Buckhead Center for Nursing & Healing

In the surveyor’s words

From the most serious findings on record at Buckhead Center for Nursing & Healing, in the surveyor’s own words.

• Immediate jeopardy, isolatedF580Jul 20, 2023

  Based on interviews, record review, and review of the facility policy titled Notification of Changes, the facility failed to notify the resident representative of a significant change in condition for two of 32 sampled residents (R) (R#20 and R#24). On 2/4/22, the facility failed to notify R#20's representative of an increase in the resident's mood and behaviors and failed to notify the resident's representative of the resident signing an Against Medical Advice (AMA) discharge form and exiting the facility. […]

• Immediate jeopardy, isolatedF600Jul 20, 2023

  Based on staff interviews, resident representative interviews, record review, and review of the facility policies titled Abuse, Neglect and Exploitation, Transfer and Discharge (including AMA), and Notification of Changes, the facility failed to protect one of 32 sampled residents (R) (R#20) from neglect by not ensuring the resident's cognitive level and mental status was appropriate for him to make an informed decision to discharge by signing an Against Medical Advice (AMA) form and exiting the facility. On 2/4/22, R#20 was allowed to sign an AMA form and then exited the facility without the knowledge or assistance from his representative or a discharge plan in place. […]

• Immediate jeopardy, isolatedF624Jul 20, 2023

  Based on staff interviews, resident representative interviews, record reviews, and the facility policy titled Transfer and Discharge (including AMA), the facility failed to ensure one of 32 sampled residents (R) (R#20) had an appropriate discharge by ensuring the resident's cognitive level and mental status was appropriate for him to make an informed decision for self-discharging by signing an Against Medical Advice (AMA) form and exiting the facility. On 7/13/23, 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. […]

• Immediate jeopardy, isolatedF710Jul 20, 2023

  Based on staff interviews, resident representative interviews, record reviews, and the facility policy titled Transfer and Discharge (including AMA), the physician failed to assess one of 32 sampled residents (R) (R#20) to ensure the resident's cognitive level and mental status was appropriate for him to make an informed decision for self-discharge by signing an Against Medical Advice (AMA) form and exiting the facility. On 2/4/23, the resident was allowed to sign an AMA form and then exited the facility without the knowledge or assistance from his representative or a discharge plan in place. A review of Psychiatric Evaluations and facility assessments revealed that R#20 was unable to make safe self-care decisions. […]

• Immediate jeopardy, isolatedF835Jul 20, 2023

  Based on record review, review of the Nursing Home Administrator and Director of Nursing (DON) job descriptions, and staff interviews, the facility administration failed to effectively oversee the facility's discharge process resulting in an unsafe discharge for one of 32 sampled residents (R) (R#20). On 7/13/23, 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 Regional Director of Operations (Interim Administrator), the [NAME] President (VP) of Clinical Operations, and the Regional Director of Clinical Operations were informed of the Immediate Jeopardy (IJ) on 7/13/23 at 2:19 p.m. […]