failure to properly disinfect the glucometer after use per manufacturer's specifications by two nurses observed during fingerstick blood sugar testing for three residents.
Failure to properly disinfect and store glucometers and maintain infection control to decrease cross contamination during COVID testing.
Report Facts
Residents requiring fingerstick: 23
Residents observed with improper glucometer use: 3
COVID tests observed on counter: 3
Boxes of COVID tests: 2
Dwell time for disinfectant wipes: 1
Dwell time for COVID test results: 15
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN AA | Licensed Practical Nurse | Observed improperly disinfecting glucometer and not sanitizing hands during procedures |
| RN BB | Registered Nurse | Observed improperly disinfecting glucometer and placing it on soiled surfaces |
| Unit Manager | Observed placing used COVID tests on nurse's station counter and responsible for COVID testing that day | |
| Regional Nurse Consultant | Provided information on disinfectant dwell time and nurse education | |
| Administrator | Provided information on COVID cart setup and ICP responsibilities |
Inspection Report
Complaint Investigation
Census: 59
Deficiencies: 2
Date: Oct 10, 2024
Visit Reason
A revisit survey was conducted from September 22 to October 10, 2024, including investigation of multiple complaint intake numbers. The visit was triggered by complaints and a revisit survey to assess compliance with Medicare/Medicaid regulations.
Complaint Details
Complaint Intake Numbers GA00249161, GA00251105, GA00250965, GA00251075, and GA00251229 were investigated. Complaints GA00249161, GA00251105, GA00250965, and GA00251229 were unsubstantiated. Complaint GA00251075 was substantiated with no deficiencies.
Findings
The facility was found not in substantial compliance with infection prevention and control requirements, specifically failing to properly disinfect glucometers and maintain infection control during COVID testing. Several observations revealed improper cleaning and storage of glucometers and unsafe handling of COVID test materials.
Deficiencies (2)
Failure to properly disinfect the glucometer after use per manufacturer's specifications by two nurses observed obtaining fingerstick blood sugar for three residents.
Failure to properly disinfect and store glucometers and maintain infection control to decrease cross contamination during COVID testing.
Report Facts
Residents requiring fingerstick: 23
Residents observed for fingerstick: 3
COVID tests observed: 3
Time for COVID test results: 15
Dwell time for disinfectant wipes: 1
Dwell time for disinfectant wipes (COVID test): 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN AA | Licensed Practical Nurse | Observed improperly disinfecting glucometer and failing to sanitize hands during fingerstick blood sugar testing |
| RN BB | Registered Nurse | Observed improperly disinfecting glucometer and placing it on soiled surfaces during fingerstick blood sugar testing |
| Unit Manager | Observed placing used COVID tests on nurse's station counter and described COVID testing procedures | |
| Regional Nurse Consultant | Provided information on disinfectant dwell time and infection control responsibilities | |
| Administrator | Provided information on COVID cart setup and infection control practices |
Inspection Report
Re-Inspection
Census: 59
Deficiencies: 0
Date: Oct 10, 2024
Visit Reason
The visit was conducted as a Revisit survey on 11/10/2024 to investigate multiple complaint intake numbers.
Complaint Details
Complaint Intake Numbers GA00249161, GA00251105, GA00250965, GA00251229 were unsubstantiated, and complaint GA00251075 was substantiated with no deficiencies cited.
Findings
The complaint investigation found that four complaints were unsubstantiated and one complaint was substantiated with no deficiencies cited.
Report Facts
Complaint Intake Numbers Investigated: 5
Facility Census: 59
Inspection Report
Routine
Deficiencies: 5
Date: Jul 31, 2024
Visit Reason
The inspection was conducted from July 28, 2024 through July 31, 2024 to determine compliance with State Long Term Care Requirements at Altamaha Healthcare Center.
Findings
The facility was cited for failure to document behaviors and nonpharmacological interventions prior to administering antipsychotic medication to one resident, failure to follow manufacturer's instructions for cleaning and disinfecting a glucometer between residents, failure to comply with tuberculosis testing guidelines for staff, and failure to maintain a current infection surveillance program for 2024.
Deficiencies (5)
Failure to document behaviors and nonpharmacological interventions prior to administration of antipsychotic medication (Seroquel IM) for one resident.
Failure to follow manufacturer's instructions for cleaning and disinfecting one glucometer between residents' use.
Failure to follow pre-employment and annual purified protein derivative (PPD) tuberculosis testing guidelines for six of nine personnel files.
Failure to obtain annual PPD test for two personnel files.
Failure to maintain a current infection surveillance program for 2024.
Report Facts
Residents reviewed for unnecessary medications: 28
Personnel files reviewed: 9
Residents on sliding scale orders: 7
Units of insulin prepared: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN1 | Registered Nurse | Observed failing to clean and disinfect glucometer between resident uses and admitted lack of training. |
| Regional Operations Manager | Interviewed regarding lack of documentation for behaviors and nonpharmacological interventions and training on glucometer disinfection. | |
| Administrator | Interviewed regarding expectations for infection control and PPD documentation. | |
| Director of Nursing | Interviewed regarding infection surveillance documentation and program implementation. |
Inspection Report
Routine
Census: 52
Deficiencies: 12
Date: Jul 31, 2024
Visit Reason
A standard routine survey was conducted at Altamaha Healthcare Center from July 28, 2024 through July 31, 2024, including investigation of multiple complaint intake numbers.
Complaint Details
Complaint Intake Numbers GA00244274 and GA00248607 were substantiated with deficiency. GA00243076, GA00244372, and GA00246934 were unsubstantiated. GA00247628 was substantiated with no deficiency.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations, with deficiencies including failure to provide advance directive information, incomplete background checks for employees, failure to provide written transfer and bed hold notices to residents and representatives, incomplete care plan revisions, inadequate bed rail assessments, missing nurse staffing postings, medication administration errors, unsafe food handling practices, and infection control deficiencies.
Deficiencies (12)
Failed to provide written information to five residents and/or their representatives concerning the right to formulate an advance directive.
Failed to obtain background and criminal checks at time of employment for four of nine employee files reviewed.
Failed to ensure seven residents and their representatives were provided with written transfer/discharge notice for emergent hospital transfers.
Failed to ensure seven residents and their representatives received written bed hold notice including all required information.
Failed to revise care plan to include fall interventions and ensure care conferences were held for one resident.
Failed to ensure bed rail assessments and documentation of attempted alternatives prior to bed rail use for three residents.
Failed to post daily nurse staffing information accurately for three of four survey days.
Failed to ensure pharmacy provided medications timely and residents received medications as ordered for one resident.
Failed to document behaviors and nonpharmacological interventions prior to administration of antipsychotic medication for one resident.
Failed to follow physician order and provide insulin per sliding scale order for one resident, causing a significant medication error.
Failed to ensure food was not stored on the floor, expired foods disposed timely, ready-to-eat food not touched with bare hands, and moldy food not stored for use.
Failed to follow manufacturer's instructions for cleaning and disinfecting glucometer between residents, failed to follow pre-employment and annual PPD guidelines for staff, and failed to maintain a current infection surveillance program.
Report Facts
Residents reviewed for advance directive information: 28
Residents with missing advance directive info: 5
Employee files reviewed for background checks: 9
Employee files missing background checks: 4
Residents reviewed for transfer notice: 28
Residents missing transfer notice: 7
Residents missing bed hold notice: 7
Residents reviewed for care planning: 28
Residents missing care plan revision: 1
Residents reviewed for bed rail use: 28
Residents missing bed rail assessments: 3
Survey days missing nurse staffing posting: 3
Residents reviewed for medication administration: 28
Residents with medication errors: 1
Residents reviewed for unnecessary medications: 28
Residents with undocumented behaviors prior to antipsychotic use: 1
Residents reviewed for insulin administration: 7
Residents with insulin administration errors: 1
Facility census: 52
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN1 | Registered Nurse | Named in medication administration error for insulin and glucometer disinfection failure. |
| LPN5 | Licensed Practical Nurse | Named in medication administration and transfer notice findings. |
| Administrator | Named in multiple findings including background checks, transfer notices, bed hold notices, infection control. | |
| Director of Nursing | DON | Named in medication administration, transfer notices, infection control, and staffing postings. |
| Social Services Director | SSD | Named in advance directive and transfer notice findings. |
| Cook1 | Cook | Named in food handling violations. |
| Cook2 | Cook | Named in food storage violations. |
| Dietary Aide 2 | DA2 | Named in moldy food storage violation. |
| Regional Operations Manager | ROM | Named in medication administration and infection control findings. |
| Medical Director | Named in medication administration findings. | |
| Physical Therapist | PT | Named in care plan findings. |
| Certified Occupational Therapy Assistant | COTA | Named in care plan findings. |
| MDS Coordinator | MDSC | Named in care plan findings. |
Inspection Report
Complaint Investigation
Deficiencies: 3
Date: Jul 31, 2024
Visit Reason
The inspection was conducted to investigate complaints related to medication administration errors, pharmacy delivery delays, and infection control practices at the facility.
Complaint Details
The investigation was complaint-driven, focusing on medication administration errors and infection control deficiencies. The complaints were substantiated based on observations, interviews, and record reviews.
Findings
The facility failed to ensure timely pharmacy delivery and administration of medications for residents, resulting in missed doses and potential harm. Additionally, the facility did not follow infection control protocols for cleaning glucometers, lacked proper tuberculosis testing documentation for staff, and had no current infection surveillance program in place.
Deficiencies (3)
F0755: The facility failed to ensure pharmacy provided medications timely and residents received medications as ordered for one of six residents reviewed. Multiple medications were not administered on ordered dates with no follow-up documentation.
F0760: The facility nurse failed to follow physician orders and provide insulin per sliding scale for one of seven residents reviewed. The resident did not have insulin available, causing a significant medication error affecting diabetes management.
F0880: The facility failed to follow manufacturer's instructions for cleaning and disinfecting a glucometer between residents' use, failed to obtain required tuberculosis testing for staff, and lacked a current infection surveillance program for 2024.
Report Facts
Residents reviewed for medication administration: 28
Residents reviewed for insulin administration: 7
Personnel files reviewed for tuberculosis testing: 9
Residents affected by medication delays: 1
Residents affected by insulin administration error: 1
Residents affected by infection control deficiencies: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN1 | Registered Nurse | Named in insulin administration error and glucometer cleaning deficiency |
| LPN5 | Licensed Practical Nurse | Interviewed regarding medication order processing and pharmacy delivery issues |
| Director of Nursing | Director of Nursing (DON) | Interviewed regarding pharmacy delivery problems and infection control program status |
| Medical Director | Medical Director | Interviewed regarding insulin order delays and resident medication management |
| Administrator | Administrator | Interviewed regarding pharmacy delays, infection control expectations, and personnel records |
| Regional Operations Manager | Regional Operations Manager (ROM) | Provided resident diagnosis lists and commented on staff training for glucometer disinfection |
Inspection Report
Routine
Deficiencies: 12
Date: Jul 31, 2024
Visit Reason
Routine inspection of Altamaha Healthcare Center to assess compliance with healthcare regulations including resident rights, staff background checks, transfer notifications, care planning, medication administration, infection control, and food safety.
Findings
The facility had multiple deficiencies including failure to provide advance directive information to residents, incomplete background checks for staff, lack of written transfer and bed hold notices for hospital transfers, incomplete care planning and care conferences, inadequate bed rail assessments, failure to post daily nurse staffing, delayed medication provision from pharmacy, failure to document behaviors prior to antipsychotic medication administration, medication errors including missed insulin doses, food safety violations, and incomplete infection prevention and control practices.
Deficiencies (12)
F 0578: The facility failed to provide written information about the right to formulate an advance directive to five residents and/or their representatives.
F 0607: The facility failed to obtain background and criminal checks at time of employment for four of nine employee files reviewed.
F 0623: The facility failed to provide timely written transfer/discharge notices including appeal rights to seven residents and their representatives.
F 0625: The facility failed to provide written bed hold notices to seven residents and their representatives upon hospital transfer.
F 0657: The facility failed to revise the care plan to include fall interventions and failed to hold care conferences for one resident.
F 0700: The facility failed to ensure three residents had bed rail assessments and documented attempts of alternatives prior to bed rail use.
F 0732: The facility failed to post daily nurse staffing information accurately for three of four survey days.
F 0755: The facility failed to ensure timely provision of medications from the pharmacy and residents did not receive medications as ordered for one resident.
F 0758: The facility failed to document behaviors and nonpharmacological interventions prior to administration of antipsychotic medication for one resident.
F 0760: The facility nurse failed to follow physician orders and provide insulin per sliding scale for one resident, causing a significant medication error.
F 0812: The facility failed to ensure food was not stored on the floor, expired foods were disposed timely, ready-to-eat food was not touched with bare hands, and moldy food was not discarded.
F 0880: The facility failed to follow manufacturer's instructions for cleaning and disinfecting a glucometer between residents, failed to maintain required tuberculosis testing for staff, and lacked a current infection surveillance program.
Report Facts
Residents reviewed: 28
Staff files reviewed: 9
Residents affected by transfer notice deficiency: 7
Residents affected by bed hold notice deficiency: 7
Residents affected by bed rail assessment deficiency: 3
Residents affected by medication administration deficiency: 6
Residents affected by infection control deficiencies: 52
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN1 | Registered Nurse | Involved in medication administration and glucometer cleaning deficiency |
| LPN5 | Licensed Practical Nurse | Provided information on medication delivery and transfer processes |
| Administrator | Confirmed multiple deficiencies including staffing posting, background checks, PPD testing, and infection control program | |
| Director of Nursing | DON | Confirmed medication delivery issues, infection control program status, and transfer notice deficiencies |
| Regional Operations Manager | ROM | Reviewed care plans, medication records, and infection control training |
| Medical Director | Provided guidance on medication delays and insulin administration | |
| Social Services Director | SSD | Interviewed regarding advance directive and transfer notice documentation |
| Cook1 | Observed touching food with bare hands | |
| Cook2 | Interviewed about food storage and expiration | |
| Dietary Aide 2 | DA2 | Confirmed moldy food presence and produce checks |
Inspection Report
Life Safety
Census: 52
Capacity: 62
Deficiencies: 0
Date: Jul 30, 2024
Visit Reason
The Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found in compliance with the Emergency Preparedness Program requirements and Life Safety Code standards during the survey.
Inspection Report
Complaint Investigation
Census: 57
Deficiencies: 0
Date: Jan 22, 2024
Visit Reason
An Abbreviated/Partial Extended Survey was conducted to investigate multiple complaints identified by codes GA00240518, GA00238603, GA00240090, GA00231248, GA00241615, GA00239777, and GA00230206.
Complaint Details
The survey investigated complaints GA00240518, GA00238603, GA00240090, GA00231248, GA00241615, GA00239777, and GA00230206. No deficiencies were found related to these complaints.
Findings
No deficiencies were cited related to the investigated complaints during the survey conducted from January 17 to January 22, 2024.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Sep 5, 2023
Visit Reason
A focused infection control survey was conducted at Altamaha Healthcare Center on 9/5/2023 by CertiSurv on behalf of the Georgia Department of Community Health.
Findings
The survey revealed that the facility was in substantial compliance with Medicare/Medicaid regulations at 42 Code of Federal Regulations (C.F.R.) Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Annual Inspection
Deficiencies: 0
Date: Sep 5, 2023
Visit Reason
Annual inspection survey conducted to assess compliance with health and safety regulations at Altamaha Healthcare Center.
Findings
No health deficiencies were found during the inspection.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Sep 6, 2022
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Altamaha Healthcare Center following a survey completed on September 6, 2022.
Findings
No specific deficiencies or findings are detailed in the provided document.
Inspection Report
Re-Inspection
Census: 52
Deficiencies: 0
Date: Sep 6, 2022
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the prior standard survey conducted on 2022-06-24.
Findings
All deficiencies cited in the 6/24/2022 standard survey were found to be corrected during the revisit survey.
Report Facts
Census: 52
Inspection Report
Follow-Up
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey deficiencies.
Findings
All previously cited survey tags have been corrected as noted during the follow-up survey.
Inspection Report
Life Safety
Census: 52
Capacity: 62
Deficiencies: 3
Date: Jul 1, 2022
Visit Reason
The Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and emergency preparedness at Altamaha Healthcare Center.
Findings
The facility was found not in substantial compliance with emergency lighting testing, fire drill conduction and documentation, and generator maintenance/testing requirements. Missing monthly emergency light tests for March 2022, a missed fire drill during 2nd shift of 1st quarter 2022, and failure to exercise the generator under load for 30 minutes in March and April 2022 were noted.
Deficiencies (3)
Failure to ensure emergency lights were tested at proper intervals and documentation was incomplete, missing March 2022 test.
Failure to conduct and properly document fire drills, missing 2nd shift fire drill in 1st quarter 2022.
Failure to exercise generator under load 12 times a year at intervals of 20-40 days; missing 30-minute load tests for March and April 2022.
Report Facts
Census: 52
Total Capacity: 62
Missing emergency light test months: 1
Missed fire drills: 1
Missed generator load tests: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M confirmed findings related to emergency lighting and fire drills | ||
| Staff A confirmed findings related to generator testing |
Inspection Report
Annual Inspection
Deficiencies: 0
Date: Jun 24, 2022
Visit Reason
The inspection was conducted from June 21, 2022 through June 24, 2022 to determine compliance with State Long Term Care Requirements.
Findings
No State Health Deficiencies were cited during the health survey.
Inspection Report
Complaint Investigation
Census: 57
Deficiencies: 3
Date: Jun 24, 2022
Visit Reason
A standard survey was conducted from June 21, 2022 through June 24, 2022, including investigation of Complaint Intake Number GA00223187, which was not substantiated.
Complaint Details
Complaint Intake Number GA00223187 was investigated in conjunction with the standard survey and was not substantiated.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations, with deficiencies including failure to promptly document residents' code/advance directive status, inaccurate PASARR screenings for mental illness diagnoses, and a medication error rate exceeding 5%.
Deficiencies (3)
Failure to ensure resident's code/advance directive status was promptly determined and documented in an accessible location for one resident.
Failure to ensure accurate Preadmission Screening and Resident Review (PASRR) reflecting diagnosed mental illnesses for three residents.
Medication error rate was 24% with six errors out of 25 opportunities affecting two residents.
Report Facts
Resident census: 57
Medication error rate: 24
Medication errors: 6
Medication administration opportunities: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| AA | Director of Nursing | Interviewed regarding missing code status documentation for Resident #154 |
| BB | Director of Social Work | Interviewed regarding Resident #154's code status and PASRR process |
| CC | Licensed Practical Nurse, Unit Manager | Admission nurse for Resident #154, interviewed about code status documentation |
| DD | Licensed Practical Nurse | Observed administering medications and interviewed regarding medication errors |
Inspection Report
Annual Inspection
Deficiencies: 3
Date: Jun 24, 2022
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements including advance directives documentation, PASARR screening accuracy, and medication administration error rates at Altamaha Healthcare Center.
Findings
The facility failed to ensure timely documentation of residents' code/advance directive status, accurate PASARR screening for mental disorders for sampled residents, and maintain medication error rates below 5%, resulting in a 24% medication error rate affecting two residents.
Deficiencies (3)
F 0578: The facility failed to ensure the resident's code/advance directive status was promptly determined and documented in an accessible location, affecting one resident whose code status was not documented upon admission.
F 0645: The facility failed to ensure PASARR Level I screenings accurately reflected diagnosed mental illnesses for three of six sampled residents reviewed.
F 0759: The facility failed to maintain medication error rates below 5%, with six medication errors in 25 opportunities resulting in a 24% error rate affecting two residents.
Report Facts
Medication errors: 6
Medication administration opportunities: 25
Residents affected by medication errors: 2
Residents reviewed for PASARR: 6
Residents with inaccurate PASARR screening: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| AA | Director of Nursing | Named in the finding regarding failure to document resident code status. |
| BB | Director of Social Work | Involved in discussion about code status documentation and PASARR process. |
| CC | Licensed Practical Nurse, Unit Manager | Admission nurse for resident with undocumented code status. |
| DD | Licensed Practical Nurse | Involved in medication administration errors for two residents. |
| Administrator | Provided statements on expectations for code status documentation and medication administration. | |
| BOM | Business Office Manager | Discussed PASARR process and responsibilities. |
| AC | Admission Coordinator | Discussed PASARR completion and referral communication. |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Nov 4, 2021
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaints #GA00216955, #GA00216693, and #GA00218880.
Complaint Details
Complaints #GA00216955, #GA00216693, and #GA00218880 were investigated and found to be unsubstantiated with no deficiencies cited.
Findings
The complaints investigated were unsubstantiated and no deficiencies were cited during the survey.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jul 1, 2021
Visit Reason
An Abbreviated/Partial Extended Survey was conducted to investigate multiple complaints identified by their numbers.
Complaint Details
Complaints #GA002015653, #GA00215468, #GA00215166, #GA00215489, #GA00215470, and #GA00215469 were investigated and found to be unsubstantiated with no deficiencies cited.
Findings
All complaints investigated during the survey were unsubstantiated and no deficiencies were cited.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jun 7, 2021
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaints #GA00214419 and #GA00214897.
Complaint Details
Complaints #GA00214419 and #GA00214897 were investigated and found to be unsubstantiated.
Findings
The complaints #GA00214419 and #GA00214897 were found to be unsubstantiated and no deficiencies were cited during the survey.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jan 26, 2021
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA00211056.
Complaint Details
Complaint #GA00211056 was investigated and found to be unsubstantiated with no deficiencies cited.
Findings
The complaint was unsubstantiated and no deficiencies were cited during the survey.
Inspection Report
Deficiencies: 0
Date: Nov 16, 2020
Visit Reason
The document is a statement of deficiencies and plan of correction for Altamaha Healthcare Center following a state inspection.
Findings
The report contains a summary statement of deficiencies identified during the inspection, but no specific deficiencies or findings are detailed in the provided page.
Inspection Report
Re-Inspection
Census: 55
Deficiencies: 0
Date: Nov 16, 2020
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the standard survey conducted from 8/24/2020 through 8/26/2020.
Findings
All deficiencies cited in the prior standard survey were found to be corrected during this revisit survey.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Oct 20, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA00208857 in conjunction with a COVID-19 focused survey for nursing homes.
Complaint Details
Complaint #GA00208857 was investigated and found not substantiated.
Findings
The complaint #GA00208857 was not substantiated and no deficiencies were cited during the survey.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Sep 18, 2020
Visit Reason
An abbreviated survey was conducted to investigate complaint #GA00207932.
Complaint Details
Complaint #GA00207932 was investigated and found to be not substantiated.
Findings
The complaint was not substantiated and no deficiencies were identified or written.
Inspection Report
Original Licensing
Deficiencies: 0
Date: Aug 26, 2020
Visit Reason
Licensure survey conducted to determine compliance with State Long Term Care Requirements.
Findings
No State Health Deficiencies were cited during the survey conducted from August 24, 2020 through August 26, 2020.
Inspection Report
Abbreviated Survey
Census: 55
Deficiencies: 1
Date: Aug 26, 2020
Visit Reason
An unannounced abbreviated survey was conducted to investigate Complaint Intake numbers GA00203579, GA00205723, and GA00207455 at Altamaha Health Care Center.
Complaint Details
Complaint Intake numbers GA00203579 and GA00207455 were unsubstantiated. GA00205723 was substantiated with a deficiency cited related to failure to provide medications upon discharge.
Findings
The facility was found to have failed to provide one of three residents with medications upon discharge to another facility. Two complaints were unsubstantiated, and one was substantiated with a cited deficiency related to medication delivery and discharge documentation.
Deficiencies (1)
Facility failed to give one of three residents medications when discharged; discharge medication list was blank despite prescribed medications.
Report Facts
Complaint Intake numbers investigated: 3
Medications prescribed: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| HH | Office Manager | Interviewed regarding resident #3 medication delivery and discharge |
| GG | Social Service Designee | Interviewed and unaware resident #3 left without medications |
| DON | Director of Nursing | Interviewed; acknowledged incomplete discharge summary and lack of medication delivery records |
Inspection Report
Routine
Census: 52
Deficiencies: 0
Date: Aug 25, 2020
Visit Reason
A COVID-19 Focused Infection Control survey was conducted by Healthcare Management Solutions, LLC on behalf of the Georgia Department of Health and Community Health (DCH) to assess compliance with infection control regulations related to COVID-19.
Findings
The facility was found to be in compliance with 42 CFR 483.73 and 42 CFR §483.80 infection control regulations and has implemented the CMS and CDC recommended practices to prepare for COVID-19.
Inspection Report
Routine
Census: 57
Deficiencies: 0
Date: Jul 21, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Centers for Medicare & Medicaid Services (CMS) to assess the facility's compliance with infection control regulations and preparedness for COVID-19.
Findings
The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and had implemented CMS and CDC recommended practices to prepare for COVID-19.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jan 9, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaints GA00198318, GA00198994, and GA00200272.
Complaint Details
The investigation of complaints GA00198318, GA00198994, and GA00200272 resulted in unsubstantiated findings with no deficiencies.
Findings
The complaints were unsubstantiated and no deficiencies were found during the investigation.
Inspection Report
Re-Inspection
Census: 59
Deficiencies: 0
Date: Jul 3, 2019
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the previous standard survey conducted on 2019-05-16.
Findings
All deficiencies cited as a result of the 5/16/19 standard survey were found to be corrected during the revisit survey.
Inspection Report
Follow-Up
Deficiencies: 0
Date: Jul 2, 2019
Visit Reason
A Follow-Up Survey was conducted to verify that all previously cited survey tags have been corrected.
Findings
The surveyor noted that all previously cited survey tags have been corrected during this follow-up survey.
Inspection Report
Routine
Census: 33
Deficiencies: 4
Date: May 16, 2019
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to PASRR screening, laboratory test reporting, food storage and sanitation, and medication administration documentation at Altamaha Healthcare Center.
Findings
The facility failed to accurately complete PASRR Level I Assessment forms for two residents, failed to obtain and report laboratory test results timely for one resident, failed to properly store food and clean pans in the kitchen, and failed to ensure complete and accurate medication administration documentation for one resident.
Deficiencies (4)
F 0645 PASARR screening for Mental disorders or Intellectual Disabilities was not completed accurately and timely for two residents, with diagnoses not properly reflected on PASRR forms.
F 0773 The facility failed to obtain lab results as ordered and failed to report abnormal lab results to the physician for one resident, with missing documentation of communication.
F 0812 The facility failed to store opened food items in secured or sealed containers and failed to store clean pans in a dry, sanitary manner, potentially affecting all 57 residents receiving an oral diet.
F 0842 The facility failed to ensure complete and accurate documentation of medication administration on MARs for one resident, with multiple instances of unsigned or uninitialed medications without documented reasons.
Report Facts
Residents reviewed: 33
Residents affected: 57
Medication administration missing signatures: 20
Employees mentioned
| Name | Title | Context |
|---|---|---|
| AA | Marketing Director/Admissions Coordinator | Interviewed regarding PASRR tracking system and audit initiation |
| BB | Social Worker | Interviewed regarding PASRR audit and resident case load |
| EE | Licensed Practical Nurse (LPN) | Interviewed regarding lab result communication and documentation |
| DD | Nurse Consultant / Regional Nurse / Incoming Director of Nursing | Provided lab results and discussed medication administration documentation expectations |
| GG | Licensed Practical Nurse (LPN) | Admitted to not signing medication administration on MARs despite administering medications |
Inspection Report
Life Safety
Census: 57
Capacity: 62
Deficiencies: 3
Date: May 14, 2019
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found not in substantial compliance with fire safety requirements due to failures in inspecting the kitchen hood extinguishing system, building fire extinguishers, and conducting/documenting fire drills as required.
Deficiencies (3)
The kitchen's hood extinguishing system had not been inspected since September 18, 2018.
The building's fire extinguishers had not been inspected since March 2018.
A fire drill was not conducted and documented during the 3rd shift of the 1st quarter of 2019.
Report Facts
Census: 57
Total Capacity: 62
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Interviewed and confirmed findings during facility tour |
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Nov 5, 2018
Visit Reason
A Revisit Survey was conducted to verify correction of deficiencies cited during the standard survey of 2018-09-03.
Findings
All deficiencies cited as a result of the standard survey conducted on 2018-09-03 were found to be corrected during the revisit survey.
Inspection Report
Follow-Up
Deficiencies: 0
Date: Oct 19, 2018
Visit Reason
A Follow-Up Survey was conducted to verify that all previously cited survey tags had been corrected.
Findings
The surveyor noted that all previously cited survey tags have been corrected.
Inspection Report
Life Safety
Census: 62
Capacity: 58
Deficiencies: 1
Date: Sep 4, 2018
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and emergency preparedness.
Findings
The facility was found not in substantial compliance with the Life Safety Code requirements due to failure to ensure the generator was exercised under load 12 times a year at intervals of 20-40 days, potentially placing all residents at risk during a power outage.
Deficiencies (1)
Failure to ensure the generator was exercised under load 12 times a year in intervals of 20-40 days.
Report Facts
Residents at risk: 58
Census: 62
Inspection Report
Abbreviated Survey
Census: 56
Deficiencies: 0
Date: Jul 18, 2018
Visit Reason
An abbreviated survey was conducted to investigate complaint GA00187434 at Altamaha Healthcare Center.
Complaint Details
Investigation of complaint GA00187434; facility found in substantial compliance.
Findings
The facility was found to be in substantial compliance with Medicare/Medicaid regulations at 42 C.F.R. Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jan 10, 2018
Visit Reason
A complaint survey was conducted to investigate complaint GA 00182695 by a Registered Nurse Surveyor to determine compliance with Federal and State Long Term Care Requirements.
Complaint Details
Complaint GA 00182695 was investigated and found to have no deficiencies.
Findings
No deficiencies were cited during the complaint investigation survey.
Inspection Report
Life Safety
Census: 53
Capacity: 62
Deficiencies: 0
Date: Sep 18, 2017
Visit Reason
Life Safety Code Survey conducted to assess compliance with Medicare/Medicaid participation requirements and NFPA 101 Life Safety Code 2012 edition.
Findings
Altamaha Healthcare Center was found in substantial compliance with the Life Safety Code requirements during the survey.
Inspection Report
Annual Inspection
Census: 52
Deficiencies: 0
Date: Sep 17, 2017
Visit Reason
A standard survey was conducted at Altamaha Healthcare Center from September 15, 2017 through September 17, 2017 to assess compliance with Medicare/Medicaid regulations.
Findings
The standard survey revealed that the facility was in substantial compliance with Medicare/Medicaid regulations at 42 C.F.R. Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: May 13, 2017
Visit Reason
A complaint (GA00174797) was investigated on May 13, 2017 to determine compliance with Federal and State Long Term Care Requirements, 42 CFR, Part 483, Subpart B, Requirements for Long Term Care Facilities.
Complaint Details
Complaint GA00174797 was investigated and found to have no deficiencies.
Findings
No deficiencies were cited during the complaint investigation.
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