Inspection Reports for
Diversicare of Batesville
154 Woodland Road, Batesville, MS, 38606
Back to Facility Profile43 Reports
Inspection Report — Aug 25, 2026
Complaint Investigation
Date: Aug 25, 2026
Visit Reason
The State Agency conducted a Complaint Investigation (CI) CI MS# 3003826 at the facility on 8/25/26.
Complaint Details
Complaint number CI MS# 3003826 was investigated and found to have no deficiencies; the facility was in compliance.
Findings
The facility was found in compliance with the requirements of participation in Medicare and Medicaid Services and there were no deficiencies cited.
Report Facts
Complaint investigations: 1
Inspection Report — Jan 21, 2026
Complaint Investigation
Date: Jan 21, 2026
Visit Reason
The State Agency conducted a Complaint Investigation (CI MS #2702878) at the facility on 1/21/26 related to missing items and nursing services.
Complaint Details
CI MS #2702878: Complaint related to missing items and nursing services; the complaint was investigated and no deficiencies were cited.
Findings
The facility was found in compliance with the Mississippi Regulations for Minimum Standards for Institutions for the Aged or Infirm. No deficiencies were cited.
Report Facts
Complaint count: 1
Inspection Report — Jul 22, 2025
Follow-Up
Date: Jul 22, 2025
Visit Reason
On 7/22/25 the SA conducted an onsite revisit for the annual survey completed 6/3/25 through 6/15/25. The information reviewed confirmed the facility had put measures in place to correct the deficient practice and sustain compliance with Medicare and Medicaid requirements of participation and the Mississippi Regulations for Minimum Standards for Institutions for Aged or Infirm.
Findings
The SA is recommending that the facility be placed back in compliance effective 7/3/25. No deficiencies were cited in this revisit.
Inspection Report — Jul 21, 2025
Complaint Investigation
Date: Jul 21, 2025
Visit Reason
The State Agency conducted an Investigation at the facility on 7/21/25 for Incident #2563755 and Complaint #2563037.
Complaint Details
Complaint #2563037 was investigated and found to have no deficiencies cited; the facility was in compliance.
Findings
During the investigation, the SA determined the facility was in compliance with the requirements of participation in Medicare and Medicaid with no deficiencies cited.
Report Facts
Complaints investigated: 1
Inspection Report — Jun 12, 2025
Routine
Date: Jun 12, 2025
Visit Reason
The inspection was a routine survey to assess compliance with regulatory requirements related to resident rights, abuse prevention, dialysis care, medication storage, rehabilitative services, and infection control at Diversicare of Batesville.
Findings
The facility was found deficient in multiple areas including failure to promote resident dignity, neglect related to non-functioning mechanical lifts, failure to timely evaluate therapy referrals, improper medication cart security, inadequate dialysis site monitoring, and poor infection control practices related to wound care.
Deficiencies (6)
F 0550: The facility failed to promote dignity for two residents by not providing a spoon for pudding and leaving a wound VAC with drainage visible in a resident's room.
F 0600: The facility failed to prevent neglect by not ensuring availability of functioning total mechanical lifts, causing a resident to remain in a wheelchair for many hours, resulting in incontinence and pain.
F 0698: The facility failed to assess and document the presence of bruit and thrill at the dialysis access site as ordered for one dialysis resident.
F 0761: The facility failed to ensure medications on a treatment cart were locked and secured, as the cart was found unlocked with keys on top.
F 0825: The facility failed to ensure a timely occupational therapy evaluation after a nursing referral, delaying care for a resident at risk of decline.
F 0880: The facility failed to maintain proper infection control by leaving a wound VAC device with old drainage in a resident's room, posing an infection risk.
Report Facts
Residents in sample: 35
Residents in sample: 36
Residents in sample: 4
Medication/treatment carts observed: 5
Residents in sample: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nurse Assistant (CNA) #5 | Confirmed resident did not have a spoon to eat pudding | |
| Infection Preventionist | Confirmed dignity concern for pudding and wound VAC drainage | |
| Director of Nursing (DON) | Confirmed dignity concerns and neglect related to mechanical lifts and wound VAC | |
| Licensed Practical Nurse (LPN) #2 | Confirmed wound VAC drainage was visible and not in use | |
| Administrator | Confirmed battery charging issues and lift unavailability | |
| Certified Occupational Therapy Assistant (COTA) | Confirmed therapy got resident up and timing of therapy | |
| Registered Nurse (RN)/Lift Champion | Reported charging issues with lifts and monitoring duties | |
| Wound Nurse | Confirmed lack of post-incident assessment and infection control concerns | |
| Director of Therapy | Confirmed delay in occupational therapy evaluation | |
| Wound Nurse | Observed unlocked medication cart and acknowledged error |
Inspection Report — Jun 12, 2025
Annual Inspection
Date: Jun 12, 2025
Visit Reason
The State Agency (SA) conducted an annual re-certification survey at the facility from 6/9/25 through 6/12/25. During the survey, the SA determined that the facility was not in compliance with the requirements for participation in Medicare and Medicaid and cited F550, F600, F698, F761, F825, and F880.
Findings
The facility was found not in compliance with Medicare and Medicaid participation requirements, with deficiencies cited in resident rights, abuse and neglect, dialysis care, drug storage, specialized rehab services, and infection control.
Deficiencies (6)
F0550 - Resident Rights. The facility failed to promote dignity for two residents by not providing a spoon for eating pudding and leaving a wound vacuum canister with foul drainage visible in a resident's room.
F0600 - Free from Abuse and Neglect. The facility failed to ensure a resident was free from neglect by not having functioning mechanical lifts available, resulting in the resident sitting in a wheelchair for many hours soiled and in pain.
F0698 - Dialysis. The facility failed to assess and document the presence of a bruit and thrill at the dialysis access site as ordered for one resident receiving dialysis.
F0761 - Label/Store Drugs and Biologicals. The facility failed to ensure medications on a treatment cart were locked and secured, leaving the cart unlocked with keys on top.
F0825 - Provide/Obtain Specialized Rehab Services. The facility failed to ensure timely therapy evaluations after referral for one resident, delaying needed occupational therapy.
F0880 - Infection Prevention & Control. The facility failed to maintain proper infection control by leaving a wound vacuum canister with putrid drainage in a resident's room after discontinuation, posing an infection risk.
Report Facts
Deficiencies cited: 6
Inspection Report — May 27, 2025
Complaint Investigation
Date: May 27, 2025
Visit Reason
The State Agency conducted a complaint survey at the facility on 5/27/25 for CI MS#28396, CI MS#28931 and CI MS#28976.
Complaint Details
Complaint investigation for CI MS#28396, CI MS#28931 and CI MS#28976. The SA determined the facility was in compliance with no deficiencies cited.
Findings
The facility was found in compliance with the requirements of participation in Medicare and Medicaid services with no deficiencies cited.
Report Facts
Complaints investigated: 3
Inspection Report — Dec 30, 2024
Complaint Investigation
Date: Dec 30, 2024
Visit Reason
The State Agency conducted two complaint investigations (CI MS #27012 and CI MS #27062) at the facility on 12/30/24.
Complaint Details
Complaint investigations CI MS #27012 and CI MS #27062 were conducted; the facility was found in compliance and no deficiencies were cited.
Findings
The facility was found in compliance with the Minimal Standards of Operation for Institutions for the Aged or Infirm and no deficiencies were cited.
Report Facts
Complaint investigations conducted: 2
Inspection Report — Sep 4, 2024
Complaint Investigation
Date: Sep 4, 2024
Visit Reason
The State Agency conducted a Complaint Investigation (CI MS #25410) at the facility from 9/4/24 through 9/4/24. The SA investigated dignity, incontinent care, wandering, and neglect.
Complaint Details
Complaint number CI MS #25410 involved allegations of dignity, incontinent care, wandering, and neglect. The complaint was investigated and no deficiencies were cited.
Findings
The facility was found in compliance with the Minimum Standards of Operation for Institutions of Aged or Infirm, state licensure requirements. No deficiencies were cited.
Report Facts
Complaint investigations conducted: 1
Inspection Report — May 16, 2024
Complaint Investigation
Date: May 16, 2024
Visit Reason
The State Agency conducted a complaint investigation (CI MS #24878, CI MS #24942, and CI MS #25000) at the facility from 5/15/24 through 5/16/24.
Complaint Details
Complaint investigation numbers CI MS #24878, CI MS #24942, and CI MS #25000 were investigated. No deficiencies were cited related to Quality of Care, neglect, or abuse.
Findings
The facility was found to be in compliance with Medicare and Medicaid participation requirements with no deficiencies cited for the complaints investigated.
Report Facts
Complaint investigations: 3
Inspection Report — Apr 17, 2024
Complaint Investigation
Date: Apr 17, 2024
Visit Reason
The State Agency conducted a complaint investigation (CI MS # 24364) at the facility on 4/17/24.
Complaint Details
Complaint CI MS # 24364 regarding misappropriation of resident funds was investigated and found to have no deficiencies cited.
Findings
The facility was found in compliance with the Mississippi Regulations for Minimum Standards for Institutions for Aged or Infirm. There were no deficiencies cited related to misappropriation of resident funds.
Report Facts
Complaint investigations: 1
Inspection Report — Jan 22, 2024
Follow-Up
Date: Jan 22, 2024
Visit Reason
The State Agency conducted a revisit to the annual recertification survey on 1/22/24-1/22/24. During the survey, the SA determined the facility was in compliance with the requirements for participation in Medicare and Medicaid as of 1/04/24.
Findings
The facility was found in compliance with all requirements during this revisit.
Inspection Report — Dec 7, 2023
Routine
Date: Dec 7, 2023
Visit Reason
Routine state inspection of Diversicare of Batesville nursing home to assess compliance with regulatory requirements including medication self-administration, reporting of incidents, bed hold notifications, assessments, care plans, resident safety, fluid restrictions, and psychotropic medication use.
Findings
The facility was found deficient in multiple areas including failure to complete and document medication self-administration evaluations, failure to report a major injury incident involving van transport, failure to provide written bed hold notifications, inaccurate Minimum Data Set (MDS) coding, failure to submit required PASARR referrals, incomplete care plans, inadequate assistance with activities of daily living, failure to ensure resident safety during transport, failure to monitor fluid restrictions, and failure to provide stop dates on PRN psychotropic medications.
Deficiencies (10)
F 0554: The facility failed to complete and document a resident self-administration of medications evaluation for Resident #28 who preferred to self-administer breathing treatments.
F 0609: The facility failed to timely report an accident involving the transport van which resulted in a major injury to Resident #66.
F 0625: The facility failed to provide written notification to Residents #74 and #28 or their representatives regarding bed hold when transferred to the hospital.
F 0641: The facility failed to accurately code the Minimum Data Set (MDS) assessments for Residents #3, #13, and #99.
F 0644: The facility failed to submit a change in status referral for a Level II resident review for Resident #3 following psychiatric hospitalization.
F 0656: The facility failed to develop and implement care plans for Resident #28's self-administration of medications, activities of daily living for Residents #48 and #44, and fluid restriction for Resident #12.
F 0677: The facility failed to provide adequate oral care for Resident #44 and failed to shave Resident #48 as indicated in care plans.
F 0689: The facility failed to ensure safety measures to prevent an accident during van transport for Resident #66, resulting in a fractured leg due to unsecured wheelchair.
F 0692: The facility failed to monitor fluid intake for Resident #12 who was on a 1 liter fluid restriction, including allowing a water pitcher in the room and incomplete intake documentation.
F 0758: The facility failed to provide a stop date on a psychotropic PRN medication order for Resident #68.
Report Facts
Residents reviewed for medication self-administration: 1
Residents reviewed for transport accident: 5
Residents reviewed for bed hold notification: 5
MDS assessments reviewed: 28
Residents reviewed for PASARR referral: 7
Care plans reviewed: 28
Residents on fluid restriction reviewed: 13
Residents reviewed for psychotropic medication use: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Provided interviews confirming deficiencies related to medication self-administration, bed hold notifications, psychotropic medication orders, and care plan expectations. | |
| Administrator | Confirmed failure to report transport accident and lack of documentation for bed hold notifications. | |
| Licensed Practical Nurse #3 | Confirmed observations related to medication self-administration and oral care deficiencies. | |
| Maintenance Staff #1 | Reported on van safety check failures and seatbelt malfunction. | |
| MDS Registered Nurse | Verified MDS coding errors for residents. | |
| Licensed Social Worker | Acknowledged failure to submit PASARR change in status referral. |
Inspection Report — Dec 7, 2023
Annual Inspection
Date: Dec 7, 2023
Visit Reason
The State Agency (SA) conducted an annual recertification at the facility from 12/04/23 through 12/07/23. During the survey, the SA determined that the facility was not in compliance with the requirements of participation in Medicare and Medicaid and cited F554, F609, F625, F641, F644, F656, F677, F689, F692, and F758.
Findings
The facility was found not in compliance with multiple requirements including medication self-administration evaluation, reporting of alleged violations, bed hold policy notification, accuracy of assessments, PASARR coordination, comprehensive care planning, ADL care, accident prevention during van transport, nutrition/hydration monitoring, and psychotropic medication management.
Deficiencies (10)
F0554 - Resident self-administration of medications evaluation was not completed and documented for one resident who self-administered breathing treatments.
F0609 - The facility failed to report a major injury accident involving a resident falling from a wheelchair in the facility van to the State Agency in a timely manner.
F0625 - The facility failed to provide written bed hold policy notification to residents or their representatives upon transfer to hospital for two residents.
F0641 - The facility failed to accurately code PASARR Level II status on Minimum Data Set assessments for three residents.
F0644 - The facility failed to submit a change in status referral for a Level II resident review after psychiatric hospitalization and medication changes for one resident.
F0656 - The facility failed to develop and implement comprehensive care plans for a resident self-administering medications, two residents needing ADL care, and one resident on fluid restriction.
F0677 - The facility failed to provide oral care for one resident and failed to shave another resident as required.
F0689 - The facility failed to ensure safety measures to prevent an accident during van transport, resulting in a resident falling from a wheelchair and sustaining a fractured leg.
F0692 - The facility failed to monitor fluid intake for a resident on a 1 liter fluid restriction, allowing a water pitcher in the resident's room.
F0758 - The facility failed to provide a stop date on a psychotropic PRN medication order for one resident.
Report Facts
Deficiencies cited: 10
Inspection Report — Dec 6, 2023
Life Safety
Date: Dec 6, 2023
Visit Reason
The facility was surveyed for compliance with the 2012 Edition of the Life Safety Code (LSC) of the National Fire Protection Association (NFPA).
Findings
The facility was found to meet the applicable provisions of the 2012 Edition of the Life Safety Code. There were no Life Safety Code deficiencies cited during this survey.
Inspection Report — Oct 31, 2023
Complaint Investigation
Date: Oct 31, 2023
Visit Reason
The State Agency conducted a Complaint Investigation (CI MS #23069) at the facility on 10/30/23 and 10/31/23. The SA investigated neglect/pressure sores and quality of care/tx/resident safety/falls.
Complaint Details
CI MS #23069 investigated neglect/pressure sores and quality of care/tx/resident safety/falls and was not substantiated; no deficiencies were cited.
Findings
The facility was found in compliance with Medicare and Medicaid requirements with no deficiencies cited during the complaint investigation.
Report Facts
Complaint investigations conducted: 1
Inspection Report — Sep 26, 2023
Complaint Investigation
Date: Sep 26, 2023
Visit Reason
The State Agency conducted a complaint investigation (CI MS# 22641) related to excessive bruising of unknown cause at the facility from 09/25/23 through 09/26/23.
Complaint Details
CI MS# 22641 related to excessive bruising of unknown cause. The complaint was investigated and no deficiencies were cited.
Findings
The facility was found in compliance with Medicare and Medicaid participation requirements. No deficiencies were cited during this complaint investigation.
Report Facts
Complaint investigations: 1
Inspection Report — Aug 10, 2023
Complaint Investigation
Date: Aug 10, 2023
Visit Reason
The State Agency conducted a complaint investigation, CI MS# 22169, at the facility from 8/9/23 through 8/10/23.
Complaint Details
CI MS# 22169 involved allegations related to ordered therapy not being provided, physical environment issues including needed repairs and a mold-covered air conditioner filter, and quality of care concerns about a resident being left wet for over 3 hours and no response to the call light. The complaint was not substantiated and no deficiencies were cited.
Findings
The facility was found in compliance with Medicare and Medicaid requirements. No deficiencies were cited for CI MS# 22169.
Report Facts
Complaint investigations: 1
Inspection Report — Jul 11, 2023
Complaint Investigation
Date: Jul 11, 2023
Visit Reason
The State Agency conducted a complaint investigation (CI MS #21959) at the facility on 7/11/23. The SA investigated physical environment/no hot water, quality of care/body odor, resident rights/dignity, respect.
Complaint Details
Complaint CI MS #21959 involved allegations regarding physical environment/no hot water, quality of care/body odor, and resident rights/dignity/respect. The complaint was investigated and no deficiencies were cited.
Findings
The facility was found in compliance with the requirements for participation in Medicare and Medicaid with no deficiencies cited.
Report Facts
Complaint investigations: 1
Inspection Report — Apr 27, 2023
Complaint Investigation
Date: Apr 27, 2023
Visit Reason
The State Agency conducted a complaint survey, MS CI #21207 at the facility on 4/27/23. The complaint involved physical environment and feeding assistance.
Complaint Details
Complaint MS CI #21207 involved physical environment and feeding assistance. The complaint was investigated and found to be unsubstantiated with no deficiencies cited.
Findings
The facility was found to be in compliance with Medicare and Medicaid requirements and no deficiencies were cited.
Report Facts
Deficiencies cited: 0
Inspection Report — Jan 24, 2023
Complaint Investigation
Date: Jan 24, 2023
Visit Reason
On 1/23/23-1/24/23 the State Agency conducted onsite complaint investigations, MS #19885, MS #20504 and #20505. The SA determined the facility was in compliance with Medicare and Medicaid requirements of participation.
Complaint Details
Complaint investigations MS #19885, MS #20504 and #20505 were conducted and the facility was found in compliance with no deficiencies cited.
Findings
The facility was found in compliance with Medicare and Medicaid requirements during the complaint investigations.
Report Facts
Complaint investigations: 3
Inspection Report — Nov 3, 2022
Complaint Investigation
Date: Nov 3, 2022
Visit Reason
The State Agency conducted a complaint survey MS #19695 on 11/1/22 and 11/3/22. The SA did not substantiate the complaint of MS #19695 for allegations of medications not administered as ordered, residents not groomed, falls, physical environment.
Complaint Details
Complaint MS #19695 was investigated for allegations of medications not administered as ordered, residents not groomed, falls, and physical environment. The complaint was not substantiated and no deficiencies were cited.
Findings
The facility was found in compliance with the Mississippi Regulations for Minimum Standards for Institutions for Aged or Infirm with no deficiencies cited.
Report Facts
Complaint count: 1
Inspection Report — Nov 3, 2022
Routine
Date: Nov 3, 2022
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 11/1/22 to 11/3/22.
Findings
The facility was found to be in compliance with 42 CFR 483.80 infection control regulations and has implemented the CMS and Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Inspection Report — Sep 7, 2022
Annual Inspection
Date: Sep 7, 2022
Visit Reason
On 09/07/22 the State Agency (SA) conducted a desk review of the information that was provided to our agency related to the annual survey that was completed on 07/28/22.
Findings
The information provided by the facility confirmed the facility was in compliance with the Minimum Standards of Operation for Institutions for the Aged or Infirm. The SA is recommending that your facility be placed back in compliance effective 08/31/22.
Inspection Report — Sep 7, 2022
Date: Sep 7, 2022
Visit Reason
The State Agency conducted a desk review of information related to the annual survey completed on 07/28/22. The information confirmed the facility had put measures in place to correct the deficient practice and sustain compliance with Medicare and Medicaid requirements of participation.
Findings
The State Agency is recommending that the facility be placed back in compliance effective 08/31/22. No deficiencies were cited in this desk review.
Inspection Report — Sep 7, 2022
Life Safety
Date: Sep 7, 2022
Visit Reason
On 09/07/22 the State Agency (SA) conducted a desk review of the information that was provided related to the annual survey conducted on 07/28/22. The information confirmed the facility had put measures in place to correct the deficient practice and sustain compliance with the Life Safety Code.
Findings
The facility was found to be in compliance with the applicable provisions of the 2012 Edition of the Life Safety Code. The State Agency is recommending the facility be placed back in compliance effective 08/31/22.
Inspection Report — Jul 28, 2022
Routine
Date: Jul 28, 2022
Visit Reason
The inspection was conducted to assess compliance with food safety, sanitation, and environmental standards at the nursing home facility.
Findings
The facility failed to maintain clean and sanitary kitchen appliances, including buildup in the ice machine and ovens, and failed to maintain a sanitary environment due to overflowing garbage dumpsters visible at the facility entrance.
Deficiencies (2)
F0812: The facility failed to maintain clean and sanitary kitchen appliances, evidenced by buildup in the ice machine and ovens, and incomplete cleaning schedules for these appliances.
F0921: The facility failed to provide a sanitary environment as evidenced by two overflowing garbage dumpsters visible at the facility entrance, with garbage scattered on the ground attracting animals and pests.
Report Facts
Cleaning schedule months completed: 1
Garbage dumpsters observed: 2
Waste removal contract frequency: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dietary Manager | Confirmed buildup in ice machine and ovens and incomplete cleaning schedules | |
| Maintenance Supervisor | Confirmed ice machine cleaning frequency and contamination concerns | |
| Clinical Director | Commented on garbage dumpsters being full and overflowing | |
| Administrator | Confirmed garbage pickup issues and contract details with waste removal company | |
| Housekeeping Director | Noticed garbage not picked up and informed Administrator | |
| Maintenance Director | Confirmed responsibility for garbage cleanup and presence of animals |
Inspection Report — Jul 28, 2022
Annual Inspection
Date: Jul 28, 2022
Visit Reason
The State Agency conducted an annual recertification survey, along with a complaint, CI MS# 18811, from 7/25/22 to 7/28/22. During the survey, the SA determined that the facility was not in compliance with the requirements for participation in Medicare and Medicaid. The SA unsubstantiated the complaint CI MS # 18811.
Complaint Details
CI MS# 18811 was investigated during the survey but was unsubstantiated by the State Agency.
Findings
The facility was found not in compliance with two deficiencies related to food procurement and sanitary environment. The facility failed to maintain clean kitchen appliances and failed to provide a sanitary environment due to overflowing garbage dumpsters visible at the facility entrance.
Deficiencies (2)
F0812 - Food procurement, storage, preparation, and service were not sanitary as evidenced by buildup in the icemaker and ovens, incomplete cleaning schedules, and staff not consistently closing the ice machine lid.
F0921 - The facility failed to provide a safe and sanitary environment as evidenced by two overflowing garbage dumpsters with garbage scattered on the ground, attracting animals and posing infection control risks.
Report Facts
Deficiencies cited: 2
Inspection Report — Jul 28, 2022
Life Safety
Date: Jul 28, 2022
Visit Reason
The facility underwent a Life Safety Code survey to assess compliance with the 2012 Edition of the Life Safety Code of the National Fire Protection Association (NFPA).
Findings
The facility was found deficient in properly conducting and documenting fire drills and generator testing as required by NFPA standards.
Deficiencies (2)
K0712 - The facility failed to properly perform fire drills as required by NFPA 101 section 19.7.1.2, including missing documentation for multiple shifts and quarters in 2021 and 2022.
K0918 - The facility failed to properly document records of annual generator testing and weekly inspections as required by NFPA 110 and NFPA 99, with incomplete documentation for 2021 and 2022.
Report Facts
Deficiencies cited: 2
Inspection Report — Jul 28, 2022
Date: Jul 28, 2022
Visit Reason
The Mississippi State Department of Health conducted a survey at the facility on 07/28/2022 to assess compliance with Life Safety Code requirements.
Findings
The facility was found deficient in properly performing and documenting fire drills as required by NFPA 101. Missing documentation included times, narratives, and staff signatures for multiple shifts and quarters.
Deficiencies (1)
M1245 - The facility failed to properly perform and document fire drills as required by NFPA 101, missing times, narratives, and staff signatures for several shifts and quarters.
Report Facts
Deficiencies cited: 1
Inspection Report — Apr 26, 2022
Routine
Date: Apr 26, 2022
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 04/26/2022.
Findings
The facility was found to be in compliance with the requirements for participation in Medicare and Medicaid and no deficiencies were cited.
Inspection Report — Apr 12, 2022
Complaint Investigation
Date: Apr 12, 2022
Visit Reason
On 04/12/22 the State Agency conducted a desk review of the information provided related to the complaint survey conducted on 2/24/22. The facility confirmed measures were put in place to correct the deficient practice and sustain compliance with Medicare and Medicaid requirements.
Complaint Details
Complaint survey conducted on 2/24/22; the facility was found in compliance with no deficiencies cited.
Findings
The State Agency found the facility in compliance and recommended it be placed back in compliance effective 03/30/22. No deficiencies were cited in this document.
Report Facts
Deficiencies cited: 0
Inspection Report — Feb 24, 2022
Complaint Investigation
Date: Feb 24, 2022
Visit Reason
The State Agency conducted a Complaint Survey at the facility from 02/17/22 through 02/24/22 for Complaint Investigations (CI) MS #18519 for facility staffing, dignity and respect, nursing services, resident medications not given according to physician's instructions and resident client/patient neglect.
Complaint Details
CI MS #18519 for facility staffing, dignity and respect, nursing services, resident medications not given according to physician's instructions and resident client/patient neglect. The SA determined the facility was not in compliance and cited F609, F760 and F842. CI MS #18434 for no pressure sore precautions taken by the facility, resident assessment, and quality of care was unsubstantiated.
Findings
The facility was found not in compliance due to a medication error where Resident #1 was administered medications prescribed for another resident, causing serious harm and requiring emergency room treatment. The facility failed to report the incident timely to the State Agency and failed to ensure accurate entry of physician orders into the medical record.
Deficiencies (3)
F0609 - Reporting of Alleged Violations. The facility failed to notify the State Agency when a medication error caused harm to Resident #1 and required emergency room treatment.
F0760 - Residents are Free of Significant Medication Errors. The facility failed to ensure Resident #1 was free from significant medication errors when medications prescribed for another resident were entered into Resident #1's medical record and administered, causing serious harm and requiring emergency room treatment.
F0842 - Resident Records - Identifiable Information. The facility failed to maintain accurate medical records for Resident #1 when another resident's medications were entered into Resident #1's record and administered, causing serious harm and requiring emergency room treatment.
Report Facts
Deficiencies cited: 3
Inspection Report — Dec 15, 2021
Complaint Investigation
Date: Dec 15, 2021
Visit Reason
The State Agency conducted a facility reported incident complaint survey, MS # 18281 at the facility from 12/15/2021 to 12/15/2021.
Complaint Details
Complaint MS #18281 alleged quality of care issues related to residents being left wet for extended periods, services not performed, and services not received. The complaint was not substantiated and no deficiencies were cited.
Findings
The facility was found to be in compliance with the Minimum Standards for the Institutions for the Aged or Infirm. No deficiencies were cited.
Report Facts
Complaint count: 1
Inspection Report — Aug 17, 2021
Routine
Date: Aug 17, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey and a Complaint Investigation (CI MS #17974) were conducted by State Agency on 8/16/21-8/17/21.
Complaint Details
Complaint Investigation CI MS #17974 involved Resident Assessment/Elopement and was unsubstantiated with no deficiencies cited.
Findings
The facility was found to be in compliance with infection control regulations and has implemented CMS and CDC recommended practices to prepare for COVID-19. The complaint investigation was unsubstantiated and no deficiencies were cited.
Report Facts
Complaint investigations: 1
Inspection Report — Sep 28, 2020
Routine
Date: Sep 28, 2020
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency on 9/28/20. The State Survey Agency also conducted a complaint investigation on 9/28/20 which was unsubstantiated with no deficiencies cited.
Complaint Details
CI MS #16766: The complaint investigation conducted on 9/28/20 was unsubstantiated with no deficiencies cited. The facility was found in compliance with Medicare and Medicaid requirements.
Findings
The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and CMS and CDC recommended practices to prepare for COVID-19. No deficiencies were cited during the complaint investigation.
Report Facts
Complaint investigations: 1
Inspection Report — Aug 10, 2020
Routine
Date: Aug 10, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 8/10/2020. The facility was found to not be in compliance with infection control regulations and did not implement the CMS and Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Findings
F0880 - The facility failed to prevent the potential spread of infection related to placing a contaminated ice scoop on the ice while passing ice to residents during one of four random tours of the facility.
Deficiencies (1)
F0880 - Infection Prevention & Control. The facility failed to prevent the potential spread of infection by allowing a contaminated ice scoop to be placed on the ice while passing ice to residents, contrary to their policy requiring the scoop to be cleaned daily and stored properly.
Report Facts
Deficiencies cited: 1
Inspection Report — Jul 13, 2020
Routine
Date: Jul 13, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey was conducted by the Centers for Medicare & Medicaid Services (CMS) on 7/13/2020.
Findings
The facility was found to be in compliance with 42 CFR §483.73 related to E-0024 (b)(6).
Inspection Report — Jul 13, 2020
Routine
Date: Jul 13, 2020
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 7/13/20.
Findings
The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and has implemented the CMS and Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Inspection Report — Jun 18, 2020
Routine
Date: Jun 18, 2020
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 6/18/20. The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and has implemented the CMS and Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Findings
The facility was found to be in compliance with infection control regulations and no deficiencies were cited.
Inspection Report — Dec 19, 2019
Complaint Investigation
Date: Dec 19, 2019
Visit Reason
The State Survey Agency conducted a complaint investigation on 12/19/19.
Complaint Details
CI MS #16196 & CI MS #16227: Complaint investigation conducted and found unsubstantiated with no deficiencies cited.
Findings
The investigation was unsubstantiated with no deficiencies cited. The facility was found in compliance with Medicare and Medicaid requirements for participation.
Inspection Report — Sep 5, 2019
Complaint Investigation
Date: Sep 5, 2019
Visit Reason
The State Agency conducted a complaint survey investigating MS CI 16184 beginning 9/5/19. Concerns identified in the complaint were related to possible abuse and neglect of Resident #1, specifically wound care, oral hygiene, and catheter care.
Complaint Details
CI MS #16184: Allegations of possible abuse and neglect related to wound care, oral hygiene, and catheter care were investigated and found not substantiated; no deficiencies were cited.
Findings
The concerns were not substantiated and no deficiencies were cited. The facility was determined to be in substantial compliance with requirements for participation in Medicare and Medicaid.
Report Facts
Complaint investigations: 1
Inspection Report — May 10, 2019
Annual Inspection
Date: May 10, 2019
Visit Reason
The State Agency (SA) determined during an annual recertification survey, conducted from 5/7/19 to 5/10/19, the facility was not in compliance with the Mississippi Regulations for Minimum Standards for Institutions for Aged or Infirm with deficiencies cited at M705 and M1020.
Findings
The facility was found not in compliance with medication administration procedures and housekeeping standards. Deficiencies included medication errors during administration via PEG tube and incorrect dosage given, as well as failure to maintain clean and sanitary resident bedrooms.
Deficiencies (2)
M705 - Policies and procedures. The facility failed to ensure accurate pharmacy procedure for administration of medications to maintain a medication error rate less than 5 percent, evidenced by incorrectly administering medications via PEG tube to Resident #97 and giving an incorrect dosage of Minoxidil to Resident #13.
M1020 - Resident Bedrooms. The facility failed to keep a clean and sanitary environment in resident bedrooms, evidenced by dirty pillows stained with dark brown material, trash and syringe caps on the floor, and splatters on oxygen concentrators and feeding pump poles in rooms of Residents #5, #15, and #91.
Report Facts
Deficiencies cited: 2
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