Inspection Reports for Camellia Health & Rehabilitation
700 EAST LONG STREET, GA, 30417
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation following an inspection completed on June 11, 2025.
Findings
The report contains initial comments but does not provide detailed findings or deficiencies within the provided page.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 11, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of deficiencies from the Complaint Investigation survey that exited on 2025-04-25.
Findings
All citations associated with the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of June 6, 2025.
Complaint Details
The visit was a follow-up to a Complaint Investigation survey that exited on 2025-04-25. All citations from that survey were corrected.
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation, indicating a regulatory inspection was conducted.
Findings
The report contains initial comments but does not provide detailed findings or deficiencies in the provided page.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 11, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of citations associated with the Complaint Investigation survey that exited on 2025-04-25.
Findings
All citations from the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of 2025-06-06.
Complaint Details
This follow-up visit was related to a prior Complaint Investigation survey that exited on 2025-04-25. The citations were corrected and compliance was achieved.
Report Facts
Date of prior complaint investigation exit: Apr 25, 2025
Date facility back in compliance: Jun 6, 2025
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation following a survey completed on June 11, 2025.
Findings
The report contains initial comments but does not provide specific details on deficiencies or findings.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 11, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of deficiencies from a prior Complaint Investigation survey that exited on 2025-04-25.
Findings
All citations associated with the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of June 6, 2025.
Complaint Details
The visit was a follow-up to a Complaint Investigation survey that exited on 2025-04-25.
Inspection Report
Deficiencies: 0
Jun 11, 2025
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation, indicating a regulatory inspection was conducted.
Findings
The report contains initial comments but does not provide specific details on deficiencies or findings.
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of citations associated with the Complaint Investigation survey that exited on 2025-04-25.
Findings
All citations from the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of June 6, 2025.
Complaint Details
The visit was related to a Complaint Investigation survey that exited on 2025-04-25. All citations from that survey were corrected.
Report Facts
Date of prior complaint survey exit: Apr 25, 2025
Date facility back in compliance: Jun 6, 2025
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation, indicating a regulatory inspection was conducted.
Findings
The report contains initial comments but does not provide specific findings or deficiencies in the extracted text or image.
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 11, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of citations associated with the Complaint Investigation survey that exited on 2025-04-25.
Findings
All citations from the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of 2025-06-06.
Complaint Details
This visit was a follow-up to a Complaint Investigation survey that exited on 2025-04-25. All citations were corrected.
Report Facts
Date of prior complaint survey exit: Apr 25, 2025
Date facility back in compliance: Jun 6, 2025
Inspection Report
Follow-Up
Deficiencies: 0
Jun 9, 2025
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey tags.
Findings
All previously cited survey tags have been corrected as noted during the follow-up survey.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 9, 2025
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 by the surveyor.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 9, 2025
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 by the surveyor.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 9, 2025
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey tags.
Findings
All previously cited survey tags have been corrected as noted during the follow-up survey.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 9, 2025
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey tags.
Findings
All previously cited survey tags have been corrected as noted by the surveyor.
Inspection Report
Plan of Correction
Deficiencies: 0
May 7, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Camellia Health & Rehabilitation, indicating a regulatory inspection was conducted.
Findings
The report contains initial comments but does not provide specific details on deficiencies or findings.
Inspection Report
Follow-Up
Deficiencies: 0
May 7, 2025
Visit Reason
A desk review was conducted in lieu of an on-site revisit to verify correction of citations associated with the Complaint Investigation survey that exited on 2025-03-27.
Findings
All citations from the prior Complaint Investigation survey were corrected, and the facility was found to be back in compliance as of 2025-05-01.
Complaint Details
This follow-up visit was related to a prior Complaint Investigation survey that exited on 2025-03-27. All citations were corrected.
Report Facts
Date of prior complaint investigation exit: Mar 27, 2025
Compliance date: May 1, 2025
Inspection Report
Life Safety
Census: 55
Capacity: 87
Deficiencies: 7
May 1, 2025
Visit Reason
The inspection was a Life Safety Code Survey conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and building codes.
Findings
The facility was found not in substantial compliance with several Life Safety Code requirements, including issues with exit door locking devices, holes in ceilings, dusty sprinkler heads, wires on sprinkler piping, unsealed firewalls, blocked electrical panels, and power strips on the floor.
Severity Breakdown
D: 6
F: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Exit doors had multiple locking devices, violating egress door requirements. | D |
| Hole in the ceiling above the dryer in the laundry room. | D |
| Sprinkler heads at the front entrance were covered with dust. | D |
| Wires were present on sprinkler piping in the attic space above corridors. | F |
| Firewalls were not properly sealed; doors above ceilings were open and unsealed. | D |
| Electrical panel in the laundry building was blocked by a rack of clothing. | D |
| Power strip was found on the floor in the social services office. | D |
Report Facts
People affected: 20
People affected: 5
People affected: 10
People affected: 30
People affected: 87
People affected: 10
People affected: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during facility tour and observations |
Inspection Report
Complaint Investigation
Census: 52
Deficiencies: 1
Apr 25, 2025
Visit Reason
A standard survey was conducted from April 22 through April 25, 2025, including investigation of three complaint intake numbers (GA00254591, GA00254714, GA00254484). Two complaints were unsubstantiated and one was substantiated with no deficiencies cited.
Findings
The facility failed to maintain good repair of residents' wheelchair armrests and backs for three of four residents observed, with wheelchairs missing parts, torn, or tattered, posing potential risk for skin tears. Documentation of wheelchair inspections was found to be inaccurate.
Complaint Details
Complaint Intake Numbers GA00254591, GA00254714, and GA00254484 were investigated. Intake GA00254484 and GA00254714 were unsubstantiated. Intake GA00254591 was substantiated with no deficiencies cited.
Severity Breakdown
Level E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to maintain good repair of residents' wheelchair armrests and backs for three residents (R8, R39, R47), with wheelchairs missing parts, torn, or tattered. | Level E |
Report Facts
Residents present: 52
Complaint intake numbers investigated: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| AA | Licensed Practical Nurse (LPN) | Interviewed regarding wheelchair conditions and observations |
| CC | Director of Nursing (DON) and Corporate Nurse (CN) | Interviewed regarding wheelchair maintenance and storage |
| DD | Certified Nursing Assistant (CNA) | Observed and commented on wheelchair conditions |
| MA/FT | Maintenance Assistant/Floor Technician | Interviewed regarding wheelchair inspection frequency and documentation |
Inspection Report
Annual Inspection
Deficiencies: 1
Apr 22, 2025
Visit Reason
The inspection was a State Licensure survey conducted from April 22, 2025 through April 25, 2025 to determine compliance with the State Long Term Care Requirements and State Health regulations.
Findings
The facility failed to maintain good repair of residents' wheelchairs, specifically the armrests and backs, for three of four residents observed. Wheelchairs were found to be missing parts, torn, or tattered, posing a potential risk for skin tears. Documentation of wheelchair inspections was found to be inaccurate.
Deficiencies (1)
| Description |
|---|
| Facility failed to maintain good repair of residents' wheelchair armrests and backs for three residents, with observed missing, torn, or tattered areas. |
Report Facts
Number of residents with wheelchair deficiencies: 3
Dates of wheelchair inspections documented: 3
BIMS score: 15
BIMS score: 13
BIMS score: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| AA | Licensed Practical Nurse (LPN) | Observed and commented on the condition of wheelchairs and potential risks for skin tears. |
| CC | Director of Nursing (DON) and Corporate Nurse (CN) | Interviewed regarding wheelchair maintenance responsibilities and condition. |
| DD | Certified Nursing Assistant (CNA) | Observed wheelchairs and confirmed condition could cause skin tears. |
| MA/FT | Maintenance Assistant/Floor Technician | Provided information on wheelchair inspection frequency and acknowledged documentation inaccuracies. |
Inspection Report
Annual Inspection
Deficiencies: 1
Mar 27, 2025
Visit Reason
The inspection was a State Licensure survey conducted at Camellia Health & Rehabilitation to assess compliance with state health regulations.
Findings
The facility failed to notify the responsible party of a significant change in condition for one of twenty sampled residents (Resident #5), despite policies requiring prompt notification. Interviews confirmed the family was not notified as required.
Deficiencies (1)
| Description |
|---|
| Failure to notify the responsible party of a resident's significant change in condition. |
Report Facts
Sampled residents: 20
Mental Status (BIMS) score: 11
Oxygen liters per minute: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| LPN B | Licensed Practical Nurse | Applied oxygen to Resident #5 and informed nursing supervisor |
| LPN Supervisor C | Licensed Practical Nurse Supervisor | Interviewed regarding notification of family |
| Director of Nursing | Director of Nursing (DON) | Stated family should have been notified of resident's condition change |
Inspection Report
Abbreviated Survey
Deficiencies: 1
Mar 27, 2025
Visit Reason
An Abbreviated/Partial Extended Survey was conducted at Camellia Health & Rehabilitation to investigate multiple complaints (GA00254263, GA00253417, GA00251784, and GA00250213) from March 25 to March 27, 2025.
Findings
The facility failed to notify the responsible party of a resident's significant change in condition for one of 20 sampled residents (Resident #5), despite policy requirements and staff awareness. Interviews confirmed the family was not notified as required.
Complaint Details
The survey was complaint-related, investigating four complaint numbers. The complaint was substantiated as the facility failed to notify the resident's family of a significant change in condition.
Severity Breakdown
SS= D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to notify the responsible party of a resident's change in condition for one (1) of 20 sampled residents (Resident #5). | SS= D |
Report Facts
Sampled residents: 20
Complaints investigated: 4
Oxygen liters per minute: 2
BIMS score: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse (LPN) B | Applied oxygen to Resident #5 and informed nursing supervisor about condition | |
| LPN Supervisor C | Stated she had not called the family regarding Resident #5's condition | |
| Director of Nursing (DON) | Stated the family should have been notified of Resident #5's change in condition |
Inspection Report
Deficiencies: 0
Mar 28, 2024
Visit Reason
The document is a statement of deficiencies and plan of correction for Camellia Health & Rehabilitation, indicating a regulatory inspection was conducted.
Findings
The report contains initial comments and a summary statement of deficiencies, but no specific deficiencies or findings are detailed in the provided page.
Inspection Report
Re-Inspection
Deficiencies: 0
Mar 28, 2024
Visit Reason
A revisit survey was conducted to verify correction of all deficiencies cited on the Complaint survey conducted on February 5, 2024.
Findings
All deficiencies cited on the prior Complaint survey have been corrected as of the revisit survey date.
Complaint Details
The revisit survey was conducted following a Complaint survey on February 5, 2024, to verify correction of cited deficiencies.
Inspection Report
Routine
Deficiencies: 1
Feb 5, 2024
Visit Reason
A State Licensure survey was conducted to assess compliance with state health regulations at Camellia Health and Rehabilitation.
Findings
The facility failed to provide adequate supervision and monitoring to prevent the elopement of one resident, resulting in the resident leaving the facility unsupervised and sustaining injury. An unsecured employee entrance door allowed the resident to exit the building.
Deficiencies (1)
| Description |
|---|
| Failure to provide supervision and monitoring to prevent elopement of one resident who walked out of the facility and fell. |
Report Facts
Residents reviewed for elopement: 3
Time resident was unsupervised outside: 30
Date resident discharged: Jan 29, 2024
Number of exit doors observed: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Administrator | Interviewed regarding door security and incident details | |
| Corporate Environment Director | Interviewed regarding door security and maintenance | |
| Corporate Maintenance Director | Checked door functionality after incident | |
| Certified Nursing Assistant | Found resident outside during lunch break |
Inspection Report
Complaint Investigation
Census: 54
Deficiencies: 1
Feb 5, 2024
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint number GA00243298.
Findings
The facility was found to have failed in providing adequate supervision and monitoring to prevent the elopement of one resident, resulting in the resident walking out of the facility unsupervised and sustaining injury. The investigation revealed issues with door security and supervision.
Complaint Details
Complaint number GA00243298 was substantiated. The resident was found outside unsupervised for 30 minutes with bruising and bleeding on her nose after exiting through an unsecured employee entrance door.
Severity Breakdown
SS= D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to provide supervision and monitoring to prevent the elopement of one resident resulting in the resident walking out of the facility and falling. | SS= D |
Report Facts
Facility census: 54
Incident date: Jan 24, 2024
Resident discharge date: Jan 29, 2024
Inspection Report
Complaint Investigation
Census: 60
Deficiencies: 0
Dec 15, 2023
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA00235002.
Findings
The complaint GA00235002 was unsubstantiated with no regulatory violations cited.
Complaint Details
Complaint GA00235002 was unsubstantiated with no regulatory violations cited.
Inspection Report
Follow-Up
Deficiencies: 0
May 24, 2023
Visit Reason
A follow-up survey was conducted to verify that previously cited survey tags had been corrected.
Findings
The follow-up survey noted that all previously cited survey tags have been corrected.
Inspection Report
Follow-Up
Deficiencies: 1
Apr 17, 2023
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited deficiencies.
Findings
The facility failed to ensure the sprinkler system was green tagged as required. During the tour, the sprinkler riser was observed to be yellow tagged and awaiting repair, affecting the entire building.
Severity Breakdown
SS=F: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to ensure sprinkler system was green tagged; sprinkler riser was yellow tagged awaiting repair. | SS=F |
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M confirmed the sprinkler riser was yellow tagged at the time of discovery. |
Inspection Report
Annual Inspection
Census: 52
Deficiencies: 0
Mar 2, 2023
Visit Reason
A standard survey was conducted at Camellia Health & Rehabilitation from February 27, 2023, through March 2, 2023, by Certi Surv LLC on behalf of the Georgia Department of Community Health.
Findings
The standard survey revealed that the facility was in substantial compliance with the Health Portion of the Medicare/Medicaid regulations at 42 CFR Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Life Safety
Census: 52
Capacity: 83
Deficiencies: 3
Feb 28, 2023
Visit Reason
The visit was a Life Safety Code Survey conducted to assess compliance with 42 CFR Subpart 483.90(a), Life Safety from Fire, and the related NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found not in substantial compliance with life safety requirements, including issues with a broken self-closing door mechanism on the Beauty Shop door, improper maintenance of the sprinkler system with yellow-tagged and painted sprinkler heads, and unsealed penetrations in fire rated walls affecting the ceiling above the day room.
Severity Breakdown
SS= D: 1
SS= E: 1
SS= F: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| The self-closing mechanism on the Beauty Shop door is broken and not operational. | SS= D |
| The sprinkler system is not properly maintained; it is yellow-tagged, wires are attached to sprinkler pipes above ceiling, and several sprinkler heads are painted. | SS= F |
| Penetrations in fire rated walls are not sealed properly, affecting the ceiling above the day room; the access door in firewall above ceiling is missing. | SS= E |
Report Facts
Census: 52
Total Capacity: 83
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings related to self-closing door, sprinkler system, and fire rated wall penetrations during facility tour |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Jan 18, 2023
Visit Reason
An Abbreviated Survey was conducted to investigate complaint #GA00225124.
Findings
The complaint was unsubstantiated and no regulatory violations were cited during the survey.
Complaint Details
Complaint #GA00225124 was investigated and found to be unsubstantiated.
Inspection Report
Deficiencies: 0
Jul 23, 2021
Visit Reason
The document is a statement of deficiencies and plan of correction for Camellia Health & Rehabilitation following a state inspection.
Findings
The report contains initial comments and a summary statement of deficiencies, but no specific deficiencies or findings are detailed in the provided page.
Inspection Report
Re-Inspection
Census: 42
Deficiencies: 0
Jul 23, 2021
Visit Reason
A revisit survey was conducted on 7/22/21 through 7/23/21 to verify correction of deficiencies cited in the Recertification Survey of 5/27/2021 and the Federal Monitoring Survey of 6/24/21.
Findings
All deficiencies cited as a result of the Recertification Survey of 5/27/2021 and the Federal Monitoring Survey of 6/24/21 were found to be corrected.
Inspection Report
Annual Inspection
Census: 40
Deficiencies: 4
May 27, 2021
Visit Reason
A licensure survey was conducted at Camellia Health & Rehabilitation from May 24, 2021 through May 27, 2021 to assess compliance with Medicare/Medicaid regulations for long term care facilities.
Findings
The facility was found not in substantial compliance due to failures in developing and implementing care plans for catheter care and oxygen therapy, failure to invite a resident to care plan meetings, and improper catheter bag positioning that could affect urine drainage.
Severity Breakdown
SS= D: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to develop and implement a care plan related to catheter care for one resident with an indwelling catheter. | SS= D |
| Failed to develop and implement a care plan for one resident receiving oxygen therapy. | SS= D |
| Failed to invite one resident to participate in care plan meetings. | SS= D |
| Failed to ensure a resident's Foley catheter bag was always kept below the level of the bladder to promote adequate urine drainage. | SS= D |
Report Facts
Census: 40
Oxygen flow rate: 3.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse (LPN) AA | Confirmed catheter bag positioning and oxygen flow rate discrepancies | |
| Licensed Practical Nurse (LPN) BB | MDS coordinator who explained care plan invitation process and acknowledged resident #1 was overlooked |
Inspection Report
Routine
Census: 40
Deficiencies: 4
May 27, 2021
Visit Reason
A standard survey was conducted at Camellia Health & Rehabilitation from May 24, 2021 through May 27, 2021 to assess 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 with regulations, with deficiencies including failure to develop and implement comprehensive care plans for residents receiving oxygen therapy and with indwelling catheters, failure to invite a resident to care plan meetings, improper catheter bag positioning, and failure to follow physician orders for oxygen therapy.
Severity Breakdown
D: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to develop and implement a care plan related to catheter care for one resident with an indwelling catheter and for one resident receiving oxygen therapy. | D |
| Failed to invite one resident to participate in care plan meetings. | D |
| Failed to ensure a resident's Foley catheter bag was kept below the level of the bladder to promote adequate drainage. | D |
| Failed to follow the physician's order for oxygen therapy for one resident receiving oxygen therapy. | D |
Report Facts
Resident census: 40
Oxygen flow rate observed: 3.5
Oxygen flow rate ordered: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| AA | Licensed Practical Nurse (LPN), Charge Nurse | Confirmed oxygen flow rate discrepancy for Resident #8 and catheter bag positioning for Resident #24 |
| BB | Licensed Practical Nurse (LPN), MDS Coordinator | Confirmed failure to invite Resident #1 to care plan meetings |
Inspection Report
Life Safety
Census: 41
Capacity: 89
Deficiencies: 0
May 25, 2021
Visit Reason
The visit was conducted to perform a Life Safety Code Survey to assess compliance with Medicare/Medicaid participation requirements and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found to be in substantial compliance with the Emergency Preparedness Program requirements and Life Safety Code standards.
Report Facts
Certified beds: 89
Census: 41
Inspection Report
Complaint Investigation
Deficiencies: 0
Oct 20, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA0028963.
Findings
The complaint #GA0028963 was unsubstantiated and no regulatory violations were cited.
Complaint Details
Complaint #GA0028963 was investigated and found to be unsubstantiated with no regulatory violations cited.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Sep 9, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint #GA00204446.
Findings
The complaint was unsubstantiated and no deficient practice was cited during the survey.
Complaint Details
Complaint #GA00204446 was investigated and found to be unsubstantiated.
Inspection Report
Routine
Census: 50
Deficiencies: 0
Jul 10, 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.
Findings
The facility was found to be in compliance with 42 CFR §483.73 and §483.80 infection control regulations and had implemented recommended practices to prepare for COVID-19.
Report Facts
Census: 50
Inspection Report
Abbreviated Survey
Deficiencies: 0
Feb 20, 2020
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint allegations GA#00202428 and GA#00201279.
Findings
The investigation of the complaints GA#00202428 and GA#00201279 was concluded with both complaints found to be unsubstantiated.
Complaint Details
Complaints GA#00202428 and GA#00201279 were investigated and found to be unsubstantiated.
Inspection Report
Follow-Up
Deficiencies: 0
Oct 22, 2019
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 deficiencies had been corrected during the follow-up survey.
Inspection Report
Re-Inspection
Census: 64
Deficiencies: 0
Oct 22, 2019
Visit Reason
A revisit survey was conducted from 10/16/19 through 10/18/19, including investigation of two complaint intake numbers on 10/21/19 and 10/22/19.
Findings
All deficiencies cited in the prior Standard Survey and Federal Monitoring Survey were corrected. The complaint investigations found the allegations were not substantiated and no regulatory violations were cited.
Complaint Details
Complaint Intake Numbers GA00199972 and GA00200398 were investigated and found not substantiated with no regulatory violations cited.
Report Facts
Census: 64
Inspection Report
Re-Inspection
Deficiencies: 0
Oct 18, 2019
Visit Reason
A revisit survey was conducted from 10/16/19 through 10/18/19 to verify correction of deficiencies cited in the previous survey conducted on 8/18/19.
Findings
All deficiencies cited as a result of the survey conducted on 8/18/19 were found to be corrected during the revisit survey.
Inspection Report
Re-Inspection
Deficiencies: 0
Oct 18, 2019
Visit Reason
A revisit survey was conducted from 10/16/19 through 10/18/19 to verify correction of deficiencies cited during the Recertification survey conducted on 7/12/19.
Findings
All deficiencies cited in the prior Recertification survey were found to be corrected during this revisit survey.
Inspection Report
Life Safety
Census: 65
Capacity: 87
Deficiencies: 2
Aug 20, 2019
Visit Reason
A Life Safety Code Federal Monitoring Survey was conducted by CMS following a state survey. The visit was to assess compliance with Life Safety Code and related fire safety regulations.
Findings
The facility was found not in substantial compliance with Life Safety Code requirements, specifically related to sprinkler system maintenance and smoke barrier doors. Deficiencies included improper sprinkler system maintenance and use of non-compliant doors and closing devices in smoke barrier walls.
Severity Breakdown
SS= D: 1
SS= F: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to properly maintain the automatic sprinkler system, including lack of sprinklers with red or green frangible bulbs in the spare sprinkler cabinet and absence of a list of installed sprinklers. | SS= D |
| Failure to maintain doors in smoke barrier walls as required, including use of coil spring not listed for door closing and presence of an 8"x12" hole in a smoke barrier door. | SS= F |
Report Facts
Census: 65
Total Capacity: 87
Spare sprinklers quantity: 5
Hole size in smoke barrier door: 96
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance Director | Present during identification of deficiencies related to sprinkler system and smoke barrier doors |
Inspection Report
Routine
Census: 67
Deficiencies: 6
Aug 8, 2019
Visit Reason
A Federal Monitoring survey was conducted to assess compliance with Medicare/Medicaid regulations at a long term care facility.
Findings
The facility was found not in substantial compliance with multiple deficiencies including failure to ensure resident privacy during medication administration, failure to implement dental care plans, inadequate ADL care, failure to provide dental services, food safety violations, and failure to ensure proper hand hygiene during medication preparation.
Severity Breakdown
SS= D: 5
SS= F: 1
Deficiencies (6)
| Description | Severity |
|---|---|
| Failure to ensure privacy for residents during medication pass observation. | SS= D |
| Failure to implement dental care plan for a resident requiring dental services. | SS= D |
| Failure to provide scheduled baths to a resident dependent on staff for ADL care. | SS= D |
| Failure to provide routine and emergency dental services to residents requiring dental care. | SS= D |
| Failure to ensure food safety including cracked eggs stored improperly, improperly cooled cooked meat, expired food items, inadequate freezer temperatures, and improper food storage. | SS= F |
| Failure to ensure staff washed hands prior to medication preparation and administration. | SS= D |
Report Facts
Census: 67
Medication units administered: 8
Medication units administered: 6
Baths provided: 2
Baths provided: 5
Baths provided: 11
Cracked eggs: 2
Eggs with dried yolk: 1
Freezer temperature: 5
Freezer temperature: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Interviewed regarding privacy expectations during medication pass | |
| Licensed Practical Nurse (LPN) #1 | Observed administering medications without providing privacy and without handwashing | |
| Licensed Practical Nurse (LPN) #2 | Observed administering medications without providing privacy | |
| Social Worker | Interviewed regarding dental consults for residents | |
| Certified Dietary Manager (CDM) | Interviewed and observed during kitchen tour regarding food safety violations | |
| Infection Control Nurse | Interviewed regarding hand hygiene expectations | |
| Regional Vice President and Administrator in Training | Interviewed regarding food safety policies and freezer temperatures |
Inspection Report
Routine
Census: 64
Deficiencies: 4
Jul 12, 2019
Visit Reason
A standard survey was conducted from July 9, 2019 through July 12, 2019, including investigation of two complaint intake numbers GA00197157 and GA00198028.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations, with deficiencies including failure to offer resident choice in bathing, unsafe and unsanitary shower and bathroom environments, and failure to provide adequate bathing and personal care according to residents' care plans and preferences.
Complaint Details
Complaint Intake Numbers GA00197157 and GA00198028 were investigated in conjunction with the standard survey.
Severity Breakdown
SS= D: 3
SS= E: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to offer one of five residents the choice of shower versus bed bath. | SS= D |
| Unsafe, unclean, and unsanitary conditions in multiple shower rooms and resident bathrooms including missing tiles, standing water, spider webs, peeling ceiling, exposed wires, black substances, strong urine odors, and presence of dead bugs and lizard skeleton in light fixtures. | SS= E |
| Failure to develop and implement comprehensive care plans that meet residents' medical, nursing, and psychosocial needs including bathing schedules and preferences. | SS= D |
| Failure to provide adequate bathing and personal hygiene care for dependent residents, including inadequate number of baths/showers and lack of nail care documentation for multiple residents. | SS= D |
Report Facts
Resident census: 64
Bath/shower opportunities: 31
Bath/shower opportunities: 31
Bath/shower opportunities: 30
Bath/shower opportunities: 30
Inspection Report
Routine
Deficiencies: 4
Jul 12, 2019
Visit Reason
The inspection was conducted to assess compliance with care plans related to Activities of Daily Living (ADL) and bathing/showering schedules for residents, following concerns about inadequate provision of these services.
Findings
The facility failed to follow the care plans for four residents regarding ADL care and bathing/showering. Residents were not offered baths or showers as scheduled, and nail care was not provided or documented. Interviews with residents and staff confirmed inadequate bathing and grooming services, and the facility lacked a policy for ADL care.
Deficiencies (4)
| Description |
|---|
| Facility failed to follow care plans for ADL and bathing/showering for four residents (R#20, R#29, R#45, R#6). |
| Residents were not offered baths/showers according to their schedules, with significantly fewer baths/showers provided than scheduled. |
| Nail care was not provided or documented for residents despite need and preference. |
| No policy existed for ADL care or care and services for the facility. |
Report Facts
Bath/shower opportunities for Resident #20: 31
Baths/showers provided to Resident #20: 3
Bath/shower opportunities for Resident #29: 30
Baths/showers provided to Resident #29: 17
Bath/shower opportunities for Resident #45: 30
Baths/showers provided to Resident #45: 14
Bath/shower opportunities for Resident #6: 31
Baths/showers provided to Resident #6: 9
Staffing ratio: 2.68
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing (DON) | Interviewed regarding expectations for staff to follow care plans and provide ADL care including baths/showers and nail care. |
| Administrator | Administrator | Interviewed regarding oversight and awareness of bathing and ADL care issues. |
| CNA AA | Certified Nursing Assistant | Interviewed regarding care needs and refusals of Resident #29. |
| Resident Care Coordinator CC | Resident Care Coordinator | Interviewed regarding Resident #6's bath/shower schedule. |
Inspection Report
Life Safety
Census: 64
Capacity: 87
Deficiencies: 0
Jul 11, 2019
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 Emergency Preparedness plan requirements and Life Safety Code standards.
Report Facts
Stories: 1
Construction Year: 1971
Inspection Report
Abbreviated Survey
Deficiencies: 0
Jan 14, 2019
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA00193969.
Findings
The complaint was unsubstantiated and no deficiencies were found during the survey.
Complaint Details
Complaint GA00193969 was investigated and found to be unsubstantiated with no deficiencies.
Inspection Report
Follow-Up
Deficiencies: 0
Jun 22, 2018
Visit Reason
A follow-up survey was conducted to verify that previously cited survey tags had been corrected.
Findings
The follow-up survey noted that all previously cited survey tags had been corrected.
Inspection Report
Routine
Census: 60
Deficiencies: 0
May 10, 2018
Visit Reason
A standard survey was conducted at Camellia Health & Rehabilitation from May 7, 2018 through May 10, 2018 to assess compliance with Medicare/Medicaid regulations for long term care facilities.
Findings
The facility was found to be in substantial compliance with the health portion of the Medicare/Medicaid regulations at 42 C.F.R. Part 483, Subpart B.
Inspection Report
Life Safety
Census: 61
Capacity: 87
Deficiencies: 3
May 8, 2018
Visit Reason
The visit was a 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 emergency lighting, exit signage, and sprinkler system requirements. Specifically, emergency lighting was not operational at exit discharges, an exit sign near the admissions office was not properly powered, and the sprinkler system's water motor gong was not operational due to a closed alarm line control valve.
Severity Breakdown
F: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Emergency lighting of at least 1-1/2-hour duration was not operational at eight building exit discharges. | F |
| Exit sign near the admissions office was not operating on required power sources (120 volts or 24 volts). | F |
| Sprinkler system water motor gong was not operational because the alarm line control valve was left in the closed position. | F |
Report Facts
Census: 61
Total Capacity: 87
Number of deficient emergency lights: 2
Number of exit discharges lacking emergency lighting: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during facility tour and staff interviews |
Inspection Report
Abbreviated Survey
Census: 59
Deficiencies: 0
Apr 4, 2018
Visit Reason
An abbreviated survey was conducted to investigate complaint GA00186788 at Camellia Health and Rehabilitation.
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.
Complaint Details
Investigation of complaint GA00186788; facility found in substantial compliance.
Report Facts
Facility census: 59
Inspection Report
Follow-Up
Deficiencies: 0
Jul 11, 2017
Visit Reason
A follow-up visit was conducted on 7/11/17 to verify correction of deficiencies identified in the recertification survey.
Findings
The deficiency identified in the prior recertification survey was corrected as of the follow-up visit.
Inspection Report
Complaint Investigation
Census: 63
Deficiencies: 1
May 18, 2017
Visit Reason
A standard survey was conducted in conjunction with Complaint Intake Number GA00169457 to investigate compliance with Medicare/Medicaid regulations at a long term care facility.
Findings
The facility failed to ensure that privacy curtains provided full visual privacy in 19 of 36 rooms on two halls, with gaps up to 80 inches between curtains and walls. Interviews revealed lack of awareness and policy regarding curtain privacy.
Complaint Details
Complaint Intake Number GA00169457 was investigated in conjunction with the standard survey.
Severity Breakdown
E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Privacy curtains did not provide full visual privacy due to large gaps between curtains and walls in 19 of 36 rooms. | E |
Report Facts
Resident census: 63
Rooms with privacy curtain issues: 19
Sample size: 26
Gap width: 80
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Assistant Director of Nursing | ADON | Confirmed room assignment with Zone Defense rounding but does not inspect privacy curtains |
| Housekeeping Supervisor | Unaware of short privacy curtains | |
| Maintenance Supervisor | Reported management staff complete Zone defense rounding and inspect rooms | |
| Certified Nursing Aide AA | CNA | Reported privacy curtains are pulled during care but did not notice if curtains fully cover from wall to wall |
| Administrator | Reported no policy on privacy curtains and described Zone defense department responsibilities | |
| Director of Nursing | DON | Reported gaps in privacy curtains had not been identified as a problem but some curtains were ordered for low beds |
Inspection Report
Life Safety
Census: 63
Capacity: 87
Deficiencies: 0
May 16, 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
The facility was found in substantial compliance with the Life Safety Code requirements and related NFPA standards.
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