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Complaint Investigation

Golden Age Nursing Home

Inspection Date: September 4, 2025
Total Violations 3
Facility ID 255307
Location GREENWOOD, MS
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Inspection Findings

F-Tag F0585

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

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

During an interview with Resident #2's representative on 7/2/25 at 4:00 PM, she confirmed she was notified of the missing phone but stated the facility never offered reimbursement or replacement.

Record review of the “admission Record” revealed Resident #2 was admitted on [DATE REDACTED].

Record review of a BIMS for Resident #2 dated 8/14/25 revealed a score of 12 indicating the resident was moderately cognitively impaired.

Resident #3Record review of a Missing Item Report Form dated 6/5/25 documented Resident #3's black iPhone 16 as missing. The follow-up/results section was blank.

During an interview with Certified Nursing Assistant (CNA) #1 on 9/3/25 at 12:00 PM, she stated she reported Resident #3's phone missing after it was not located. She confirmed the resident used it regularly, but it had not been replaced.

In an interview with the ADM on 9/4/25 at 8:35 AM, she confirmed the cell phones for Residents #1, #2, and #3 were never located or replaced. She stated she reviewed video footage of Residents #2 and #3's rooms but could not substantiate misappropriation.

During an interview with the Social Worker on 9/4/25 at 8:40 AM, she confirmed she searched for the phones of Residents #1, #2, and #3 but did not find them. She stated all three residents used their cell phones regularly and kept them within reach. She also confirmed the Missing Item Reports for all three residents contained no documentation of a resolution.

Record review of the “admission Record” revealed Resident #3 was admitted on [DATE REDACTED].

Record review of the BIMS dated 7/22/25 revealed a score of 11, indicating Resident #3 was moderately cognitively impaired.

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

Event ID:

Facility ID:

If continuation sheet

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

09/04/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Golden Age Nursing Home

2901 Highway 82 East Greenwood, MS 38930

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 F0602

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

F 0602

Protect each resident from the wrongful use of the resident's belongings or money.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on resident and staff interviews, record review and facility policy review, the facility failed to ensure residents were free from misappropriation of property for one (1) of four (4) residents reviewed (Resident #1).

Findings include:

Residents Affected - Few

Review of the facility policy titled, “Abuse, Neglect, Exploitation,” revised August 2018, revealed: “Each resident has the right to be free from . misappropriation of property .Misappropriation of Resident Property' means the deliberate misplacement, exploitation, or wrongful, temporary or permanent, use of a resident's belongings without the resident's consent .

An interview on 9/3/25 at 8:40 AM with the Administrator (ADM) revealed that Resident #1 had reported her phone missing on 6/27/25. She confirmed that a facility-reported incident dated 6/27/25 had been completed regarding the reported missing phone, staff used the resident's iPad to track the phone, which pinged at the address of Housekeeper #1. She further stated video footage showed Housekeeper #1 entering Resident #1's room at 1:27 PM, discarding the phone case, concealing the phone in her bra, and leaving the room. The Administrator confirmed that police were notified the same day, that Housekeeper #1 was terminated on 6/27/25, and that the housekeeper was later arrested. She acknowledged the facility did not reimburse or replace the resident's stolen phone.

Review of a payroll change form confirmed Housekeeper #1's termination on 6/27/25 related to “stealing resident property.”

During an interview with Resident #1 on 9/3/25 at 9:20 AM, she stated that on 6/27/25 she spoke to her daughter on the phone around 11:30 AM. After lunch she dozed off, and upon waking her cell phone was missing. She stated she always kept it nearby in case her family called. She reported the loss to staff who used her iPad to locate it. She stated the police came and confirmed her phone was taken, and she was later informed the housekeeper was fired. Resident #1 stated, however, the facility did not replace her phone, and her daughter had to buy her a new one.

Review of the “admission Record” revealed Resident #1 was admitted on [DATE REDACTED].

Review of the Brief Interview for Mental Status (BIMS) dated 6/7/25 revealed a score of 15, indicating the resident was cognitively intact.

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

Event ID:

Facility ID:

If continuation sheet

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

09/04/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Golden Age Nursing Home

2901 Highway 82 East Greenwood, MS 38930

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 F0609

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

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Record review of an in-service dated 7/14/25 revealed both LPN #1 and RN #1 attended training on immediately reporting allegations of abuse. The in-service emphasized: “Abuse must be reported to MSDH within two hours by Administration. … Remember to always report any suspicion of abuse and neglect immediately. … When in doubt, report it.”

Record review of the “admission Record” revealed Resident #4 was admitted on [DATE REDACTED] with

a diagnosis of dementia, unspecified severity with agitation.

Record review of the BIMS dated 5/9/25 revealed a score of 99, indicating the resident was rarely/never understood.

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

Event ID:

Facility ID:

If continuation sheet

📋 Inspection Summary

GOLDEN AGE NURSING HOME in GREENWOOD, MS 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 GREENWOOD, MS, (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 GOLDEN AGE NURSING HOME or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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