Based on record review, staff interviews, and the facility policy titled Pharmacy Services and Medication Regimen Review (MRR), the facility failed to ensure that one of nine residents (R) (R1) was free from a significant medication error related to facility staff administering Methotrexate 2.5 mg (milligram) once a day instead of once weekly, as ordered. As a result, R1 experienced medical complications requiring a transfer to an acute care hospital and expired on [DATE] due to Methotrexate toxicity.On [DATE], a determination was made that a situation in which the facility's noncompliance with one or more requirements of participation had the likelihood to cause serious injury, harm, impairment, or death to residents.The facility's Administrator and Director of Nursing (DON) were informed… …
F760 citations in Georgia
Significant medication errors · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Georgia cites F760 less often than its own record predicts
0.70 times the national share — cited less often here than elsewhere.
Of every deficiency written in Georgia in 2025, this is the portion that was F760.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Georgia surveyors wrote
F760 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 observation, interview, record review, and review of facility policy titled Medication Orders and Admissions revealed the facility failed to order an anticonvulsant for one of 17 sampled residents (R) (R1) who received an anticonvulsant for seizures and an antibiotic. Harm was identified to have occurred on 2/15/2025, when R1 was rehospitalized for seizure activities due to not receiving the required anticonvulsant medication.Findings included:A review of the facility policies titled Admissions, reviewed and updated in October 2016, revealed that it is the intent of the facility to gather necessary information upon a resident's admission to the facility. The procedural guidelines reflect that residents' readmission and new admission data must be recorded. …
Based on record review, staff interviews, and policy review, the facility failed to ensure one of five residents (R) (R8) reviewed for medication administration was free of significant medication errors out of a total sample of 60 residents. Specifically, the facility failed to ensure that physician-ordered medications were administered and documented for R8. This deficient practice had the potential to result in ineffective treatment of the residents' medical conditions and adverse clinical outcomes.Findings include:Review of R8's admission Record located under the Profile tab in the electronic medical record (EMR) revealed R8 was admitted on [DATE] with a diagnosis of type II diabetes. …
The short window
Recent years
| Year | Share of Georgia citations | vs expected |
|---|---|---|
| 2023 | 0.34% | 0.31× |
| 2024 | 0.81% | 0.69× |
| 2025 | 0.91% | 0.70× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Georgia surveyors cite →
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