Canton Center For Nursing And Healing Llc

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Based on record review, resident family and staff interviews, and review of the facility policy titled, Notification, the facility failed to notify the responsible party of a change in medication and to provide a psychiatric evaluation for one of 50 sampled residents (R) (Resident R2).Findings include:Review of the facility policy titled Notification dated January 2023 revealed under Compliance Guidelines: The facility must inform the resident, consult with the resident's physician and /or notify the resident's family member or legal representative when there is a change requiring such notification. Circumstances requiring notification include: . 3. Circumstances that require a need to alter treatment. This may include: a. New treatment. b.

Discontinuation of current treatment due to: i. Adverse consequences. ii. Acute condition. iii. ????erbation of

a chronic condition. Review of the electronic medical record (EMR) revealed the following diagnoses that include but not limited to generalized anxiety disorder, unspecified, dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance and anxiety, delirium due to physiological condition.Review of the Physician Orders for Resident R2 dated 8/22/2025 revealed that the medication was reordered on this date for the lesser amount of 25mg (milligrams) after consultation with family to increase

the dose.Telephone interview conducted with Resident R2's family member (responsible party) on 12/22/2025 at 10:37 am revealed he could not understand why the facility never called to inform him Resident R2 was no longer taking the medication or receiving a psychiatric consultation. He stated the medication had dropped off and his family member had been without for nearly three weeks, causing an increase in anxiety and depression and Resident R2 being sent to the hospital.Interview with the NP AA on 12/23/2025 at 10:26 am revealed confirmed that she should have followed up with this order and the resident.Interview on 12/23/2025 at 9:31 am with

the Director of Nursing (DON) revealed that nurses should follow the physician orders as written.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date

these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

12/30/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Canton Center for Nursing and Healing LLC

321 Hospital Road Canton, GA 30114

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0742 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.

Based on record review and resident family and staff interviews, the facility failed to document behavior monitoring correctly and follow up administration of antidepressant medication for one of 50 sampled Residents (R) (Resident R2) related to the use of antidepressant medication. Findings include:Review of the electronic medical record (EMR) revealed Resident R2 was admitted with diagnoses to include but not limited to generalized anxiety disorder and unspecified dementia.Review of August 2025 Medication Administration

Record (MAR) for Resident R2 revealed a physician order for behavior monitoring for antidepressant medication: Sertraline. The behavior monitoring section of the MAR documented no behaviors through 8/22/2025.

Nurses Notes and Progress Notes revealed crying, suicidal ideation, anxiety and Resident R2 was sent to the local hospital for these diagnoses.Review of the Physician Orders dated 8/22/2025 document that the medication was reordered on this date for the lesser amount of 25mg after consultation with family to increase the dose.Review of the Physician Orders dated 7/17/2025 revealed there was no order for a consultation with psychiatric services.Telephone interview conducted with the Resident R2's family member (responsible party) on 12/22/2025 at 10:37 am revealed the family stated that Nurse Practitioner (NP) AA had been consulted for

the resident's depression and anxiety increase and the medication (Sertraline) was increased from 25mg to 50mg, and a psychiatric consultation was ordered.Interview with the NP AA on 12/23/2025 at 10:26 am revealed that Resident R2 was ordered 25mg of Sertraline on admission, the NP discussed with the daughter and

the dose was increased to 50mg and consultation for psychiatric services ordered. The dose of 50mg was

in effect from 7/17/2025 to 8/1/2025 where it was dropped and Resident R2 did not receive any medication until it was reordered on 8/22/2025, which was for the lower dose of 25mg. Resident R2 was sent to hospital on 8/22/2025. (Resident went 22 days without the anti-depressant ordered.) NP AA confirmed that she should have followed up with this order and the resident.Interview on 12/23/2025 at 9:31 am with the DON revealed that

the nurses should follow the physician orders as written. She revealed that behavior notes should be a red flag. She stated that recently they have started going over behavior notes in the morning clinical meeting and NP AA and they had a new psychiatric service who also attended the meetings.

Event ID:

Facility ID:

If continuation sheet