Inspection Reports for
Keysville Nursing Home & Rehab
1005 GA HIGHWAY 88, BLYTHE, GA, 30805
Back to Facility ProfileDeficiencies (last 8 years)
Deficiencies (over 8 years)
3.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
33% better than Georgia average
Georgia average: 4.9 deficiencies/yearDeficiencies per year
12
9
6
3
0
Census
Latest occupancy rate
88% occupied
Based on a May 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Life Safety
Census: 56
Capacity: 64
Deficiencies: 2
Date: May 27, 2025
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found not in substantial compliance due to deficiencies including a non-functioning exit sign on B Hall affecting 10 people and the presence of a power strip on the floor in the Administration office affecting 5 people.
Deficiencies (2)
Exit sign on B Hall did not operate when tested.
Power strip was found on the floor in the Administration office.
Report Facts
People affected by exit sign deficiency: 10
People affected by power strip deficiency: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings of exit sign and power strip deficiencies during tour |
Inspection Report
Annual Inspection
Deficiencies: 1
Date: May 22, 2025
Visit Reason
A State Licensure survey was conducted from May 19, 2025, through May 22, 2025, at Keysville Nursing Home & Rehab to assess compliance with state health regulations.
Complaint Details
The allegation of abuse was reported on 2/4/2025 after the resident (R13) told a family member that someone hit them on the head with a book on 1/31/2025. The investigation lacked sufficient documentation, witness statements, and follow-up assessments. The resident had moderate cognitive impairment and could not recall the incident. The facility's investigation was acknowledged as incomplete by the Administrator.
Findings
The facility failed to thoroughly investigate an allegation of abuse involving one resident (R13) among 27 sampled residents. Documentation and investigation procedures were incomplete, including lack of staff interviews and progress notes.
Deficiencies (1)
Failure to thoroughly investigate an allegation of abuse for one resident, including inadequate documentation and incomplete interviews.
Report Facts
Number of sampled residents: 27
Date of abuse allegation report: Feb 4, 2025
Date of incident: Jan 31, 2025
BIMS score: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse 1 | LPN | Received abuse allegation call, informed ADON, did not document assessment or progress note |
| Assistant Director of Nursing | ADON | Received report from LPN1, notified DON, described investigation procedures |
| Director of Nursing | DON | Conducted investigation, reviewed camera footage, acknowledged lack of documentation |
| Administrator | Facility Administrator | Set expectations for abuse investigations, acknowledged incomplete investigation |
Inspection Report
Complaint Investigation
Census: 58
Deficiencies: 2
Date: May 22, 2025
Visit Reason
A standard survey was conducted from May 19, 2025 through May 22, 2025, including investigation of four complaint intake numbers related to the facility's compliance with Medicare/Medicaid regulations.
Complaint Details
The investigation included Complaint Intake Numbers GA00246207, GA00249781, GA00248773, and GA00254779. The abuse allegation for resident R13 was not thoroughly investigated, with missing documentation and incomplete interviews. The referral for resident R41 with new mental health diagnoses was not made to the state agency as required.
Findings
The facility was found not in substantial compliance with regulations, with deficiencies including failure to thoroughly investigate an allegation of abuse for one resident and failure to make a required referral to the state authority for another resident with newly evident serious mental disorders.
Deficiencies (2)
Failure to thoroughly investigate an allegation of abuse for one of 27 sampled residents (R13), including lack of documentation of assessments, interviews, and incomplete investigation.
Failure to make a referral to the state-designated authority regarding newly evident or possible serious mental disorders for one of five residents (R41).
Report Facts
Complaint Intake Numbers: 4
Resident census: 58
Sampled residents for abuse allegation: 27
Residents reviewed for PASARR referral: 5
BIMS score: 9
BIMS score: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN1 | Licensed Practical Nurse | Received abuse allegation from family member, reported to ADON, but did not document assessment or progress note |
| ADON | Assistant Director of Nursing | Notified by LPN1 of abuse allegation, notified DON, described investigation process |
| DON | Director of Nursing | Conducted investigation, reviewed camera footage, acknowledged lack of documentation and incomplete investigation |
| Administrator | Facility Administrator | Stated expectations for thorough investigations and documentation, acknowledged deficiencies in abuse investigation and PASARR referral |
| SSD | Social Service Director | Responsible for PASARR screening and referrals, confirmed failure to submit PASRR form for resident R41 |
| Business Office Manager | Business Office Manager | Provided a witness statement during abuse investigation |
Inspection Report
Follow-Up
Deficiencies: 0
Date: Mar 7, 2024
Visit Reason
A Life Safety Code (LSC) Desk Review Follow-Up survey was conducted to verify correction of previously cited LSC deficiencies.
Findings
The follow-up survey found that all previously cited Life Safety Code deficiencies had been corrected.
Inspection Report
Renewal
Deficiencies: 0
Date: Jan 21, 2024
Visit Reason
The visit was a State Licensure survey conducted from January 19, 2024, through January 21, 2024, to determine compliance with the State Long Term Care Requirements.
Findings
No State Health deficiencies were cited during the survey.
Inspection Report
Routine
Census: 58
Deficiencies: 0
Date: Jan 21, 2024
Visit Reason
A standard survey was conducted at Keysville Nursing Home and Rehab from January 19, 2024, through January 21, 2024, to assess compliance with Medicare/Medicaid regulations.
Findings
The facility was found to be in substantial compliance with the Health Portion of the Medicare/Medicaid regulations at 42 C.F.R. Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Life Safety
Census: 58
Capacity: 65
Deficiencies: 1
Date: Jan 20, 2024
Visit Reason
The visit was a Life Safety Code Survey conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and the National Fire Protection Association (NFPA) Life Safety Code standards.
Findings
The facility was found not in substantial compliance due to failure to maintain the sprinkler system. Specifically, two sprinkler heads in one resident hallway were found with paint on them, which could impair their function.
Deficiencies (1)
Two sprinkler heads with paint on them in one resident hallway, affecting 1/4 of the hallway.
Report Facts
Census: 58
Total Capacity: 65
Number of sprinkler heads affected: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings of painted sprinkler heads during facility tour |
Inspection Report
Deficiencies: 0
Date: Jul 28, 2022
Visit Reason
The document is a statement of deficiencies and plan of correction for Keysville Nursing Home & Rehab following a state inspection.
Findings
The report contains initial comments but does not provide specific details on deficiencies or findings.
Inspection Report
Re-Inspection
Census: 60
Deficiencies: 0
Date: Jul 28, 2022
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the 5/22/22 Recertification Survey.
Findings
All deficiencies cited as a result of the 5/22/22 Recertification Survey were found to be corrected.
Inspection Report
Re-Inspection
Census: 60
Deficiencies: 0
Date: Jul 28, 2022
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the 6/16/22 Federal Monitoring Health Comparative survey.
Findings
All deficiencies cited in the previous survey were found to be corrected during this revisit survey.
Inspection Report
Routine
Census: 61
Deficiencies: 5
Date: Jun 16, 2022
Visit Reason
A Federal Monitoring Health Comparative Survey was conducted by the Centers for Medicare & Medicaid Services from June 13 to June 16, 2022, to assess compliance with 42 CFR Part 483, Subpart B-Requirements for Long Term Care Facilities.
Findings
The facility was found not in substantial compliance with multiple regulatory requirements including respiratory care, medication storage, nutritional adequacy of pureed diets, food safety related to cooler temperatures, and infection prevention and control, including lack of a water management policy to reduce Legionella risk.
Deficiencies (5)
Failure to ensure a CPAP machine was properly covered when not in use for one resident.
Expired medication found in medication refrigerator.
Failure to ensure standardized recipes for puree menu to ensure nutritional adequacy for residents.
Failure to maintain walk-in cooler temperatures below 44 degrees Fahrenheit, risking foodborne illness.
Failure to develop and implement a water management policy to reduce risk of Legionella and other pathogens.
Report Facts
Census: 61
Expired medication open date: Mar 4, 2022
Medication last administered date: May 11, 2022
Walk-in cooler temperature range: 42
Walk-in cooler temperature range: 46
Residents on puree diet: 13
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing | Interviewed regarding uncovered CPAP mask and expired medication handling |
| License Practical Nurse #1 | LPN | Observed expired medication in refrigerator |
| Dietary Manager | Dietary Manager | Interviewed regarding puree food preparation and walk-in cooler temperatures |
| Dietary Aide #3 | Dietary Aide | Observed preparing puree foods without recipes |
| Registered Dietitian | Registered Dietitian | Interviewed regarding puree food preparation and nutritional adequacy |
| Maintenance Director | Maintenance Director | Interviewed regarding water testing and water management policy |
| Nursing Home Administrator | Nursing Home Administrator | Interviewed regarding water testing and water management policy |
| City Code Enforcement Officer | City Code Enforcement Officer | Interviewed regarding water supply testing |
Inspection Report
Renewal
Deficiencies: 0
Date: May 22, 2022
Visit Reason
The inspection was conducted as a Licensure Survey from 5/20/2022 through 5/22/2022 to assess compliance for license renewal.
Findings
No deficiencies were identified during the Licensure Survey conducted from 5/20/2022 through 5/22/2022.
Inspection Report
Life Safety
Census: 63
Capacity: 64
Deficiencies: 0
Date: May 20, 2022
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found to be in compliance with the Emergency Preparedness Program requirements and Life Safety Code standards.
Report Facts
Certified beds: 64
Census: 63
Inspection Report
Re-Inspection
Census: 40
Deficiencies: 0
Date: Feb 10, 2021
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the 12/17/2020 COVID-19 Infection Control Survey.
Findings
All deficiencies cited in the previous COVID-19 Infection Control Survey were found to be corrected during this revisit survey.
Inspection Report
Routine
Census: 46
Deficiencies: 1
Date: Dec 17, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted on December 17, 2020 by Healthcare Management Solutions, LLC on behalf of the Georgia Department of Community Health (DCH). The facility was evaluated for compliance with infection control regulations.
Findings
The facility was found not to be in compliance with 42 CFR §483.80 infection control regulations due to failure to have an effective Infection Prevention Control program related to COVID-19. Specifically, a nurse was observed entering a COVID positive resident's room without appropriate Personal Protective Equipment (PPE), increasing the risk of COVID-19 transmission.
Deficiencies (1)
Failure to use appropriate Personal Protective Equipment (PPE) prior to entering a resident's room on contact and droplet precautions, increasing risk of COVID-19 transmission.
Report Facts
Census: 46
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN AA | Licensed Practical Nurse | Observed entering COVID positive resident's room without appropriate PPE |
| Director of Nursing | Director of Nursing | Accompanied survey tour and confirmed PPE requirements |
| Infection Control Preventionist | Infection Control Preventionist | Provided information on PPE requirements for contact and droplet precautions |
| Administrator | Administrator | Stated expectations for staff to follow isolation precautions and wear full PPE |
Inspection Report
Routine
Census: 58
Deficiencies: 0
Date: Jul 14, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey and a COVID-19 Focused Infection Control Survey were conducted at Keysville Nursing Home on July 14, 2020 to assess compliance with relevant federal regulations.
Findings
The facility was found to be in compliance with 42 CFR §483.73 related to emergency preparedness and 42 CFR §483.80 related to infection control regulations, including implementation of CMS and CDC recommended practices for COVID-19.
Report Facts
Total census: 58
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Jan 8, 2020
Visit Reason
An Abbreviated/Partial Extended Survey was conducted to investigate complaint #GA00201231.
Complaint Details
Complaint #GA00201231 was investigated and found to have no deficiencies.
Findings
No deficiencies were cited during the survey.
Inspection Report
Re-Inspection
Census: 55
Deficiencies: 0
Date: Oct 17, 2019
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the 8/23/19 recertification survey.
Findings
All deficiencies cited in the previous recertification survey were found to be corrected during this revisit survey.
Inspection Report
Follow-Up
Deficiencies: 0
Date: Oct 8, 2019
Visit Reason
A Follow-Up Survey was conducted to verify correction of previously cited survey tags.
Findings
All previously cited survey tags have been corrected as noted during the follow-up survey.
Inspection Report
Life Safety
Census: 51
Capacity: 64
Deficiencies: 4
Date: Aug 20, 2019
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with fire safety regulations and related NFPA standards at Keysville Nursing Home & Rehab.
Findings
The facility was found not in substantial compliance with life safety requirements, including failure to maintain fire doors, emergency lighting, fire alarm system testing and maintenance, and staff not having gate keys for egress. These deficiencies could place all 51 residents and staff at risk in the event of fire.
Deficiencies (4)
Facility failed to have staff maintain a gate key on every employee to escape the fenced yard.
Facility failed to maintain all fire doors; specifically, the fire door to kitchen pantry was missing the door closer.
Facility failed to maintain emergency lighting; emergency light in the kitchen was very weak.
Facility failed to maintain the fire alarm system and/or its components; no current documentation for sensitivity testing of smoke alarms.
Report Facts
Residents present: 51
Total licensed beds: 64
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Staff member who confirmed findings during the tour and interviews |
Inspection Report
Follow-Up
Deficiencies: 0
Date: Jul 17, 2018
Visit Reason
The visit was a Follow-Up Survey conducted to verify that all previously cited survey tags had been corrected.
Findings
The surveyor noted that all previously cited survey tags had been corrected during the follow-up visits conducted on 07/16/2018 and 07/18/2018.
Inspection Report
Annual Inspection
Census: 58
Deficiencies: 0
Date: Jun 1, 2018
Visit Reason
A standard survey was conducted at Keysville Nursing and Rehabilitation from May 29, 2018 through June 1, 2018 to assess compliance with Medicare/Medicaid regulations.
Findings
The standard survey revealed that the facility was in substantial compliance with Medicare/Medicaid regulations at 42 Code of Federal Regulations Part 483, Subpart B-Requirements for Long Term Care Facilities.
Inspection Report
Life Safety
Census: 59
Capacity: 65
Deficiencies: 10
Date: May 29, 2018
Visit Reason
The inspection was conducted to evaluate Keysville Nursing Home & Rehab's compliance with emergency preparedness and life safety code requirements, including sprinkler system maintenance, emergency preparedness plan compliance, and fire safety standards.
Findings
The facility was found not in substantial compliance with emergency preparedness requirements as the emergency plan lacked policies on the facility's role under section 1135, communication plans, testing requirements, annual reviews, patient population policies, and collaboration with local emergency officials. Life safety deficiencies included damaged dry sprinkler heads, non-compliant use of power strips and flexible cords, presence of non-code-compliant space heaters, and improper segregation of oxygen cylinders.
Deficiencies (10)
Emergency Preparedness Plan not in substantial compliance with Appendix Z requirements including lack of policy on facility role under section 1135 waiver.
Emergency Preparedness Plan lacked communication plan for occupancy and needs.
Facility failed to demonstrate compliance with emergency preparedness testing requirements.
Emergency Preparedness Plan had not undergone annual review and update.
Emergency Preparedness Plan did not address patient/client population and continuity of operations.
Emergency Preparedness Plan lacked process for cooperation and collaboration with local, tribal, state, and federal emergency preparedness officials.
Dry sprinkler heads beneath the outside canopy were damaged and dry sprinkler system quick opening device was not in service.
Facility used power strips lying directly on the floor and flexible cords in place of permanent wiring, violating NFPA 101 and NFPA 70.
Facility failed to maintain a facility free of non-code-compliant portable space heaters exceeding 212 degrees Fahrenheit.
Oxygen cylinders were not segregated properly; used and new cylinders were mixed.
Report Facts
Census: 59
Total Capacity: 65
Stories: 1
Construction Year: 1995
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during inspection and interviews |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 27, 2017
Visit Reason
An unannounced complaint survey was conducted to investigate complaint GA00181290.
Complaint Details
Complaint GA00181290 was investigated and found to have no deficiencies.
Findings
No deficiency was cited during the complaint investigation survey.
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Sep 19, 2017
Visit Reason
An Abbreviated/Partial Extended Survey was conducted to investigate complaint GA00179165.
Complaint Details
The complaint was substantiated.
Findings
The facility was found to be in compliance with Federal and State Long Term Care regulations. The complaint was substantiated and no deficiencies were cited.
Inspection Report
Follow-Up
Deficiencies: 0
Date: Jul 18, 2017
Visit Reason
A follow-up visit was conducted on 07/18/2017 to verify correction of deficiencies identified in the prior recertification survey.
Findings
All deficiencies identified in the prior recertification survey had been corrected as of the follow-up visit.
Inspection Report
Life Safety
Census: 50
Capacity: 64
Deficiencies: 0
Date: May 31, 2017
Visit Reason
A Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid participation requirements and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found in substantial compliance with the Life Safety Code requirements and related NFPA standards during the survey.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 29, 2017
Visit Reason
The inspection was conducted as a Complaint Survey to investigate complaint numbers GA00166203 and GA00168131 and to determine compliance with Federal and State Long Term Care regulations.
Complaint Details
The visit was complaint-related to investigate complaints GA00166203 and GA00168131; no deficiencies were found, indicating no substantiated issues.
Findings
No deficiencies were cited during the complaint survey conducted on April 28 and 29, 2017.
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