Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at South Haven Health And Rehabilitation, Llc during CMS and state inspections, most recent first.
A resident whose preferred language is Spanish was not informed of their medications in a language they could understand. Staff communicated in English, and the LPN did not use translation tools, leading to the resident not being fully informed of their care.
A resident with a history of myocardial infarction and dementia was found with a bruise on their right ankle, which was later revealed to be a fracture. The injury was not reported to ADPH in a timely manner, violating the facility's policy. The LPN failed to notify the abuse coordinator, and the root cause of the injury could not be determined.
A facility failed to thoroughly investigate an injury of unknown origin for a resident with dementia. The resident was found with a swollen and discolored right ankle, but no further investigation was conducted to determine the cause. The Administrator admitted to not interviewing staff who cared for the resident before the bruise was documented, resulting in the root cause remaining undetermined.
A resident with Multiple Sclerosis reported that staff did not assist with oral care and hair washing as required by the care plan. CNAs admitted to not following the care plan, and the DON confirmed the necessity of these tasks for infection control.
A facility failed to follow the care plan for a resident with upper and lower extremity range of motion limitations, as the resident was observed without required hand splints or rolled washcloths on multiple occasions. Staff interviews revealed a lack of awareness and understanding of the care plan interventions.
The facility failed to ensure proper hand hygiene, as observed in two separate incidents where CNAs did not wash or sanitize their hands between resident interactions and wore the same gloves for multiple tasks. This had the potential to affect three residents with various diagnoses, including Urinary Tract Infection and Heart Failure.
Failure to Inform Resident in Preferred Language
Penalty
Summary
The facility failed to ensure that a resident, whose preferred language is Spanish, was fully informed of their care and treatments in a language they could understand. The resident, identified as RI #7, was admitted to the facility and had a quarterly Minimum Data Set (MDS) assessment indicating Spanish as their preferred language. During an interview conducted with the resident using a phone translator, the resident stated that the staff communicated with them in English, making it difficult for them to understand their care. An observation confirmed that an LPN administered medications to the resident while speaking in English, despite the resident responding in Spanish and not understanding English. Further interviews with the LPN and the Director of Nursing (DON) revealed that the staff were aware of the requirement to inform residents of their medications before administration. However, the LPN admitted to not informing the resident of the medication names due to the language barrier. The DON acknowledged the risk of residents not knowing their medications and stated that staff should have used translation tools such as Google translator or a 1800 number for a translator to communicate effectively with the resident.
Failure to Timely Report Injury of Unknown Origin
Penalty
Summary
The facility failed to ensure an injury of unknown origin was reported to the Alabama Department of Public Health (ADPH) in a timely manner. On 11/07/2023, a Certified Nursing Assistant (CNA) discovered discoloration and bruising on a resident's right ankle. The Licensed Practical Nurse (LPN) who was informed of the bruise did not report it to anyone, including the abuse coordinator. An x-ray performed on 11/10/2023 revealed a fracture, but the injury was not reported to ADPH until 11/12/2023. This delay in reporting violated the facility's policy, which requires reporting suspicious injuries of unknown origin within two hours. The resident involved had a history of myocardial infarction and dementia with behavioral disturbances and was unable to be interviewed due to impaired cognition. The facility's policies on incidents, accidents, and abuse were not followed, as the LPN failed to notify the appropriate personnel about the bruise. The Director of Nursing (DON) and the Administrator confirmed that the incident was not reported in a timely manner and that the root cause of the injury could not be determined. The failure to report the injury promptly left the resident unprotected and highlighted a significant lapse in the facility's adherence to its own policies and state regulations.
Failure to Investigate Injury of Unknown Origin
Penalty
Summary
The facility failed to thoroughly investigate an injury of unknown origin for a resident when a bruise was identified. The resident, who had a diagnosis of dementia with behavioral disturbances, was found to have a swollen and discolored right ankle on 11/07/2023. The bruise was documented by a CNA and signed off by an LPN, but no further investigation was conducted to determine the cause of the injury. The facility's investigative file did not contain interviews with staff who may have had knowledge of occurrences that could have caused or contributed to the injury. The Administrator admitted that she did not interview the staff who cared for the resident before the bruise was documented. As a result, the root cause of the bruise could not be determined. The facility's policies required a complete and thorough investigation of all incidents, including suspicious injuries of unknown origin, within five working days, but this protocol was not followed in this case.
Failure to Assist Resident with ADLs
Penalty
Summary
The facility failed to ensure staff assisted a resident with hair washing and oral care on 04/09/2024. The resident, who has Multiple Sclerosis, reported to the surveyor that staff did not assist with oral care and that he/she had to get water from the sink independently. The resident also stated that staff had not taken him/her to the shower since March and did not offer to wash his/her hair or assist with dressing. Interviews with CNAs confirmed that the resident's care plan required assistance with these activities, but the staff did not follow through on these requirements. CNA #14 admitted to forgetting to wash the resident's hair, and CNA #10 acknowledged not assisting with oral care despite the care plan's instructions. The Director of Nursing (DON) confirmed that staff should assist with washing hair on assigned bath days, when visibly soiled, or upon request, and that the care plan for the resident included assistance with brushing teeth and oral care. The DON stated that staff should set up and stay at the resident's bedside during oral care to prevent infection control issues. The failure to provide the necessary assistance as outlined in the care plan led to the deficiency identified in the report.
Failure to Implement Care Plan for Resident with Contractures
Penalty
Summary
The facility failed to ensure that a resident with upper and lower extremity range of motion limitations received the appropriate care as outlined in their care plan. Specifically, the resident was supposed to have hand splints or rolled washcloths placed in their hands every morning and removed at bedtime to manage contractures. However, observations on multiple occasions revealed that the resident did not have these items in place. The resident was observed without hand splints or rolled washcloths on 04/09/2024, 04/10/2024, and 04/11/2024, despite the care plan's requirements. Interviews with staff members, including a Nursing Assistant and the Director of Nursing, confirmed that the care plan interventions were not being implemented. The Nursing Assistant admitted to not being aware of the need for hand rolls or splints and did not understand their purpose. The Director of Nursing acknowledged that the nursing staff were responsible for ensuring the implementation of these interventions and recognized the risk of injury and increased contractures if the care plan was not followed. This deficiency was identified during the investigation of complaint/report number AL00043223.
Infection Control Deficiency Due to Improper Hand Hygiene
Penalty
Summary
The facility failed to ensure staff provided care in a manner to prevent the spread of infection. On 04/09/2024, a Certified Nursing Assistant (CNA) was observed not washing or sanitizing her hands when moving between two residents' rooms. The CNA handled items in one resident's room and then entered another resident's room without performing hand hygiene. The CNA admitted to not washing her hands and acknowledged the risk of cross-contamination. Another incident on 04/11/2024 involved a different CNA who wore the same gloves while assisting a resident with a transfer, transporting the resident, and obtaining clean clothes and supplies, without removing the gloves or washing her hands. This CNA also acknowledged the risk of cross-contamination. The Director of Nursing (DON) confirmed that staff should wash or sanitize their hands before entering and after leaving a resident's room and that there was a risk of cross-contamination if staff did not follow proper hand hygiene protocols. The facility's policy on hand hygiene, effective since 06/11/2020, was reviewed and it outlined the necessity of hand hygiene in various situations, including after coming into contact with a resident's intact skin and after removing gloves. The failure to adhere to these guidelines had the potential to affect three of the eight sampled residents, who had various diagnoses including Urinary Tract Infection, Chronic Kidney Disease, Acute Respiratory Failure with Hypoxia, and Heart Failure.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Birmingham
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Aspire Physical Recovery Center At Hoover, Llc | 0.3 mi | ★★★★★ | 0 | 0 |
| Diversicare Of Riverchase | 2.3 mi | ★★★★★ | 0 | 0 |
| Galleria Woods Skilled Nursing Facility | 2.6 mi | ★★★★★ | 0 | 0 |
| Brookdale University Park Snf (al) | 3.7 mi | ★★★★★ | 0 | 0 |
| Aspire Physical Recovery Center At Cahaba River | 4.5 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.