Pruitthealth - Rome
PRUITTHEALTH - ROME in ROME, GA — inspection on February 20, 2026.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During an observation on 2/17/2026 at 10:33 am, R53's fingernails were observed to be long and jagged. R53 stated he had asked for them to be cut a while ago, and added his toenails were really long. R53 removed his shoes and socks, which revealed that his toenails were overgrown on both feet, curling into the skin.
The toenails were cloudy/tan colored and were curled up on the side of the nails, pulling away from the nailbed.A record review of the EMR revealed that R53 was admitted to the facility on [DATE], with diagnoses including, but not limited to, vascular dementia, emphysema, and chronic obstructive pulmonary disease.A review of the admission MDS assessment dated [DATE] revealed a BIMS score of nine, indicating that R53 had moderate cognitive impairment. A record review of the admission MDS assessment dated [DATE], revealed that R53 required staff assistance for set up/cleanup for personal hygiene.A review of the care plan for R53, with a start date of 9/3/2025, revealed R53 experienced an ADL self-care decline related to recent hospitalization, and an approach included, but was not limited to, checking nails and ensuring they are clean.A review of the care plan revealed that R53 required staff assistance for ADL care. R53's care plan specified that staff should check nails and ensure they are clean.
During an interview on 2/18/2026 at 1:05 pm, CNA KK stated that all CNAs can trim fingernails.
Podiatry comes every two months. CNA KK stated that usually she does nailcare during the shower.
She stated she does not do toenails.
During an interview on 2/19/2026 at 10:40 am, CNA MM stated she trimmed R53's nails. CNA MM stated the shower aid should be doing nail care.
The shower aid can trim nails as long as they are not diabetic. CNA MM stated she trimmed R53's nails and said it was painful, but felt better when it was done. CNA MM stated she did not know who normally trimmed R53's nails.
During an interview on 2/19/2026 at 11:27 am, the Director of Health Services (DHS) stated she talked to the NP, and she confirmed that R53's toenails were long.
The DHS stated that a resident-specific care plan would identify the needs of each resident and that care plans are supposed to be resident-specific.During an interview on 2/19/2026 at 10:50 am, LPN JJ stated R53 did not have resident-specific interventions for nail care. LPN JJ verified there was no documentation that the resident refused care or had care planned interventions tried or documented.A review of the facility's policy titled Comprehensive Care Plans, implemented in March 2025, revealed that the care planning process will include an assessment of the resident's strengths and needs, and will incorporate the resident's personal and cultural preferences in developing goals of care.
All services provided or arranged by the facility, as outlined by the comprehensive care plan, must meet professional standards of quality and incorporate culturally competent and trauma-informed care as indicated.
The comprehensive care plan will be prepared by an interdisciplinary team that includes, but is not limited to, the resident and the resident's representative, to the extent practicable, and other appropriate staff or professionals in disciplines as determined by the resident's needs or as requested by the resident. A review of the policy titled Care Plan, revised 10/21/2025, documented that the care plan approach serves as instructions for the patient/resident's care and provides continuity of care by all partners.
When approaches that involve the CNA have been added to the care plan, those approaches should also be included on the CNA Care Record or Resident Profile/Care Plan.
Updates to the care plans should be made with any changes in condition at the time the change in condition occurred.
Care plans will be updated by nurses, Case Mix Directors (CMD), or any other interdisciplinary team member so that the care plan will reflect the patient/resident's needs at any given moment.
115719 02/20/2026
Pruitthealth - Rome 2 Three Mile Road NE Rome, GA 30165
behaviors.During a telephone interview on 2/18/2026 at 11:00 am, a family member of R113 revealed
agitated and resisting.
The family member stated that R113 usually had 2 to 3 people assist her and
wheelchair and sustained a fracture.
During an interview on 2/18/2026 at 2:54 pm, the Education Coordinator revealed that in a situation where a resident becomes physically resistant to care and agitated during changing their clothes, she would expect staff to ensure the resident was decent and then get help, but not to leave the resident until assuring the safety of the resident.
Education Coordinator stated for the situation with R113 when she slid from her chair with the CNA present on 1/13/2026, she would hope that the CNA would have stopped when R113 began trying to pull off the shirt while the CNA was trying to put it on her, especially if she knew she was already agitated and if necessary, yell out for help but not leave the resident to ensure her safety.
During an interview on 2/19/2026 at 12:21 pm, the DHS revealed that for residents with behaviors that could result in potential injury to self or staff, the staff receive regular education related to how to care for residents with dementia and behaviors.
She stated that specific education related to challenging behaviors is provided regularly through in-house staff, providing education as well as online.
The DHS stated it was her expectation that staff would stop what they are doing and retrieve additional help when a resident is agitated, resistant to care, and unable to be redirected.A review of the facility policy titled Occurrences, revised 1/11/2024, documented Policy Statement: The healthcare center recognizes that due to the frailty of the patients/residents served, there is an increased risk of occurrences that may result in injury to the patient/resident and/or others. To prevent occurrences, each patient/resident will be observed and assessed for risks.
Appropriate, realistic interventions will be implemented in accordance with their care plan.A review of the facility policy titled Dementia Care Policy, revised 10/19/2021, documented Policy Statement: [Name of the facility] recognizes that no single strategy is sufficient and some residents with dementia will need a combination of approaches that might include prescribing of appropriate medications and specialized psychological interventions.
Procedure: 2. [Name of the facility] partners are encouraged to see residents with dementia as a whole person and accept their reality. 3. [Name of facility] partners are required to treat residents with dementia with respect and dignity. 4.
Approaches to providing care for residents with dementia include: a.
Communication 2. Be mindful of non-verbal communication. 7.
Don't argue or contradict. 9.
Slow down (slower is faster). Be patient and give the resident time to respond without feeling rushed.