Above average — CMS composite of the measures below.
The next survey window likely opens around November 2026
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 A.g. Rhodes Home, Inc - Cobb during CMS and state inspections, most recent first.
Failure to revise a resident’s communication care plan when interventions were not working. A resident with deaf mutism, stroke, and severe cognitive impairment had a care plan for impaired communication that included a dry erase board, hand gestures, and sign language interpreter services, but staff and the resident reported that communication boards were not being used effectively and staff lacked formal training in sign language or other communication methods. Observations showed no communication supports in the room and little staff interaction around the resident’s preferences, while leadership interviews confirmed the care plan was not updated when the interventions failed.
Uncovered, unlabeled urinals were repeatedly observed in shared bathrooms adjoining resident rooms on the third floor, including bathrooms shared by female residents. The Administrator and Maintenance Director confirmed the urinals were not bagged or labeled, and the DON/Director of Education and Infection Prevention stated that urinals, bedpans, and washbasins in shared restrooms should be bagged and labeled with the elder’s name.
A resident with severe cognitive impairment and multiple medical conditions experienced an unexplained leg fracture. The facility's investigation was incomplete, as it relied on verbal interviews and lacked written statements from all relevant staff, failing to meet policy requirements for a thorough abuse investigation.
The facility failed to discard expired food items, label and date items in refrigerators, and maintain sanitary conditions as kitchen staff did not wear hairnets and beard guards. Expired food items were found, and several food items were not labeled or dated. The Kitchen Director confirmed that all kitchen staff were responsible for checking expiration dates and ensuring proper labeling and storage, but these procedures were not consistently followed.
The facility failed to secure hazardous materials, as an unlocked janitorial room with cleaning products and a container of Dakin solution left in a resident's room were observed. The resident, with severe cognitive decline, was at risk due to these oversights. The Environmental Services Director lacked a key to the janitorial room, highlighting a lapse in securing potentially dangerous areas.
The facility failed to maintain complete records of controlled drug shift audits, with missing signatures on audit sheets for eight medication carts. Observations revealed gaps in documentation across various carts and wings, confirmed by staff interviews. The issue was attributed to staffing challenges or nurses being sidetracked.
A resident with chronic respiratory conditions was found to have an oxygen concentrator with a filter covered in a white-gray, fuzzy substance, indicating it was not cleaned timely. The facility's policy requires regular cleaning of these filters, but observations and staff interviews revealed non-compliance, potentially affecting the resident's respiratory care.
Failure to Revise Communication Care Plan When Interventions Were Ineffective
Penalty
Summary
The facility failed to update and revise the care plan for a resident with significant communication needs when the planned interventions were not working. The resident had diagnoses including deaf nonspeaking, left hand contracture, and stroke, and a quarterly MDS showed severe cognitive impairment with extensive assistance needed for ADLs and dependent mobility in most areas. The care plan identified impaired communication related to hearing impairment, deaf mutism, and impaired cognition, and included interventions such as using a dry erase board, hand gestures, sign language interpreter services, and staff anticipating needs. Record review and interviews showed the resident reported staff did not know sign language and did not use a communication book or board. Observations found no staff acknowledging or speaking to the resident during activities, no communication book or board in the resident’s room, and no staff communicating with the resident about preferences while waiting for lunch. A CNA stated she used hand signals, motions, and pointing but had not received formal training, and an LPN stated she used gestures and basic signs despite not knowing sign language and having no facility training. Additional interviews showed the Unit Manager stated the facility had tried communication boards but the resident became frustrated because specific items were not on the board, and staff had developed their own interpretation system because the resident could read lips but could not see masks. The Social Services Director stated the resident had previously used a TTY device, but it did not work properly, and no other interventions had been put in place. The MDS Director stated she was responsible for updating the communication care plan and had heard the interventions were not working, but could not remember whether the care plan was updated at that time; she also stated the care plan should be updated immediately when interventions are not working.
Unlabeled, Unbagged Urinals in Shared Bathrooms
Penalty
Summary
The facility failed to provide a clean and comfortable environment to help prevent transmission of infection when unbagged and unlabeled urinals were observed in shared resident bathrooms on the third floor of the Legacy building. Review of the facility’s Routine Cleaning and Disinfection policy and Infection Prevention and Control Program policy showed that the facility’s stated purpose was to maintain a safe, sanitary, and comfortable environment and to prevent the development and transmission of infections. During observations, surveyors found uncovered urinals secured on handrails or hanging from handrails in shared bathrooms adjoining private rooms assigned to female residents, including bathrooms shared by rooms 352 and 353 and by rooms 354 and 355, as well as other shared bathrooms on the unit. These conditions were observed repeatedly during multiple rounds, with urinals noted as not labeled and not bagged in four of 19 resident bathrooms on the third floor. During an environmental tour, the Administrator and Maintenance Director confirmed that the urinals in the shared bathrooms were without labels and not bagged, and the Administrator stated her expectation was that urinals be bagged and labeled with residents’ names. The Director of Education and Infection Prevention stated that urinals, bedpans, and washbasins in shared restrooms should be bagged and labeled with the elder’s name, and that CNAs and charge nurses were responsible for ensuring this. She also stated that if staff were unfamiliar with the elder, they might use another elder’s waste collection container.
Failure to Thoroughly Investigate Allegation of Potential Abuse
Penalty
Summary
The facility failed to ensure that an allegation of potential abuse involving a resident with severe cognitive impairment was thoroughly investigated, as required by its own policies. The resident, who had diagnoses including chronic pulmonary disease, osteoporosis, dementia, and diabetes, was assessed to have a severely impaired mental status. After the resident complained of leg and foot pain, a mobile x-ray revealed acute fractures, and the resident was sent to the emergency room. The facility's investigation into the incident was initiated only after the x-ray results were known, and focused on reviewing the resident's electronic medical record and obtaining statements from staff on the shift when the pain was reported. However, the investigation did not include written statements from staff on previous shifts, except for a verbal interview with a CNA who worked on an earlier date when the resident was noted to be restless. The Director of Nursing acknowledged that many staff interviews were conducted verbally and not documented in writing. The investigation summary was compiled by the team, but lacked comprehensive written documentation from all potentially involved staff, as required by facility policy. This incomplete investigation process resulted in a failure to thoroughly address the allegation of potential abuse.
Deficiencies in Food Storage and Sanitation Practices
Penalty
Summary
The facility failed to adhere to its food storage and sanitation policies, leading to several deficiencies in the kitchen area. Observations revealed that frozen and refrigerated food items were not discarded by their expiration dates, and many items in the reach-in refrigerator units were not labeled or dated. Specifically, expired items such as salted pork, pork sausage, ground pork, and various other meats and food products were found. Additionally, several food items in the second-floor country kitchen and the third-floor reach-in refrigerator were not labeled or dated, including pound cake slices, sandwiches, pudding, and a pitcher of lemonade with an expired date. Furthermore, the facility did not maintain proper sanitary conditions as kitchen staff were observed not wearing hairnets and beard guards while preparing food. The Kitchen Director confirmed that it was the responsibility of all kitchen staff, including the cook and food service aide, to check expiration dates and ensure proper labeling and storage. However, it was noted that sometimes staff did not follow these procedures due to being rushed. The District Manager and Kitchen Director confirmed that cleaning and inventory checks were conducted twice a week, but the responsibility for labeling, storing, and discarding expired items was not consistently upheld.
Failure to Secure Hazardous Materials in Facility
Penalty
Summary
The facility failed to secure potentially hazardous materials, creating a risk for residents, particularly those with severe cognitive impairments. During a tour, it was observed that the janitorial room on the third floor was unlocked and taped open, allowing access to cleaning carts with various cleaning products and full waste containers. The Environmental Services Director confirmed that she did not have a key to the room, and only the Maintenance Director had a set of keys. This oversight posed a potential hazard for the 23 residents with severe cognitive impairment residing on the third floor. Additionally, a container of Dakin wound care solution, which is a dilute sodium hypochlorite solution, was found on the nightstand of a resident with severe cognitive decline. The resident, who requires maximum assistance for daily activities, was diagnosed with unspecified dementia and other health conditions. An LPN confirmed that the solution should not have been left at the resident's bedside, indicating a lapse in proper storage and supervision of hazardous materials.
Incomplete Controlled Drug Shift Audit Documentation
Penalty
Summary
The facility failed to maintain a complete record of the controlled drug shift audit, as evidenced by missing signatures on audit sheets for eight out of twelve medication carts. This deficiency was identified during a medication administration observation conducted on 7/24/2024. The observation revealed missing signatures on the controlled drug shift audit sheets across various medication carts, including the Starvine, Trillium, Dogwood, and Magnolia carts, as well as in the Legacy building's Pink wing and [NAME] hall. The missing signatures spanned multiple dates in July 2024, indicating a lack of proper documentation and verification of narcotic counts. Interviews with staff, including an LPN and the Director of Nursing (DON), confirmed the presence of missing signatures on the narcotic count sheets. The LPN acknowledged the gaps in documentation and noted that CMAs were not authorized to administer certain medications, such as insulin from a vial, breathing treatments, or narcotics, which meant that the responsibility for signing off on the narcotic counts fell to the nurses. The DON suggested that the issue might be related to staffing challenges or nurses becoming sidetracked and failing to sign the count sheets.
Failure to Maintain Oxygen Concentrator Filters
Penalty
Summary
The facility failed to properly maintain the oxygen concentrator for a resident, identified as R77, who required oxygen therapy due to acute and chronic respiratory conditions. Observations revealed that the oxygen concentrator filter was covered with a white-gray, fuzzy substance, indicating it had not been cleaned in a timely manner. The facility's policy on oxygen concentrator care, revised on 6/23/2023, mandates that filters should be cleaned as needed or as directed by the supplier. However, the observations on 7/25/2024 at 11:35 am and 2:15 pm showed that the filter was visibly dirty, suggesting non-compliance with the policy. R77's medical records indicated a history of acute and chronic respiratory failure, malignant neoplasm of the upper lobe, and other respiratory conditions, necessitating the use of oxygen at two liters per minute via nasal cannula. Interviews with the LPN/Unit Manager confirmed that the filters were supposed to be cleaned weekly on Fridays, but the presence of the white-gray substance on the filter suggested this was not done adequately. This oversight in maintaining the oxygen concentrator could potentially compromise the resident's respiratory care.
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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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| Autumn Breeze Health And Rehab | 2.8 mi | ★★★★★ | 6 | 0 |
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| Marietta Center For Nursing And Healing | 5.1 mi | ★★★★★ | 1 | 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.