Inspection Reports for Camellia Gardens of Life Care
804 SOUTH BROAD STREET BOX 1959, GA, 31792
Back to Facility ProfileDeficiencies per Year
12
9
6
3
0
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Deficiencies: 1
Jun 16, 2025
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey tags.
Findings
All previously cited survey tags were corrected except for a deficiency related to the fire alarm power circuit not being properly labeled, which could affect staff and residents.
Severity Breakdown
F: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure the fire alarm power circuit was properly labeled on the circuit box. | F |
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M confirmed the deficiency regarding the unlabeled fire alarm power circuit. |
Inspection Report
Life Safety
Census: 71
Capacity: 83
Deficiencies: 12
May 12, 2025
Visit Reason
The inspection was conducted to review the facility's Emergency Preparedness Program and to perform a Life Safety Code Survey to assess compliance with Medicare/Medicaid participation requirements and NFPA 101 Life Safety Code standards.
Findings
The facility was found not in substantial compliance with emergency preparedness requirements and multiple Life Safety Code deficiencies were identified, including obstructed exits, malfunctioning self-closing doors, blocked fire alarm pull stations, improperly installed sprinkler heads, obstructed fire extinguishers, missing ceiling tiles, and unsafe use of power strips.
Severity Breakdown
F: 5
E: 6
D: 2
Deficiencies (12)
| Description | Severity |
|---|---|
| Emergency Preparedness Program was not in substantial compliance with 42 CFR § 483.73 requirements. | F |
| Means of egress were blocked in exit doors in the patient dayroom and rehab room. | E |
| Self-closing doors were not operating correctly; laundry room door self-closing device was disabled and several doors were propped open with wedges. | F |
| Exit access corridors in the rehab area were obstructed, reducing corridor width. | E |
| Hazardous areas were not properly enclosed with self-closing doors; laundry room door self-closing device disabled. | D |
| Fire pull station in patient day room was blocked by a piano. | F |
| Fire alarm power circuit was not properly labeled. | F |
| Sprinkler head in Medication Room was installed more than 12 inches from the ceiling. | D |
| Sprinkler heads were obstructed by storage less than 18 inches from sprinkler head in Medication Room. | E |
| Ceiling tiles were missing in the IT Room. | E |
| Fire extinguishers were blocked by furniture and rehab equipment in the rehab room. | E |
| Power strips were found laying on the floor in multiple locations including conference room, rehab office, and nursing station. | E |
Report Facts
Census: 71
Total Capacity: 83
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Staff member who confirmed findings during the inspection |
Inspection Report
Annual Inspection
Deficiencies: 3
May 2, 2025
Visit Reason
A State Licensure survey was conducted at Camellia Gardens of Life Care from April 29, 2025, through May 2, 2025, to assess compliance with state health regulations and facility licensure requirements.
Findings
The survey revealed multiple deficiencies including failure to follow physician orders for pain management for two residents, inadequate fall prevention interventions for one resident, and failure to maintain a clean and orderly environment across multiple nursing units and resident rooms.
Deficiencies (3)
| Description |
|---|
| Failure to provide nursing services consistent with professional standards by not following physician orders for pain management for two residents (R51 and R5). |
| Failure to provide interventions as planned for the prevention of falls for one resident (R26). |
| Failure to provide housekeeping and/or maintenance services to maintain a clean and orderly environment on four of six nursing units/floors including multiple resident rooms and failure to ensure cleanliness of the carpet. |
Report Facts
Medication doses administered below physician ordered pain scale: 11
Medication doses administered below physician ordered pain scale: 4
Medication doses administered below physician ordered pain scale: 7
Medication doses administered: 15
Medication doses administered: 34
Medication doses administered: 43
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Interviewed on 5/1/2025 confirming nursing staff administered pain medication below physician ordered parameters and lack of documentation of non-pharmacological interventions. | |
| RN DD | Registered Nurse | Interviewed on 5/1/2025 regarding bed position and lack of signage for resident R26. |
| MDS Coordinator FF | MDS Coordinator | Interviewed on 5/2/2025 regarding care plan interventions for resident R26. |
| Maintenance Director GG | Maintenance Director | Confirmed environmental deficiencies during tour on 5/2/2025. |
Inspection Report
Routine
Census: 75
Deficiencies: 5
May 2, 2025
Visit Reason
A standard survey was conducted on behalf of the Georgia Department of Community Health at Camellia Gardens of Life Care Health and Rehabilitation from April 29, 2025 through May 2, 2025 to assess compliance with Medicare/Medicaid regulations.
Findings
The facility was found not in substantial compliance with regulations, with deficiencies including failure to maintain a clean environment, failure to provide fall prevention interventions, inadequate assistance and documentation of meal intake, failure to follow physician orders for pain management, and medication administration errors.
Severity Breakdown
Level E: 3
Level D: 2
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to provide housekeeping and maintenance services to maintain a clean and orderly environment on multiple nursing units including resident rooms, with issues such as paint chips exposing drywall, scuff marks, broken fixtures, stains, and unclean carpets. | Level E |
| Failure to provide interventions as planned for the prevention of falls for one resident reviewed for falls. | Level D |
| Failure to provide assistance and accurate documentation of meal intake for one resident reviewed for nutrition status. | Level D |
| Failure to provide nursing services consistent with professional standards by failing to follow physician orders for pain management for two residents reviewed for pain. | Level E |
| Failure to provide medications accurately and as ordered for two residents observed during medication pass, including improper administration of nasal spray, inhalers, eye drops, and failure to follow blood pressure parameters for holding medications. | Level E |
Report Facts
Resident census: 75
Medication pass opportunities: 45
Medication pass error rate: 11.11
Pain medication doses administered below ordered pain level: 11
Pain medication doses administered below ordered pain level: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| GG | Maintenance Director | Confirmed environmental deficiencies during tour |
| DD | Registered Nurse | Confirmed bed height and lack of signage for fall prevention resident |
| FF | MDS Coordinator | Described informal process for ensuring fall prevention interventions |
| HH | Certified Nursing Assistant | Described assistance and documentation for resident meal intake |
| AA | Registered Nurse | Observed medication administration errors including holding BP medication and nasal spray administration |
| BB | Licensed Practical Nurse | Observed medication administration errors including eye drops, nasal spray, and inhaler administration |
| DON | Director of Nursing | Provided interviews regarding care plan adherence, medication administration policies, and pain management |
Inspection Report
Complaint Investigation
Census: 73
Deficiencies: 0
Apr 3, 2025
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint numbers GA00243773 and GA00245848.
Findings
The complaints were unsubstantiated, no regulatory violations were cited, and the facility was found to be in compliance with 42 CFR §483.80 infection control regulations, implementing CMS and CDC recommended practices for COVID-19.
Complaint Details
Complaint numbers GA00243773 and GA00245848 were investigated and found to be unsubstantiated.
Report Facts
Complaint numbers: 2
Inspection Report
Complaint Investigation
Census: 73
Deficiencies: 0
Apr 3, 2025
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint numbers GA00243773 and GA00245848.
Findings
The complaints were unsubstantiated, no regulatory violations were cited, and the facility was found to be in compliance with 42 CFR §483.80 infection control regulations, implementing CMS and CDC recommended practices for COVID-19.
Complaint Details
Complaints GA00243773 and GA00245848 were investigated and found to be unsubstantiated.
Report Facts
Complaint numbers: GA00243773 and GA00245848
Inspection Report
Complaint Investigation
Census: 73
Deficiencies: 0
Apr 3, 2025
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint numbers GA00243773 and GA00245848.
Findings
The complaints were unsubstantiated, no regulatory violations were cited, and the facility was found to be in compliance with 42 CFR §483.80 infection control regulations, implementing CMS and CDC recommended practices for COVID-19 preparation.
Complaint Details
Complaint numbers GA00243773 and GA00245848 were investigated and found to be unsubstantiated.
Report Facts
Complaint numbers: 2
Inspection Report
Complaint Investigation
Census: 73
Deficiencies: 0
Apr 3, 2025
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint numbers GA00243773 and GA00245848.
Findings
The complaints were unsubstantiated, no regulatory violations were cited, and the facility was found to be in compliance with 42 CFR §483.80 infection control regulations, implementing CMS and CDC recommended practices for COVID-19.
Complaint Details
Complaint numbers GA00243773 and GA00245848 were investigated and found to be unsubstantiated.
Report Facts
Complaint numbers: 2
Inspection Report
Complaint Investigation
Census: 73
Deficiencies: 0
Apr 3, 2025
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint numbers GA00243773 and GA00245848.
Findings
The complaints were unsubstantiated, no regulatory violations were cited, and the facility was found to be in compliance with 42 CFR §483.80 infection control regulations, implementing CMS and CDC recommended practices for COVID-19.
Complaint Details
Complaints GA00243773 and GA00245848 were investigated and found to be unsubstantiated.
Report Facts
Complaint numbers: GA00243773 and GA00245848
Inspection Report
Abbreviated Survey
Census: 77
Deficiencies: 0
Dec 11, 2023
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA00236805.
Findings
The complaint GA00236805 was unsubstantiated with no regulatory violations cited during the survey.
Complaint Details
Complaint GA00236805 was investigated and found to be unsubstantiated with no regulatory violations.
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 1, 2023
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction for Camellia Gardens of Life Care, indicating a regulatory inspection was conducted.
Findings
The document does not provide specific findings or deficiencies in the visible content; it serves as a cover sheet for the Statement of Deficiencies and Plan of Correction.
Inspection Report
Re-Inspection
Census: 68
Deficiencies: 0
Jun 1, 2023
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the March 16, 2023 Recertification with Complaint Survey.
Findings
All deficiencies cited in the prior March 16, 2023 survey were found to be corrected during this revisit survey.
Inspection Report
Follow-Up
Deficiencies: 0
May 26, 2023
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
Annual Inspection
Census: 31
Deficiencies: 2
Mar 16, 2023
Visit Reason
A State Licensure survey was conducted from March 14, 2023 through March 16, 2023 to determine compliance with State Long Term Care Requirements.
Findings
The facility failed to assess two residents for the ability to self-administer medications prior to leaving medications at the bedside, and failed to ensure proper catheter care for one resident, increasing risk of urinary tract infection.
Severity Breakdown
SS= D: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to assess two residents for ability to self-administer medications prior to leaving medications at bedside. | SS= D |
| Failure to ensure catheter bag was below bladder level, tubing not looped, and catheter not secured, increasing risk of urinary tract infection for one resident. | SS= D |
Report Facts
Residents sampled: 31
Residents with catheters observed: 4
Residents with catheter deficiency: 1
BIMS score: 15
BIMS score: 13
Medication orders reviewed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| BB | Licensed Practical Nurse (LPN) | Interviewed regarding medication administration and observations of medications left at bedside |
| FF | LPN Restorative Nurse/Risk Management Nurse | Interviewed regarding interdisciplinary team decisions and medication self-administration education |
| CC | Certified Nursing Assistant (CNA) | Interviewed regarding catheter care observations for resident #6 |
| DD | LPN Treatment Nurse/Unit Manager | Interviewed regarding catheter bag care and resident education |
| DON | Director of Nursing | Interviewed regarding medication administration policies and catheter care deficiencies |
Inspection Report
Annual Inspection
Census: 72
Deficiencies: 5
Mar 16, 2023
Visit Reason
A recertification survey was conducted from March 14 to March 16, 2023, including investigation of a complaint GA00232015, to assess compliance with Medicare/Medicaid regulations for long term care facilities.
Findings
The facility was found not in substantial compliance with regulations, with deficiencies including failure to assess residents for medication self-administration, improper storage of medications at bedside, environmental maintenance issues, improper catheter care, and failure to follow infection control during medication administration and laundry handling.
Complaint Details
Complaint GA00232015 was investigated in conjunction with the standard survey.
Severity Breakdown
D: 3
E: 2
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to assess two residents for ability to self-administer medications prior to leaving medications at bedside. | D |
| Failed to maintain a clean, sanitary, homelike environment including dust buildup, scuffed walls, chipped paint, stained privacy curtains, and ceiling tiles in disrepair across multiple rooms and halls. | E |
| Failed to provide an environment free from potential accidents and hazards related to improperly stored medications on bedside tables for two residents. | D |
| Failed to ensure indwelling catheter drainage bag was below bladder level, tubing not looped properly, and catheter not secured, increasing risk of urinary tract infection for one resident. | D |
| Failed to ensure nursing staff performed hand hygiene during medication administration and failed to maintain infection control during storage of clean laundered Hoyer lift pads. | E |
Report Facts
Resident census: 72
Sampled residents: 31
Residents who wander: 5
BIMS score: 15
BIMS score: 13
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| BB | Licensed Practical Nurse | Named in medication self-administration and catheter care findings |
| FF | LPN Restorative/ Risk Management Nurse | Named in medication self-administration findings |
| EE | Certified Nursing Assistant | Named in medication storage and resident care findings |
| CC | Certified Nursing Assistant | Named in catheter care findings |
| DD | LPN Treatment Nurse/Unit Manager | Named in catheter care findings |
| DON | Director of Nursing | Named in multiple findings including medication storage, catheter care, and infection control |
| Laundry Aide AA | Laundry Aide | Named in laundry infection control findings |
| Laundry Supervisor | Laundry Supervisor | Named in laundry infection control findings |
| Administrator | Administrator | Named in environmental maintenance findings |
| Maintenance Director | Maintenance Director | Named in environmental maintenance findings |
| Housekeeping Supervisor | Housekeeping Supervisor | Named in environmental maintenance findings |
Inspection Report
Monitoring
Deficiencies: 0
Mar 16, 2023
Visit Reason
A Federal Monitoring Resource Support Survey was conducted at Camellia Gardens of Life Care from March 14 to March 16, 2023.
Findings
The document provides a summary statement of deficiencies and plan of correction related to the Federal Monitoring Resource Support Survey conducted at the facility.
Inspection Report
Life Safety
Census: 72
Capacity: 83
Deficiencies: 3
Mar 14, 2023
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and the National Fire Protection Association (NFPA) Life Safety Code standards.
Findings
The facility was found not in substantial compliance with life safety requirements, including use of unrated temporary barrier walls in corridors, improper installation of the fire alarm system, and failure to properly inspect, test, and maintain the sprinkler system.
Severity Breakdown
D: 1
E: 1
F: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Facility failed to maintain rating of interior finish in corridors; use of unrated temporary barrier walls in the Front Hall near Rooms 1 thru 9. | D |
| Fire alarm circuit was not identified and was not locked in the open position, affecting the fire alarm power supply. | F |
| Sprinkler heads in the Rehab Gym, Kitchen, Cafeteria, and near Room 15 were loaded with dust and/or lint, indicating failure to ensure proper inspection, testing, and maintenance of the sprinkler system. | E |
Report Facts
Certified beds: 83
Census: 72
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during facility tour and observations |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Jan 20, 2023
Visit Reason
An Abbreviated/Partial Extended Survey investigating complaint GA00231117 was initiated on 2023-01-09 and concluded on 2023-01-20.
Findings
The complaint was unsubstantiated and no regulatory violations were cited.
Complaint Details
Complaint GA00231117 was investigated and found to be unsubstantiated.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Dec 27, 2022
Visit Reason
An Abbreviated/Partial Extended Survey was conducted to investigate complaints GA00228988 and GA00229098.
Findings
The complaints were unsubstantiated and no regulatory violations were cited during the survey.
Complaint Details
The investigation of complaints GA00228988 and GA00229098 concluded with the complaints being unsubstantiated.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Oct 6, 2022
Visit Reason
An abbreviated survey was conducted to investigate complaint #GA00227711 from 10/4/2022 to 10/6/2022.
Findings
The complaint was unsubstantiated and no deficiencies were cited during the survey.
Complaint Details
Complaint #GA00227711 was investigated and found to be unsubstantiated with no deficiencies cited.
Inspection Report
Plan of Correction
Deficiencies: 0
Apr 13, 2022
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Camellia Gardens of Life Care following a regulatory inspection.
Findings
The report includes initial comments but does not provide detailed findings or deficiencies on this page.
Inspection Report
Original Licensing
Deficiencies: 0
Feb 17, 2022
Visit Reason
Licensure survey conducted to determine compliance with State Long Term Care Requirements.
Findings
No State Health deficiencies were cited during the licensure survey conducted from February 15 through February 17, 2022.
Inspection Report
Routine
Census: 71
Deficiencies: 1
Feb 17, 2022
Visit Reason
A standard survey was conducted to assess the facility's compliance with Medicare/Medicaid regulations at 42 CFR Part 483, Subpart B - Requirements for Long Term Care Facilities.
Findings
The facility was found not in substantial compliance due to failure to timely obtain a Physician's Order for Restoril 15 mg for one resident (R#48), resulting in a delay of medication administration from 2/11/22 to 2/16/22.
Severity Breakdown
Level D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to follow up timely in obtaining a Physician's Order for Restoril 15 mg for one resident, causing delayed medication administration. | Level D |
Report Facts
Resident census: 71
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse AA | Licensed Practical Nurse | Confirmed resident R#48 received Restoril 15 mg for the first time on 2/16/22 |
| Director of Nurses | Director of Nurses | Reported unawareness of delayed medication until 2/16/22 and confirmed medication was not given from 2/11/22 to 2/16/22 |
| Social Services Director | Social Services Director | Faxed medication order to Physician on 2/11/22 and refaxed on 2/15/22 after order was not returned |
Inspection Report
Life Safety
Census: 71
Capacity: 80
Deficiencies: 0
Feb 15, 2022
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with fire safety regulations and related standards.
Findings
The facility was found to be in substantial compliance with the requirements for participation in Medicare/Medicaid under 42 CFR Subpart 483.90(a) and the NFPA 101 Life Safety Code 2012 edition.
Report Facts
Census: 71
Total Capacity: 80
Inspection Report
Abbreviated Survey
Deficiencies: 0
Jul 27, 2021
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA00214556.
Findings
The complaint #GA00214556 was substantiated, but no deficiencies were cited during the survey.
Complaint Details
Complaint #GA00214556 was substantiated with no deficiencies cited.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Mar 22, 2021
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint number #GA00212670.
Findings
The complaint #GA00212670 was unsubstantiated and no deficiencies were cited during the survey.
Complaint Details
Complaint number #GA00212670 was investigated and found to be unsubstantiated.
Inspection Report
Complaint Investigation
Census: 51
Deficiencies: 0
Jan 28, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted in conjunction with a complaint survey investigating complaint #GA00205119 from January 26, 2021 through January 28, 2021.
Findings
The complaint was unsubstantiated and no regulatory violations were cited. 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.
Complaint Details
Complaint #GA00205119 was unsubstantiated and no regulatory violations were cited.
Report Facts
Total census: 51
Inspection Report
Routine
Census: 55
Deficiencies: 0
Dec 22, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control Survey was conducted to assess compliance with CMS and CDC recommended practices related to COVID-19 preparedness and infection control.
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 recommended practices to prepare for COVID-19.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Nov 2, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA00203646.
Findings
The complaint was unsubstantiated and no regulatory violations were cited during the survey.
Complaint Details
Complaint #GA00203646 was investigated and found to be unsubstantiated.
Inspection Report
Re-Inspection
Census: 52
Deficiencies: 0
Sep 1, 2020
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the previous survey dated 2020-06-26.
Findings
All deficiencies cited in the 6/26/2020 survey were found to be corrected during the revisit survey on 9/1/2020.
Inspection Report
Abbreviated Survey
Census: 44
Deficiencies: 1
Jun 26, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted on June 25-26, 2020 by Ascellon on behalf of the Georgia Department of Community Health (DCH) to assess compliance with infection control regulations.
Findings
The facility was found not in substantial compliance with 42 CFR §483.80 infection control regulations due to failure to demonstrate competency in hand hygiene during meal service for five of eight sampled residents. Observations showed staff did not perform proper hand hygiene before handling food and feeding residents.
Severity Breakdown
SS=E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to demonstrate competency in hand hygiene during meal service for five of eight sampled residents. | SS=E |
Report Facts
Total census: 44
Number of residents sampled for hand hygiene observation: 8
Number of residents with failed hand hygiene compliance: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| AA | Certified Nursing Assistant (CNA) | Observed failing to perform hand hygiene during meal service for residents #4, #5, and #6 |
| BB | Certified Nursing Assistant (CNA) | Observed failing to perform hand hygiene during meal service for residents #7 and #8 |
| Infection Preventionist | Interviewed and stated staff were trained to 'gel in and gel out' when entering and leaving resident rooms | |
| Director of Nursing | Director of Nursing | Interviewed and stated staff should clean their hands in between serving residents |
Inspection Report
Complaint Investigation
Deficiencies: 0
Dec 3, 2019
Visit Reason
The inspection was conducted to investigate complaints #GA00197224 and #GA00199249 to determine compliance with Federal and State Long Term Care regulations.
Findings
No deficiencies were cited during the complaint survey conducted from 12/2/19 through 12/3/19.
Complaint Details
The survey was complaint-related for complaints #GA00197224 and #GA00199249 and found no deficiencies.
Inspection Report
Re-Inspection
Deficiencies: 0
Feb 11, 2019
Visit Reason
A Revisit Survey was conducted to verify correction of deficiencies cited in the standard survey of 12/19/18.
Findings
All deficiencies cited in the prior standard survey were found to be corrected during the revisit survey.
Inspection Report
Life Safety
Census: 68
Capacity: 83
Deficiencies: 0
Dec 17, 2018
Visit Reason
A 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 substantial compliance with the Life Safety Code requirements, including the Emergency Preparedness plan review which met Appendix Z standards.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Sep 26, 2018
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA00190953.
Findings
The complaint was unsubstantiated and no deficiencies were found during the survey.
Complaint Details
Complaint GA00190953 was investigated and found to be unsubstantiated with no deficiencies.
Inspection Report
Re-Inspection
Deficiencies: 0
Mar 16, 2018
Visit Reason
A Revisit Survey was conducted at Camellia Gardens of Life Care on 3/16/18 to verify correction of deficiencies cited during the standard survey on 1/18/18.
Findings
All deficiencies cited as a result of the standard survey on 1/18/18 were found to be corrected during the revisit survey.
Inspection Report
Follow-Up
Deficiencies: 0
Mar 8, 2018
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.
Inspection Report
Routine
Census: 80
Deficiencies: 2
Jan 18, 2018
Visit Reason
A standard survey was conducted to assess compliance with Medicare/Medicaid Regulations at 42 CFR Part 483, Subpart B for Long Term Care Facilities.
Findings
The facility was found not in substantial compliance due to multiple deficiencies related to medication storage, labeling, and expiration date management across medication carts, medication rooms, emergency medication box, and treatment cart.
Severity Breakdown
F: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Medications, biologicals, and supplies were not stored properly following manufacturers' recommendations or supplier instructions, including expired medications found in two of four medication carts, one of two medication storage rooms, and one emergency medication box. | F |
| Medications and biologicals were not labeled or stored in accordance with professional principles and regulatory requirements, including multiple opened medications without dates and expired medications in medication rooms, carts, emergency box, and treatment cart. | F |
Report Facts
Resident census: 80
Expired Alprazolam tablets: 18
Expired Lortab tablets: 7
Expired Tramadol tablets: 8
Expired Lorazepam tablets: 21
Expired medications in Emergency Medication Box: 42
Number of medication carts: 4
Number of medication rooms: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| FF | Consulting Pharmacist | Interviewed regarding medication checks and expiration date verification |
| ADON | Assistant Director of Nursing | Participated in medication storage observations and interviews |
| DON | Director of Nursing | Interviewed regarding policies and procedures for medication expiration checks |
| AA | Licensed Practical Nurse, Back Station Unit Coordinator | Participated in medication storage observations |
| CC | LPN Unit Coordinator | Participated in medication storage observations |
| DD | LPN | Interviewed about medication receipt and expiration date checks |
| EE | LPN | Interviewed about medication receipt and expiration date checks |
| BB | LPN | Interviewed about medication receipt and expiration date checks |
Inspection Report
Annual Inspection
Census: 80
Deficiencies: 4
Jan 18, 2018
Visit Reason
The inspection was a licensure survey conducted from January 16 through January 18, 2018, to determine compliance with State Long Term Care Requirements.
Findings
The facility failed to ensure medications, biologicals, and supplies were stored properly according to manufacturers' recommendations, including expiration dates, across multiple medication carts, medication storage rooms, and the emergency medication box. Numerous expired medications and undated opened bottles were observed during the inspection.
Deficiencies (4)
| Description |
|---|
| Medications, biologicals, and supplies were not stored properly following manufacturers' recommendations or supplier instructions, including failure to check expiration dates on medication carts, medication storage rooms, and emergency medication box. |
| Expired medications found in multiple medication carts and storage rooms, including Alprazolam, Lortab, Tramadol, Lorazepam, and others. |
| Opened medication bottles without dates found in medication carts and storage rooms. |
| Emergency medication box contained multiple expired medications and was not routinely opened and checked for expiration dates. |
Report Facts
Census: 80
Expired Alprazolam tablets: 18
Expired Lortab tablets: 7
Expired Tramadol tablets: 8
Expired Lorazepam tablets: 13
Expired medication counts in Emergency Medication Box: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CC | LPN Unit Coordinator | Participated in medication room and cart observations |
| AA | Licensed Practical Nurse, Back Station Unit Coordinator | Participated in medication room and cart observations |
| ADON | Assistant Director of Nursing | Participated in medication room and cart observations and interviews |
| FF | Consulting Pharmacist | Interviewed regarding medication checks and emergency box procedures |
| DD | LPN | Interviewed about medication receipt, expiration checks, and documentation |
| EE | LPN | Interviewed about medication receipt, expiration checks, and documentation |
| BB | LPN | Interviewed about medication receipt and expiration checks |
| DON | Director of Nursing | Interviewed about policies and procedures for medication expiration checks |
Inspection Report
Life Safety
Census: 80
Capacity: 83
Deficiencies: 7
Jan 16, 2018
Visit Reason
Life Safety Code Survey 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 life safety requirements including emergency lighting, exit signage, hazardous area enclosures, corridor doors, smoke detection, sprinkler system installation, and electrical safety. Multiple deficiencies were observed that could place residents at risk in the event of fire.
Severity Breakdown
E: 4
D: 3
F: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Emergency lighting at Rehabilitation hall and dining service exit was not operational. | E |
| Exit sign in front hall by business office not working; inappropriate exit signage on dining room patio door. | D |
| Facility failed to properly maintain doors; janitor's closet door and safety shower closet door did not close or latch properly. | E |
| Facility failed to maintain corridor doors; clean linen doors, room #34 door, and clean linen back hall door did not close and latch. | E |
| Facility failed to provide smoke detection in dining area open to corridor. | D |
| Sprinkler protection not provided in sprinkler riser/valve room; no ceiling in this area. | D |
| Electrical hazards including spliced wiring without junction box, piggybacked surge protectors, unapproved extension cords, unapproved cube adapter, open void in panel box, and improperly labeled breakers. | F |
Report Facts
Census: 80
Total Capacity: 83
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during facility tour and observations |
Inspection Report
Re-Inspection
Deficiencies: 0
Oct 6, 2017
Visit Reason
A Revisit survey was conducted on 10/06/17 for the Abbreviated/Partial Extended Survey investigating GA#00177908 on 8/14/17.
Findings
The Revisit revealed that all previously cited deficiencies had been corrected. The facility was in substantial compliance as of 9/28/17.
Inspection Report
Complaint Investigation
Deficiencies: 1
Aug 14, 2017
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA#00177908 regarding the facility's compliance with federal and state long term care regulations.
Findings
The facility failed to respond timely to call light requests for assistance for six out of eight interviewed residents, potentially causing distress and risk of injury. Observations and resident interviews confirmed delays in answering call lights, especially at night and on weekends.
Complaint Details
Complaint GA#00177908 was substantiated. Interviews with residents revealed delays ranging from sometimes an hour to up to 45 minutes in response to call lights. Resident Council meeting minutes documented complaints about staff responsiveness and staffing shortages on weekends. The Director of Nursing reported recent hiring of CNAs and LPNs who are completing orientation.
Severity Breakdown
SS= D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to provide timely response to call light requests for assistance. | SS= D |
Inspection Report
Follow-Up
Deficiencies: 0
Mar 3, 2017
Visit Reason
A follow-up survey was conducted to verify that all previously cited survey deficiencies had been corrected.
Findings
The follow-up survey noted that all previously cited survey tags had been corrected.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Mar 2, 2017
Visit Reason
An abbreviated survey was conducted to investigate complaint #GA00170972 initiated on 2017-03-01 and concluded on 2017-03-02.
Findings
The complaint was unsubstantiated and no deficiencies were identified during the survey.
Complaint Details
Complaint #GA00170972 was investigated and found to be unsubstantiated with no deficiencies.
Inspection Report
Re-Inspection
Deficiencies: 0
Mar 1, 2017
Visit Reason
A revisit was conducted on 2/27/17 to the Standard QIS Survey conducted from 1/09/2017 through 1/12/2017 to verify compliance with Federal and State Long Term Care regulations.
Findings
Camellia Gardens of Life Care was found to be in compliance with Federal and State Long Term Care regulations 42 CFR, Part 483, Subpart B for Long Term Care Requirements for Long Term Care Facilities.
Inspection Report
Life Safety
Census: 74
Capacity: 80
Deficiencies: 2
Jan 10, 2017
Visit Reason
The Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and the National Fire Protection Association (NFPA) 101 Life Safety Code 2012 edition.
Findings
The facility was found not in substantial compliance due to improperly placed smoke detectors in the corridor beside the dining room leading into the kitchen, and fire walls above smoke doors in the main hallway that were penetrated and not properly sealed. These deficiencies could affect or place at risk approximately 30% of the residents.
Severity Breakdown
C: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Smoke detection systems were not properly placed in the corridor beside the dining room leading into the kitchen. | C |
| Fire wall above smoke doors in the front main hallway were penetrated by rooms 11 and 13 and conduit coming out of smoke walls by rooms 31 and 32 was not sealed. | C |
Report Facts
Percentage of residents potentially affected: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings related to smoke detector placement and fire wall penetration |
Loading inspection reports...
