Cycle 1
Health 2025-08-07 · Fire 2025-08-07
6 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Peachtree City, GA
Southland Health And Rehabilitation
3-star overall rating with 2-star inspections with abuse icon flag with 6 recent health deficiencies
151 Wisdom Road, Peachtree City, GA
(770) 631-9000
Overall
3 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
155
Certified beds
Average residents
149
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
Ethica Health
Operator or chain grouping
Approved since
1989-09-29
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
48 facilities
Chain averages 4 overall / 4 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.34
Registered nurse staffing · state 0.49 · national 0.68
LPN hours / resident day
0.65
Licensed practical nurse staffing · state 0.93 · national 0.87
Aide hours / resident day
2.23
Nurse aide staffing · state 2.15 · national 2.35
Total nurse hours
3.22
All reported nurse hours · state 3.57 · national 3.89
Licensed hours
0.99
RN + LPN hours · state 1.42 · national 1.54
Weekend hours
2.68
Weekend nurse staffing · state 3.09 · national 3.43
Weekend RN hours
0.19
Weekend registered nurse coverage · state 0.33 · national 0.47
Physical therapist
0.07
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.35
CMS adjusted RN staffing hours
Adjusted total hours
3.29
CMS adjusted total nurse staffing hours
Case-mix index
1.34
Higher values indicate more complex resident acuity
RN turnover
11%
Annual RN turnover · state 46% · national 45%
Total nurse turnover
28%
Annual nurse turnover · state 47% · national 46%
SNF VBP
Value-based purchasing
Program rank
7,442
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
29.74
Composite VBP score used to determine payment impact.
Payment multiplier
0.9856
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
1.41
Baseline 22.37% · Performance 21.35% · Measure score 1.41 · Achievement 0 · Improvement 1.41
Healthcare-associated infections
0.87
Baseline 7.34% · Performance 7.57% · Measure score 0.87 · Achievement 0.87 · Improvement 0
Total nurse turnover
7.19
Baseline 43.21% · Performance 34.29% · Measure score 7.19 · Achievement 7.19 · Improvement 4.36
Adjusted total nurse staffing
2.43
Baseline 3.45 hours · Performance 3.77 hours · Measure score 2.43 · Achievement 2.43 · Improvement 0.87
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 11.45% |
10.72%
0.7 pts worse
|
No Different than the National Rate · Eligible stays 231 · Observed rate 10.82% · Lower 95% interval 8.33% |
| Discharge to community | 62.1% |
50.57%
11.5 pts better
|
Better than the National Rate · Eligible stays 217 · Observed rate 57.6% · Lower 95% interval 54.68% |
| Medicare spending per beneficiary | 0.82 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 98.9% |
95.27%
3.6 pts better
|
Numerator 180 · Denominator 182 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 182 |
| Discharge self-care score | 47.83% |
53.69%
5.9 pts worse
|
Numerator 44 · Denominator 92 |
| Discharge mobility score | 35.87% |
50.94%
15.1 pts worse
|
Numerator 33 · Denominator 92 |
| Pressure ulcers or injuries, new or worsened | 2.75% |
2.29%
0.5 pts worse
|
Numerator 5 · Denominator 182 · Adjusted rate 2.78% |
| Healthcare-associated infections requiring hospitalization | 7.57% |
7.12%
0.5 pts worse
|
No Different than the National Rate · Eligible stays 170 · Observed rate 7.65% · Lower 95% interval 5.03% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 151 |
| Staff flu vaccination coverage | 49.69% |
42%
7.7 pts better
|
Numerator 80 · Denominator 161 |
| Discharge function score | 48.91% |
56.45%
7.5 pts worse
|
Numerator 45 · Denominator 92 |
| Transfer of health information to provider | 53.33% |
95.95%
42.6 pts worse
|
Numerator 40 · Denominator 75 |
| Transfer of health information to patient | 87.32% |
96.28%
9 pts worse
|
Numerator 62 · Denominator 71 |
| Resident COVID-19 vaccinations up to date | 12.05% |
25.2%
13.1 pts worse
|
Numerator 10 · Denominator 83 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.8 |
2.2
1.4 pts better
|
1.9
1.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.9 · Expected 2.0 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.4 |
2.0
1.6 pts better
|
1.8
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.4 · Observed 0.4 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 84.7% |
91.2%
6.5 pts worse
|
93.4%
8.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 86.0% · Q2 81.4% · Q3 83.6% · Q4 87.9% · 4Q avg 84.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 90.2% |
95.0%
4.8 pts worse
|
95.5%
5.3 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 90.2% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.5% |
3.2%
0.7 pts better
|
3.3%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.7% · Q2 3.1% · Q3 3.0% · Q4 2.3% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.9% |
9.6%
7.7 pts better
|
11.4%
9.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.9% · Q2 0.8% · Q3 2.5% · Q4 3.3% · 4Q avg 1.9% |
| Percentage of long-stay residents who lose too much weight | 8.7% |
5.9%
2.8 pts worse
|
5.4%
3.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.7% · Q2 6.1% · Q3 15.1% · Q4 9.3% · 4Q avg 8.7% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.7% |
20.7%
4 pts worse
|
19.6%
5.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.2% · Q2 25.9% · Q3 23.6% · Q4 24.4% · 4Q avg 24.7% |
| Percentage of long-stay residents who received an antipsychotic medication | 19.3% |
21.4%
2.1 pts better
|
16.7%
2.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 19.4% · Q2 17.7% · Q3 20.4% · Q4 19.6% · 4Q avg 19.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 16.6% |
17.9%
1.3 pts better
|
16.3%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.7% · Q2 22.6% · Q3 16.6% · Q4 17.8% · 4Q avg 16.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 12.0% |
16.2%
4.2 pts better
|
14.9%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 14.9% · Q2 13.2% · Q3 8.2% · Q4 12.0% · 4Q avg 12.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.9% |
1.1%
0.2 pts better
|
1.0%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 0.6% · Q3 0.5% · Q4 1.2% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.2% |
2.5%
1.3 pts better
|
1.7%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.8% · Q2 0.0% · Q3 2.3% · Q4 1.5% · 4Q avg 1.2% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 16.5% |
16.1%
0.4 pts worse
|
19.8%
3.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.0% · Q2 19.0% · Q3 20.0% · Q4 15.7% · 4Q avg 16.5% |
| Percentage of long-stay residents with pressure ulcers | 10.1% |
6.2%
3.9 pts worse
|
5.1%
5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.8% · Q2 8.0% · Q3 11.3% · Q4 11.9% · 4Q avg 10.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 77.1% |
80.4%
3.3 pts worse
|
81.7%
4.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 77.0% · Q2 78.9% · Q3 77.5% · Q4 74.8% · 4Q avg 77.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 5.3% |
12.2%
6.9 pts better
|
12.0%
6.7 pts better
|
Short Stay · 20240701-20250630 · Adjusted 5.3% · Observed 5.3% · Expected 11.1% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.3% |
2.2%
0.9 pts better
|
1.6%
0.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.9% · Q2 0.0% · Q3 0.0% · Q4 5.0% · 4Q avg 1.3% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 86.4% |
78.2%
8.2 pts better
|
79.7%
6.7 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 86.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 25.5% |
24.2%
1.3 pts worse
|
23.9%
1.6 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 25.5% · Observed 27.3% · Expected 25.5% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-10-05 · Fire 2023-10-05
2 health deficiencies
Top issue: Infection Control (1 deficiency)
3 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2022-01-07 · Fire 2022-01-07
4 health deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2023-10-05
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-11-13
F · Potential for more than minimal harm
2023-10-05
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-05
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-11-13
Inspection history
Recent health citations
G · Actual harm
2025-08-07
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2025-10-02
E · Potential for more than minimal harm
2025-08-07
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-10-02
D · Potential for more than minimal harm
2025-08-07
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2025-10-02
D · Potential for more than minimal harm
2025-08-07
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-10-02
D · Potential for more than minimal harm
2025-08-07
F693 · Quality of Life and Care Deficiencies
Health
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected 2025-10-02
D · Potential for more than minimal harm
2025-08-07
F745 · Quality of Life and Care Deficiencies
Health
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Corrected 2025-10-02
D · Potential for more than minimal harm
2023-10-05
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-05
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-11-13
E · Potential for more than minimal harm
2022-01-07
F565 · Resident Rights Deficiencies
Health
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected 2022-02-21
E · Potential for more than minimal harm
2022-01-07
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2022-02-21
D · Potential for more than minimal harm
2022-01-07
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2022-02-21
D · Potential for more than minimal harm
2022-01-07
F800 · Nutrition and Dietary Deficiencies
Health
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Corrected 2022-02-21
Penalties and ownership
What sits behind the stars
$0
2025-08-07
Payment Denial
Payment Denial · denial start 2025-09-06 · 16 days
16 day denial
Ownership
Community Health Systems Inc
5% Or Greater Indirect Ownership Interest · Organization
Health Scholarships Inc
5% Or Greater Direct Ownership Interest · Organization
Clinical Services Inc
Operational/Managerial Control · Organization
Jenkins, Bolivia
Operational/Managerial Control · Individual
Lambert, Reno
Operational/Managerial Control · Individual
Pittman, Jacqueline
Operational/Managerial Control · Individual
Vorie, Joanna
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Fayetteville Center For Nursing & Healing LLC
Fayetteville, GA
2-star overall rating with 3-star inspections with $11,171 in total fines with 12 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
#2
Ansley Park Health And Rehabilitation
Newnan, GA
5-star overall rating with 5-star inspections with 5 fire-safety deficiencies in the latest cycle
#3
Christian City Rehabilitation Center
Union City, GA
2-star overall rating with 2-star inspections with 20 recent health deficiencies
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