Below average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at The Guest House Skilled Nursing And Rehabilitation during CMS and state inspections, most recent first.
The facility failed to maintain RN coverage for 8 consecutive hours per day, 7 days a week. Payroll review showed 8 dates with only 1 RN coverage, and 2 of those dates had less than 8 hours of RN time. S6 Human Resources and the DON confirmed the RN coverage requirement was not met.
Failure to provide privacy during showering. A resident with intact cognition and diagnoses including cerebral ischemia, hepatic encephalopathy, and depression reported using a community shower room because the in-room shower had no water pressure. The resident stated another resident opened the door while the resident was showering, and later a staff member entered without knocking and held the door open while the resident was uncovered. Surveyors observed that the shower rooms had open layouts, no barrier to block view from the door, and doors that could not be locked from the inside.
Failure to Report Resident-to-Resident Physical Abuse: A resident-to-resident physical abuse incident was not reported to the State agency within the required 2-hour timeframe. An LPN witnessed one resident push another resident down, causing a facial bruise, and later saw the same resident push the other resident down again and drag her by the hair. The LPN did not document the second incident or complete an assessment, and the Administrator and DON acknowledged the incidents were not reported to the State agency.
A resident with schizophrenia, dementia, and anxiety had a care plan for psychotropic medications ordered by the physician, including monthly Invega Sustenna. The MAR showed the monthly dose was not administered even though the medication had been delivered to the facility and received by the Unit Manager. The DON acknowledged the missed dose, and the Unit Manager stated he failed to enter the order and later found the syringe after the missed administration.
Respiratory care was not provided consistently for three residents with oxygen and other respiratory therapy needs. Staff failed to date oxygen tubing and a humidification bottle, failed to bag oxygen, nebulizer, CPAP, and BiPAP equipment when not in use, and failed to document lung sound checks after nebulizer treatments for one resident. Observations and interviews confirmed undated tubing, un-bagged masks and hoses, and missing post-treatment lung sound monitoring.
Failure to monitor edema during diuretic therapy. A resident with chronic pulmonary edema, HTN, and CKD stage 3A had an order for PRN Lasix for leg swelling, and the MAR showed the medication was given multiple times. However, the MAR did not show edema monitoring, despite the care plan calling for documentation of edema and observation for adverse reactions. The DON confirmed there was no evidence of edema monitoring in the record.
State agency complaint information was not posted in an accessible location for residents and resident representatives. During facility observation, the LDH Nursing Home complaint phone number was not displayed, and both the DON and Administrator confirmed it was not posted.
Incomplete advance directive documentation was found for two residents. Both residents had Advanced Medical Directives forms with the section asking whether an advance directive had been executed left blank, and the Administrator and Corporate Nurse confirmed the forms should have been completed. One resident had multiple cardiac and metabolic diagnoses, and the other had COPD, DM2, dementia with agitation, and heart disease.
A resident with COPD and obstructive sleep apnea had orders for CPAP at HS and PRN O2 via NC, but the quarterly MDS did not indicate oxygen use or respiratory therapy. The MDS nurse confirmed the assessment was inaccurate and should have been marked yes for both oxygen use and respiratory treatment.
A resident with moderate cognitive impairment eloped from the facility by crawling out of a window, highlighting the facility's failure to perform required visual checks on high-risk residents. Video surveillance showed staff did not conduct checks on other residents at risk for elopement, violating facility policy. Interviews confirmed the resident had a history of exit-seeking behaviors, yet effective preventive measures were not in place.
The facility failed to supervise residents at risk for elopement, leading to a resident eloping and being found a mile away. The resident, moderately cognitively impaired, exited through a window and was not missed until a call from a responsible party. Video review showed staff did not perform required checks on other at-risk residents. Interviews confirmed the lack of supervision, highlighting a deficiency in monitoring procedures.
A resident with multiple health issues, including dementia, eloped from the facility through a window and was found at a gas station. The facility failed to report this incident to the State Survey and Certification Agency and did not complete an investigation as required by their policy.
A resident with dementia eloped from the facility and was found at a gas station. The staff failed to conduct a thorough investigation into the incident, despite facility policies requiring such actions. The DON and Administrator acknowledged the lack of investigation.
The facility failed to conduct weekly skin assessments and implement wound care plans for residents with a history of wounds. A resident with a resolved unstageable pressure ulcer, another with a resolved sacral DTI, and a third with a chronic arterial ulcer did not receive necessary assessments or care planning. Staff confirmed these deficiencies, acknowledging the lack of adherence to the facility's procedures for pressure ulcer prevention and risk assessment.
A facility failed to document the destruction of 13 tablets of Sulfamethoxazole-Trimethoprim for a resident. The resident had two orders for the medication, with 32 tablets dispensed and only 19 administered. Interviews with the DON and a Corporate Nurse confirmed the discrepancy, and the facility's logs lacked documentation for the destruction of the remaining tablets.
The facility failed to verify the licensure of two staff members, S6 and S7, before allowing them to perform duties as licensed nurses. S6 was only licensed in Texas, not Louisiana, and S7's licensure status was not verified upon hire or annually, as required.
The facility failed to update the care plan for a resident admitted to Hospice. The resident's physician's orders indicated Hospice admission, but the care plan did not reflect this change or include related interventions. The MDS Coordinator confirmed the oversight during an interview.
The facility failed to ensure that a resident's oxygen concentrator filter was cleaned weekly as required, resulting in the filter being covered with a large amount of fluffy gray particles. The DON acknowledged the oversight.
RN Coverage Not Maintained for Required Daily Hours
Penalty
Summary
The facility failed to ensure an RN was on duty for 8 consecutive hours per day, 7 days a week, during FY Quarter 1 2025. Review of the payroll summary report provided by S6 Human Resources showed 8 dates with only 1 RN coverage, and 2 of those dates had RN coverage of less than 8 hours: 10/05/2025 with 6.30 hours and 11/30/2025 with 7.55 hours. During interviews on 06/04/2026, S6 Human Resources confirmed the facility did not have RN coverage for 8 consecutive hours on those two dates, and S2 DON also confirmed there should have been RN coverage for 8 hours per day and there was not.
Failure to Provide Privacy During Showering
Penalty
Summary
The facility failed to ensure Resident #127’s right to a dignified existence by not providing privacy during showering in a community hall shower room. Resident #127 was admitted on 01/23/2026 with diagnoses including cerebral ischemia, hepatic encephalopathy, and depression, and the 04/30/2026 quarterly MDS showed a BIMS score of 15, indicating intact cognition. The resident reported that the shower in the resident’s room had no water pressure, so the resident used the shower room across the hall and changed the outside sign to “in use” before entering. During the shower, another resident opened the door, and Resident #127 stated this made the resident angry and caused the resident to holler, “Can’t you read the sign?” The resident later reported that a staff member entered the shower room without knocking and held the door open while the resident was uncovered. Observation confirmed two shower rooms on Hall A and one on Hall B, each with an open layout, no barrier to block view between the door and shower, and doors that could not be locked from the inside. Facility staff, including the CNA Coordinator, Administrator, and Corporate Nurse, confirmed there was nothing to block residents from being seen when the shower room door was opened.
Failure to Report Resident-to-Resident Physical Abuse
Penalty
Summary
The facility failed to ensure an alleged resident-to-resident physical abuse incident was reported to the appropriate state agency within 2 hours after the allegation was made for two residents. Record review showed the facility’s abuse reporting policy required crimes to be reported within 2 hours, but the incident involving Resident #11 and Resident #88 was not reported to the state agency. During interview, the LPN assigned to both residents stated she witnessed Resident #88 push Resident #11 down from behind around 10:00 a.m., causing Resident #11 to fall and sustain a facial bruise. She and a CNA separated the residents, and Resident #11 was placed in her room and assessed. The same LPN reported that later that day Resident #88 again pushed Resident #11 to the floor and dragged her by the hair down the hallway toward the exit, after which Resident #88 was sent to a local emergency room due to behaviors. The LPN acknowledged she did not document the second incident or assess Resident #11 after it occurred. Resident #11 stated she and her husband, Resident #88, had an altercation in the facility and that he hit her in the face, leaving her with a black and blue eye and fear during the event. The Administrator and DON acknowledged the incidents were not reported to the appropriate State Agency, and the DON also acknowledged an incident report had not been completed for Resident #11 related to the events.
Psychotropic Medication Dose Not Administered as Ordered
Penalty
Summary
The facility failed to ensure a plan of care was implemented for Resident #11, who had diagnoses including paranoid schizophrenia, dementia, and generalized anxiety disorder. The resident’s comprehensive care plan identified schizophrenia and psychotropic medication use, with an intervention to administer psychotropic medications as ordered by the physician. The physician ordered Invega Sustenna 156 mg intramuscularly every month for paranoid schizophrenia, and the resident’s MDS indicated antipsychotic medication use. Review of the May 2026 MAR showed the monthly Invega Sustenna dose was not administered. The pharmacy manifest showed the medication was delivered to the facility and signed for by the Unit Manager, but the dose still was not given. During interviews, the DON acknowledged the dose had not been administered and stated the medication should have been given as soon as it was received. The Unit Manager reported the resident did not have an available dose, had contacted the pharmacy, found the syringe on 06/01/2026, and stated he failed to enter the May 2026 order.
Respiratory Equipment Not Properly Dated, Stored, or Monitored
Penalty
Summary
Provide safe and appropriate respiratory care for residents when needed was deficient for three residents who required oxygen therapy and related respiratory equipment care. The facility failed to ensure oxygen tubing was dated when changed for Residents #37, #50, and #51, failed to ensure the humidification bottle was dated when changed for Resident #37, and failed to ensure oxygen tubing was bagged when not in use for Resident #37. The facility also failed to ensure nebulizer, BiPAP, and CPAP masks were bagged when not in use for Residents #37, #50, and #51. Resident #37 had diagnoses including dementia, COPD, and obstructive sleep apnea, with orders for oxygen PRN and CPAP at bedtime. On observation, the resident had an undated oxygen nasal cannula hanging on the headboard, no date on the oxygen humidification bottle, and an un-bagged CPAP mask on the bedside table. The resident stated staff had not replaced the oxygen tubing in a really long time or provided a bag for storage when not in use. The RN confirmed the tubing and humidification bottle were not dated and the cannula and CPAP mask were not bagged and should have been. Resident #50 had diagnoses including chronic respiratory failure with hypoxia, COPD, and asthma, with orders for oxygen PRN and nebulizer treatment with lung sound assessment after administration. The MAR for May 2026 did not show lung sound monitoring after nebulizer treatments, and observations showed undated oxygen tubing and an un-bagged nebulizer mask on the bedside table. Resident #50 stated staff had not changed the oxygen tubing and never bagged the nebulizer mask or listened to his lungs. Resident #51 had diagnoses including COPD, acute and chronic respiratory failure with hypoxia, and heart failure, with orders for continuous oxygen and BiPAP at bedtime. Observations showed undated oxygen tubing, a CPAP on the bedside table with the hose on the floor, no mask attached, and the hose un-bagged; the resident stated staff had not changed the oxygen tubing in a long time and had not provided a storage bag. The LPN confirmed the tubing was not dated and the CPAP hose was on the floor and un-bagged.
Failure to Monitor Edema During Diuretic Therapy
Penalty
Summary
The facility failed to ensure a resident's drug regimen was free from unnecessary medications for 1 of 5 residents reviewed for unnecessary medications. Resident #4 was admitted with diagnoses including chronic pulmonary edema, essential hypertension, and chronic kidney disease stage 3A. The resident had a physician order for Lasix 20 mg by mouth every 8 hours as needed for leg swelling, and the MAR showed the medication was administered on 05/23/2026, 05/25/2026, and 05/28/2026. However, the May 2026 MAR did not show that the resident was monitored for edema, even though the care plan identified diuretic therapy interventions that included documenting edema and observing and reporting adverse reactions to diuretic therapy. The DON reviewed the record and confirmed there was no evidence that edema monitoring had been conducted in May 2026.
State Agency Complaint Information Not Posted
Penalty
Summary
The facility failed to ensure that the name, address, and telephone numbers of all pertinent State agencies were posted in a manner accessible to residents and resident representatives. During observation throughout the facility, the LDH Nursing Home complaint phone number was not posted in a place accessible to residents and resident representatives. In interviews, the DON confirmed that the LDH Nursing Home complaint phone number was not posted, and the Administrator later confirmed the same finding.
Incomplete Advance Directive Documentation for Two Residents
Penalty
Summary
The facility failed to provide documentation regarding the existence of written advance directives for 2 of 2 residents reviewed for advanced directives, Resident #4 and Resident #20. The facility policy titled Advance Directives stated that upon admission the resident would be provided written information about the right to refuse or accept medical or surgical treatment and to formulate an advance directive, and that the Social Services Director or designee would inquire about the existence of any written advance directives prior to or upon admission. Resident #4 was admitted with diagnoses including chronic pulmonary edema, diabetes mellitus, unstable angina, myocardial infarction, atherosclerotic heart disease of native coronary artery without angina pectoris, and essential hypertension. Resident #20 was admitted with diagnoses including chronic obstructive pulmonary disease, type 2 diabetes mellitus, dementia with agitation, and atherosclerotic heart disease of native coronary artery without angina pectoris. Review of each resident’s Advanced Medical Directives Form showed the section asking whether an Advanced Directive had been executed was incomplete, with no box checked to indicate whether an advance directive had or had not been executed. During interview, the Administrator and Corporate Nurse reviewed both forms and confirmed the unchecked boxes should have been completed and were not.
Inaccurate MDS Respiratory Assessment
Penalty
Summary
The facility failed to accurately assess Resident #37’s respiratory status by not ensuring the MDS assessment was accurate. Resident #37 was admitted with diagnoses including unspecified dementia with anxiety, COPD, and obstructive sleep apnea, and had physician orders for CPAP at bedtime and oxygen at 2 liters via nasal cannula as needed for shortness of breath or saturation greater than 90%. Review of the quarterly MDS dated 03/18/2026 showed a brief interview for mental status score of 15, indicating the resident was cognitively intact, but the record review did not show that the resident required oxygen or respiratory therapy. During interview, the MDS nurse confirmed the MDS was inaccurate for respiratory and oxygen use and stated it should have been marked yes for oxygen use and respiratory treatment.
Failure to Supervise High-Risk Residents Leads to Elopement
Penalty
Summary
The facility failed to adequately supervise cognitively impaired residents who were at high risk for elopement, resulting in an Immediate Jeopardy situation. Resident #1, who had a moderate cognitive impairment and was known for exit-seeking behaviors, managed to elope from the facility by crawling out of a window. The staff was unaware of the resident's absence until they received a call from the resident's responsible party, who found the resident at a gas station approximately one mile away. This incident highlighted the facility's failure to perform visual checks every two hours as required by their policy. Further investigation revealed that the facility's staff did not conduct the necessary visual checks on other residents identified as high risk for elopement, such as Residents #5 and #6. Video surveillance showed that staff failed to perform these checks during the night shift, which was a direct violation of the facility's policy. Both residents had severe cognitive impairments and were at risk for elopement, yet the staff did not enter their rooms to ensure their safety. Interviews with various staff members confirmed that Resident #1 had a history of exit-seeking behaviors, such as following staff and visitors out of the facility. Despite this, the facility did not implement effective measures to prevent the resident from leaving. The lack of supervision and failure to adhere to the facility's policies put multiple residents at risk, demonstrating a significant oversight in maintaining a safe environment for those at risk of elopement.
Failure to Supervise Residents at Risk for Elopement
Penalty
Summary
The facility failed to administer its resources effectively and efficiently, resulting in a deficiency related to the supervision of residents at risk for elopement. Specifically, the facility did not have an adequate system in place to ensure that three of six sampled residents who were at risk for elopement were adequately supervised. This lack of oversight led to an Immediate Jeopardy situation when a moderately cognitively impaired resident, who ambulated with a walker, was able to elope from the facility. The resident crawled out of a window and was found at a gas station approximately one mile away, having traversed a dark single-lane highway and a four-lane divided highway during the night. The resident had been assessed as at risk for elopement, but protective measures were not implemented despite a documented history of exit-seeking behaviors. Further review of the facility's video surveillance revealed that staff failed to perform visual checks on residents every two hours as required by the facility's policy. This was particularly evident on Hall A, where two other residents identified at risk for elopement were not adequately monitored. Interviews with the Corporate Nurse and Assistant Administrator confirmed that the night shift staff did not complete the required visual checks, which had the potential to adversely affect the remaining ten residents at risk for elopement. The facility's failure to ensure that nurses and CNAs were performing routine checks every two hours contributed to the deficiency.
Failure to Report Resident Elopement Incident
Penalty
Summary
The facility failed to report an alleged violation involving neglect to the State Survey and Certification Agency. This deficiency was identified during a review of an incident involving a resident who eloped from the facility. The facility's policy requires that all reports of resident abuse, neglect, exploitation, misappropriation of resident property, mistreatment, and/or injuries of unknown source be promptly reported to local, state, and federal agencies and thoroughly investigated by facility management. However, the facility did not adhere to this policy in the case of the resident's elopement. The incident involved a resident with a history of chronic obstructive pulmonary disease, heart failure, depression, insomnia, problems related to living alone, and a history of falling. The resident was found at a gas station by a responsible party after eloping from the facility through a window. The staff had previously observed what appeared to be the resident asleep in bed, but upon further inspection, it was discovered that the bed was stuffed with pillows and blankets to resemble a body. The facility's incident investigation reports did not document the resident's elopement, and the administrator acknowledged that an investigation was not completed as required.
Failure to Investigate Resident Elopement
Penalty
Summary
The facility failed to thoroughly investigate an alleged violation involving the elopement of a resident with dementia. The resident was found at a gas station by a responsible party after leaving the facility through a window. The staff had previously observed what appeared to be the resident asleep in bed, but upon further inspection, it was discovered that the bed was stuffed with pillows and blankets to resemble a body. The facility's policy required routine resident checks to ensure safety, but it is unclear if these checks were conducted as required. Interviews revealed that the Director of Nursing was notified of the incident the following day, but an investigation was not completed. The Administrator also acknowledged that an investigation should have been conducted but was not. The lack of a thorough investigation into the resident's elopement represents a failure to adhere to the facility's policy on abuse investigation and reporting, which mandates prompt reporting and thorough investigation of all alleged violations.
Failure to Conduct Weekly Skin Assessments and Implement Wound Care Plans
Penalty
Summary
The facility failed to provide necessary treatment and services to residents with wounds or a history of wounds, as required by professional standards of practice. This deficiency was identified for three residents who did not receive weekly skin assessments or have a written wound care plan implemented. The facility's procedures for the prevention of pressure ulcers and injury risk assessment were not followed, as evidenced by the lack of comprehensive skin assessments upon admission and the absence of weekly body audits to identify abnormal skin conditions. Resident 1, with a history of an unstageable pressure ulcer, did not have weekly skin assessments performed after the ulcer resolved, and there was no care plan for wound prevention. Resident 2, with a history of a resolved sacral deep tissue injury, also lacked weekly skin assessments and a care plan for wound history. Resident 3, who had a chronic arterial ulcer of the sacrum, did not receive weekly skin assessments. Interviews with facility staff confirmed these deficiencies, acknowledging that the required assessments and care planning were not conducted.
Failure to Document Medication Disposal
Penalty
Summary
The facility failed to provide pharmaceutical services that met the needs of a resident by not accurately disposing of medications. Specifically, the facility did not document the destruction of 13 tablets of Sulfamethoxazole-Trimethoprim that were not administered to a resident. The facility's policy requires that unused medications be destroyed and documented, but this was not followed in this case. The resident had two separate orders for Sulfamethoxazole-Trimethoprim, with a total of 32 tablets dispensed, but only 19 tablets were documented as administered. Interviews with the Director of Nursing (DON) and a Corporate Nurse confirmed the discrepancy in the medication records. Both acknowledged that the pharmacy dispensed two separate orders for the medication, resulting in 32 tablets, but only 19 were administered according to the records. The facility's medication destruction logs did not show any documentation for the destruction of the remaining 13 tablets, indicating a failure to comply with the facility's policy for medication disposal.
Failure to Verify Nursing Licenses
Penalty
Summary
The facility failed to ensure that two staff members, identified as S6 and S7, were licensed in accordance with applicable state laws before performing duties as licensed nurses. S6 was hired without verification of a practical nurse license for the state of Louisiana, although they held a license for Texas that had expired. During an interview, S6 confirmed they had applied for a Louisiana multistate license but had not yet received it, indicating they only had a license to practice in Texas. Similarly, S7 was hired without verification of their licensure status. The facility provided evidence of a Louisiana practical nurse license that had expired and a registered nurse license with an alert from the Louisiana Registered Nurse Board of Nursing, indicating further verification was needed. The facility did not conduct a license verification for S7 upon hire and had not verified their licensure status annually since their date of hire. This was confirmed by S3 Corporate Nurse, who acknowledged the lack of documentation proving S7 had an active license in Louisiana.
Failure to Update Care Plan for Hospice Admission
Penalty
Summary
The facility failed to ensure the plan of care was revised for a resident who was admitted to Hospice. The resident's physician's orders indicated an admission to Hospice on 03/13/2024. However, a review of the resident's comprehensive care plan revealed that it had not been updated to include the Hospice admission or any related interventions and services. During an interview on 05/08/2024, the MDS Coordinator confirmed that the resident had been admitted to Hospice on 03/13/2024 and acknowledged that the care plan had not been updated accordingly.
Failure to Maintain Oxygen Concentrator Filter
Penalty
Summary
The facility failed to provide necessary respiratory care and services in accordance with accepted professional standards of practice for a resident. Specifically, the facility did not ensure that the oxygen concentrator filter for a resident with chronic obstructive pulmonary disease and other medical conditions was cleaned weekly as required. The resident's physician's orders included instructions to clean the concentrator filter every Wednesday night shift and as needed for contamination. However, an observation revealed that the filter was covered with a large amount of fluffy gray particles, indicating it had not been cleaned. The Director of Nursing acknowledged that the filter was dirty and should have been cleaned during the scheduled maintenance.
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Illustrative
What surveyors actually found near you
We read the 141 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — 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
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Illustrative
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Nursing homes near Shreveport
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Southern Hills Healthcare And Rehabilitation | 0.7 mi | ★★★★★ | 3 | 0 |
| The Bradford Skilled Nursing And Rehabilitation | 0.7 mi | ★★★★★ | 8 | 0 |
| Heritage Manor South | 1.3 mi | ★★★★★ | 4 | 0 |
| Garden Park Nursing & Rehab Ctr, Llc | 2.7 mi | ★★★★★ | 9 | 0 |
| Heritage Manor West | 4.1 mi | ★★★★★ | 8 | 0 |
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