Below 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 Cartersville Center For Nursing And Healing during CMS and state inspections, most recent first.
Surveyors found that food items were not consistently labeled or stored properly, kitchen equipment was not maintained or cleaned as required, and staff failed to follow facility policies for food brought in by families. Observations included unlabeled and improperly stored food, unclean coffee cups, and a ceiling fan with significant buildup above the dish area. Maintenance issues, such as a faulty freezer latch and ice buildup, were not reported or addressed in a timely manner, contributing to unsanitary conditions affecting most residents.
The facility experienced a medication error rate of 17.24%, significantly above the acceptable threshold, due to multiple instances of omitted doses, late administration, and failure to follow proper medication administration procedures. Errors included missed doses of prescribed medications, lack of instruction for inhaler use, and delays caused by medication unavailability, as confirmed by staff interviews and pharmacy records.
Two residents with Foley catheters were observed without privacy bags covering their urinary drainage bags, despite facility policy and staff expectations that privacy covers be used at all times. LPNs and the DON confirmed that privacy bags should be in place and checked regularly, but observations showed this was not consistently done.
A resident with multiple chronic conditions was discharged home, but the facility incorrectly coded the discharge in the MDS as a hospital transfer and did not transmit a correction to CMS as required. Staff interviews revealed oversight and uncertainty in the discharge coding process, and the error was not identified or corrected in a timely manner.
A resident with multiple chronic conditions did not receive two prescribed medications at the scheduled time due to delays in pharmacy delivery and insurance denial, despite staff efforts to locate and reorder the medications. The facility's procedures for acquiring and administering medications were not effectively followed, resulting in the resident missing doses as ordered.
Multiple residents with various medical conditions were moved between rooms without receiving the required written notice or advance explanation, despite facility policy and federal regulations mandating such notification. Staff interviews confirmed that only verbal communication and EHR updates were used, and residents reported not being given written notice or the opportunity to express their preferences regarding room changes.
The facility did not provide timely access to or copies of medical records for three residents after written requests were made by legal representatives or next of kin. In each case, significant delays occurred, with records being provided only after 35, 39, and 116 days, far exceeding the required two-working-day timeframe. Staff and compliance company interviews confirmed that the process for handling such requests was routinely delayed, particularly for discharged residents or when legal representatives were involved.
The facility failed to follow its policies on food storage, preparation, and sanitation, affecting 108 residents. Observations revealed improperly labeled and expired food items, unclean ice machines, and incorrect thawing procedures. The morning cook did not adhere to the puree recipe, and expired apple juice was found in emergency supplies. These issues indicate lapses in food safety protocols.
A facility failed to inform a resident's responsible party about new medication orders, despite the resident's religious beliefs against taking medications. The resident was receiving multiple medications without the responsible party's knowledge. Staff interviews revealed a lack of adherence to the expectation of notifying family and responsible parties about medication changes.
The facility failed to ensure accurate MDS assessments for two residents. One resident's MDS inaccurately documented the presence of a Foley catheter, which had been removed, while another resident's MDS did not reflect their reported pain despite having a care plan for pain management. These discrepancies highlight a failure to update assessments accurately based on current conditions and resident feedback.
The facility failed to provide scheduled showers for two residents dependent on staff for ADLs. One resident received only one shower during the observed period, while another received six out of 13 scheduled showers. Staff interviews revealed issues with EMR documentation, and the administration could not provide evidence of resident refusals for missed showers.
A resident expressed concerns about the lack of a television and activities in his room after being moved. Despite requests, no activities were introduced, and the Activities Department had staffing issues. The facility's policy required activities based on assessments, but this was not followed for the resident.
A resident with multiple medical conditions did not receive prescribed compression stockings and ointment as per physician's orders. Observations showed the resident's legs were discolored and swollen, and staff interviews revealed a lack of awareness and communication regarding the orders.
A resident's room contained unsecured O2 tanks, one without a regulator and covered with a plastic cap, indicating it was full. Facility policy requires O2 tanks to be stored securely outside the resident's room, but this was not followed. Staff interviews confirmed the tanks should not have been in the room, highlighting a deficiency in adhering to safety protocols.
A resident with a history of leg and back pain did not receive prescribed pain medication due to it being out of stock. Despite a care plan and a new order, the medication was not retrieved from the emergency system, leading to the resident experiencing increased pain for over six hours. The issue was resolved later when the medication was finally administered, reducing the pain to zero.
The facility failed to secure a medication cart and properly organize the medication storage room, leading to potential unauthorized access and misuse of medications. An LPN left a medication cart unlocked, and the storage room contained expired and used items mixed with new ones. Staff interviews confirmed the oversight and lack of proper labeling, contributing to the deficiency.
A facility failed to maintain accurate documentation for a resident with multiple health conditions, including cellulitis and heart failure. Despite physician orders for daily skin assessments, wound care, and compression stockings, records inaccurately reflected care provided. Observations and interviews revealed discrepancies, with the resident not receiving documented treatments. Nursing staff confirmed the inaccuracies, highlighting a failure to document care truthfully.
The facility failed to maintain infection control protocols during catheter insertion, medication administration, and contact isolation. An LPN did not perform hand hygiene between changing sterile gloves, compromising sterile technique. Another LPN failed to perform hand hygiene during medication preparation. Additionally, doors to rooms of residents on contact precautions were left open, contrary to protocol. These deficiencies were confirmed by staff interviews and observations.
A facility failed to follow proper infection control practices for a resident on contact isolation for MRSA. An LPN entered the resident's room without washing hands or wearing gloves and a gown, and continued to prepare medications for other residents without sanitizing hands. The breach in protocol was confirmed by the Infection Control Preventionist and the Director of Nursing.
Deficient Food Storage, Labeling, and Kitchen Sanitation
Penalty
Summary
The facility failed to ensure that food was labeled, stored, and prepared under sanitary conditions, as well as to maintain cleanliness and proper functioning of kitchen equipment. During an observation tour, multiple food items on the steam table were found covered in plastic wrap and labeled with preparation dates, but the reason for their placement was unclear, and a box of powdered sugar was open, unsealed, and unlabeled. In the walk-in refrigerator, a carton of liquid whole eggs was found open and without an open date, and in the walk-in freezer, a large package of meat was wrapped in plastic wrap but not labeled or dated. The freezer also had ice buildup due to a door latch that did not secure properly, and there was no record of maintenance being notified about this issue for several months. Further observations revealed that coffee cups described as clean and ready for use had an orange-colored film inside, and a ceiling fan above the dishwasher and dish area was covered with a buildup of fuzzy grey matter. In a pantry refrigerator, a box of take-out chicken brought in by family was found with only a room number written on it, lacking the required resident name and date. Staff interviews confirmed that perishable foods brought in by family should be labeled with the resident's name and date, and items older than three days should be discarded, but these procedures were not followed. The facility's policies required food service employees to comply with safe food handling practices, proper labeling and storage of perishable foods, and regular cleaning and maintenance of equipment. However, these policies were not consistently implemented, as evidenced by the lack of labeling, improper storage, unclean equipment, and failure to report or address maintenance issues in a timely manner. These deficiencies affected the majority of residents receiving meals from the kitchen.
Medication Error Rate Exceeds Acceptable Threshold
Penalty
Summary
The facility failed to maintain a medication error rate below 5%, with an observed error rate of 17.24% during medication administration for four residents. Specific errors included omitted doses, such as polyethylene glycol for one resident and a Nepro supplement for another due to unavailability. Additionally, a resident was not instructed to rinse his mouth after using an inhaler, and another resident's medications were delayed or omitted due to issues with medication availability and timing. One LPN was observed to be significantly behind schedule during the morning medication pass, with more than half of the residents on her cart still awaiting their 9:00 am medications well after the scheduled time. Interviews with nursing staff and management confirmed expectations that medications should be administered within one hour before or after the scheduled time, and that medications should be ordered in advance to prevent running out. Pharmacy records and staff interviews revealed that some medications were not available at the time of administration, despite being ordered previously, and that there was no drug shortage for the omitted medications. The combination of omitted doses, late administration, and failure to follow proper medication administration procedures contributed to the elevated medication error rate.
Failure to Provide Privacy Bags for Catheter Drainage Bags
Penalty
Summary
The facility failed to provide privacy bags for urinary drainage bags on Foley catheters for two residents, as required by facility policy. Observations revealed that one male resident with diagnoses including urinary retention, chronic kidney failure, and congestive heart failure was seen in both the therapy room and dining room without a privacy cover on his catheter drainage bag. Another resident was observed in bed with a Foley catheter and no privacy cover in place. The facility's policy states that privacy bags should be available and used at all times, and replaced when soiled, with a catheter change, or as needed. Interviews with LPNs confirmed that all residents with catheters are expected to have privacy bags, and that this should be checked by both nurses and CNAs. The DON also stated that privacy bags should be put in place on admission if not already present. Despite these expectations and policies, the lack of privacy covers was observed on multiple occasions for both residents, indicating a failure to follow established catheter care protocols.
Failure to Accurately Code Resident Discharge and Transmit Correction to CMS
Penalty
Summary
The facility failed to properly code a resident's discharge in accordance with its policy and federal requirements. Specifically, for one resident with multiple chronic conditions, the Minimum Data Set (MDS) was inaccurately coded as a discharge to a hospital when the resident had actually been discharged home. The facility's policy requires that discharge assessments be completed using the discharge date as the Assessment Reference Date (ARD) and that corrections be transmitted to CMS if errors are identified. However, no correction transmittal was sent to CMS for this resident, and the error was not identified or corrected in a timely manner. Interviews with the MDS Coordinator and Remote MDS Coordinator revealed uncertainty and oversight regarding the correct discharge coding for the resident. The MDS Coordinator was unsure why the resident was coded as a hospital discharge, and the Remote MDS Coordinator acknowledged that the discharge should have been coded as 'return not anticipated' and that a correction should have been made. The DON stated that she expected the MDS process to be checked and rechecked to ensure accuracy, but this did not occur in this instance.
Failure to Provide Timely Pharmaceutical Services
Penalty
Summary
The facility failed to provide routine and emergency pharmaceutical services to meet the needs of a resident, as required by policy and regulation. Specifically, a resident with multiple chronic conditions, including chronic kidney disease, diabetes, heart failure, and atrial fibrillation, did not receive two ordered medications—apixaban and Spiriva—at the scheduled time. Observations during medication pass revealed that both medications were missing from the medication cart, and staff were unable to locate apixaban in the emergency stock. After contacting the nurse practitioner, orders were received to hold the medications due to their unavailability. The resident eventually received the available medication later in the morning, but Spiriva remained unavailable. Interviews with staff and pharmacy personnel revealed that apixaban had been ordered several days prior and was only delivered the night before, while Spiriva had not been filled due to an unexplained delay and subsequent insurance denial. The pharmacy cited staffing shortages and indicated that medication turnaround should typically be 24 hours. Facility staff reported that medication reordering should occur a week in advance, and if medications are unavailable, the pharmacy and prescriber are contacted. Despite these procedures, the resident did not receive all prescribed medications as ordered, constituting a failure to ensure timely access to necessary pharmaceutical services.
Failure to Provide Written Notice of Room Changes
Penalty
Summary
The facility failed to provide written notice to residents or their responsible parties prior to making room changes, as required by both facility policy and federal regulation. This deficiency was identified through interviews, record reviews, and policy examination, affecting four residents who experienced multiple room changes. The facility's policy states that written notice, including the reason for the move, must be given in advance in a language and manner the resident and representative understand. However, documentation and interviews revealed that only verbal notifications or phone calls were made, and no written notifications were provided. Residents affected by this deficiency had varying medical histories, including end stage renal disease, congestive heart failure, schizophrenia, diabetes mellitus, and chronic obstructive pulmonary disease. Cognitive assessments showed that most residents had intact cognition, with one resident having moderate cognitive impairment. Despite their cognitive abilities, these residents were not given written notice or the opportunity to express their preferences regarding room changes. Progress notes and census reports confirmed multiple room changes for each resident without evidence of written notification. Staff interviews, including those with CNAs, LPNs, RNs, the Social Services Director, the DON, and the Administrator, consistently indicated that the process for room changes involved verbal communication and updates in the electronic health record, but not written notification. Staff were generally unaware that written notice was a regulatory requirement. Residents reported being moved without advance notice or written communication, and some expressed dissatisfaction with the lack of choice or information about the moves. The deficiency was systemic, as no staff member reported providing written notice for any room change.
Failure to Timely Provide Resident Medical Records
Penalty
Summary
The facility failed to provide written copies of residents' medical records within two working days of initial written requests for three residents, as required by both facility policy and federal regulations. The policy specified that residents or their legal representatives should receive access to their records within 24 hours and copies within two working days, with a possible extension if notification is provided. However, in all three cases reviewed, significant delays occurred, and the records were not provided within the required timeframe. For one resident with severe cognitive impairment and a history of Alzheimer's disease and vascular dementia, a law firm representing the resident sent a written request for medical records, which was received and signed for by the facility. Despite this, the process to obtain the records took 39 calendar days, involving multiple communications between the facility, a compliance company, and former facility owners. The delay was attributed to the need for verification, gathering records from previous owners, and waiting for payment before release. Another resident, who was cognitively intact and had a history of atrial fibrillation and COPD, had a medical records request faxed to the facility by a law firm. The process to provide access to the records took 35 calendar days, with the compliance company and facility staff involved in compiling and verifying the records before release. In the third case, a resident with severe cognitive impairment and multiple comorbidities had a request for records made by their next of kin, followed by repeated unsuccessful attempts by a law office to contact the facility. The records were not made available until 116 calendar days after the initial request. Interviews with staff and the compliance officer confirmed that the facility's process routinely failed to meet the required 48-hour or two-working-day timeframe, especially for requests involving discharged residents or legal representatives.
Food Safety and Sanitation Deficiencies
Penalty
Summary
The facility failed to adhere to its policies regarding food storage, preparation, and sanitation, which had the potential to affect 108 residents receiving oral diets. During a kitchen tour, it was observed that various food items in the walk-in refrigerator and freezer were not properly labeled or dated, and some dry storage foods were expired. The Dietary Manager confirmed these issues and acknowledged that the morning kitchen staff, including himself, were responsible for checking labeling, storage, and dates. Additionally, a black substance was found on the ice machines, indicating a lack of proper cleaning, as no cleaning log was presented, and the last deep cleaning was recorded months prior. Further observations revealed improper thawing procedures, with ground beef being thawed under hot running water, contrary to the facility's policy. The morning cook also deviated from the puree recipe process, using a beef base on uncooked pork ribs instead of following the prescribed method. This was confirmed by the Dietary Director, who noted the cook's actions. Additionally, expired apple juice was found in the emergency preparedness supplies. These deficiencies highlight lapses in following established protocols for food safety and sanitation within the facility.
Failure to Notify Responsible Party of Medication Changes
Penalty
Summary
The facility failed to notify the responsible party of new medication orders for a resident, identified as R315, who was part of a sample of 63 residents. The resident's daughter expressed concern about the facility's lack of communication regarding her mother's medication regimen, noting that her mother, a high religious dignitary, did not believe in taking medications except for blood pressure medication. A review of the electronic medical record showed that the only documented conversations with the responsible party were not related to medication and occurred on 3/8/2024 and 4/19/2024. Despite this, the resident was prescribed and receiving multiple medications, including Topamax, Depakote, Ivermectin, and Lexapro, without the responsible party being informed. Interviews with facility staff, including a registered nurse and the Director of Clinical Services, revealed a lack of awareness and adherence to the expectation that family and responsible parties should be notified of any changes in medication orders.
Inaccurate Resident Assessments in MDS Documentation
Penalty
Summary
The facility failed to ensure accurate assessments for two residents, R413 and R68, as required by their policy on the Minimum Data Set (MDS). For R413, an observation and interview revealed that the resident was alert, oriented, and capable of performing certain activities independently, such as using the restroom. However, the MDS assessment inaccurately documented the presence of a Foley catheter, which had been removed earlier in the month. This discrepancy between the resident's current condition and the documented assessment indicates a failure to update the MDS accurately. For R68, the quarterly MDS assessment showed intact cognition and independence in activities of daily living, but it failed to accurately reflect the resident's pain status. Despite having a care plan that acknowledged potential pain due to neuropathy and pressure ulcers, the MDS did not document any pain issues. During an interview, R68 reported experiencing pain in both feet and taking medication as needed. The RN interviewed acknowledged that pain assessments should include detailed descriptions and interventions based on the assessment, orders, and care plan, which was not reflected in the MDS documentation.
Failure to Provide Scheduled Showers for Residents
Penalty
Summary
The facility failed to provide scheduled showers or baths for two residents who were dependent on staff for activities of daily living (ADLs). Resident R10, diagnosed with chronic obstructive pulmonary disease, hypertensive chronic kidney disease, and unspecified osteoarthritis, was scheduled for bathing three times a week and as needed. However, records indicated that R10 received a shower only once during the observed period, despite expressing a desire for more frequent showers. Similarly, Resident R45, with diagnoses including Parkinsonism and neurocognitive disorder with Lewy bodies, was scheduled for bathing three times a week and as needed but received showers only six out of the 13 scheduled times. Interviews with staff revealed issues with documentation and understanding of the electronic medical record (EMR) system. A Certified Nursing Assistant (CNA) admitted to difficulties in using the EMR system, which may have contributed to incomplete records. The facility's administration claimed sufficient staffing to meet shower schedules but could not provide documentation of resident refusals when showers were missed. The lack of documentation and adherence to scheduled care routines led to the identified deficiency in providing necessary ADL support to the residents.
Failure to Provide Activities Program for Resident
Penalty
Summary
The facility failed to develop and introduce an activities program for a resident, identified as R413, which had the potential to place the resident at risk for a diminished quality of life. The resident, who was awake and alert, expressed concerns about being moved into a room without a television, which was his only source of entertainment. Despite his requests for a television and inquiries about activities, no one had spoken to him about available activities. The facility's policy stated that activities should be based on comprehensive assessments and care plans, but the resident was not informed or included in any activities. Observations over several days confirmed that the resident did not have a television in his room and had not been visited by the Activities Department. Interviews with the Administrator and Activities Director revealed that there were staffing issues in the Activities Department, and the expected process of conducting initial assessments and follow-ups was not followed for this resident. The Administrator confirmed that the facility provides televisions for residents, but this had not been addressed for R413. The Activities Director was not familiar with the resident and confirmed there was no additional documentation for activities for him.
Failure to Follow Physician's Orders for Compression Stockings and Ointment
Penalty
Summary
The facility failed to adhere to the physician's orders for a resident, identified as R413, who was admitted with conditions including cellulitis, lymphedema, venous insufficiency, and heart failure. The orders included a skin assessment every Friday, application of Dermaphor ointment twice daily for dry skin, and the use of compression stockings every morning to be removed at bedtime. Observations revealed that the resident did not have compression stockings on multiple occasions, and his legs showed signs of discoloration, swelling, and extremely dry, scaly skin. The resident reported that the compression stockings had been removed several days prior and had not been reapplied, and that no ointment had been applied to his legs. Interviews with staff indicated a lack of awareness and communication regarding the physician's orders. LPN II was unaware of the order for compression stockings and noted that it did not appear on the Medication Administration Record (MAR), while LPN JJ confirmed the orders were present on the MAR. The Treatment Nurse stated that topical treatments were administered by unit nurses, and RN LL indicated that the Treatment Nurse managed wounds and assessed skin as needed. This lack of adherence to the physician's orders had the potential to place the resident at risk for medical complications and a diminished quality of life.
Improper Storage of Oxygen Tanks in Resident's Room
Penalty
Summary
The facility failed to ensure the safe and appropriate storage of oxygen (O2) tanks for a resident, leading to a deficiency. During an observation, it was noted that a resident had two O2 tanks in their room, one of which was not secured in a holder. The facility's policy requires that O2 tanks be stored in a designated, secure location to prevent accidents and hazards. However, the tanks were found in the resident's room, with one tank lacking a regulator and covered with a plastic cap, indicating it was full. Additionally, there was no signage indicating O2 usage on the resident's room door, and the resident's records showed no physician orders for O2 usage. Interviews with facility staff, including a registered nurse unit manager, the administrator, and a respiratory therapist, confirmed that the O2 tanks should not have been in the resident's room and should have been stored securely outside the facility. The staff acknowledged the potential danger posed by unsecured O2 tanks, which could cause injury if they fell. The facility's policy and staff interviews highlighted the responsibility of staff to ensure O2 tanks are properly stored and secured, yet this was not adhered to in this instance, resulting in a deficiency.
Failure in Pain Management for Resident
Penalty
Summary
The facility failed to provide appropriate pain management for a resident, identified as R68, who was admitted with diagnoses including pain in both legs, low back pain, and neuropathy. Despite having a care plan that included administering pain medication and non-pharmacological interventions, the facility did not have the prescribed oxycodone acetaminophen in stock during a medication administration observation. When the resident complained of pain at a level seven out of ten, the LPN discovered the medication was unavailable and attempted to substitute it with Tylenol, which did not alleviate the resident's pain. The resident's pain increased to eight out of ten, and no follow-up assessment was conducted for over six hours, contrary to the facility's pain management policy. The LPN and Unit Manager failed to retrieve the medication from the emergency management backup system, even after a new order was signed. The resident remained in pain until the medication was finally administered later in the day, reducing the pain to zero. The facility's failure to follow its pain management protocol resulted in the resident experiencing prolonged pain.
Medication Storage and Security Deficiencies
Penalty
Summary
The facility failed to ensure that drugs and biologicals were stored securely and appropriately, as observed during a survey. A medication cart was left unlocked and unattended by an LPN, which was confirmed during an interview with the LPN who admitted forgetting to lock the cart. This oversight had the potential to allow unauthorized access to medications by residents, staff, or visitors. Additionally, the facility's medication storage room was found to be disorganized, with expired and used items co-mingled with new items, and various pharmacy items improperly stored in bags, a sink, and a storage box. During a tour of the medication storage room, it was observed that there were several issues, including a Foley Catheter with an open outer layer and an expired date, a laundry basket full of resident medication cards awaiting disposal, and a sink filled with various items such as IV fluids and tubing. Interviews with staff, including an LPN and the Unit Manager, revealed that the used items should have been discarded and not returned to the storage room. The Unit Manager confirmed that the items in brown bags were not marked as 'Do Not Use' and were supposed to be picked up by the pharmacy, but this had not occurred. The lack of proper labeling and organization in the medication storage room contributed to the potential for misuse of medications and biologicals.
Inaccurate Documentation of Resident Care
Penalty
Summary
The facility failed to maintain accurate documentation of care and services provided for a resident, identified as R413. The facility's policy on medical record documentation requires that each resident's medical record accurately represent their experiences with complete, accurate, and timely documentation. However, a review of R413's clinical records revealed discrepancies in the documentation of care. The resident was admitted with conditions including cellulitis, lymphedema, venous insufficiency, and heart failure. Physician orders included daily skin assessments, wound care with Dermaphor ointment, and the use of compression stockings. Despite these orders, the medication administration record (MAR) indicated that wound care and compression stocking application were documented as performed on specific dates, but observations and resident interviews contradicted this documentation. On multiple occasions, R413 was observed without compression stockings, and the resident reported that no ointment had been applied to their legs. Interviews with nursing staff confirmed the discrepancies in documentation. An LPN acknowledged the orders and documentation but did not provide further clarification. An RN confirmed the documentation of compression stockings and ointment application, as well as urinary catheter care, which was documented after the catheter's removal. The RN stated that staff are expected to document only what they perform and not falsify records, highlighting a failure in maintaining accurate and truthful documentation of care provided to the resident.
Infection Control Protocol Failures in LTC Facility
Penalty
Summary
The facility failed to maintain infection control protocols during the insertion of an indwelling urinary catheter for a resident with a neurogenic bladder. The Licensed Practical Nurse (LPN) involved did not perform hand hygiene between changing sterile gloves and compromised the sterile technique by fanning the gloves in the air and coiling the catheter in her hand without its sterile packaging. This lapse in protocol was acknowledged by the LPN and confirmed by another LPN present during the procedure. Another deficiency was observed during medication administration for a resident. An LPN did not perform hand hygiene after leaving the medication cart to retrieve multivitamins from the medication storage room and returning to complete medication preparation. This was confirmed by the LPN during an interview. Additionally, the facility failed to adhere to contact isolation protocols for two residents diagnosed with infectious conditions. Observations revealed that the doors to the rooms of these residents, who were on contact precautions, were left open despite signage indicating they should remain closed. The Infection Preventionist confirmed that it was expected for the doors to be closed to prevent the spread of infection.
Failure to Follow Infection Control Practices for Resident on Contact Isolation
Penalty
Summary
The facility failed to follow proper infection control practices for a resident on contact isolation. Specifically, a Licensed Practical Nurse (LPN) entered the resident's room without washing or sanitizing her hands, and without wearing gloves or a gown, despite the resident being on contact isolation for MRSA. The LPN also failed to wash or sanitize her hands after leaving the room and continued to prepare medications for other residents, thereby potentially spreading the infection. The facility's policy on hand hygiene and the use of personal protective equipment (PPE) was not followed, as confirmed by the Infection Control Preventionist and the Director of Nursing. The resident involved had a medical history that included acute renal failure, diarrhea, possible clostridium difficile, and a urinary tract infection with MRSA. The care plan for this resident required staff to wear gowns and masks when in contact with the resident. Despite clear signage on the resident's door indicating contact precautions and the need for hand hygiene and PPE, the LPN did not adhere to these protocols. This lapse in infection control was acknowledged by the LPN, who admitted to forgetting the resident's isolation status, and by the Infection Control Preventionist and the Director of Nursing, who confirmed the breach in protocol.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 152 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
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Cartersville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Townsend Park Health And Rehabilitation | 0.8 mi | ★★★★★ | 1 | 0 |
| Cartersville Crossing Of Journey Llc | 1.2 mi | ★★★★★ | 7 | 0 |
| Ross Memorial Health Care Ctr | 14.4 mi | ★★★★★ | 0 | 0 |
| Chulio Hills Health And Rehab | 15.4 mi | ★★★★★ | 12 | 0 |
| Woodstock Center For Nursing And Healing Llc | 16.4 mi | ★★★★★ | 11 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Cartersville Center For Nursing And Healing.
100% money-back within 48 hours.
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.