Inspection Reports for Magnolia Manor of Marion County
349 GENEVA ROAD, BUENA VISTA, GA, 31803
Back to Facility ProfileInspection Report Summary
The most recent inspection on April 2, 2025, was a complaint investigation that found no deficiencies. Earlier inspections showed a pattern of deficiencies related mainly to medication management, infection control, nutrition, environmental maintenance, and Life Safety Code compliance, with some issues corrected upon reinspection. Prior citations included failure to follow pureed food recipes, medication errors exceeding allowed rates, inadequate infection control practices, and environmental concerns such as unsecured doors and electrical hazards. Complaint investigations were mostly unsubstantiated or substantiated without citations, and no fines, immediate jeopardy findings, or license actions were listed in the available reports. The facility has shown some improvement over time, with several previously cited deficiencies verified as corrected in follow-up surveys.
Deficiencies (last 8 years)
Deficiencies (over 8 years)
3.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
22% better than Georgia average
Georgia average: 4.9 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
58 residents
Based on a April 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 58
Deficiencies: 0
Date: Apr 2, 2025
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint numbers GA00254459 and GA00254448.
Complaint Details
Investigation of complaints GA00254459 and GA00254448 resulted in no deficiencies cited.
Findings
No deficiencies were cited during the investigation.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Mar 10, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Magnolia Manor of Marion County following a survey completed on 03/10/2025.
Findings
The document contains initial comments and references deficiencies and plans of correction, but no specific deficiencies or findings are detailed in the provided page.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Mar 4, 2025
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Magnolia Manor of Marion County following a regulatory inspection.
Findings
The report contains initial comments but does not provide specific details on deficiencies or findings.
Inspection Report
Re-Inspection
Census: 61
Deficiencies: 0
Date: Mar 4, 2025
Visit Reason
A Revisit Survey was conducted at Magnolia Manor of Marion County to verify correction of deficiencies cited during the Recertification with Complaint Survey on January 16, 2025.
Findings
The deficiencies cited in the prior Recertification with Complaint Survey were found to be corrected.
Inspection Report
Life Safety
Census: 57
Capacity: 70
Deficiencies: 2
Date: Jan 27, 2025
Visit Reason
The Life Safety Code Survey was conducted to assess compliance with 42 CFR Subpart 483.90(a), Life Safety from Fire, and the related NFPA 101 Life Safety Code 2012 edition requirements.
Findings
The facility was found not in substantial compliance due to failure to secure doors to a hazardous area and failure to properly safeguard an electrical panel, both confirmed by staff during the tour.
Deficiencies (2)
Doors with self-closing devices were propped open, failing to secure doors to a hazardous area near the kitchen corridor.
An electrical panel had an open slot that was not covered to prevent shock, failing to properly safeguard the panel.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings regarding propped open door and uncovered electrical panel during facility tour. |
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 4
Date: Jan 16, 2025
Visit Reason
The inspection was conducted as a State Licensure survey to determine compliance with the State Long Term Care Requirements at Magnolia Manor of Marion County.
Findings
The facility was found deficient in multiple areas including failure to follow pureed food recipes affecting nutritional value for 16 residents, inadequate infection control practices for 4 residents, a medication error rate exceeding 5% for one resident, and failure to maintain a safe, clean, and comfortable environment in six rooms.
Deficiencies (4)
Failure to follow the recipe by not measuring all ingredients while pureeing meat, potentially placing 16 residents at risk of decreased nutritional intake.
Failure to ensure infection control practices including improper cleaning of glucometer, failure to sanitize shared equipment between residents, and failure to follow Enhanced Barrier Precautions during wound care for 4 residents.
Medication error rate of 7.69% during medication administration for one resident, exceeding the allowed 5%, with two medication errors observed.
Failure to provide a safe, clean, comfortable, home-like environment due to leaking faucets, broken bedside dresser, blown light bulb, dirty blinds, and discolored air conditioning unit in six rooms.
Report Facts
Residents affected by pureed food deficiency: 16
Residents affected by infection control deficiency: 4
Residents observed for infection control: 39
Medication error rate: 7.69
Medication opportunities observed: 26
Medication errors observed: 2
Rooms with environmental deficiencies: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Cook AA | Cook | Named in deficiency for not following pureed food recipe instructions. |
| LPN EE | Licensed Practical Nurse | Observed and interviewed regarding glucometer cleaning practices. |
| CNA BB | Certified Nursing Assistant | Observed not sanitizing blood pressure equipment between residents. |
| LPN GG | Licensed Practical Nurse | Did not don appropriate PPE during wound care for resident on Enhanced Barrier Precautions. |
| LPN CC | Licensed Practical Nurse | Involved in medication errors during medication administration observation. |
| Administrator | Interviewed regarding facility policies and expectations for staff compliance. | |
| Certified Food Manager | Certified Food Manager | Confirmed staff should follow recipe instructions when preparing pureed food. |
| Register Dietitian | Registered Dietitian | Interviewed about importance of following recipes for nutritional value. |
| Assistant Director of Nursing | Assistant Director of Nursing | Informed of medication errors and confirmed review of Medication Administration Record. |
| Director of Nursing | Director of Nursing | Confirmed understanding of Enhanced Barrier Precautions and staff responsibilities. |
| Maintenance Director | Maintenance Director | Confirmed environmental deficiencies and use of TELS system for maintenance. |
| Infection Control Nurse | Infection Control Nurse | Interviewed regarding glucometer cleaning procedures. |
Inspection Report
Routine
Census: 58
Deficiencies: 5
Date: Jan 16, 2025
Visit Reason
A standard survey was conducted from January 14 through January 16, 2025, including investigation of Complaint Intake Number GA00253136, which was substantiated with no deficiencies cited.
Complaint Details
Complaint Intake Number GA00253136 was investigated in conjunction with the standard survey and was substantiated with no deficiencies cited.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations, with deficiencies including failure to maintain a safe and comfortable environment in six rooms, failure to obtain a physician order for restorative care for one resident, medication administration errors exceeding the allowed error rate, failure to follow pureed food preparation recipes, and inadequate infection control practices including improper cleaning of equipment and failure to follow Enhanced Barrier Precautions during wound care.
Deficiencies (5)
Facility failed to provide a safe, clean, comfortable, home-like environment for six rooms with issues such as leaking faucets, broken furniture, blown light bulbs, and dirty blinds.
Failed to obtain a physician order for restorative splints for one resident with contractures, leading to potential progression of contractures.
Medication error rate of 7.69% observed during medication administration for one resident, exceeding the allowed 5%.
Failed to ensure nutritional value of pureed food by not following recipe instructions, risking decreased nutritional intake for 16 residents.
Failed to ensure infection control practices including proper cleaning of glucometer, sanitizing shared equipment between residents, and adherence to Enhanced Barrier Precautions during wound care.
Report Facts
Residents present: 58
Medication administration opportunities observed: 26
Medication errors observed: 2
Medication error rate: 7.69
Residents receiving pureed diet: 16
Days splints applied: 9
Splint application duration: 240
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN CC | Licensed Practical Nurse | Administered medications in error to resident R14 despite low blood pressure |
| CNA BB | Certified Nurse Aide | Reported blood pressure to nurse and observed not sanitizing blood pressure equipment between residents |
| CNA FF | Restorative CNA | Responsible for applying splints to resident R3 but documentation showed splints were not applied as ordered |
| LPN EE | Licensed Practical Nurse | Performed fingerstick blood sugar procedure and cleaned glucometer improperly |
| LPN GG | Licensed Practical Nurse | Failed to wear appropriate PPE during wound care for resident R4 |
| Administrator | Interviewed regarding maintenance system and policy adherence | |
| Maintenance Director | Confirmed facility maintenance issues and use of TELS system | |
| Assistant Director of Nursing | Informed of medication errors during observation | |
| Rehabilitation Director | Responsible for ensuring restorative care compliance | |
| Cook AA | Observed not following recipe instructions for pureed food preparation | |
| Certified Food Manager | Confirmed recipe instructions should be followed for pureed food | |
| Registered Dietitian | Confirmed importance of following recipe for nutritional value | |
| Infection Control Nurse | Interviewed about glucometer cleaning procedures | |
| Director of Nursing | Confirmed policy on Enhanced Barrier Precautions and staff education |
Inspection Report
Abbreviated Survey
Census: 61
Deficiencies: 0
Date: Jul 3, 2024
Visit Reason
An abbreviated/partial extended survey was conducted to investigate complaint GA00239111.
Complaint Details
Complaint GA00239111 was investigated and found to be unsubstantiated.
Findings
The complaint GA00239111 was unsubstantiated and no regulatory violations were cited during the survey.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Sep 14, 2023
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Magnolia Manor of Marion County following a regulatory inspection.
Findings
The report contains a summary statement of deficiencies identified during the inspection, but no specific deficiencies or severity levels are detailed in the provided page.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Sep 14, 2023
Visit Reason
This document is a Statement of Deficiencies and Plan of Correction for Magnolia Manor of Marion County following a survey completed on 09/14/2023.
Findings
No deficiencies or findings are stated in the document; the form appears to be blank with no deficiencies or corrective actions listed.
Inspection Report
Life Safety
Deficiencies: 0
Date: Sep 7, 2023
Visit Reason
A Life Safety Code revisit was conducted at Magnolia Manor Of Marion County to verify correction of previously cited Life Safety Code deficiencies.
Findings
The revisit found that all previously cited Life Safety Code deficiencies had been corrected.
Inspection Report
Annual Inspection
Census: 62
Deficiencies: 4
Date: Jul 23, 2023
Visit Reason
A State Licensure survey was conducted at Magnolia Manor of Marion County from July 21, 2023 through July 23, 2023 to assess compliance with state health regulations.
Findings
The facility failed to implement stop dates for psychotropic medications for two residents, maintain accurate controlled substance records on one medication cart, and ensure proper labeling and storage of drugs and biologicals on medication carts. Additionally, the facility failed to label and date opened food items in the dry storage area and bulk food containers.
Deficiencies (4)
Failure to ensure a stop date was implemented, not to exceed 14 days, for psychotropic medications for two residents.
Failure to maintain accurate records on controlled substances on one of three medication carts (A Wing cart), including missing signatures on Narcotic Shift Count documents.
Failure to ensure drugs and biologicals were labeled and stored properly and in accordance with manufacturer's recommendations on two of three medication carts.
Failure to label and date opened food items in the dry storage area and bulk food items.
Report Facts
Missing signatures on Narcotic Shift Count document: 25
Missing signatures on Narcotic Shift Count document: 29
Missing signatures on Narcotic Shift Count document: 19
Facility census: 62
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Acknowledged missing stop dates for psychotropic medications and discussed medication audit processes | |
| Licensed Practical Nurse CC | Verified missing signatures on controlled medication count documents and medication storage issues | |
| Registered Nurse BB | Verified missing opened date label on Trelegy Ellipta inhaler | |
| Administrator | Discussed expectations for nursing staff regarding medication storage and controlled medication reconciliation | |
| Vice President of Operations | Discussed expectations for nursing staff to follow medication storage guidelines | |
| Certified Dietary Manager | Confirmed lack of dating on bulk food containers and lack of awareness of dating necessity | |
| Dietary Aide AA | Confirmed opened food items in dry storage area were not labeled or dated |
Inspection Report
Routine
Census: 63
Deficiencies: 5
Date: Jul 23, 2023
Visit Reason
A standard survey was conducted at Magnolia Manor of Marion County from July 21, 2023 through July 23, 2023, including investigation of two complaint intakes (GA00236931 and GA00237179).
Complaint Details
Complaint Intake Number GA00236931 was unsubstantiated. Complaint Intake Number GA00237179 was substantiated with no citations cited.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations. One complaint intake was substantiated with no citations, and the other was unsubstantiated. Deficiencies included failure to report an allegation of abuse, failure to maintain accurate controlled substance records, failure to implement stop dates on psychotropic medications, improper medication storage and labeling, and failure to label and date opened food items in the dry storage area.
Deficiencies (5)
Failed to report an allegation of abuse for one resident on the Memory Care Unit.
Failed to maintain accurate records on controlled substances on one medication cart, missing 25 signatures of 86 required on Narcotic Shift Count documents.
Failed to ensure a stop date was implemented, not to exceed 14 days, for psychotropic medications for two residents.
Failed to ensure drugs and biologicals were labeled and stored properly according to manufacturer's recommendations on two medication carts.
Failed to label and date opened food items in the dry storage area and failed to date opened bulk food items.
Report Facts
Resident census: 63
Missing signatures: 25
Required signatures: 86
Missing signatures: 29
Missing signatures: 19
Medication administrations: 14
Medication doses remaining: 20
Facility census: 62
Employees mentioned
| Name | Title | Context |
|---|---|---|
| ZZ | Certified Medication Aide | Reported allegation of abuse from resident's family member |
| CC | Licensed Practical Nurse | Verified missing signatures on Narcotic Shift Count document and medication storage issues |
| BB | Registered Nurse | Observed medication cart and verified missing opened date label on inhaler |
| AA | Dietary Aide | Confirmed unlabeled and undated food items in dry storage |
Inspection Report
Life Safety
Census: 62
Capacity: 70
Deficiencies: 3
Date: Jul 22, 2023
Visit Reason
The inspection was a Life Safety Code Survey conducted to assess compliance with Medicare/Medicaid participation requirements related to fire safety and related NFPA standards.
Findings
The facility was found not in substantial compliance with the Life Safety Code requirements, specifically failing to provide complete sprinkler protection throughout the facility, maintain electrical components properly, and ensure proper storage of oxygen cylinders.
Deficiencies (3)
Sprinkler protection was not provided at the loading dock, housekeeping closet, can washroom, fan room, boiler room, and chiller room adjacent to the loading dock.
An open electrical junction box was observed above the drop ceiling at the B Wing nurses' station.
Oxygen cylinder storage area lacked an approved no smoking sign, was not secured against unauthorized entry, and was not properly separated from combustibles.
Report Facts
Census: 62
Total Capacity: 70
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff M | Confirmed findings during facility tour and observations |
Inspection Report
Re-Inspection
Census: 61
Deficiencies: 0
Date: Feb 9, 2022
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the standard survey of December 16, 2021.
Findings
All deficiencies cited in the December 16, 2021 survey were found to be corrected during the revisit survey.
Inspection Report
Re-Inspection
Census: 61
Deficiencies: 0
Date: Feb 9, 2022
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited in the standard survey of December 16, 2021.
Findings
All deficiencies cited in the prior standard survey were found to be corrected during this revisit survey.
Inspection Report
Annual Inspection
Census: 59
Deficiencies: 0
Date: Dec 16, 2021
Visit Reason
A licensure survey was conducted from 12/14/2021 through 12/16/2021, including investigation of Complaint Intake Number GA00219339.
Complaint Details
Complaint Intake Number GA00219339 was investigated and found to be unsubstantiated.
Findings
Complaint Intake Number GA00219339 was found to be unsubstantiated. No State Health Deficiencies were cited during the survey.
Inspection Report
Annual Inspection
Census: 59
Deficiencies: 3
Date: Dec 16, 2021
Visit Reason
A standard annual survey was conducted from 12/14/2021 through 12/16/2021, including investigation of Complaint Intake Number GA00219339, which was found unsubstantiated.
Complaint Details
Complaint Intake Number GA00219339 was investigated in conjunction with the standard survey and was found to be unsubstantiated.
Findings
The facility was found not in substantial compliance with Medicare/Medicaid regulations due to environmental hazards including loose sinks in bathrooms of rooms 132, 133, and 134, and an electrical outlet pulled loose from the wall in room 130. Additionally, the facility failed to post daily nurse staffing information in a location readily accessible to all residents and visitors.
Deficiencies (3)
Three sinks in bathrooms of rooms 132, 133, and 134 were loose and not securely fastened to the wall.
An electrical outlet in room 130 was pulled loose from the wall near the head of the bed.
Failure to post daily nurse staffing information in a prominent place readily accessible to residents and visitors.
Report Facts
Resident census: 59
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN AA | Licensed Practical Nurse | Interviewed regarding reporting maintenance or repair concerns. |
| Maintenance Supervisor | Interviewed about maintenance policies, confirmed observations of loose sinks and electrical outlet, and discussed reporting procedures. | |
| Corporate Administrator | Made aware of maintenance/repair concerns and stated expectation for timely repairs. | |
| Director of Nursing | Director of Nursing | Interviewed regarding nurse staffing information posting practices. |
Inspection Report
Life Safety
Census: 59
Capacity: 70
Deficiencies: 0
Date: Dec 15, 2021
Visit Reason
The visit was conducted as a Life Safety Code Survey to assess compliance with Medicare/Medicaid participation requirements and the NFPA 101 Life Safety Code 2012 edition.
Findings
The facility was found to be in substantial compliance with the Emergency Preparedness Program requirements and Life Safety Code standards during the survey.
Report Facts
Census: 59
Certified Beds: 70
Inspection Report
Routine
Census: 53
Deficiencies: 0
Date: Jun 19, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness Survey and a COVID-19 Focused Infection Control Survey were conducted from June 18, 2020 through June 19, 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, implementing CMS and CDC recommended practices for COVID-19 preparation.
Report Facts
Total census: 53
Inspection Report
Re-Inspection
Census: 59
Deficiencies: 0
Date: Dec 27, 2018
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the standard survey on November 8, 2018.
Findings
All deficiencies cited in the prior standard survey were found to be corrected during this revisit survey.
Inspection Report
Life Safety
Census: 55
Capacity: 70
Deficiencies: 0
Date: Nov 6, 2018
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 the Emergency Preparedness plan met the requirements set forth in Appendix Z.
Inspection Report
Follow-Up
Deficiencies: 0
Date: May 4, 2018
Visit Reason
A follow-up to a complaint investigation was conducted during an unannounced visit to Magnolia Manor of Marion County to investigate complaint GA-00187946.
Complaint Details
Complaint investigation GA-00187946 was conducted and found not substantiated.
Findings
The complaint investigation was completed during the visit and resulted in the complaint not being substantiated. The Ombudsman and complainant were notified of the surveyor's presence.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 4, 2018
Visit Reason
The inspection was conducted to investigate complaint #GA00186929 to determine compliance with Federal and State Long Term Care regulations.
Complaint Details
Complaint #GA00186929 was investigated and found to have no deficiencies.
Findings
No deficiencies were cited during the complaint survey.
Inspection Report
Annual Inspection
Census: 63
Deficiencies: 0
Date: Dec 14, 2017
Visit Reason
A standard survey was conducted at Magnolia Manor of Marion County Nursing Homes from December 11, 2017, through December 14, 2017, 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: 63
Capacity: 70
Deficiencies: 0
Date: Dec 12, 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 emergency preparedness plan requirements and Life Safety Code standards.
Inspection Report
Follow-Up
Deficiencies: 0
Date: Mar 31, 2017
Visit Reason
A Follow-Up Survey was conducted to verify that all previously cited survey tags had been corrected.
Findings
The surveyor noted that all previously cited deficiencies had been corrected.
Inspection Report
Re-Inspection
Deficiencies: 0
Date: Mar 30, 2017
Visit Reason
A revisit survey was conducted to verify correction of deficiencies cited during the recertification survey conducted on 2017-02-09.
Findings
All deficiencies cited as a result of the recertification survey conducted on 2017-02-09 were found to be corrected.
Report Facts
Previous survey date: Feb 9, 2017
Inspection Report
Life Safety
Census: 65
Capacity: 70
Deficiencies: 4
Date: Feb 6, 2017
Visit Reason
A Life Safety Code Survey was conducted to assess the facility's compliance with Medicare/Medicaid participation requirements related to fire safety and the NFPA 101 Life Safety Code standards.
Findings
The facility was found not in substantial compliance with life safety requirements, including failure to maintain illumination of means of egress, lack of supervisory signals on sprinkler system valves, corridor doors not resisting smoke passage or latching properly, and smoke barriers not properly sealed, placing residents at risk in the event of fire.
Deficiencies (4)
Failed to maintain illumination of means of egress including exit discharge to a public way.
Failed to maintain automatic sprinkler system supervisory attachments on the four valves of the backflow preventer.
Failed to maintain corridor doors to resist passage of smoke and to have means to keep doors closed; specific doors had holes, gaps, or would not latch.
Failed to maintain smoke barrier walls with required fire resistance rating; penetrations and tops of smoke barriers were not properly sealed.
Report Facts
Residents at risk due to lack of illumination of means of egress: 10
Residents at risk due to sprinkler system supervisory signal failure: 65
Residents at risk due to corridor door deficiencies: 30
Residents at risk due to smoke barrier deficiencies: 30
Census: 65
Total licensed capacity: 70
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff O | Staff interviewed and confirmed findings during facility tour |
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