Average — CMS composite of the measures below.
The next survey window likely opens around December 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 Greene County Health And Rehabilitation during CMS and state inspections, most recent first.
Expired and improperly labeled food items were found in a dietary refrigerator, including opened sliced bologna past its use-by date and opened cheeses without open dates. Surveyors also observed mustard stored unrefrigerated despite label instructions to refrigerate after opening. The Dietary Supervisor acknowledged the findings, and the Administrator stated the Dietary Manager and Dietary Supervisor were responsible for oversight of food storage and safety practices.
Uncovered Catheter Drainage Bag Exposed Resident: A resident with dementia and moderately impaired cognition was observed lying in bed with an indwelling urinary catheter drainage bag hanging on the side of the bed, uncovered and visible when the room door was opened. RN confirmed the bag should have been covered for dignity, and the DON and Administrator stated staff were expected to keep catheter drainage bags covered at all times using privacy covers.
Failure to Include Specific Transfer Reason in Transfer Notice: A resident with schizoaffective disorder and bipolar type was sent to the hospital twice for acute changes including low O2 sats, fever, disorientation, and difficulty swallowing meds. The written transfer notices sent to the resident's rep only stated that the resident transferred to the hospital/home with anticipated return and did not include the clinical reason for either transfer, and the BOM and Admin stated they were unaware the specific reason was required.
A resident with hemiplegia and hemiparesis, and moderately impaired cognition, had a physician order for PRN oxygen at 3 L/min for SOB or O2 saturation below 92%. Staff observed the resident on oxygen via nasal cannula running at 2 L/min, and an LPN confirmed the setting did not match the order. The MAR also lacked documentation that PRN oxygen was administered, despite the resident being observed wearing oxygen.
An LPN failed to verify a resident's identity and administered another resident's medications, resulting in a significant medication error. The affected resident, who had COPD and diabetes, experienced a change in mental status and required hospital evaluation, IV fluids, potassium replacement, and oxygen therapy. Facility staff confirmed that medication administration protocols were not followed, leading to the error.
A facility failed to identify and document a chest harness as a restraint for a resident with Spastic Quadriplegic Cerebral Palsy. The resident, unable to remove the harness independently, wore it while sitting in a wheelchair. Staff interviews confirmed the resident's inability to remove the harness, yet the facility did not consider it a restraint due to the resident's cognitive impairment. The facility's policy requires documentation and evaluation of restraints, which was not followed in this case.
A facility failed to develop a comprehensive care plan for a resident using a physical restraint. The resident, with severely impaired cognitive skills and diagnosed with Spastic Quadriplegic Cerebral Palsy, was observed in a wheelchair with a restraint that she could not remove. The DON confirmed the absence of a care plan for this restraint, highlighting the need for staff awareness of care interventions.
A foreign object was found in a sugar bin during a kitchen observation, indicating a failure in proper sanitation and food handling practices. Despite previous training, dietary staff were unsure how the object entered the bin, highlighting a lapse in following established procedures. The administrator emphasized the importance of ensuring food is free from contaminants before serving to residents.
Expired and Improperly Labeled Food Items Found in Dietary Storage
Penalty
Summary
The facility failed to maintain safe food handling and storage practices by leaving expired and improperly labeled food items in the dietary storage areas. During observation of reach-in refrigerator #2, surveyors found opened, repackaged sliced bologna sandwich meat with an opened date of 10/8/25 and a best-by/use-by date of 11/8/25 that had expired. The same refrigerator also contained several packages of opened, repackaged sliced white cheese and sliced American cheddar cheese that had been opened and repackaged without an open date labeled on the outside of the clear plastic bags. Surveyors also observed a container of French's mustard opened and stored unrefrigerated on a shelf even though the manufacturer instructions indicated it should be refrigerated after opening. During interview, the Dietary Supervisor acknowledged the expired and improperly labeled items and stated it was the responsibility of dietary staff to routinely check dates in refrigerators and freezers and remove expired food items. The Administrator later stated the dietary department was expected to conduct routine weekly monitoring for expired foods and proper refrigeration, and identified the Dietary Manager and Dietary Supervisor as responsible for oversight of food storage and safety practices.
Uncovered Catheter Drainage Bag Exposed Resident
Penalty
Summary
The facility failed to ensure a resident's right to dignity when Resident #13's indwelling urinary catheter drainage bag was left uncovered and visible when the resident's door was opened. The facility's policy stated that privacy bags would be available and catheter drainage bags would be covered at all times while in use, and the Resident Rights policy stated that employees shall treat all residents with dignity. Resident #13 was admitted with dementia, had a BIMS score of 9 indicating moderately impaired cognition, and had a physician's order for catheter care every shift and as needed. During observation, Resident #13 was lying in bed with the catheter drainage bag hanging on the side of the bed, uncovered and visible to anyone entering the room. The resident stated she did not know why she had a urinary catheter. RN #2 confirmed the drainage bag was exposed and should have been covered for resident dignity. The DON stated the resident had an indwelling catheter since 12/28/2025, that wound care staff were responsible for catheter placement and changes, and that staff were required to keep catheter drainage bags covered at all times. The Administrator also stated she expected staff to place all catheter drainage bags in privacy covers to maintain resident dignity.
Failure to Include Specific Transfer Reason in Written Notice
Penalty
Summary
The facility failed to provide written notification of a resident transfer that included the specific reason for the transfer in a language and manner the resident's representative could understand for Resident #49. The resident was admitted on 9/15/24 and had diagnoses including Schizoaffective Disorder, Bipolar Type. A Discharge MDS with an ARD of 1/4/26 showed an unplanned discharge to an acute hospital with return anticipated. Progress notes documented that the resident was sent to a local acute care hospital ER for evaluation related to low O2 saturations and elevated temperature, and later that same day was disoriented, aroused with sternal rub, had difficulty swallowing medications, and was ordered sent to a neighboring county acute care hospital for further treatment. The Notice of Resident Transfer or Discharge dated 1/5/26 for each hospital transfer stated only that the resident had transferred to the hospital/home with the anticipation of return. The notices did not identify the clinical reason for either transfer. During interview, the Business Office Manager stated the resident was sent to the hospital twice on 1/4/26 and that she mailed the notices to the resident's representative, but confirmed the notices did not list the specific reason for transfer and that she was not aware the specific reason was required. The Administrator also stated she was not aware of the specific federal requirements for written notification of resident transfers.
Failure to Administer and Document Oxygen at Ordered Rate
Penalty
Summary
The facility failed to provide respiratory care in accordance with physician orders and professional standards of practice for one resident. Resident #2, who had diagnoses including hemiplegia and hemiparesis and a BIMS score of 12 indicating moderately impaired cognition, had an active physician order dated 7/18/24 for oxygen at 3 liters per minute as needed for shortness of breath or oxygen saturation less than 92%. During an observation on 1/20/26, the resident was seen lying in bed with oxygen via nasal cannula running at 2 liters per minute. A nurse later confirmed the oxygen concentrator was set at 2 liters per minute and stated this did not match the physician’s order for 3 liters per minute. The facility’s policy stated oxygen is to be administered under physician orders and that staff shall document the initial and ongoing assessment warranting oxygen and the response to oxygen therapy. The RN stated the primary nurse or floor nurse was responsible for monitoring oxygen flow rates and oxygen saturation levels, and the DON stated the floor nurse was responsible for ensuring oxygen was administered at the ordered rate. A review of the January 2026 MAR showed no documentation that the resident received PRN oxygen on 1/20/26, despite the resident being observed wearing oxygen via nasal cannula.
Significant Medication Error Due to Failure to Verify Resident Identity
Penalty
Summary
A significant medication error occurred when a Licensed Practical Nurse (LPN), identified as an agency nurse, administered another resident's medications to a resident with a history of Chronic Obstructive Pulmonary Disease (COPD) and Type 2 Diabetes Mellitus. The facility's policy required staff to verify the resident's identity before administering medications, but this protocol was not followed. The error was discovered after a Certified Nurse Aide (CNA) found a medication cup labeled with another resident's name in the affected resident's trash can. The resident subsequently exhibited a change in mental status, including drowsiness and unresponsiveness, which was reported to the Registered Nurse (RN) and led to further assessment and intervention. The resident was transferred to the emergency room for evaluation and received treatment including intravenous fluids, potassium replacement, and oxygen therapy. Documentation confirmed that the medications administered matched those prescribed to another resident, which included several medications for epilepsy and pain management. Interviews with facility staff, including the DON and Administrator, confirmed that the LPN failed to follow the five rights of medication administration, resulting in a significant medication error that required hospital evaluation and overnight observation for the resident.
Failure to Identify and Document Use of Restraint
Penalty
Summary
The facility failed to ensure a resident's right to be free from physical restraints by not identifying and documenting the use of a chest harness as a restraint for one of the sampled residents. The facility's policy on the use of restraints, revised in April 2017, states that restraints should only be used for the safety and well-being of residents after other alternatives have been tried unsuccessfully. The policy also defines physical restraints as any device that a resident cannot remove, which restricts their ability to change position. However, the facility did not document the use of a chest harness as a restraint for Resident #38, who was unable to remove it without staff assistance. Resident #38, who was admitted to the facility with diagnoses including Spastic Quadriplegic Cerebral Palsy, was observed wearing a cloth cross-body strap support while sitting in her wheelchair. Interviews with the facility's staff, including the Administrator, LPN, CNA, and DON, confirmed that the resident could not remove the harness independently. Despite this, the facility did not consider the harness a restraint due to the resident's lack of mental capacity to understand or remove it. The resident's medical record lacked documentation regarding the use of the restraint, and the facility had not previously identified the strapping device as a restraint.
Failure to Develop Care Plan for Restraint Use
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan for a resident regarding the use of a physical restraint. During an observation, it was noted that the resident was sitting in a wheelchair with a cloth cross-body strap support on her upper chest, which she was unable to remove. A review of the resident's comprehensive care plan revealed that there was no care plan developed related to the use of this physical restraint. The Director of Nursing (DON) acknowledged that the resident had not been care planned for the restraint and explained that care planning is essential to note the focus area with goals and interventions for staff. The resident, who was admitted to the facility with diagnoses including Spastic Quadriplegic Cerebral Palsy, had severely impaired cognitive skills for daily decision-making, as noted in the Quarterly Minimum Data Set (MDS). The lack of a care plan for the restraint use was confirmed during an interview with the DON.
Improper Food Handling Practices Lead to Contamination
Penalty
Summary
The facility failed to adhere to proper sanitation and food handling practices, as evidenced by the presence of a foreign object in the sugar bin during a kitchen observation. The facility's policy on the storage of canned and dry food, revised in October 2017, mandates that dry food products such as sugar be removed from their original packaging and stored in bins that are cleaned and sanitized according to a schedule. However, during an observation on October 7, 2024, a foreign object, identified as a rock, was found in the sugar bin. Dietary staff confirmed the presence of the object and acknowledged their responsibility to check the sugar, although they were unsure how the object entered the bin. Interviews with dietary staff revealed that the contaminated sugar was subsequently discarded, and the container was cleaned and refilled. The facility had previously conducted an in-service training in March 2024, instructing kitchen staff to check, clean, and sanitize containers of dry goods. Despite this training, the incident occurred, indicating a lapse in following the established procedures. The administrator emphasized the expectation for staff to ensure all food is sanitary and free from foreign objects before serving it to residents.
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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 Leakesville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Leakesville Rehabilitation And Nursing Center, Inc | 0.4 mi | ★★★★★ | 5 | 0 |
| George Regional Health & Rehab Center | 16.2 mi | ★★★★★ | 0 | 0 |
| Glen Oaks Nursing Center | 16.9 mi | ★★★★★ | 0 | 0 |
| Crowne Health Care Of Citronelle | 19.4 mi | ★★★★★ | 0 | 0 |
| Perry County Nursing Center | 25.8 mi | ★★★★★ | 6 | 0 |
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