Inspection Reports for
Diversicare of Quitman
191 Highway 511 East Kenyatta Pearson, Quitman, MS, 39355
Back to Facility Profile56 Reports
Inspection Report — Aug 20, 2026
Complaint Investigation
Date: Aug 20, 2026
Visit Reason
The State Agency conducted two Complaint Investigations (CI MS #3092747 and CI MS #3092013) at the facility from 8/19/26 through 8/20/26. CI MS #3092747 was investigated for rehab services, quality of care, accidents/falls, resident rights, misappropriation of property, and nursing services. CI MS #3092013 was investigated for quality of care, misappropriation of property, and nursing services.
Complaint Details
Complaint Investigations CI MS #3092747 and CI MS #3092013 were conducted for multiple allegations including rehab services, quality of care, accidents/falls, resident rights, misappropriation of property, and nursing services. The facility was found in compliance with no deficiencies cited.
Findings
During the survey, the State Agency determined the facility was in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Inspection Report — Aug 20, 2026
Complaint Investigation
Date: Aug 20, 2026
Visit Reason
The State Agency conducted two Complaint Investigations (CI MS #3092747 and CI MS #3092013) at the facility from 8/19/26 through 8/20/26. The investigations focused on rehab services, quality of care, accidents/falls, resident rights, misappropriation of property, and nursing services.
Complaint Details
Two complaint investigations were conducted: CI MS #3092747 for rehab services, quality of care, accidents/falls, resident rights, misappropriation of property, and nursing services; and CI MS #3092013 for quality of care, misappropriation of property, and nursing services. Both complaints were investigated and no deficiencies were cited.
Findings
During the survey, the State Agency determined the facility was in compliance with the requirements for participation in Medicare and Medicaid, and there were no deficiencies cited.
Report Facts
Complaint Investigations: 2
Inspection Report — Jun 24, 2026
Complaint Investigation
Date: Jun 24, 2026
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #3042487, at the facility on 6/24/26. MS #3042487 was investigated for quality of care, dietary, and dental services.
Complaint Details
CI MS #3042487 was investigated for quality of care, dietary, and dental services. The complaint was determined to be in compliance with no deficiencies cited.
Findings
The survey determined the facility was in compliance with the requirements for participation in Medicare and Medicaid and there were no deficiencies cited.
Report Facts
Complaint count: 1
Inspection Report — Jun 24, 2026
Complaint Investigation
Date: Jun 24, 2026
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #3042487, at the facility on 6/24/26. MS #3042487 was investigated for quality of care, dietary, and dental services.
Complaint Details
Complaint number CI MS #3042487 was investigated for quality of care, dietary, and dental services. The complaint was not substantiated as no deficiencies were cited.
Findings
The survey determined the facility was in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Inspection Report — Jun 23, 2026
Follow-Up
Date: Jun 23, 2026
Visit Reason
The State Agency conducted a follow-up revisit at the facility on 6/23/26 related to an annual re-licensure survey and Complaint Investigation at the facility from 5/18/26 through 5/21/26.
Findings
The State Agency determined the facility was in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement and recommends the facility be placed back in compliance effective 6/19/26.
Inspection Report — Jun 23, 2026
Follow-Up
Date: Jun 23, 2026
Visit Reason
The State Agency conducted a follow-up revisit at the facility on 6/23/26 related to an annual recertification survey and Complaint Investigation at the facility from 5/18/26 through 5/21/26.
Findings
The State Agency found the facility to be in compliance with the requirements of participation in Medicare and Medicaid and recommends the facility be placed back in compliance effective 6/19/26.
Inspection Report — May 21, 2026
Annual Inspection
Date: May 21, 2026
Visit Reason
The State Agency (SA) conducted an annual recertification survey and Complaint Investigation (CI) MS #2980096 at the facility from 05/18/26 through 05/21/26. The SA investigated CI # 2980096 for quality of care, nutrition and weight loss. There was no citation related to the complaint investigation. During the annual recertification survey, the SA determined the facility was not in compliance with the requirements of participation in Medicare and Medicaid and cited F628, F656, F558, F657, F684, and F695.
Complaint Details
CI MS #2980096 investigated for quality of care, nutrition and weight loss. There was no citation related to the complaint investigation.
Findings
The facility was found not in compliance with multiple requirements including transfer notification, care planning, call light accessibility, medication administration, quality of care, and respiratory care. Deficiencies were cited for failure to provide written transfer notifications, timely develop care plans, ensure call light accessibility, revise care plans to reflect current orders, monitor and follow up on blood sugar and medication administration, timely implement catheter orders, and properly store oxygen equipment.
Deficiencies (6)
F0628 - The facility failed to ensure residents and their representatives received written notification of hospital transfers, including reasons for transfer, for three of four residents reviewed.
F0656 - The facility failed to timely develop a comprehensive care plan with interventions related to an indwelling catheter placement for one of twenty residents reviewed.
F0558 - The facility failed to ensure a resident's call light remained accessible and within reach for one of twenty residents reviewed.
F0657 - The facility failed to revise the comprehensive care plan to reflect a resident's current diabetic management orders and interventions for one of twenty residents reviewed.
F0684 - The facility failed to provide treatment and services according to professional standards by failing to monitor, assess, and provide appropriate follow-up for abnormal blood sugar results, insulin holds/refusals, glucagon administration, and timely implement catheter orders for two of twenty residents reviewed.
F0695 - The facility failed to store oxygen tubing and a nasal cannula in a manner to prevent possible contamination and respiratory complications for one resident reviewed for respiratory care.
Report Facts
Deficiencies cited: 6
Inspection Report — May 21, 2026
Annual Inspection
Date: May 21, 2026
Visit Reason
The State Agency conducted an annual re-licensure survey and Complaint Investigation (CI) MS #2980096 at the facility from 05/18/26 through 05/21/26. The SA investigated CI #2980096 for quality of care, nutrition and weight loss. There was no citation related to the complaint investigation.
Complaint Details
Complaint Investigation (CI) MS #2980096 was investigated for quality of care, nutrition and weight loss. There was no citation related to the complaint investigation.
Findings
The facility was found not in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirements and cited M500 and M655 deficiencies related to residents' rights and special needs care.
Deficiencies (2)
M500 - Residents' rights. The facility failed to ensure a resident’s call light remained accessible and within reach for one of twenty sampled residents, Resident #77, due to a missing clip on the call light string.
M655 - Special needs. The facility failed to store oxygen tubing and a nasal cannula properly to prevent contamination and respiratory complications for one resident, Resident #29.
Report Facts
Deficiencies cited: 2
Inspection Report — May 19, 2026
Life Safety
Date: May 19, 2026
Visit Reason
The facility was surveyed for compliance with the 2012 Edition of the Life Safety Code (LSC) and Emergency Preparedness requirements.
Findings
The facility was found to be in compliance with all applicable Life Safety Code and Emergency Preparedness requirements. No deficiencies were cited during this survey.
Inspection Report — Apr 20, 2026
Complaint Investigation
Date: Apr 20, 2026
Visit Reason
On 04/20/26 the State Agency conducted a desk review of the information provided related to the complaint survey completed on 03/17/26. The facility confirmed measures were put in place to correct the deficient practice and sustain compliance with Medicare and Medicaid requirements.
Complaint Details
CI MS#26995 complaint survey completed on 03/17/26; the facility was found in compliance with no deficiencies cited.
Findings
The facility was found to be in compliance as of 04/15/26 with no deficiencies cited during this desk review.
Report Facts
Deficiencies cited: 0
Inspection Report — Mar 17, 2026
Complaint Investigation
Date: Mar 17, 2026
Visit Reason
The State Agency conducted two Complaint Investigations (CI MS #2791948 and CI MS #2709498) at the facility on 03/16/26 through 03/17/26. CI MS #2791948 was investigated for nursing services and resident/patient/client neglect. CI MS #2709498 was investigated for resident/patient/client abuse and quality of care.
Complaint Details
Two complaint investigations were conducted: CI MS #2791948 for nursing services and resident neglect, and CI MS #2709498 for resident abuse and quality of care. Deficiency F0880 was cited indicating the facility was not in compliance.
Findings
The facility was found not in compliance with infection prevention and control requirements. The facility failed to implement Enhanced Barrier Precautions and infection prevention and control practices for one sampled resident with a sacral wound and infection.
Deficiencies (1)
F0880 - Infection Prevention & Control. The facility failed to implement Enhanced Barrier Precautions and infection prevention and control practices for one of six sampled residents, including failure to post signage, wear gowns during wound care, and ensure proper hand hygiene.
Report Facts
Deficiencies cited: 1
Inspection Report — Mar 17, 2026
Complaint Investigation
Date: Mar 17, 2026
Visit Reason
The State Agency conducted two Complaint Investigations (CI MS #2791948 and CI MS #2709498) at the facility on 03/16/26 through 03/17/26. CI MS #2791948 was investigated for nursing services and resident/patient/client neglect. CI MS #2709498 was investigated for resident/patient/client abuse and quality of care.
Complaint Details
Two complaint investigations were conducted: CI MS #2791948 for nursing services and neglect, and CI MS #2709498 for abuse and quality of care. Deficiency M1570 was cited related to infection control failures; the complaints were substantiated.
Findings
The facility was found not in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirements, and cited M1570 for failure to implement Enhanced Barrier Precautions and infection prevention and control practices for one of six sampled residents (Resident #2).
Deficiencies (1)
M1570 - The facility failed to implement Enhanced Barrier Precautions and infection control practices during wound care for Resident #2, who had a sacral wound with infection, as evidenced by lack of gown use, no EBP signage, and inadequate hand hygiene.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
Inspection Report — Nov 18, 2025
Complaint Investigation
Date: Nov 18, 2025
Visit Reason
The State Agency conducted Complaint Investigations (CIs), MS #2601576 and MS #2598762 at the facility from 11/17/25 through 11/18/25 related to allegations of abuse and pressure ulcer care and precautions.
Complaint Details
Complaint Investigations MS #2601576 and MS #2598762 involved allegations of abuse and pressure ulcer care and precautions. The facility was found in compliance and no deficiencies were cited.
Findings
The facility was found in compliance with Medicare and Medicaid participation requirements and no deficiencies were cited.
Report Facts
Complaint Investigations: 2
Inspection Report — Nov 18, 2025
Complaint Investigation
Date: Nov 18, 2025
Visit Reason
The State Agency conducted Complaint Investigations (CIs), MS #2601576 and MS #2598762 at the facility from 11/17/25 through 11/18/25 related to allegations of abuse and pressure ulcer care and precautions.
Complaint Details
Complaint numbers MS #2601576 and MS #2598762 were investigated related to allegations of abuse and pressure ulcer care and precautions. The SA determined the facility was in compliance with no deficiencies cited.
Findings
The facility was found in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Report Facts
Complaint Investigations: 2
Inspection Report — Oct 16, 2025
Complaint Investigation
Date: Oct 16, 2025
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #2620723 and MS #2599284, related to resident on resident abuse.
Complaint Details
Complaint Investigation MS #2620723 and MS #2599284 related to resident on resident abuse; no deficiencies cited as the facility was found in compliance.
Findings
The facility was found in compliance with the requirements for participation in Medicare and Medicaid and no deficiencies were cited.
Report Facts
Complaints investigated: 2
Inspection Report — Oct 16, 2025
Complaint Investigation
Date: Oct 16, 2025
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #2620723 and MS #2599284, related to resident on resident abuse.
Complaint Details
Complaint Investigation MS #2620723 and MS #2599284 related to resident on resident abuse. The facility was found in compliance with no deficiencies cited.
Findings
The facility was found in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Report Facts
Complaint Investigations: 2
Inspection Report — May 29, 2025
Complaint Investigation
Date: May 29, 2025
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #29055 at the facility on 5/28/25 related to resident abuse and resident safety.
Complaint Details
CI MS#29055 was investigated related to resident abuse and resident safety. The SA determined the facility was in compliance with no deficiencies cited.
Findings
The facility was found in compliance with the requirements for participation in Medicare and Medicaid and no deficiencies were cited.
Report Facts
Complaint investigations: 1
Inspection Report — Jan 24, 2025
Follow-Up
Date: Jan 24, 2025
Visit Reason
The State Agency conducted a follow-up revisit at the facility on 1/24/25 related to the complaint and annual recertification survey that was conducted from 12/15/24 through 12/18/24.
Findings
The State Agency found the facility to be in compliance with the requirements of participation in Medicare and Medicaid and recommends the facility be placed back in compliance effective 1/14/25.
Inspection Report — Jan 24, 2025
Follow-Up
Date: Jan 24, 2025
Visit Reason
The State Agency conducted a follow-up revisit at the facility on 1/24/25 related to the complaint and recertification survey that was conducted from 12/15/24 through 12/18/24.
Findings
The State Agency found the facility to be in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement, and recommends the facility be placed back in compliance effective 1/14/25.
Inspection Report — Dec 18, 2024
Annual Inspection
Date: Dec 18, 2024
Visit Reason
The State Agency conducted an annual recertification survey and Complaint Investigations (CIs), MS #26660 and CI MS #27032, at the facility from 12/15/24 through 12/18/24. The SA investigated CI MS #26660 for Resident/Patient/Client neglect, Quality of care, Resident/Patient dignity. The SA investigated CI MS #27032, a facility reported incident, for facility Resident to Resident client abuse, and cited M640. During the survey, the SA determined the facility was not in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirements and cited M225 and M500.
Complaint Details
Complaint Investigations MS #26660 and CI MS #27032 were investigated. CI MS #26660 involved neglect, quality of care, and resident dignity. CI MS #27032 involved resident-to-resident abuse and was substantiated with citation of M640.
Findings
The facility was found not in compliance with state licensure requirements and cited for deficiencies including failure to provide adequate supervision to prevent resident-on-resident accidents, resulting in injury to a resident. The facility implemented corrective actions including staff in-service and increased monitoring.
Deficiencies (3)
M640 - The facility failed to provide supervision to prevent a resident-on-resident altercation when Resident #61 wandered into another resident's room, resulting in injury and an emergency department visit.
M225 - The facility was not in compliance with Minimum Standards for Institutions for the Aged or Infirm as cited during the survey.
M500 - The facility was not in compliance with Minimum Standards for Institutions for the Aged or Infirm as cited during the survey.
Report Facts
Deficiencies cited: 3
Inspection Report — Dec 18, 2024
Annual Inspection
Date: Dec 18, 2024
Visit Reason
The State Agency conducted an annual recertification survey and two Complaint Investigations (CI MS #26660 and CI MS #27032) at the facility from 12/15/24 through 12/18/24. The investigations involved resident neglect, quality of care, dignity, and resident-to-resident abuse.
Complaint Details
Two complaint investigations were conducted: CI MS #26660 for resident neglect, quality of care, and dignity; and CI MS #27032 for resident-to-resident abuse. Deficiency F0689 was cited related to the abuse complaint.
Findings
The facility was found not in compliance with Medicare and Medicaid participation requirements, citing deficiencies in resident rights, comprehensive care planning, professional standards, accident prevention, and staffing sufficiency.
Deficiencies (5)
F0550 - Resident rights were not ensured as wandering residents entered rooms without permission and a urinary drainage bag was left uncovered, violating residents' privacy and dignity.
F0656 - The facility failed to develop and implement comprehensive care plans for residents with a CPAP machine and an indwelling catheter, affecting two sampled residents.
F0658 - Physician orders for CPAP use and indwelling catheter care were not implemented, failing to meet professional standards for two residents.
F0689 - The facility failed to provide adequate supervision to prevent a resident-on-resident altercation, resulting in injury and an emergency department visit for one resident.
F0725 - The facility failed to ensure sufficient nursing staff to provide safe and adequate care, with documented low staffing levels especially on weekends.
Report Facts
Deficiencies cited: 9
Inspection Report — Dec 18, 2024
Life Safety
Date: Dec 18, 2024
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. No deficiencies were cited.
Inspection Report — Dec 18, 2024
Complaint Investigation
Date: Dec 18, 2024
Visit Reason
The inspection was conducted following a complaint regarding inadequate supervision that led to a resident-on-resident altercation resulting in injury.
Complaint Details
The complaint investigation found that Resident #61 wandered into another resident's room, leading to an altercation and injury. The incident was substantiated with medical records and staff interviews confirming the event and subsequent interventions.
Findings
The facility failed to provide adequate supervision to prevent a resident-on-resident altercation where Resident #61 was injured and required emergency department care. Interventions such as stop signs and increased monitoring were implemented after the incident.
Deficiencies (1)
F 0689: The facility failed to provide supervision to prevent a resident-on-resident altercation resulting in Resident #61 sustaining a hematoma and requiring emergency department treatment.
Report Facts
Sampled residents: 22
Residents affected: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrator | Informed of the incident and discussed interventions | |
| Director of Nursing (DON) | Reported the incident to the State Agency and started an investigation | |
| Floor Tech | Observed the incident and assisted in removing Resident #61 | |
| Training Center Account Manager (TCAM) | Assisted in removing Resident #61 from Resident #91's room | |
| Registered Nurse (RN) #3 | Reported the incident to DON and Nurse Practitioner and performed neurological checks |
Inspection Report — Dec 18, 2024
Routine
Date: Dec 18, 2024
Visit Reason
The inspection was conducted to assess compliance with regulatory standards related to residents' rights, care planning, implementation of physician orders, accident prevention, and staffing adequacy at Diversicare of Quitman nursing home.
Findings
The facility failed to ensure residents' rights to privacy, develop comprehensive care plans for certain residents, implement physician orders for CPAP and catheter care, provide adequate supervision to prevent resident-on-resident altercations, and maintain sufficient nursing staff to meet residents' needs safely.
Deficiencies (5)
F550: The facility failed to ensure residents' rights to privacy by allowing wandering residents to enter rooms without permission and failing to cover a urinary drainage bag for three of 22 sampled residents.
F0656: The facility failed to develop care plans related to a CPAP machine and an indwelling catheter for two of 22 sampled residents.
F0658: The facility failed to implement physician orders for the use of a CPAP machine and an indwelling catheter for two of 22 sampled residents.
F0689: The facility failed to provide supervision to prevent a resident-on-resident altercation resulting in a hematoma and emergency department visit for one of 22 sampled residents.
F0725: The facility failed to ensure sufficient nursing staff to provide nursing and related services to meet residents' needs safely for one of four staffing quarters reviewed.
Report Facts
Sampled residents: 22
Staffing quarters reviewed: 4
BIMS score: 12
BIMS score: 15
BIMS score: 4
Staffing levels: 16
Staffing levels: 6
Staffing levels: 5
Staffing levels: 4
Staffing levels: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Registered Nurse #1 | Registered Nurse | Placed indwelling catheter for Resident #74 and acknowledged responsibility to verify orders |
| Licensed Practical Nurse #1 | Licensed Practical Nurse | Confirmed failure to follow hospital discharge orders related to CPAP usage for Resident #2 |
| Licensed Practical Nurse #3 | Licensed Practical Nurse | Reported Resident #5's door closure to prevent wandering residents and staffing shortages |
| Licensed Practical Nurse #4 | Licensed Practical Nurse | Pulled to cover short staffing and confirmed low staffing levels |
| Nurse Practitioner | Nurse Practitioner | Expressed concerns about Resident #2's obstructive sleep apnea diagnosis and CPAP non-implementation |
| Director of Nursing | Director of Nursing | Acknowledged communication breakdowns, staffing shortages, and confirmed investigation of resident altercation |
| Administrator | Administrator | Confirmed staffing challenges and discussed interventions for resident altercation |
| Floor Tech | Floor Technician | Assisted in removing Resident #61 during altercation and cleaning water on floor |
| Training Center Account Manager | Training Center Account Manager | Assisted in removing Resident #61 during altercation |
| Registered Nurse #3 | Registered Nurse | Reported incident of resident altercation and performed neurological checks |
| Registered Nurse #2 | Registered Nurse | Responsible for developing Resident #74's care plan and acknowledged lack of orders |
| Certified Nurse Aide #1 | Certified Nurse Aide | Reported staffing shortages and resident assignments |
| Workforce Manager | Workforce Manager | Provided staffing grid data and confirmed low staffing alerts |
Inspection Report — Aug 6, 2024
Complaint Investigation
Date: Aug 6, 2024
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #25913 and MS #25984, at the facility from 8/5/24 through 8/6/24. MS #25913 was investigated related to quality of care and unwitnessed fall. MS #25984 was investigated for dietary services.
Complaint Details
Complaint Investigation MS #25913 was related to quality of care and unwitnessed fall; MS #25984 was related to dietary services. The facility was found in compliance with no deficiencies cited.
Findings
During the survey, the SA determined the facility was in compliance with the requirements for participation in Medicare and Medicaid and there were no deficiencies cited.
Inspection Report — Aug 6, 2024
Complaint Investigation
Date: Aug 6, 2024
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #25913 and MS #25984, at the facility from 8/5/24 through 8/6/24. MS #25913 was investigated related to quality of care and unwitnessed fall. MS #25984 was investigated for dietary services.
Complaint Details
Complaint Investigation MS #25913 was related to quality of care and unwitnessed fall, and MS #25984 was related to dietary services. Both complaints were investigated and no deficiencies were cited.
Findings
During the survey, the State Agency determined the facility was in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Inspection Report — Nov 28, 2023
Complaint Investigation
Date: Nov 28, 2023
Visit Reason
The State Agency conducted Complaint Investigations (CIs), MS #22897 and MS #23204, at the facility from 11/27/23 through 11/28/23. CI MS #22897 was investigated for improper incontinent care products with no citations. CI MS #23204 was related to employee-to-resident verbal abuse, resulting in a deficiency citation.
Complaint Details
Complaint investigation MS #23204 was related to employee-to-resident verbal abuse. The deficiency was substantiated and cited. Complaint MS #22897 for improper incontinent care products was not cited.
Findings
The facility was found not in compliance due to failure to protect a resident from verbal abuse by a Certified Nurse Assistant (CNA #1). The CNA used profanity toward Resident #1 and was terminated. The facility implemented corrective actions prior to the survey.
Deficiencies (1)
F0600 - Free from Abuse and Neglect. The facility failed to protect a resident from verbal abuse by a CNA who used profanity and disrespectful language toward the resident.
Report Facts
Deficiencies cited: 1
Inspection Report — Nov 28, 2023
Complaint Investigation
Date: Nov 28, 2023
Visit Reason
The inspection was conducted due to a complaint investigation regarding verbal abuse by a Certified Nurse Assistant (CNA) towards a resident.
Complaint Details
The complaint was substantiated. The CNA admitted to verbal abuse using profanity towards Resident #1. The facility reported the incident to the State Agency, Medicaid Fraud Control Unit, and local police. Corrective actions were implemented and the deficiency was corrected prior to the State Agency's entrance.
Findings
The facility failed to protect a resident from verbal abuse by a CNA who used profanity and a loud tone. The CNA was terminated, and the facility implemented corrective actions including staff in-services and a Quality Assurance Performance Improvement meeting.
Deficiencies (1)
F 0600: The facility failed to protect a resident from verbal abuse by a CNA who used profanity and a loud tone while addressing the resident. The CNA admitted to the verbal abuse and was terminated.
Report Facts
Residents sampled: 4
Residents affected: 1
Date of incident: Oct 20, 2023
Date of investigation template: Oct 24, 2023
Date of admission: Jun 28, 2021
Assessment Reference Date: Sep 16, 2023
Date of QAPI meeting: Oct 21, 2023
Date of report validation: Nov 28, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nurse Assistant (CNA) #1 | Employee who verbally abused Resident #1 and was terminated | |
| Administrator | Conducted investigation, reported incident, and provided in-services | |
| Registered Nurse (RN) #1 | Witnessed investigation and confirmed CNA's admission of verbal abuse | |
| Director of Nursing (DON) | Attended QAPI meeting discussing abuse policies | |
| Social Services Director | Attended QAPI meeting discussing abuse policies | |
| Infection Preventionist (IP) | Absent from emergency QAPI meeting | |
| Medical Director | Attended QAPI meeting via phone |
Inspection Report — Jun 6, 2023
Annual Inspection
Date: Jun 6, 2023
Visit Reason
On 06/06/23 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 04/19/23.
Findings
The information provided by the facility confirmed the facility had put measures in place to correct the deficient practice and sustain compliance with Medicare and Medicaid requirements of participation. The SA is recommending that your facility be placed back in compliance effective 05/30/23.
Inspection Report — Apr 19, 2023
Annual Inspection
Date: Apr 19, 2023
Visit Reason
The State Agency (SA) conducted an annual recertification at the facility from 04/16/23 through 04/19/23. During the survey, the SA determined that the facility was not in compliance with the requirements of participation in Medicare and Medicaid and cited F693, F695, F791, F812, F880.
Findings
The facility was found not in compliance with Medicare and Medicaid participation requirements, citing deficiencies in tube feeding management, respiratory care, dental services, food safety, and infection prevention and control.
Deficiencies (5)
F0693 - The facility failed to provide proper percutaneous endoscopic gastrostomy (PEG) feeding tube care to prevent complications for one resident, including improper cleansing technique that could lead to infection.
F0695 - The facility failed to adhere to accepted standards for proper storage of a nebulizer mask, which was observed lying on the floor without a container, risking contamination for one resident.
F0791 - The facility failed to ensure recommended dental services were provided for one resident with an abscessed tooth, resulting in delayed oral surgery due to insurance and financial issues.
F0812 - The facility failed to remove expired, undated, and spoiled food items from kitchen storage areas, risking foodborne illness for residents consuming oral diets.
F0880 - The facility failed to prevent possible infection spread when a nurse flushed and administered medication via a PEG feeding tube without wearing gloves for one resident.
Report Facts
Deficiencies cited: 5
Inspection Report — Apr 19, 2023
Annual Inspection
Date: Apr 19, 2023
Visit Reason
On 06/06/23 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 04/19/23.
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 05/30/23.
Inspection Report — Apr 19, 2023
Routine
Date: Apr 19, 2023
Visit Reason
The inspection was conducted to assess compliance with healthcare regulations related to resident care, infection control, respiratory care, dental services, and food safety at Diversicare of Quitman nursing home.
Findings
The facility was found deficient in multiple areas including improper care of peg feeding tubes, unsafe storage of respiratory equipment, failure to provide recommended dental services, presence of expired and spoiled food items in the kitchen, and failure to implement proper infection prevention practices during medication administration via peg feeding tube.
Deficiencies (5)
F 0693: The facility failed to provide proper care for a resident's peg feeding tube, including inadequate cleansing technique that could cause infection for Resident #64.
F 0695: The facility failed to store a nebulizer mask properly, leaving it on the floor and exposing Resident #74 to contamination risk.
F 0791: The facility failed to ensure recommended dental services were provided for Resident #79, resulting in untreated dental abscess due to insurance and payment issues.
F 0812: The facility failed to remove expired, undated, and spoiled food items from storage areas, potentially affecting all residents receiving food from the dietary department.
F 0880: The facility failed to prevent infection spread when a nurse flushed and administered medication via a peg feeding tube without wearing gloves for Resident #64.
Report Facts
Residents reviewed with peg feeding tubes: 3
Residents sampled for dental services: 20
Kitchen observations: 4
Residents affected by peg feeding tube care deficiencies: 1
Residents affected by respiratory care deficiencies: 2
Residents affected by dental service deficiencies: 1
Residents affected by food storage deficiencies: Many
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #1 | Licensed Practical Nurse | Named in infection prevention deficiency for not wearing gloves during peg feeding tube medication administration |
| LPN #2 | Licensed Practical Nurse | Named in deficiencies related to peg feeding tube care and respiratory equipment storage |
| RN #1 | Registered Nurse | Named in dental service deficiency related to Resident #79 |
| Director of Nursing | Director of Nursing | Provided interviews confirming deficiencies and standard practices |
| Dietary Manager | Dietary Manager | Interviewed regarding expired food removal responsibilities |
| Cook | Cook | Interviewed regarding expired food removal responsibilities |
| Dietary Aide | Dietary Aide | Interviewed regarding expired food removal responsibilities |
| Administrator | Administrator | Interviewed regarding food safety and dental service deficiencies |
| Social Worker | Social Worker | Interviewed regarding dental service follow-up |
Inspection Report — Apr 17, 2023
Life Safety
Date: Apr 17, 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 — Feb 14, 2023
Complaint Investigation
Date: Feb 14, 2023
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #20725 at the facility on 2/14/23. MS #20725 was related to an injury of unknown origin and oversedation of a resident.
Complaint Details
Complaint MS #20725 related to an injury of unknown origin and oversedation of a resident. The complaint was investigated and no deficiencies were cited.
Findings
During the survey, the facility was found to be in compliance with the requirements of participation in Medicare and Medicaid and there were no deficiencies cited.
Report Facts
Complaint number: 20725
Inspection Report — Jan 4, 2023
Complaint Investigation
Date: Jan 4, 2023
Visit Reason
The State Agency (SA) conducted a Complaint Investigation (CI), MS #19632 and MS #20243, at the facility from 1/3/23 through 1/4/23.
Complaint Details
Complaint Investigation MS #19632 regarding a Physician's Order for wound care was not substantiated. Complaint MS #20243 related to facility staffing, quality of care/treatment, accidents, resident rights, and nursing services was also not substantiated.
Findings
The SA determined the facility was in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirement. There were no deficiencies cited.
Inspection Report — Jan 4, 2023
Complaint Investigation
Date: Jan 4, 2023
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #19632 and MS #20243 at the facility from 1/3/23 through 1/4/23.
Complaint Details
Complaint MS #19632 regarding a Physician's Order for wound care was not substantiated. Complaint MS #20243 related to facility staffing, quality of care/treatment, accidents, resident rights, and nursing services was also not substantiated.
Findings
The facility was found in compliance with no deficiencies cited during the complaint investigation.
Inspection Report — Sep 22, 2022
Complaint Investigation
Date: Sep 22, 2022
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #19440 and MS #19585, at the facility from 9/21/22 through 9/22/22.
Complaint Details
Complaint Investigation MS #19440 for hospitalization and MS #19585 for staffing were not substantiated; no deficiencies were cited.
Findings
The facility was found in compliance with the Minimum Standards for Institutions for the Aged or Infirm, state licensure requirements. No deficiencies were cited.
Inspection Report — Sep 22, 2022
Complaint Investigation
Date: Sep 22, 2022
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #19440 and MS #19585, at the facility from 9/21/22 through 9/22/22.
Complaint Details
Complaint numbers MS #19440 for hospitalization and MS #19585 for staffing were investigated and not substantiated; no deficiencies were cited.
Findings
The facility was found in compliance with Medicare and Medicaid requirements. No deficiencies were cited.
Report Facts
Complaints investigated: 2
Inspection Report — Mar 28, 2022
Complaint Investigation
Date: Mar 28, 2022
Visit Reason
The State Agency conducted a Complaint Investigation (CI), MS #18103, at the facility on 3/28/22 regarding a complaint of elopement.
Complaint Details
Complaint number CI MS#18103 regarding elopement was investigated and not substantiated; no deficiencies were cited.
Findings
The State Agency did not substantiate the complaint and determined the facility was in compliance with the Mississippi Regulations for Minimum Standards for Institutions for the Aged or Infirm. There were no deficiencies cited.
Report Facts
Complaint investigations conducted: 1
Inspection Report — Mar 28, 2022
Complaint Investigation
Date: Mar 28, 2022
Visit Reason
The State Agency (SA) conducted a Complaint Investigation (CI MS #18103) at the facility on 3/28/22.
Complaint Details
Complaint number CI MS #18103 involved an allegation of elopement. The complaint was not substantiated and no deficiencies were cited.
Findings
The SA determined the facility was in compliance with the requirements for participation in Medicare and Medicaid. The SA did not substantiate the complaint for elopement and there were no deficiencies cited.
Report Facts
Complaint investigations: 1
Inspection Report — Jul 1, 2021
Complaint Investigation
Date: Jul 1, 2021
Visit Reason
The State Agency conducted two Complaint Investigations (CIs), CI #17712 and CI #17586, from 6/30/2021 to 7/1/2021.
Complaint Details
Two complaint investigations, CI #17712 and CI #17586, were conducted and not substantiated.
Findings
The facility was found in compliance with the Minimum Standards of Operation for Institutions for the Aged or Infirm and state licensure requirements.
Report Facts
Complaint Investigations conducted: 2
Inspection Report — Feb 4, 2021
Routine
Date: Feb 4, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 2/04/21.
Findings
The facility was found to be in compliance with infection control regulations and has implemented the Centers for Medicare and Medicaid (CMS) and the Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19. No Deficiencies cited.
Inspection Report — Feb 4, 2021
Routine
Date: Feb 4, 2021
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey was conducted by the State Agency (SA) on 2/04/21.
Findings
The facility was found to be in compliance with 42 CFR 483.73 related to E-0024(b)(6).
Inspection Report — Dec 28, 2020
Routine
Date: Dec 28, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 12/28/2020.
Findings
The facility was found to be in compliance with infection control regulations and has implemented the Centers for Medicare and Medicaid (CMS) and the Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Inspection Report — Dec 28, 2020
Routine
Date: Dec 28, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey was conducted by the Centers for Medicare & Medicaid Services (CMS) on 12/28/2020.
Findings
The facility was found to be in compliance with Medicaid and Medicare requirements related to E-0024 (b)(6).
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 (SA) on 9/28/20.
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 — Sep 9, 2020
Routine
Date: Sep 9, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency on 09/08/2020 through 09/09/2020. The facility was not in substantial compliance with Infection Control guidelines and was cited for a regulatory deficiency at F880.
Findings
The facility failed to prevent the likelihood of the spread of COVID-19 and other infectious diseases due to improper use of Personal Protective Equipment (PPE) by dietary staff and lack of proper hand hygiene by a Certified Nursing Assistant during resident care.
Deficiencies (1)
F0880 - Infection Prevention & Control. The facility failed to ensure proper PPE use by dietary staff and proper hand hygiene by a CNA, increasing the risk of spreading COVID-19 and other infections.
Report Facts
Deficiencies cited: 1
Inspection Report — Aug 19, 2020
Routine
Date: Aug 19, 2020
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 8/19/2020.
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 — Aug 19, 2020
Routine
Date: Aug 19, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey was conducted by the Centers for Medicare & Medicaid Services (CMS) on 8/19/2020.
Findings
The facility was found to be in compliance with 42 CFR §483.73 related to E-0024 (b)(6).
Inspection Report — Jul 1, 2020
Routine
Date: Jul 1, 2020
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency (SA) on 7/1/20.
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 — Jul 1, 2020
Routine
Date: Jul 1, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey was conducted by the Centers for Medicare & Medicaid Services (CMS) on 7/1/2020.
Findings
The facility was found to be in compliance with 42 CFR §483.73 related to E-0024 (b)(6).
Inspection Report — Feb 19, 2020
Annual Inspection
Date: Feb 19, 2020
Visit Reason
The State Agency (SA) conducted an annual recertification survey at the facility from 2/17/2020 until 2/19/2020. During the survey, the SA determined the facility was not in compliance with Medicare and Medicaid requirements for participation.
Findings
The facility was found not in compliance due to failure to properly monitor and release a physical restraint (lap buddy) every two hours for Resident #68, violating the resident's care plan and physician orders.
Deficiencies (2)
F0604 - Right to be free from physical restraints. The facility failed to ensure Resident #68 was free from physical restraint use by not monitoring and releasing her lap buddy every two hours as required.
F0656 - Develop/Implement comprehensive care plan. The facility failed to follow Resident #68's care plan for releasing the lap buddy restraint every two hours, resulting in noncompliance with the resident's plan of care.
Report Facts
Deficiencies cited: 2
Inspection Report — Feb 19, 2020
Complaint Investigation
Date: Feb 19, 2020
Visit Reason
The inspection was conducted to investigate a complaint regarding the facility's failure to ensure that Resident #68 was free from the use of physical restraints, specifically the failure to monitor and release her lap buddy restraint every two hours as ordered.
Complaint Details
The complaint was substantiated as the facility failed to follow the care plan and physician's orders regarding the use and timely release of physical restraints for Resident #68.
Findings
The facility failed to follow Resident #68's Care Plan and Medical Doctor's orders to remove the lap buddy restraint every two hours. Observations and staff interviews confirmed that the restraint was not released for over two hours, violating the facility's physical restraint policy and care plan requirements.
Deficiencies (2)
F 0604: The facility failed to ensure Resident #68 was free from physical restraint use by not releasing her lap buddy every two hours as required by policy and care plan.
F 0656: The facility failed to develop and implement a complete care plan meeting Resident #68's needs, specifically failing to follow the care plan to release the lap buddy restraint every two hours.
Report Facts
Residents affected: 1
Care plans reviewed: 23
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse (LPN) #1 | Licensed Practical Nurse | Confirmed failure to remove lap buddy restraint every two hours as per care plan. |
| Registered Nurse (RN) #1 | Staff Development Nurse | Stated nursing staff and CNAs are responsible for removing restraints every two hours. |
| Director of Nursing (DON) | Director of Nursing | Confirmed responsibility of nurses and CNAs to remove restraints and acknowledged care plan and MD orders were not followed. |
Inspection Report — Nov 7, 2019
Complaint Investigation
Date: Nov 7, 2019
Visit Reason
The State Survey Agency conducted a complaint investigation on 11/7/19.
Complaint Details
CI MS #16277: Complaint investigation for abuse and neglect was unsubstantiated with no deficiencies cited.
Findings
The investigation was unsubstantiated for abuse and neglect with no deficiencies cited. The facility was found in compliance with Medicare and Medicaid requirements for participation.
Inspection Report — Apr 9, 2019
Complaint Investigation
Date: Apr 9, 2019
Visit Reason
A complaint investigation was conducted on March 26, 2019 in the facility. The investigation was unsubstantiated with no deficiencies cited, but the facility was found not in compliance due to an Immediate Jeopardy identified by the annual survey.
Complaint Details
CI MS #15760: Complaint investigation conducted on March 26, 2019 was unsubstantiated with no deficiencies cited.
Findings
The complaint investigation was unsubstantiated with no deficiencies cited. However, the facility was found not in compliance due to an Immediate Jeopardy identified by the annual survey.
Inspection Report — Mar 15, 2019
Annual Inspection
Date: Mar 15, 2019
Visit Reason
The State Agency (SA) conducted an annual recertification survey from 3/12/19 through 3/15/19. During the survey, the facility was found not to be in compliance with the Requirements for Participation for Medicare and Medicaid.
Findings
The facility was cited for failure to follow professional standards of infection control during blood sugar testing, specifically failing to clean and disinfect the glucometer before, between, and after use for three residents, placing 33 residents at risk of blood borne pathogen cross-contamination. An Immediate Jeopardy was identified and removed after corrective actions were implemented.
Deficiencies (4)
F0658 - Services Provided Meet Professional Standards. The facility failed to follow professional standards for infection control by not cleaning and disinfecting the glucometer before, between, and after use for three residents receiving blood sugar testing, risking blood borne pathogen cross-contamination among 33 residents.
F0880 - Infection Prevention and Control. The facility failed to establish and maintain an infection prevention and control program by not cleaning or disinfecting a multi-use glucometer before, between, and after use for three residents, and not using a clean barrier, placing residents at risk of serious injury or death from blood borne pathogens.
K000 - Initial Comments. The facility met the applicable provisions of the 2012 Edition of the Life Safety Code. No deficiencies were cited.
E000 - Initial Comments. The facility met all applicable Federal, State and local emergency preparedness requirements. No deficiencies were identified.
Report Facts
Deficiencies cited: 2
Residents receiving Acu-checks: 33
Residents assessed for exposure: 3
Licensed nursing staff: 33
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