Below 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 The Guest House Care Center during CMS and state inspections, most recent first.
The facility failed to implement comprehensive care plans for two residents. One resident, with multiple diagnoses including dementia and a fractured femur, did not have wheelchair brake extenders as ordered by a physician. Another resident, dependent on assistance for ADLs, lacked a care plan addressing these needs. Staff confirmed these oversights, indicating a failure to follow physician's orders and properly plan for resident care.
A resident with a history of falls and multiple diagnoses, including a fractured femur and dementia, experienced an unwitnessed fall in the lounge area. The facility failed to update the resident's care plan with new fall interventions after the incident, as confirmed by the MDS nurse and DON, who acknowledged the oversight in care plan revision responsibilities.
A resident with chronic pain was prescribed Oxycodone, but an LPN failed to document its administration in the MAR at the time it was given. The LPN admitted to delaying documentation until later in the shift, leading to multiple instances of late entries over two months. The DON confirmed that immediate documentation was expected but not followed.
A resident experienced a significant change in condition, including pain and inability to ambulate, which was not reported to the on-call medical provider as required. This delay led to a diagnosis of a femur fracture and necessitated a hospital transfer for surgery. Interviews with staff confirmed the oversight in communication.
A resident in a long-term care facility experienced a significant change in condition, including new onset pain, swelling, and inability to bear weight, which was not adequately recognized, monitored, or documented by the nursing staff. Despite the resident's severe cognitive impairment and baseline of independent ambulation, the staff failed to notify the medical provider or document the changes, leading to a delay in treatment. The resident was later diagnosed with a femur fracture, requiring hospitalization and surgery.
A resident with a documented Do Not Resuscitate (DNR) order was found unresponsive with a belt around their neck. An LPN initiated CPR without checking the resident's code status, contrary to the facility's policy. The Director of Nursing confirmed the lapse in procedure, highlighting a failure to respect the resident's advance directive.
The facility failed to maintain accurate medical records for a resident with Major Depressive Disorder. An LPN documented sadness on the MAR due to system limitations, despite the resident not displaying such symptoms. The DON confirmed the inaccuracies.
The facility failed to provide timely incontinence care for two residents, leaving them in soiled conditions for an extended period. Both residents were found with saturated incontinence briefs, pads, and sheets, and one had stool on her buttocks. The assigned CNA did not perform the required care during her shift and did not seek assistance.
The facility failed to assess a resident for the risk of entrapment from bedrails and did not obtain informed consent prior to their installation. The resident had multiple diagnoses and required side rails for bed mobility, but there was no documentation of an entrapment risk assessment or consent from the resident's representative.
The facility failed to ensure that CNAs demonstrated competency in necessary skills and techniques, leading to inadequate care for two residents. One resident was not transferred out of bed as needed, and another received an inexperienced bed bath. The CNA's orientation was signed off without proper competency checks, and the CNA lacked computer access to review care plans.
The facility failed to ensure that a newly hired CNA was competent in assisting residents with ADLs, leading to inadequate care for two residents. The CNA did not receive proper training or supervision, and her competency was signed off without verification.
A resident with moderate cognitive impairment and requiring extensive assistance with transfers was not assisted out of bed at her requested time of 10:00 a.m. Staff were aware of her preference but failed to provide the necessary assistance, leaving the resident in bed until her family member arrived to help.
The facility failed to ensure residents received mail on Saturdays, affecting four residents. Staff responsible for mail distribution only worked Monday through Friday, resulting in weekend mail being held until Monday.
The facility failed to resolve a grievance regarding a missing phone charger for a resident with severe cognitive impairment. The issue was reported to a CNA and an LPN, but neither escalated it to the administration, resulting in the grievance not being documented or resolved as required by the facility's policy.
Failure to Implement Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for two residents, leading to deficiencies in their care. Resident #2, who was admitted with diagnoses including muscle weakness, dementia, Alzheimer's disease, repeated falls, and a fracture to the right femur, had a physician's order for wheelchair brake extenders for safety. However, during an observation, it was noted that the brake extenders were not in place, and the Assistant Director of Nursing (S2ADON) confirmed this oversight. The Director of Nursing (S1DON) also acknowledged that staff were expected to follow physician's orders, which was not done in this case. Resident #3, admitted with diagnoses including a fractured right femur, dementia, pain, and insomnia, was found to be dependent on assistance for activities of daily living (ADLs) such as eating, oral hygiene, toileting, showering, dressing, and personal hygiene. Despite these needs, the resident's care plan lacked interventions for ADLs dependency deficits. The MDS Coordinator (S3MDS) confirmed that these deficits should have been addressed in the care plan, and the Director of Nursing (S1DON) also verified that the resident was not properly care planned for these needs.
Failure to Update Care Plan After Resident Fall
Penalty
Summary
The facility failed to revise a resident's care plan to include updated fall interventions after a fall incident. Resident #3, who was admitted with diagnoses including a fractured right femur, dementia, pain, and insomnia, experienced an unwitnessed fall in the common lounge area on 12/31/2024. The resident was found sitting half on the wheelchair footrest with her right leg hanging over it, having slid out of the wheelchair. Despite this incident, the resident's care plan was not updated to include new interventions to prevent future falls. Interviews with facility staff revealed that the Minimum Data Set (MDS) nurse was responsible for updating care plans following incidents such as falls. Both the MDS nurse and the Director of Nursing (DON) confirmed that the care plan should have been revised to include interventions after the fall on 12/31/2024, but it was not. This oversight indicates a failure in the facility's process for ensuring timely updates to care plans following significant events affecting resident safety.
Failure to Document Timely Administration of Pain Medication
Penalty
Summary
The facility failed to ensure that services were provided to meet professional standards of quality in the administration of pain medication for one of the residents reviewed. Specifically, the facility did not document the administration of Oxycodone in the Medication Administration Record (MAR) at the time of administration for a resident who was prescribed Oxycodone 10 mg four times daily for chronic pain. The resident had a medical history that included chronic pain, opioid use, peripheral vascular disease, and an acquired absence of the right leg above the knee. The Licensed Practical Nurse (LPN) responsible for administering the medication admitted to not documenting the administration of Oxycodone at the time it was given. Instead, the LPN would wait until later in the shift to enter all documentation, resulting in multiple instances of delayed documentation over a two-month period. The Director of Nursing (DON) confirmed that the expectation was for nurses to document medication administration immediately after it was completed, which was not adhered to in this case.
Failure to Report Significant Change in Condition
Penalty
Summary
The facility failed to ensure timely communication of a significant change in condition to a resident's physician, resulting in an Immediate Jeopardy situation. A resident, who was typically active and able to ambulate independently, experienced a significant change in condition on the morning of July 13, 2024. The resident complained of pain in the lower extremities, exhibited swelling in the left knee, and was unable to bear weight or ambulate. Despite these symptoms indicating a significant change in condition, the on-call medical provider was not notified immediately by the nursing staff. The resident's condition continued to decline over the following days, with no further documentation or notification to the medical provider until July 15, 2024. On this date, an x-ray was ordered, revealing an acute left proximal femur fracture and chondral irregularity of the left femoral head, which could indicate avascular necrosis (AVN). The delay in notification and subsequent medical intervention resulted in the resident being transferred to the hospital for a Left Hip Hemiarthroplasty on July 16, 2024. Interviews with facility staff confirmed that the resident's significant change in condition was recognized but not reported to the medical provider as required by the facility's policy. The LPNs and the Assistant Director of Nursing acknowledged the oversight and confirmed that the on-call nurse practitioner should have been notified immediately. The delay in reporting led to a decline in the resident's range of motion, mobility, and prolonged pain.
Failure to Recognize and Address Resident's Change in Condition
Penalty
Summary
The facility failed to provide appropriate treatment and care according to professional standards of practice for a resident who experienced a significant change in condition. The resident, who was severely cognitively impaired, was observed to have new onset pain in the lower extremities, swelling in the left knee, and was unable to bear weight or ambulate. Despite these symptoms, the nursing staff did not recognize, monitor, intervene, or document the resident's condition adequately, leading to a delay in treatment. The resident's medical records indicated that prior to the incident, the resident was ambulatory without assistance or pain and was continent. However, from the morning of the incident, the resident exhibited signs of pain, decreased mobility, and new onset incontinence. The nursing staff, including LPNs and CNAs, observed these changes but failed to notify the medical provider or document the resident's condition changes in a timely manner. The resident was eventually diagnosed with an acute left proximal femur fracture after an x-ray was ordered two days later, resulting in hospitalization and surgery. Interviews with the nursing staff revealed a lack of communication and documentation regarding the resident's condition. The staff assumed the resident's symptoms were related to a gout flare-up, which was not previously documented, and did not take appropriate action to address the significant change in condition. The delay in notifying the medical provider and the lack of documentation contributed to the resident's prolonged pain and decline in mobility.
Failure to Honor Resident's DNR Order
Penalty
Summary
The facility failed to honor a resident's advance directive, specifically a Do Not Resuscitate (DNR) order. The resident, who had a documented DNR status in their clinical record and care plan, was found unresponsive with a belt around their neck. Despite the clear documentation of the resident's wishes, the Licensed Practical Nurse (LPN) who discovered the resident initiated Cardiopulmonary Resuscitation (CPR) without first checking the resident's code status. This action was contrary to the facility's policy, which requires staff to verify the resident's advance medical directive before initiating CPR. The Director of Nursing (DON) confirmed that the LPN did not follow the proper procedure, which mandates checking the chart for code status before performing CPR. The LPN admitted to panicking upon finding the resident unresponsive and starting CPR without verifying the DNR order. This failure to adhere to the resident's advance directive represents a significant deficiency in the facility's compliance with respecting residents' rights to refuse treatment.
Inaccurate Documentation of Medication Administration Record
Penalty
Summary
The facility failed to maintain accurately documented medical records in accordance with accepted professional standards and practices for one resident. Specifically, the nursing staff inaccurately documented the Medication Administration Record (MAR) for a resident diagnosed with Major Depressive Disorder. The MAR indicated that the resident exhibited sadness on multiple dates, signed by the same LPN. However, during an interview, the LPN admitted that the resident never displayed signs of sadness or depression and that she documented sadness because the electronic system did not allow her to select any other option. The Director of Nursing confirmed the inaccurate documentation upon review.
Failure to Provide Timely Incontinence Care
Penalty
Summary
The facility failed to ensure that residents who were unable to carry out activities of daily living received necessary services to maintain good hygiene. Specifically, the facility did not provide timely incontinence care for two residents, Resident #75 and Resident #88. Resident #75, who had severe cognitive impairment and was always incontinent of bowel and bladder, was observed with a strong urine odor in her room and was found with a saturated incontinence brief, incontinence pad, and fitted sheet, along with stool on her buttocks. Similarly, Resident #88, who had intact cognition but required assistance with ADLs and was at high risk for skin breakdown, was also found with a strong urine odor in her room and a saturated incontinence brief, incontinence pad, and top sheet. Both residents had not received incontinence care during the shift as required by their care plans, which specified care every two hours and as needed. Interviews with the CNA assigned to these residents revealed that she had not provided incontinence care to either resident during her shift and had not reported her inability to complete her duties or asked for assistance. Further interviews with other staff members and the Director of Nursing confirmed that the lack of timely incontinence care was unacceptable and that incontinence rounds should have been performed every two hours. The failure to provide timely incontinence care resulted in both residents being left in soiled conditions for an extended period, which was confirmed by multiple observations and staff interviews.
Failure to Assess Entrapment Risk and Obtain Consent for Bedrails
Penalty
Summary
The facility failed to ensure that residents were assessed for the risk of entrapment from bedrails and did not obtain informed consent for bedrails prior to their installation. Specifically, Resident #41, who had multiple diagnoses including movement disorders, dementia, and muscle weakness, was found to have quarter side rails in use without any documented entrapment risk assessment or consent from the resident's representative. The resident's clinical record showed physician orders for the use of side rails for bed mobility and repositioning, but there was no documentation of an entrapment risk assessment or consent for the use of these side rails. Observations and interviews confirmed that the side rails were in use whenever the resident was in bed. Staff interviews revealed that while the side rails were assessed for proper function, no assessment for entrapment risk was conducted. Additionally, the Director of Nursing was unable to provide any documentation indicating that the resident's representative had given consent for the use of the side rails. This lack of documentation and assessment led to the deficiency identified in the report.
Inadequate CNA Training and Competency Checks
Penalty
Summary
The facility failed to ensure that each nurse aide demonstrated competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments and described in the plan of care. Specifically, two residents were affected by this deficiency. Resident #28, who has moderate cognitive impairment and requires extensive assistance with transfers, was not transferred out of bed as needed. The CNA assigned to her was unsure of the resident's transfer status and did not seek assistance from another staff member, despite being unable to perform the transfer alone. This resulted in the resident remaining in bed and feeling that the CNA was incompetent to assist with her transfer needs. Resident #34, who is cognitively intact and requires partial/moderate assistance with bathing, reported that the CNA assigned to her was inexperienced and asked for guidance on how to perform a bed bath. The CNA, who had only been working at the facility for a few days, had not received proper training or computer access to review the residents' care plans. The CNA's orientation was signed off as complete without a return demonstration of care tasks, leading to inadequate care being provided to the resident. Interviews with staff revealed that the CNA's orientation and competency checks were not thoroughly conducted. The CNA responsible for training and signing off on the orientation did not observe the new CNA performing care tasks to ensure competency. Additionally, the Director of Nursing and the Administrator confirmed that the CNA should not have been providing care without knowing the specific assistance each resident required. This lack of proper training and oversight resulted in the CNA being unprepared to meet the residents' needs effectively.
Failure to Ensure CNA Competency in Resident Care
Penalty
Summary
The facility failed to ensure that its resources were used effectively and efficiently to maintain the highest practicable physical, mental, and psychosocial well-being for its residents. Specifically, the facility did not have an effective system in place to ensure that a newly hired CNA was competent in the necessary skills and techniques for assisting residents with activities of daily living (ADLs). This deficiency was identified through interviews and record reviews involving two residents who required assistance with ADLs. One resident, who had diagnoses including hemiplegia and generalized muscle weakness, required assistance with transfers and needed to be transferred on her strong side. The CNA admitted that she was unable to transfer the resident out of bed by herself and did not seek additional help, despite the resident's request. The CNA also stated that she was unsure how to identify a resident's transfer status or the level of assistance required for ADLs. Another resident, who had diagnoses including a fracture of the neck of the femur and morbid obesity, required extensive assistance with ADLs and preferred bed baths. The CNA, who had not received computer login or training on the facility's system, provided a bed bath to the resident without prior demonstration or supervision. The CNA's competency was signed off by a supervisor without proper observation or verification. The Director of Nursing and the Administrator confirmed that the CNA should not have provided care without knowing the specific assistance each resident required and that the supervisor should have ensured the CNA's competency before allowing her to work independently.
Failure to Support Resident's Choice for Transfer Time
Penalty
Summary
The facility failed to promote and facilitate resident self-determination by not supporting Resident #28's choice of when to get out of bed. Resident #28, who has moderate cognitive impairment and requires extensive assistance with transfers, expressed a preference to be out of bed by 10:00 a.m. On the day of the incident, Resident #28 requested assistance from S5CNA to be transferred to her wheelchair at 10:00 a.m., but this assistance was not provided. S5CNA informed S4LPN that she could not assist Resident #28 independently, and S4LPN instructed her to get another CNA for help. However, this did not happen, and Resident #28 remained in bed until her family member arrived and transferred her to the wheelchair. Interviews with staff members confirmed that Resident #28's request to be out of bed by 10:00 a.m. was known and should have been honored. S4LPN and S3CNAS both acknowledged that Resident #28 should have been assisted out of bed when she requested. The Director of Nursing (S2DON) also confirmed that Resident #28 should have been transferred out of bed by staff and should not have had to wait for her family member to arrive. This failure to assist Resident #28 in a timely manner demonstrates a lack of support for the resident's right to self-determination and choice.
Failure to Deliver Mail on Saturdays
Penalty
Summary
The facility failed to ensure residents received mail on Saturdays, affecting four residents (#6, #51, #53, and #66) out of 17 reviewed during a resident council meeting. The facility's General Admission & Financial Agreement states that residents have the right to promptly receive unopened mail. However, interviews with staff members S5AD and S4FIN revealed that mail delivered on weekends was held until the following Monday due to the absence of staff responsible for mail distribution on Saturdays. Both staff members confirmed that they only worked Monday through Friday, leading to a delay in mail delivery for residents over the weekend.
Failure to Resolve Resident Grievance
Penalty
Summary
The facility failed to initiate and resolve grievances for a resident with severe cognitive impairment. The grievance policy requires that grievances be documented and resolved promptly, but this was not followed in the case of a missing phone charger reported by the resident's responsible party (RP). The RP reported the missing item to a nurse, who searched for it but did not find it. The nurse did not report the missing item to the administration, and as a result, the grievance was not documented or resolved as per the facility's policy. Interviews with staff confirmed that the missing phone charger was reported to a CNA and an LPN, but neither took the necessary steps to escalate the issue to the administration. The Director of Nursing (DON) and the Administrator were unaware of the missing item until the surveyor's investigation. This failure to follow the grievance policy resulted in the resident's grievance not being addressed or resolved in a timely manner.
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What surveyors actually found near you
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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 Baton Rouge
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Capitol House Nursing And Rehab Center | 0.9 mi | ★★★★★ | 0 | 0 |
| Flannery Oaks Guest House | 2.2 mi | ★★★★★ | 0 | 0 |
| White Oak Post Acute Care | 2.4 mi | — | 12 | 1 |
| St Clare Manor Nursing And Rehabilitation | 2.4 mi | ★★★★★ | 4 | 0 |
| The Woodleigh Of Baton Rouge | 2.7 mi | ★★★★★ | 1 | 0 |
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