Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Pebblebrook Health Center at Park Springs

Stone Mountain, GA · 60 certified beds · Last Life Safety survey May 1, 2025

CMS Certification Number 115694 · first certified May 2005

Also on this campus

The same campus holds a state-licensed assisted living facility, with its own state record on the Assisted Living Index: Pebblebrook Memory Care at Park Springs (5610 New Bermuda Road). Matched by the telephone number the two records share. The records are separate and are never added together.

Ownership

Independently operated (no chain recorded by CMS) · For profit - Limited Liability company

No change of ownership on CMS record since January 1, 2016, when the records begin.

12
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
7
Inspection & testing records
Of the citations on file

Position within GA

12 citations — more than 67% of the 356 certified nursing homes in GA. Compared within GA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 0 citations; the earlier surveys in the window averaged 6. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window is open now: July 2026 to December 2026. This facility’s last Life Safety survey was May 2025. Facilities in GA are typically surveyed 14–20 months after the last one (median 16), measured over 532 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

Emergency preparedness

1 of the 12 citations on file is Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

2 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 12 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in GA, and nationally. Surveyors differ markedly between states, so the GA figure is the meaningful one.

This facility12GA median8National median11
Citations on file over three years, compared
MeasureCitations
This facility12
Median facility in GA8
Median facility nationally11

Survey history

Citations at each Life Safety survey
112022-0712023-1102025-05
Citations at each Life Safety survey
Survey dateCitations
July 17, 202211
November 2, 20231
May 1, 20250

Most-cited tags

Most-cited tags at this facility
K-07121K-02111K-07911K-09181K-03721K-02911K-03521K-02931
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0712Have simulated fire drills held at unexpected times.12022-07-17
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.12022-07-17
K-0791Ensure that any exit in an area undergoing construction, repair, or improvements shall be inspected daily to ensure its ability to be used instantly in case of emergency.12022-07-17
K-0918Have generator or other power source capable of supplying service within 10 seconds.12022-07-17
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.12022-07-17
K-0291Install emergency lighting that can last at least 1 1/2 hours.12023-11-02
K-0352Properly install and monitor supervisory attachments on automatic sprinkler systems.12022-07-17
K-0293Have properly located and lighted "Exit" signs.12022-07-17

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 5
  • Egress Deficiencies 3
  • Miscellaneous Deficiencies 2
  • Gas, Vacuum, and Electrical Systems Deficiencies 1
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies5
Egress Deficiencies3
Miscellaneous Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies1
Emergency Preparedness Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

November 2, 2023 — 1 citation

Citations issued on November 2, 2023
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (December 8, 2023)

July 17, 2022 — 11 citations

Citations issued on July 17, 2022
TagWhat the surveyor checksStatus
E-0001Establish an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (September 9, 2022)
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (September 9, 2022)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (September 9, 2022)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (September 9, 2022)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (September 9, 2022)
K-0352Properly install and monitor supervisory attachments on automatic sprinkler systems.Deficient, Provider has date of correction (September 9, 2022)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (September 9, 2022)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (September 9, 2022)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (September 9, 2022)
K-0791Ensure that any exit in an area undergoing construction, repair, or improvements shall be inspected daily to ensure its ability to be used instantly in case of emergency.Deficient, Provider has date of correction (September 9, 2022)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (September 9, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.