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Complaint Investigation

Mesun Health And Rehabilitation Center

Inspection Date: November 21, 2025
Total Violations 2
Facility ID 115772
Location LAWRENCEVILLE, GA
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Inspection Findings

F-Tag F0582

Resident Rights Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0582 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

as we are getting ready to move. Also, the amount.Review of an email document from the BOM to FM1, dated [DATE REDACTED] and provided by the facility, indicated, I will look into the time frame, and I will let you know.Review of an email document from FM1 to the facility's Corporate Financial Department, dated [DATE REDACTED] and provided by the facility, indicated, I'm just checking the status of the refund check on the resident named above [Resident R88]. The resident passed away four days after initial payment of $9,750.00 was made. The total refund due is $8,550.00 . Can you tell me what date the check was mailed out if it's been mailed as of yet?Review of an email document from the facility's Corporate Financial Department to the BOM, dated [DATE REDACTED] and provided by the facility, indicated, I forwarded this to [staff member] who handles accounts payable.Review of an email document from the facility's Corporate Financial Department to the BOM, dated [DATE REDACTED] and provided by the facility, indicated, Thank you for following up. The refund check has not been mailed out yet. It is expected to be mailed next week. I will keep you posted once it has been sent.Review of an email from the facility's Corporate Financial Department to the BOM, dated [DATE REDACTED] (32 days after Resident R88's discharge from the facility) and provided by the facility, indicated, I'd like to let you know that the payment [to FM1 for Resident R88's refund] will be sent today as follows: Refund Amount: $8,150.00. Check Payable To: [FM1]. During an interview with the Administrator on [DATE REDACTED] at 4:00 pm, he acknowledged the facility's policy indicating funds were to be returned to a resident within 45 days after discharge did not reflect the Federal Regulation indicating a 30 day time frame for the return of funds after discharge, confirmed Resident R88's money had not been mailed to the family until [DATE REDACTED], and stated his expectation was excess funds deposited by residents/their responsible parties for resident care in the facility were expected to be returned no later than 30 days after discharge.

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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

11/21/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Mesun Health and Rehabilitation Center

88 Johnson Road, Building #2 Lawrenceville, GA 30046

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)

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F-Tag F0610

Freedom from Abuse, Neglect, and Exploitation Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

investigation for Resident R3's ruptured hematoma during therapy on 7/29/2025 as a note was added to the incident report referencing the bleeding episode.During an interview on 11/21/2025 at 12:19 pm, the DON stated

the nurse that completed the incident report would have interviewed Resident R3 and documented in the progress notes. The DON reviewed the EMR for Resident R3's statement and stated, It's not here, but the nurse would have interviewed Resident R3. The DON was asked about the facility policy instructing staff to interview all persons involved in an allegation. The DON acknowledged that by not interviewing Resident R3, pertinent details may have been missed. The DON was asked if the nurse (Licensed Practical Nurse (LPN)2) who CNA1 reported the incident to had completed a statement. The DON stated LPN2 documented her statement in the incident report. During an interview on 11/21/2025 at 1:23 pm, LPN2 stated that CNA1 reported bumping Resident R3's lower leg causing her hematoma. LPN2 stated soon after the incident was reported, Resident R3 complained of leg pain.

LPN2 stated that Resident R3 was interviewable but as far as she knew, no statement was obtained. LPN2 stated

she did not talk with Resident R3 about the incident. LPN2 stated the next shift would have followed up with an investigation. LPN2 was asked if she wrote or gave a statement besides what she wrote about the incident

in the incident report. LPN2 stated, No and said no one asked her to give a statement.

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📋 Inspection Summary

MESUN HEALTH AND REHABILITATION CENTER in LAWRENCEVILLE, GA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in LAWRENCEVILLE, GA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from MESUN HEALTH AND REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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