01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-19 | 4 | 2025-06-19 | 1 |
| Cycle 2 | 2024-01-25 | 4 | 2024-01-25 | 4 |
| Cycle 3 | 2022-05-08 | 0 | 2022-05-08 | 0 |
CMS CCN 1155972026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Heritage Inn Health And Rehabilitation
307 Jones Mill Road · Statesboro, GA 30458 · Bulloch County
Certified beds92CMS provider file
Recent citation rows13current CMS citation release
Penalty rows0current 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
13 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-06-19 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-08-032025-06-19 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-08-032025-06-19 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-08-032025-06-19 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2025-08-032025-06-19 · 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 · 2025-08-032024-01-25 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2024-03-102024-01-25 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2024-03-102024-01-25 · 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 · 2024-03-102024-01-25 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2024-03-102024-01-25 · FIREK0347Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Correction field: Deficient, Provider has date of correction · 2024-03-102024-01-25 · FIREK0372Severity D · isolated; 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 · 2024-03-102024-01-25 · 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 · 2024-03-102024-01-25 · FIREK0920Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2024-03-1003 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PEAVY, TIFFANYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2026
- CABLE, PAULIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/14/2003
- DENNIS, KATHRYNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/17/2015
- NICHOLS, JOSEPHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/19/2024
- ROLLINS, RONNIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/14/2003
- WALL, JOSEPHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/14/2003
- WARNOCK, RALPHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/23/2020
- CLINICAL SERVICES INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2007
- GIBSON, MARTHAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/10/2026
- HERRON, LATASHAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/12/2020
- PATEL, MAULIKKUMARIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- PEAVY, TIFFANYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2026
- SHEFFIELD, KIMBERLYIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 04/15/2025
- CLINICAL SERVICES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/15/2025
- HERRON, LATASHAIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/15/2025
- PATEL, MAULIKKUMARIndividual · ADP OF THE SNFNOT APPLICABLE · since 08/01/2023
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 hours2.95per resident day
RN hours0.55per resident day
Weekend nurse hours2.69per resident day
Staff turnover40.8%CMS reported field
06 / LOCAL RECORDS
Open the Statesboro ledger →