PruittHealth - Lilburn

In the surveyor’s words

From the most serious findings on record at PruittHealth - Lilburn, in the surveyor’s own words.

• Immediate jeopardy, patternF600Sep 18, 2023

  Based on interviews, record review, and review of the facility policy, the facility failed to ensure residents were free from abuse. Specifically, the facility failed to ensure four residents (R) (residents (R9, R14, R25, and one unknown resident) were free from sexual abuse by R10; and eight residents (R15, R11, R19, R20, R16, R17, and R18) were free from physical abuse in a sample of 35 residents. On 9/13/2023 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. Facility Administrator was informed of the Immediate Jeopardy (IJ) on 9/13/2023 at 10:32 a.m. […]

• Immediate jeopardy, patternF610Sep 18, 2023

  Based on interviews, record reviews, and review of the facility policy, the facility failed to thoroughly report and investigate incidents of abuse. Specifically, the facility failed to report and/or thoroughly investigate incidents of sexual abuse for four residents (R) (residents (R9, R14, R25, and one unknown resident); and of physical abuse for eight residents (R15, R11, R19, R20, R16, R17, R10, R18) in a sample of 35 residents. On 9/13/2023 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. Facility Administrator was informed of the Immediate Jeopardy (IJ) on 9/13/2023 at 10:32 a.m. […]

• Immediate jeopardy, patternF835Sep 18, 2023

  Based on interviews, record review, and review of the Administrator position description, facility Administration failed to effectively oversee an abuse prevention program to promote, foster and maintain an abuse free environment. The facility census was 113. On 9/13/2023 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. Facility Administrator was informed of the Immediate Jeopardy (IJ) on 9/13/2023 at 10:32 a.m. The noncompliance related to the Immediate Jeopardy was identified to have existed on 4/23/2022. […]

• No harm, potential for more than minimal, widespreadF812Jul 29, 2026

  Based on observations, staff interviews, and review of the facility's policy titled, Labeling, Dating, and Storage, the facility failed to properly store, label, date, and discard food items. These deficiencies created a potential risk for 124 out of 129 residents who received an oral diet from the kitchen, increasing their risk of foodborne illnesses.Findings Include:Review of facility's policy titled, Labeling, Dating, and Storage dated November 11, 2022, documented in Procedures 1. Food and beverage items will have an identifying label as well as a received date and open date, as applicable; for items prepared onsite, a 'use by' date will also be indicated. 2. […]

• No harm, potential for more than minimal, patternF880May 15, 2025

  Based on observations, staff interviews, record review, and review of the facility's policies titled, Infection Prevention-Hand Hygiene, Infection Control: Glucometer Cleaning and Disinfecting, and Infection Control Prevention and Control Activities, the facility failed to perform hand hygiene and sanitize shared medical equipment while providing care to four residents during medication pass. The facility sample was 63 residents. This failure had the potential to increase the risk of infection transmission among residents and staff. Findings include: Review of the facility's policy titled, Infection Prevention-Hand Hygiene, updated 10/15/2024 revealed the Policy section included D. Indications Requiring Hand Wash or Hand Rub. 1. Before and after contact with the resident. 2. […]