Below average — CMS composite of the measures below.
The next survey window likely opens around March 2027
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 Bryan County Hlth & Rehab Ctr during CMS and state inspections, most recent first.
Pureed meals were prepared without standardized recipes or measuring tools for residents on texture-modified diets. A Dietary Aide made pureed carrots with carrots and water and pureed chicken and dumplings with chicken and dumplings, cream of chicken soup, and water, while stating she did not use a recipe. The CDM confirmed the recipe was not used and that the facility did not have a recipe for chicken and dumplings, and the DON said she was unaware dietary staff were not using recipes.
Improper Food Labeling, Dating, and Kitchen Equipment Cleanliness: Surveyors found unlabeled bread and buns, multiple expired containers of Roasted Beef Base, cheese without a use-by date, and a container of French Vanilla Alamera past its use-by date. The kitchen can opener also had a greasy, black substance. The CDM and DON confirmed the findings and stated that dietary staff were expected to properly label, date, and discard out-of-date food items.
Dumpster Area Not Kept Closed or Free of Debris: The facility failed to keep the outdoor dumpster area sanitary per its Outside Dumpster Policy. Surveyors observed wooden pallets behind the dumpsters, with two dumpster lids and one side door open; the DM confirmed the conditions and said maintenance was responsible for removing the pallets. Follow-up observations showed the side door remained open and the pallets were still present, and the DON stated she was unaware of the conditions.
Failure to Feed Residents at Eye Level: Four residents with severe cognitive impairment and dependent eating status were observed being fed while staff stood rather than sitting at eye level. The residents had diagnoses including Alzheimer’s disease, dysphagia, aphasia, dementia, and Down syndrome, and their care plans directed staff to assist with meals and oral care. Staff interviews confirmed the standing feeding practice, while later interviews with an LPN, ADON, and DON stated that staff are to sit next to residents at eye level.
A resident with severe cognitive impairment and dementia was found at the bedside with about eight pills after an LPN had given morning meds. The resident said she was taking them by herself and was unsure whether she had an order to self-administer. The record showed no physician order or assessment for self-administration, and the ADON, DON, and LPN confirmed the resident should not have been left with medication unsupervised.
A resident with hypothyroidism was given levothyroxine after breakfast even though the order and label indicated it should be given on an empty stomach before breakfast. In a separate event, an LPN crushed all of another resident's gastrostomy tube medications together and administered them as one mixture, which clogged the tube; the consultant pharmacist and DON confirmed tube medications should be crushed and given separately.
Expired and improperly dated medications were found in one medication room during an observation with the ADON. Items included expired povidone-iodine swab sticks, mineral oil enemas, Prostate, and fiber laxative, plus a tuberculin vial in the refrigerator without an open date or expiration date. The ADON also confirmed a resident’s Levemir FlexPen had passed the manufacturer expiration date, and the DON stated medications should not be expired in the medication room or medication carts.
A resident with moderate cognitive impairment and a history of acute kidney failure did not have all required skin assessments and topical treatments properly documented. Although LPNs reported completing the assessments and administering prescribed steroid cream for a skin condition, they failed to consistently record these actions in the medical record and treatment administration records, resulting in incomplete and inaccurate documentation.
Surveyors found that opened food items in the kitchen freezer, such as pork sausages, chicken breasts, and French fries, were not labeled or dated as required by facility policy. Staff interviews confirmed that all kitchen staff are responsible for labeling opened food, and the lack of labeling had the potential to affect all residents on an oral diet.
Staff failed to follow infection control protocols during wound care for two residents, including not re-cleaning wounds after contact with contaminated linens and not maintaining privacy. An LPN improperly handled and transported soiled PPE without gloves or proper containment, and did not sanitize hands or equipment as required. The facility also did not complete monthly infection surveillance or review infection control policies as required.
Staff failed to provide full privacy for four residents during wound care, leaving window blinds and privacy curtains open during treatments. This resulted in residents being exposed to view from outside areas and to roommates while receiving sensitive medical care. Nurses acknowledged not closing blinds or curtains, and the DON confirmed that full privacy was expected during such procedures.
Surveyors identified multiple environmental deficiencies, including missing and cracked plaster, chipped floor tile, stained privacy curtains, and a feeding pump pole with dried tube feeding formula. These issues were observed and verified by housekeeping, the Housekeeping Supervisor, the DON, and the Maintenance Director, with staff interviews revealing confusion over cleaning and repair responsibilities and a lack of timely reporting and resolution.
Staff did not develop or update care plans for two residents with specific medical interventions: one receiving oxygen therapy and another with an indwelling Foley catheter. Despite physician orders and documentation in the medical record, these interventions were not reflected in the residents' care plans, as confirmed by the MDS Coordinator and DON.
A resident with a history of cerebral infarction and diabetes mellitus did not receive wound care as ordered by the physician when an LPN omitted the use of rolled gauze during a dressing change, despite specific instructions in the medical record. The LPN stated the decision was due to concerns about the dressing coming off, and the DON confirmed that not following physician orders is considered a delay in care and neglect.
A resident with acute respiratory distress and heart failure was found with a free-standing, unsecured O2 tank behind their bed on multiple occasions. Staff interviews revealed that O2 tanks should not be stored in resident rooms, and a CNA admitted to forgetting to remove it. The DON confirmed the tank should not have been present, and the facility lacked a policy on accident hazards.
A resident with multiple diagnoses, including Parkinson's disease and hypertension, was observed receiving oxygen at 4 LPM via nasal cannula, contrary to the physician's order for 2 LPM as needed. Staff interviews confirmed the incorrect oxygen setting and revealed that the care plan did not address oxygen therapy, and daily checks of the oxygen concentrator were not consistently performed.
Pureed Meals Prepared Without Standardized Recipes
Penalty
Summary
Pureed foods for residents requiring texture-modified diets were not prepared according to standardized recipes and professional food service standards. During observation on 03/31/2026 at 10:49 AM, a Dietary Aide prepared pureed carrots using carrots and water without using a recipe or measuring tools. The same staff member prepared pureed chicken and dumplings using a can of chicken and dumplings, cream of chicken soup, and water, also without a recipe or measured amounts. The Dietary Aide stated she had been preparing pureed meals for a long time and knew how to do it without a recipe, and confirmed she did not use one during the puree process. The CDM confirmed that the Dietary Aide did not use a recipe and stated that the process was incorrect once it had already begun. The CDM also stated that seasoned workers had been doing the work for a long time and tended not to use a recipe, and confirmed the facility did not have a recipe for chicken and dumplings, which had been added to the menu for that evening's dinner. The DON stated on 04/01/2026 that she was unaware dietary staff were not using recipes and said her expectation was that all dietary staff use recipes when preparing all meals, including pureed meals, to ensure residents receive proper nutritional balance.
Improper Food Labeling, Dating, and Kitchen Equipment Cleanliness
Penalty
Summary
The facility failed to ensure that foods were properly labeled, dated, and discarded, and failed to ensure the cleanliness of kitchen equipment used in food preparation. During an observation tour of the kitchen with the Certified Dietary Manager (CDM), surveyors identified three loaves of raisin bread and one pack of hot dog buns without expiration dates. The refrigerator also contained five one-pound containers of Roasted Beef Base with an expiration date of May 2025, one one-pound container with an expiration date of November 2025, and one one-pound container with an expiration date of April 2025. In addition, one five-pound bag of Assorted Grated Parmesan Cheese had an open date of 01/25/2026 but no use-by date, and one metal container of French Vanilla Alamera had a use-by date of 03/06/2026. The can opener in the kitchen contained a greasy, black substance. The CDM confirmed all of the identified concerns during the observation and stated that dietary staff required re-education on proper labeling, dating, and disposal of out-of-date food items. The DON also stated that it was the facility's expectation that dietary staff properly label, date, and dispose of out-of-date food items.
Dumpster Area Not Kept Closed or Free of Debris
Penalty
Summary
The facility failed to ensure the outdoor garbage and refuse area was maintained in a sanitary manner, as required by its Outside Dumpster Policy. The policy stated that dumpster lids must remain closed after use, trash bags must not be left on the ground or outside the dumpster, only designated general trash may be disposed of in outside dumpsters, and the dumpster area must be kept free of debris. During observation on 03/30/2026 at 10:58 AM, numerous wooden pallets were seen behind the dumpsters, two of the three dumpster lids were open, and the side door of one dumpster was open. The Dietary Manager confirmed the pallets were present and stated maintenance was responsible for removing and discarding them, and also acknowledged that the dumpster lids and side door were left open at the time of observation. Follow-up observations on 03/31/2026 at 9:02 AM and 04/01/2026 at 7:56 AM showed that the side door of the trash dumpster remained open and the wooden pallets were still behind the dumpsters. During interview on 04/01/2026 at 12:43 PM, the DON stated she was unaware of the wooden pallets behind the dumpsters and unaware that the dumpster doors or lids had been left open. She stated it was her expectation that dietary and maintenance staff be re-educated on the facility's Outside Dumpster Policy.
Failure to Feed Residents at Eye Level
Penalty
Summary
The facility failed to maintain resident dignity during mealtime for four sampled residents, all of whom were dependent on staff for eating and oral hygiene and had severe cognitive impairment documented by BIMS scores of 00. The report cited the facility’s Resident Dignity & Safe Feeding Policy, which prohibited feeding while standing, rush feeding, feeding multiple residents at once, and ignoring swallowing difficulty. Each of the four residents had care plans that directed staff to assist with eating, ensure the correct diet and texture were served, and provide oral care as needed. For R7, who had diagnoses including Alzheimer’s disease, feeding difficulties, schizoaffective disorder, and dysphagia, an observation showed a Social Service DD standing while feeding the resident. For R27, who had diagnoses including acute combined systolic and diastolic heart failure, aphasia, dysphagia, and feeding difficulties, an LPN was observed standing while feeding the resident and later confirmed she was standing and stated she should sit at eye level to feed the resident. R67, who had dementia, hypertension, feeding difficulties, and a mood disorder, was observed being fed by a CNA who was standing and later confirmed she was standing while feeding the resident and stated she was supposed to sit at eye level. For R83, who had Down syndrome, epilepsy, protein C resistance, Moyamoya disease, and sleep apnea, an LPN was observed standing while feeding breakfast. The LPN confirmed she was standing and stated that she can stand or sit, but most of the time she sits to feed residents; she also stated that residents on the C Hall were different because they have dementia, so staff may sit or stand to assist with feeding. Subsequent interviews with an LPN, the ADON, and the DON stated that staff are to sit by residents at eye level to assist with feeding.
Resident Left With Bedside Medications Without Self-Administration Order
Penalty
Summary
The facility failed to ensure that a resident with severe cognitive impairment did not have access to self-administered medications. Resident R23’s record showed a BIMS score of 05, diagnoses including dementia with severe behavioral disturbances, metabolic encephalopathy, and cognitive communication deficit, and a care plan noting impaired cognition and impaired thought processes. The resident’s record also showed no physician order allowing bedside self-administration of medications and no assessment for medication self-administration. During an initial tour, R23 was observed at the bedside with approximately eight pills and stated she was taking them slowly because she did not feel well. She said the nurse had given her morning medication with water and that she was taking it by herself at the bedside, while also stating she was not supposed to take medication without supervision and was unsure whether she had an order for self-administration. The medications were removed by an LPN, and the ADON confirmed the resident had a medication cup containing eight medications at the bedside without an order for self-administration and was not to take medications unsupervised. The ADON, Administrator, and LPN all confirmed that residents do not have orders to self-administer medications and that the resident should not have been left with medication at the bedside.
Medication Timing and Tube Medication Administration Errors
Penalty
Summary
The facility failed to administer levothyroxine at the correct time for a resident with hypothyroidism, Alzheimer's disease, and atrial fibrillation. The resident's physician order was for levothyroxine sodium 50 micrograms orally once daily, and the medication label instructed administration in the morning before breakfast. During observation, the resident had already eaten breakfast when the LPN prepared to give the medication, and the medication was scheduled for 9:00 AM. The consultant pharmacist and DON both confirmed that levothyroxine should be given on an empty stomach before breakfast, and that breakfast was served earlier than the scheduled medication time. The facility also failed to crush and administer gastrostomy tube medications separately for a resident with cerebral infarction, epilepsy, gastrostomy status, and dysphagia. The care plan and physician orders required tube flushing before and after medications and with each medication, and the resident had consent for all medications to be crushed. During observation, the LPN crushed all of the resident's medications together in one pouch, mixed the crushed medications together in water, and attempted to administer them as a single mixture. The tube became clogged, and the LPN used a clog remover and repeated flushing attempts before being able to continue the medication administration and resume tube feeding. The LPN stated she knew she was not supposed to crush or administer the medications together, and the consultant pharmacist and DON confirmed that medications given through a gastrostomy tube should be crushed and administered separately.
Expired and Improperly Dated Medications in Medication Room
Penalty
Summary
The facility failed to ensure that one of two medication rooms was free of expired medications and improperly dated items. Based on observations and a concurrent interview with the ADON in the medication room for Hallways A and B, surveyors found one box of povidone-iodine swab sticks expired 09/2025, five bottles of mineral oil enemas expired 01/2025, one bottle of Prostate expired 02/12/2026, and one bottle of fiber laxative expired 02/2026. A tuberculin vial was also stored in the medication room refrigerator without an open date or expiration date, and the ADON stated she was unsure when the vial had been opened. The ADON also confirmed that a Levemir FlexPen ordered for a resident on 03/03/2024 had a manufacturer expiration date of 01/31/2026. She stated she was responsible for the medication room and explained that stock medications were arranged with the oldest items in front and newer items in back, but acknowledged that her inventory list showed stock medications would not expire until May and needed to be updated. The DON stated that medications should not be expired in the medication room or medication carts and that unit managers check and audit medication carts weekly, while the ADON is responsible for the medication room.
Incomplete Documentation of Skin Assessments and Treatments
Penalty
Summary
The facility failed to maintain a complete and accurate medical record for a resident with a history of acute kidney failure and moderate cognitive impairment, specifically in the area of skin condition management. The resident's care plan included interventions for monitoring skin integrity and treating a diagnosis of candidiasis, with instructions for regular skin assessments and topical medication administration. However, documentation in the electronic medical record showed that several scheduled weekly skin assessments were not recorded as completed on specific dates. Interviews with LPNs revealed that while some assessments were performed, the staff failed to document them due to being busy or forgetting. Additionally, the resident's treatment administration records for a prescribed steroid cream indicated multiple instances where there was no documentation of the treatment being administered as ordered. Several LPNs confirmed in interviews that they had provided the treatments but neglected to sign off on the treatment administration records after completion. Both the Regional Nurse Consultant and the Administrator acknowledged that all assessments and treatments should have been documented in a timely manner, but this was not consistently done.
Failure to Label and Date Opened Food Items in Kitchen
Penalty
Summary
During a kitchen tour, surveyors observed that several opened food items in the freezer, including pork sausages, chicken breasts, chicken nuggets, French fries, okra, and crispy fried onions, were not labeled or dated. Review of the facility's Food Storage policy indicated that all products should be dated to ensure proper stock rotation and adherence to the First-In, First-Out procedure. Interviews with staff confirmed that opened food items are required to have an open date and a use by date, and that all kitchen staff are responsible for labeling these items. The failure to label and date opened food had the potential to affect all residents on an oral diet.
Infection Control Deficiencies in Wound Care, PPE Handling, and Surveillance
Penalty
Summary
The facility failed to ensure proper infection control practices during wound care for two residents. In both cases, the wound care nurse did not re-clean the wound area after the residents were repositioned onto potentially contaminated linens before applying new dressings. Additionally, privacy was not maintained during wound care, as privacy curtains and window blinds were left open, exposing residents to view from outside or from roommates. The nurse acknowledged not following proper wound cleaning procedures after repositioning the residents. Another incident involved an LPN who did not follow correct procedures for handling and disposing of used personal protective equipment (PPE). The LPN transported soiled, reusable gowns in her ungloved hands and without bagging them, after removing them from the trash can, and carried them down the hall to the laundry room. The LPN also failed to sanitize hands after removing gloves and did not sanitize the treatment tray before returning it to the treatment cart. These actions were observed during wound care for a resident with a sacral wound and a Foley catheter. The facility also failed to conduct required infection surveillance activities. There was no evidence that infection control rates were calculated for three consecutive months, and the infection control policies had not been reviewed annually as required. The Infection Control Preventionist stated she was not trained to calculate infection rates and had not performed this task, and both the Administrator and DON were unaware of when the last policy review or surveillance had occurred.
Failure to Provide Privacy During Wound Care Treatments
Penalty
Summary
The facility failed to provide full privacy to four residents during wound care treatments, as observed by surveyors. In multiple instances, staff conducted wound care procedures without ensuring that window blinds were closed and privacy curtains were fully engaged. This resulted in residents being exposed to view from outside areas such as the courtyard and parking lot, as well as to their roommates, during sensitive medical treatments. The facility's own policies require that privacy be provided during such care, including the use of privacy curtains and closed blinds. For one resident with a stage four sacral pressure ulcer, the wound care nurse performed the dressing change with the privacy curtain pulled but left the window blinds open, allowing full view from the courtyard. The nurse acknowledged during an interview that she did not think to close the blinds during the procedure. Another resident with dementia and skin breakdown had wound care performed with both the privacy curtain and window blinds open, exposing the resident to their roommate and anyone outside. The nurse completed the entire treatment without providing privacy. Additional observations included a resident with a left ankle wound who received care while sitting near a window with open blinds, in full view of the parking lot and visitors. The LPN did not close the blinds or provide other privacy measures. Similarly, another resident with osteomyelitis of the vertebra and sacral region underwent wound care with open blinds, exposing the resident to the parking lot and a resident outside. The LPN admitted during an interview that she did not think about closing the blinds during the procedure. In all cases, the Director of Nursing confirmed that the expectation was for full privacy to be provided, including closing both privacy curtains and window blinds during resident care.
Failure to Maintain Safe, Clean, and Homelike Environment
Penalty
Summary
The facility failed to maintain a safe, clean, comfortable, and homelike environment in multiple resident rooms and common areas. Observations revealed missing and cracked plaster on two walls in Hall C, chipped floor tile near a bed in a room on Hall A, black marks and yellowish stains on a privacy curtain, and a feeding pump pole with a dried, brownish substance. The dried substance was also present on the floor around the feeding pump. These environmental issues were observed on multiple occasions and verified by housekeeping staff, the Housekeeping Supervisor, the Director of Nursing, and the Maintenance Director. The facility's policy requires weekly environmental rounds and prompt repairs, with a process for staff to report issues using a requisition form or communication slips. Interviews with staff indicated a lack of awareness and follow-through regarding the identified deficiencies. The Maintenance Director confirmed the need for wall repairs and was unaware of the chipped floor tile, noting that no communication slip had been submitted for it. Housekeeping staff acknowledged the presence of the dried substance and indicated that cleaning responsibilities were divided between nursing and housekeeping, with some confusion about who should address specific issues. The Housekeeping Supervisor stated that maintenance is responsible for curtain changes. The environmental concerns persisted over several days, indicating a failure to address and resolve the deficiencies in a timely manner.
Failure to Develop Comprehensive Care Plans for Oxygen Therapy and Indwelling Catheter
Penalty
Summary
The facility failed to develop and implement comprehensive care plans for two residents with specific medical needs. One resident, admitted with diagnoses including Parkinson's disease, hypertension, anxiety disorder, and depression, had a physician's order for oxygen therapy via nasal cannula as needed for shortness of breath, wheezing, or oxygen saturation below 92%. Despite documentation in the electronic medical record and the Minimum Data Set indicating the use of oxygen therapy, the resident's care plan did not reflect this intervention. Interviews with the MDS Coordinator and the Director of Nursing confirmed that the care plan did not address the resident's oxygen use, contrary to facility policy requiring comprehensive, person-centered care plans based on resident assessments. Another resident, admitted with conditions such as a displaced femur fracture, chronic kidney disease, and cystitis with hematuria, had a physician's order for an indwelling Foley catheter for urinary retention. The Minimum Data Set also indicated the presence of the catheter, but the resident's care plan did not include this intervention. The MDS Coordinator acknowledged responsibility for updating care plans and confirmed the omission, as did the Director of Nursing. These findings were based on record reviews, staff interviews, and facility policy review, demonstrating a failure to ensure care plans addressed all identified care needs for these residents.
Failure to Follow Physician's Wound Care Orders
Penalty
Summary
A deficiency occurred when a Licensed Practical Nurse (LPN) failed to follow a physician's order for wound care for a resident with a history of cerebral infarction and diabetes mellitus. The physician's order specified that the resident's left ankle wound should be cleansed with wound cleanser or normal saline, patted dry, treated with gentamicin ointment, and covered with a dry protective dressing such as an ABD pad, then secured with rolled gauze and tape daily or as needed if the dressing became dislodged or soiled. During an observed wound care procedure, the LPN chose not to use the rolled gauze as ordered, stating concern that it might come off if the resident rubbed her legs together. The LPN also acknowledged not replacing the dressing as needed because the rolled gauze was not used, despite the PRN order for replacement upon dislodgement or soiling. The LPN proceeded with the wound care by cleaning the area, applying the prescribed ointment, and covering the wound with a bordered dressing, but omitted the rolled gauze step. The Director of Nursing (DON) confirmed in an interview that nurses are required to follow physician's orders and that failure to do so constitutes a delay in care and neglect. The report documents that the physician's wound care order was not fully implemented as written for this resident.
Unsecured Oxygen Tank Creates Accident Hazard
Penalty
Summary
The facility failed to ensure an environment free from potential accident hazards by not properly securing an oxygen (O2) tank for a resident receiving oxygen therapy. Observations on multiple occasions revealed a free-standing, unsecured O2 tank located behind the resident's bed. The resident had diagnoses including acute respiratory distress and heart failure, and a moderate cognitive impairment as indicated by a BIMS score of 11. The resident had a physician's order for oxygen as needed at two liters per minute. Staff interviews confirmed that free-standing O2 tanks should not be stored in residents' rooms, as they could easily fall and cause injury. A CNA admitted to forgetting to remove the tank after patient care, and an RN was initially unsure of the policy due to being newly employed. The DON confirmed that under no circumstances should a free-standing O2 tank be stored in a resident's room and acknowledged that the tank had been present since the resident's recent readmission. The facility did not have a policy on accident hazards available for review.
Oxygen Therapy Not Administered as Ordered
Penalty
Summary
Staff failed to administer oxygen therapy to a resident as ordered by the physician. The physician's order specified oxygen via nasal cannula at 2 liters per minute (LPM) as needed for shortness of breath, wheezing, or oxygen saturation below 92%. However, multiple observations over two days showed the resident's oxygen concentrator was set at 4 LPM, not the ordered 2 LPM. The resident was receiving oxygen at this higher rate via nasal cannula during each observation. Interviews with staff revealed that charge nurses were responsible for ensuring residents received oxygen as ordered, but the oxygen flow rate for this resident had not been checked that day. The LPN confirmed the discrepancy between the order and the actual setting. The Director of Nursing also confirmed the resident's order was for 2 LPM and acknowledged that the resident's care plan did not address the use of oxygen therapy, despite the resident receiving it.
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Illustrative
What surveyors actually found near you
We read the 71 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
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Illustrative
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Nursing homes near Richmond Hill
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Magnolia Manor Of Midway | 10 mi | ★★★★★ | 12 | 0 |
| Abercorn Rehabilitation Center | 10.3 mi | ★★★★★ | 11 | 0 |
| Pruitthealth - Savannah | 11.2 mi | ★★★★★ | 1 | 0 |
| Resorts At Pooler Inc | 11.7 mi | ★★★★★ | 6 | 0 |
| Savannah Post Acute Llc | 12.8 mi | ★★★★★ | 2 | 0 |
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