Based on record review, staff and family interviews, and review of the policy titled Abuse Policy, the facility failed to ensure that allegations of verbal, sexual, and physical abuse were reported to the State Survey Agency (SSA). Specifically, residents (R) R30 and R125 were sexually abused by R64; and R60 was verbally and physically abused by Certified Nursing Assistant (CNA AA). The sample size was 57 residents. On 2/5/2025, a determination was made that a situation in which the facility's noncompliance with one or more requirements of participation had caused, or had the likelihood to cause, serious injury, harm, impairment, or death to residents. The facility's Administrator and Director of Nursing (DON) were informed of the Immediate Jeopardy (IJ) on 2/5/2025 5:54 pm. …
F609 citations in Georgia
Reporting alleged violations · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Georgia cites F609 more often than its own record predicts
1.31 times the share F609 takes of citations nationally.
Of every deficiency written in Georgia in 2025, this is the portion that was F609.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Georgia surveyors wrote
F609 findings written in Georgia, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on record review, interviews, and review of the facility policy titled Freedom Of Abuse Abuse Prevention Fast Alert the facility failed to ensure an allegations of neglect was reported to the State Survey Agency (SSA) within the required time frame for one Resident (R) (R9) of nine sampled residents. Resident (R9) verbally and via text reported to the facility that one Certified Nursing Assistant (CNA) BB neglected to provide her (R9) adequate incontinent care. As a result, R9 developed a blister on the left upper thigh. Due to the delay in care the blister progressed to an open wound.Findings include: Review of the policy titled Freedom Of Abuse Abuse Prevention Fast Alert dated 1/2025. …
Based on staff interviews, record review, and review of the facility's policy titled, Prevention of Resident Abuse, Neglect, Mistreatment or Misappropriation of Property, the facility failed to report suspected verbal and physical abuse for two of 41 sampled residents (R) (R74 and R67) to the Sate Survey Agency (SSA) within the required timeframe. This deficient practice could diminish and affect the residents' quality of life. Findings include:Review of the facility's policy titled, Prevention of Resident Abuse, Neglect, Mistreatment or misappropriation of Property dated January 2026 documented under the section titled. Prevention prevention of abuse will be accomplished by the timely reporting of the suspected abuse and a thorough investigation of these instances. …
The short window
Recent years
| Year | Share of Georgia citations | vs expected |
|---|---|---|
| 2023 | 2.30% | 1.16× |
| 2024 | 2.28% | 1.00× |
| 2025 | 3.20% | 1.31× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Georgia surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction