Facility profile · CCN 365293
Mt Airy Gardens Rehabilitation And Nursing Center
76 federal citations on record , including 1 at the Immediate Jeopardy level, and 1 federal enforcement actions totaling $10,039.
Record summary
Federal record · Q1 202676
Total citations
33
Last 3 years
1
Actual harm+
1
Federal penalties
$10,039
Total fines
1
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
76 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Sep 8, 2025 | F925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | Complaint |
| Sep 8, 2025 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Complaint |
| Feb 20, 2025 | F914 | Provide bedrooms that don't allow residents to see each other when privacy is needed. | D | Standard |
| Feb 20, 2025 | F849 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | Standard |
| Feb 20, 2025 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Feb 20, 2025 | F803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | F | Standard |
| Feb 20, 2025 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Feb 20, 2025 | F757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Standard |
| Feb 20, 2025 | F692 | Provide enough food/fluids to maintain a resident's health. | D | Standard |
| Feb 20, 2025 | F688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard |
| Feb 20, 2025 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard |
| Feb 20, 2025 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard |
| Feb 20, 2025 | F646 | Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. | D | Standard |
| Feb 20, 2025 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Feb 20, 2025 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Standard |
| Feb 20, 2025 | F550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Standard |
| Aug 13, 2024 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Complaint |
| Jun 12, 2024 | F760 | Ensure that residents are free from significant medication errors. | D | Complaint |
| May 20, 2024 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Complaint |
| May 20, 2024 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint |
| May 20, 2024 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | B | Complaint |
| May 20, 2024 | F580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Complaint |
| Feb 12, 2024 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Complaint |
| Nov 20, 2023 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Complaint |
| Nov 20, 2023 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Complaint |
| Nov 20, 2023 | F624 | Prepare residents for a safe transfer or discharge from the nursing home. | D | Complaint |
| Jun 7, 2023 | F804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | Complaint |
| Jun 7, 2023 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Complaint |
| Jun 7, 2023 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint |
| Jun 7, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Jun 7, 2023 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint |
| Jun 7, 2023 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Complaint |
| Apr 28, 2023 | F690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Complaint |
| Mar 3, 2023 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Complaint |
| May 11, 2021 | F919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | Standard |
| May 11, 2021 | F880 | Provide and implement an infection prevention and control program. | F | Standard |
| May 11, 2021 | F842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard |
| May 11, 2021 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard |
| May 11, 2021 | F800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | D | Standard |
| May 11, 2021 | F760 | Ensure that residents are free from significant medication errors. | D | Standard |
| May 11, 2021 | F758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard |
| May 11, 2021 | F757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Standard |
| May 11, 2021 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Standard |
| May 11, 2021 | F698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard |
| May 11, 2021 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Standard |
| May 11, 2021 | F688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard |
| May 11, 2021 | F679 | Provide activities to meet all resident's needs. | E | Standard |
| May 11, 2021 | F677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard |
| May 11, 2021 | F646 | Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. | D | Standard |
| May 11, 2021 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| May 11, 2021 | F622 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | Standard |
| May 11, 2021 | F578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard |
| May 11, 2021 | F558 | Reasonably accommodate the needs and preferences of each resident. | E | Standard |
| Mar 7, 2019 | F919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | Standard |
| Mar 7, 2019 | F880 | Provide and implement an infection prevention and control program. | D | Standard |
| Mar 7, 2019 | F868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | C | Standard |
| Mar 7, 2019 | F842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard |
| Mar 7, 2019 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Mar 7, 2019 | F758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard |
| Mar 7, 2019 | F757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Standard |
| Mar 7, 2019 | F756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | Standard |
| Mar 7, 2019 | F730 | Observe each nurse aide's job performance and give regular training. | F | Standard |
| Mar 7, 2019 | F726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | D | Standard |
| Mar 7, 2019 | F725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | D | Standard |
| Mar 7, 2019 | F695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard |
| Mar 7, 2019 | F692 | Provide enough food/fluids to maintain a resident's health. | D | Standard |
| Mar 7, 2019 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard |
| Mar 7, 2019 | F677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard |
| Mar 7, 2019 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard |
| Mar 7, 2019 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard |
| Mar 7, 2019 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Mar 7, 2019 | F623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | Standard |
| Mar 7, 2019 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Standard |
| Mar 7, 2019 | F580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Standard |
| Mar 7, 2019 | F569 | Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | D | Standard |
| Mar 7, 2019 | F550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Standard |
Federal enforcement history
Federal regulators have imposed 1 enforcement actions against this facility, including 1 civil money penalties totaling $10,039 .
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| May 20, 2024 | Fine | $10,039 | — |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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