Federal inspectors found the facility failed to train either housekeeping worker since they were hired.
Nursing Home News — Page 389
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Federal inspectors observed the resident on two separate days in September, finding the same neglected condition both times.
The incident at Autumn Lake Healthcare at Crofton was witnessed by another staff member who watched the entire confrontation unfold on February 28, 2025.
Resident 1 at Coventry Court Health Center was found lying on his left side outside his room on August 28, according to inspection records.
His hospital discharge papers were explicit.
The fall happened on September 19.
But that single competent performance masked deeper problems.
The family member reported the incident to facility staff immediately.
Resident 7 was admitted to the facility in August 2024 with multiple diagnoses including bacteremia, depression and anemia.
No other physician visits were documented in the resident's electronic medical record during the inspection period that stretched into September.
Federal inspectors documented the hygiene failures during a September complaint investigation at the 54 Peachtree Park Drive facility.
Resident B stood near QMA 2, a qualified medication aide who was preparing medications that morning.
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