01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-04 | 3 | 2025-12-04 | 7 |
| Cycle 2 | 2024-09-19 | 3 | 2024-09-19 | 2 |
| Cycle 3 | 2023-04-27 | 3 | 2023-04-27 | 12 |
CMS CCN 1156152026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Baptist Village, Inc.
2650 Carswell Ave · Waycross, GA 31502 · Ware County
Certified beds254CMS provider file
Recent citation rows30current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
30 rows in the current release
3 rows carry G–L scope/severity codes; 3 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-27 · HEALTHF0656Severity J · isolated immediate jeopardy
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Past Non-Compliance · 2026-01-20 · complaint2026-04-27 · HEALTHF0757Severity J · isolated immediate jeopardy
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Past Non-Compliance · 2026-01-20 · complaint2026-04-27 · HEALTHF0760Severity J · isolated immediate jeopardy
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Past Non-Compliance · 2026-01-20 · complaint2025-12-04 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0341Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0374Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2026-01-172025-12-04 · FIREK0919Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the use of electrical equipment.
Correction field: Deficient, Provider has date of correction · 2026-01-172024-09-19 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-11-03 · complaint2024-09-19 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-11-03 · complaint2024-09-19 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-11-03 · complaint2024-09-19 · FIREK0223Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2024-11-272024-09-19 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-11-032023-04-27 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · HEALTHF0882Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0331Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Construct fire resistant interior walls.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0351Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0364Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install properly constructed windows in hallway walls or doors.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0371Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have properly sized and located compartments to protect residents from smoke.
Correction field: Deficient, Provider has date of correction · 2023-06-112023-04-27 · FIREK0372Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2023-06-1103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-09-19 | Fine | $4,017 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- EXECUTIVE COMMITTEE OF THE BAPTIST CONVENTION OF THE STATE OF GEORGIAOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 12/21/1966
- CLOUGH, ARCHIEIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 09/12/2011
- SWEAT, HOLLIIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 07/30/2019
- CLOUGH, ARCHIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/07/2007
- MATHISON, JOHNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2020
- STIPE, SUMMERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/07/2007
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.95per resident day
RN hours0.35per resident day
Weekend nurse hours4.50per resident day
Staff turnover36.5%CMS reported field
06 / LOCAL RECORDS
Open the Waycross ledger →