D+
51/100

CARROLLTON MANOR, INCORPORATED Inspection Report, Violations & Safety Grade (CARROLLTON, Georgia)

2455 OAK GROVE CHURCH ROAD, CARROLLTON, Georgia 30117

Phone: 7708341737

CMS Overall:1/5

Overview & Bed Count

Certified Beds
100
Avg Residents/Day
85.3
Ownership
For profit - Corporation
Provider Type
Medicare and Medicaid
County
Carroll
Sprinkler Systems
Yes
Special Focus
SFF Candidate
Abuse Icon
Yes

CMS Star Ratings

Overall1/5
Health1/5
Staffing3/5
Quality1/5

Nurse Staffing Check

MetricThis FacilityGeorgia AvgDifference
RN Hours per Resident per Day0.390.50-0.11
Total Nurse Hours per Resident per Day3.893.61+0.29
CMS Staffing Rating3/52.3/5-
Nursing Staff Turnover46.5%46.8%-

Health Citation History

38 health citations on record

DateCategoryDescriptionSeverity
2026-04-25Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.G – Actual Harm
2026-04-25Quality of Life and Care DeficienciesProvide appropriate pressure ulcer care and prevent new ulcers from developing.G – Actual Harm
2026-04-25Resident Rights DeficienciesProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.F – Moderate Harm Potential
2026-04-25Nutrition and Dietary DeficienciesEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.F – Moderate Harm Potential
2026-04-25Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F – Moderate Harm Potential
2026-04-25Administration DeficienciesHave a plan that describes the process for conducting QAPI and QAA activities.F – Moderate Harm Potential
2026-04-25Infection Control DeficienciesProvide and implement an infection prevention and control program.F – Moderate Harm Potential
2026-04-25Infection Control DeficienciesImplement a program that monitors antibiotic use.F – Moderate Harm Potential
2026-04-25Environmental DeficienciesRegularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.F – Moderate Harm Potential
2026-04-25Administration DeficienciesConduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.F – Moderate Harm Potential
2026-04-25Nursing and Physician Services DeficienciesObserve each nurse aide's job performance and give regular training.E – Moderate Harm Potential
2026-04-25Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2026-04-25Resident Rights DeficienciesEnsure that residents are fully informed and understand their health status, care and treatments.D – Moderate Harm Potential
2026-04-25Resident Rights DeficienciesGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.D – Moderate Harm Potential
2026-04-25Freedom from Abuse, Neglect, and Exploitation DeficienciesDevelop and implement policies and procedures to prevent abuse, neglect, and theft.D – Moderate Harm Potential
2026-04-25Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.D – Moderate Harm Potential
2026-04-25Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D – Moderate Harm Potential
2026-04-25Quality of Life and Care DeficienciesProvide activities to meet all resident's needs.D – Moderate Harm Potential
2026-04-25Quality of Life and Care DeficienciesTry different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.D – Moderate Harm Potential
2026-04-25Quality of Life and Care DeficienciesProvide medically-related social services to help each resident achieve the highest possible quality of life.D – Moderate Harm Potential
2026-04-25Pharmacy Service DeficienciesEnsure medication error rates are not 5 percent or greater.D – Moderate Harm Potential
2026-04-25Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential
2026-04-25Nursing and Physician Services DeficienciesPost nurse staffing information every day.C – Minimal Harm Potential
2025-04-25Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.F – Moderate Harm Potential
2025-04-25Nutrition and Dietary DeficienciesEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.F – Moderate Harm Potential
2025-04-25Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F – Moderate Harm Potential
2025-04-25Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.D – Moderate Harm Potential
2025-04-08Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.D – Moderate Harm Potential
2023-03-02Infection Control DeficienciesProvide and implement an infection prevention and control program.F – Moderate Harm Potential
2023-03-02Environmental DeficienciesMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.F – Moderate Harm Potential
2023-03-02Quality of Life and Care DeficienciesProvide enough food/fluids to maintain a resident's health.E – Moderate Harm Potential
2023-03-02Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2023-03-02Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.D – Moderate Harm Potential
2023-03-02Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D – Moderate Harm Potential
2023-03-02Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.D – Moderate Harm Potential
2023-03-02Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D – Moderate Harm Potential
2023-03-02Pharmacy Service DeficienciesImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D – Moderate Harm Potential
2023-03-02Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential

Fire Safety Citation History

5 fire safety citations on record

DateCategoryDescriptionSeverity
2026-04-25Smoke DeficienciesHave approved installation, maintenance and testing program for fire alarm systems.F – Moderate Harm Potential
2025-04-25Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.D – Moderate Harm Potential
2025-04-25Smoke DeficienciesEnsure smoke barriers are constructed to a 1 hour fire resistance rating.D – Moderate Harm Potential
2025-04-25Services DeficienciesHave properly installed electrical wiring and gas equipment.D – Moderate Harm Potential
2025-04-25Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.D – Moderate Harm Potential

Total Penalties & Fines

$0
Total Fine Amount (CMS)
0
Number of Fines
0
Total Penalties

No penalty records found.

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