Based on interviews, record review and facility policy review the facility failed to monitor and implement a Quality Assurance (QA) program that prevented an elopement for Resident #1 who had previously eloped from the facility on 12/14/23 and continued to seek an exit from the building for one (1) of three (3) residents reviewed. Resident #1. Resident #1 was allowed to exit the facility on 01/07/24 unnoticed and unsupervised at an unknown time and was discovered to be missing from the facility at approximately 8:10 PM. On 01/07/24 at approximately 8:00 PM, the police department received a 911 call from an unknown bystander who had seen an elderly lady walking with no shoes on who appeared to belong to a nursing home. …
F867 citations in Mississippi
QAPI improvement activities · Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Mississippi cites F867 more often than its own record predicts
4.09 times the share F867 takes of citations nationally.
Of every deficiency written in Mississippi in 2025, this is the portion that was F867.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Mississippi surveyors wrote
F867 findings written in Mississippi, 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 staff interviews, record review, review of Quality Assurance and Performance Improvement (QAPI) documentation, facility investigation review, and facility policy review, the facility failed to measure the success of corrective actions and track performance to ensure improvements were sustained when the QAPI Committee failed to review monitoring required by a previous Plan of Correction involving unauthorized photographs or video recordings of residents during two (2) of four (4) quarterly QAPI meetings reviewed. …
The short window
Recent years
| Year | Share of Mississippi citations | vs expected |
|---|---|---|
| 2023 | 0.27% | 0.46× |
| 2024 | 0.50% | 1.12× |
| 2025 | 1.34% | 4.09× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Mississippi 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