Inspection Reports for
Green Meadow Haven
1110 Ringgold Avenue, Coushatta, LA, 71019
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Inspection Report — Aug 20, 2025
Annual Inspection CMS
Date: Aug 20, 2025
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory requirements for nursing home care.
Findings
The facility was found deficient in multiple areas including failure to accommodate resident needs, improper use of psychotropic medications, failure to provide required transfer notices, incomplete care plans, unsafe serving of hot liquids resulting in resident injury, and failure to submit required staffing data.
Deficiencies (6)
F 0558: The facility failed to ensure a resident with contractures could access the call bell for assistance, resulting in unmet needs.
F 0605: The facility failed to limit a resident's PRN psychotropic medication order to 14 days, resulting in potential chemical restraint.
F 0628: The facility failed to provide written transfer/discharge notices including appeal rights and bed hold policies to residents or their responsible parties.
F 0656: The facility failed to implement a physician's order for a urology referral appointment for a resident with urinary retention.
F 0689: The facility failed to prevent accident hazards by serving coffee at unsafe temperatures, causing a resident to sustain a second-degree burn.
F 0851: The facility failed to electronically submit required Payroll Based Journal staffing data for Fiscal Year Quarter 2 2025.
Report Facts
Residents reviewed for unnecessary medications: 6
Residents affected by failure to provide transfer notices: 3
Residents affected by coffee burn incident: 1
Residents affected by call bell accessibility issue: 1
Residents affected by failure to implement urology referral: 1
Residents affected by failure to limit psychotropic medication: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S2 DON | Director of Nursing | Acknowledged issues with call bell accessibility, psychotropic medication orders, urology referral, and coffee burn incident |
| S1 Administrator | Administrator | Acknowledged failure to submit Payroll Based Journal staffing data and lack of official scald prevention policies |
| S6 CNA | Certified Nursing Assistant | Reported discovery of resident's coffee burn and in-serviced staff on coffee safety |
| S7 LPN | Licensed Practical Nurse | Notified of resident's coffee burn and participated in staff in-service |
| S12 DM | Dietary Manager | Reported coffee brewing process and temperature monitoring |
| S5 NP | Nurse Practitioner | Assessed and treated resident's coffee burn and reported on wound healing |
Inspection Report — Jul 24, 2024
Complaint Investigation CMS
Date: Jul 24, 2024
Visit Reason
The inspection was conducted to investigate complaints regarding the facility's failure to ensure residents' drug regimens were free from unnecessary medications and to verify accurate submission of direct care staffing information to CMS.
Complaint Details
The complaint investigation found substantiated issues with medication monitoring for edema and bleeding in multiple residents and inaccurate submission of staffing data to CMS.
Findings
The facility failed to adequately monitor five residents for edema while receiving diuretics and failed to monitor one resident for bleeding while receiving an anticoagulant. Additionally, the facility failed to accurately submit mandatory direct care staffing information to CMS for Fiscal Year Quarter 2 2024.
Deficiencies (2)
F 0757: The facility failed to ensure residents' drug regimens were free from unnecessary medications by not adequately monitoring Residents #17, #34, #41, #44, and #382 for edema while receiving diuretics and Resident #17 for bleeding while receiving an anticoagulant.
F 0851: The facility failed to accurately submit mandatory direct care staffing information to CMS for Fiscal Year Quarter 2 2024, including missing RN hours on multiple dates.
Report Facts
Residents affected: 5
Total sampled residents: 26
Dates with no RN hours: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S2 Director of Nursing | Acknowledged inability to produce documentation of monitoring for edema and bleeding | |
| S4 Bookkeeper | Reported no submission of CMS information during her tenure and uncertainty about previous submissions | |
| S3 Human Resources | Indicated uncertainty about the source of submitted PBJ Staffing Data Report information | |
| S1 Administrator | Confirmed previous bookkeeper submitted inaccurate PBJ Staffing Data Report information to CMS |
Inspection Report — Aug 15, 2023
Complaint Investigation CMS
Date: Aug 15, 2023
Visit Reason
The inspection was conducted due to a complaint or allegation regarding inadequate supervision of residents at risk of elopement.
Complaint Details
The complaint investigation found that Resident #1 left the facility unsupervised through a side gate and went to a store to purchase alcohol. The resident was caught by facility staff and returned without injury. The facility implemented 15-minute checks and moved the resident to a locked dementia unit.
Findings
The facility failed to provide adequate supervision for one resident with cognitive impairment who left the facility unsupervised and went to a nearby store to purchase alcohol. The resident was returned safely, placed on increased monitoring, and subsequently moved to a locked dementia unit.
Deficiencies (1)
F 0689: The facility failed to ensure adequate supervision to prevent accidents for a resident with impaired cognition who eloped from the facility and went to a store unsupervised.
Report Facts
Residents reviewed for impaired cognition: 5
Resident BIMS score: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | S1 DON reported details of the resident elopement incident |
Inspection Report — Jun 28, 2023
Complaint Investigation CMS
Date: Jun 28, 2023
Visit Reason
The inspection was conducted due to a complaint investigation regarding failure to provide necessary care for residents unable to perform activities of daily living and failure to complete required adverse action checks for staff.
Complaint Details
The complaint investigation substantiated that Resident #40 did not receive required nail care and that adverse action checks for staff were not completed as required.
Findings
The facility failed to ensure Resident #40 received proper nail care despite documented needs and resident complaints. Additionally, the facility failed to perform adverse action checks at hire and monthly for six certified nursing assistants.
Deficiencies (2)
F 0677: The facility failed to provide nail care to Resident #40 who required extensive assistance with personal hygiene. Observations and interviews confirmed the resident's fingernails were long, dirty, and causing discomfort.
F 0729: The facility failed to ensure adverse action checks were completed at time of hire and monthly for six certified nursing assistants. Human Resources confirmed these checks were not performed.
Report Facts
Residents affected: 1
Employees affected: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S1 RN | Registered Nurse | Documented last nail care for Resident #40 and acknowledged need for nail care during interview |
| S8 Human Resources | Reported facility had not been performing adverse action checks on staff |
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