MOULTRIE, Ga. (WALB) — After WALB first investigated concerns inside one South Georgia nursing home, something unexpected happened. Phone calls. Emails. Messages. Families from across South Georgia began telling similar stories with concerns involving unanswered complaints, leaking ceilings, staffing shortages, infections, delayed care, poor communication, maintenance issues and loved ones left in unsafe conditions. In some cases, allegations of neglect that could have led to death.

On this WALB Investigates series, a critical question is raised: Are these isolated incidents, or are they part of a larger, systemic problem impacting Southwest Georgia’s elder care facilities?

WALB’s investigation reveals that a single corporate name repeatedly emerges from the heartbreak of Southwest Georgia families: PruittHealth Systems.

Across multiple counties and facilities, including Moultrie, Albany and Dawson, families describe a pattern of severe physical neglect, medical mismanagement and administrative indifference.

Albany (PruittHealth - Palmyra):

Elaine Jones’s Account

Elaine Jones says she drove weekly from Columbus to Albany to care for her older sister, Nellie Burns, who lived at the PruittHealth Palmyra facility on Palmyra Road. Burns was only 57 years old, blind and paralyzed on her left side.

“I won’t say ‘all staff,’ but the majority of the ones that dealt with my sister, they were so not compassionate with her,” Jones said. “My sister was paralyzed on her left side. She could not walk. She was blind. You would think with those disabilities, people would be more thoughtful. They weren’t.”

Because of her blindness, Burns was entirely dependent on staff for feeding, bathing and basic safety, according to the family. Instead, her family said they found her subjected to humiliating neglect:

• At mealtimes:  “My sister cried because she would go a whole day without eating. She was blind and they would leave cold food in front of her. She had to feel around in her plate to find out what food was what. Nobody assisted her with her meals.”
• Sanitation: “My sister would be lying in the bed with feces all over her yet having bed sores. She would have urine all over herself. I came waiting on somebody to change her... it’s humiliating.”
• Call light: Burns reportedly relied on a voice-activated cell phone and a call light to signal for help. “We discovered somebody went in and unplugged her call button. You can’t get no worse than that,” Jones said.

Jones said the neglect reached a mysterious climax the day Nellie Burns died in hospice care.

“Vitals were good. Her blood pressure was normal,” Jones recalled. “The lady that pronounced her dead, who had been doing this for 30 years, was shocked... she told me, ‘They let Ms. Nellie die. She kept calling for them... they wouldn’t even come in her room.’”

WALB News 10 reached out to PruittHealth Palmyra for a response. The media relations person sent a statement that did not address the specific allegations raised in the federal report nor by Elaine Jones. But it did say in part, “PruittHealth Palmyra remains committed to providing safe, high-quality care and it has submitted a corrective action plan.”

Moultrie (PruittHealth - Moultrie):

Scarlett Wimbley’s Account

A short drive away in Colquitt County, Scarlett Wimbley said her aunt, Leola Jackson McQueen, experienced an almost identical situation at PruittHealth Moultrie. She says McQueen was a healthy 79-year-old with no chronic illnesses who entered the facility for a temporary 28-day rehabilitation stay after surgery.

Instead, McQueen reportedly developed a “plethora of bed sores” on her backside and genitals.

“When we found them, it was too late,” Wimbley said. McQueen contracted sepsis from the untreated wounds and passed away.

“When I got to the hospital, it was just unbelievable,” Wimbley recalled. “It was something that you would see in a movie... You would have thought it was a makeup scene. There was just no way a human should have had to go through what they allowed her to go through there. It was pure neglect.”

Wimbley places the blame squarely on systemic understaffing.

“They are underpaid. They are understaffed. The facilities are getting monies, and they are not doing what they are supposed to do with the monies—giving the elderly the proper healthcare that they deserve.”

What the official records reveal

State and federal inspection reports from 2022 and 2023 reveal a number of violations at PruittHealth Moultrie.

PruittHealth - Moultrie: Deficiencies and Violations

A review of Centers for Medicare & Medicaid Services (CMS) Statements of Deficiencies for PruittHealth Moultrie (233 Sunset Circle, Moultrie, GA) reveals a chronic pattern of clinical and operational failures:

1. Wound Care Management Failures (Survey Date: Feb 10, 2022)

• Violation Tag: F 0842 (Medical Records and Professional Standards)
• Details: Investigators confirmed the facility failed to enter proper wound care orders in the Electronic Health Record (EHR) for a resident admitted with multiple pressure ulcers (sacrum, left elbow, right foot).
• Findings: The Skin Integrity Coordinator performed physical treatments on the wounds without verifying active physician orders or signing off that the treatments were completed. The coordinator admitted she was new and had “not received training on how to add orders to the EHR system.”

2. Kitchen Sanitation and Food Safety Risks (Survey Date: Sept 7, 2023)

• Violation Tag: F 0812 (Food Procurement and Sanitary Methods)
• Details: State inspectors cited the facility for widespread sanitary failures that had the “potential to affect 60 out of 60 residents receiving an oral diet.” The facility had received a failing 86 B score on its Georgia Department of Public Health Food Facility Inspection just months prior.
• Findings: Inspectors found raw chicken defrosting on a rolling cart in standing water and ice near a hot stove, instead of in a controlled, refrigerated environment. Additionally, staff was caught refreezing previously defrosted raw chicken for future use, and open food products like barbecue sauce, meats, and cheese were stored in freezers and pantries completely unsealed, unlabeled, and undated.

3. Respiratory Care Standards Violations (Survey Date: Sept 7, 2023)

• Violation Tag: F 0695 (Respiratory Care Standards)
• Details: The facility failed to secure a specific physician’s order for a resident on continuous oxygen therapy, leaving it as a broad range (2-5 Liters Per Minute) with no guidance on flow adjustment.
• Findings: Inspectors observed the resident’s water humidification bottle completely dry and empty on multiple occasions. Staff admitted they failed to monitor the water level despite knowing high oxygen flow rates empty the bottles every 2-3 days.

4. Unsecured hallway medications (Survey Date: Sept 7, 2023)

• Violation Tag: F 0761 (Labeling and Storage of Drugs)
• Details: A nurse left an insulin pen and four packages of oral medications unattended on top of a medication cart in a hallway where multiple residents independently ambulate, presenting a severe risk of accidental ingestion.

PruittHealth - Albany: Deficiencies and Violations

State and federal records obtained by WALB Investigates show severe regulatory citations at PruittHealth-Palmyra in Albany, Georgia. Most notably, the facility was slapped with an Immediate Jeopardy (IJ) citation—the most severe classification indicating resident safety was in imminent danger:

• F 0656 (Immediate Jeopardy - Skin Inspections & Care Plans): State inspectors issued an Immediate Jeopardy citation on May 20, 2025, after discovering the facility completely failed to develop and implement care plans for routine weekly skin assessments on high-risk residents. Widespread failures were identified:
  • One resident with a Stage IV sacral pressure ulcer had zero skin assessments documented for the entire month of January 2025, allowing a Stage II thigh ulcer and a reopened Stage IV sacral wound to go undetected until a facility-wide skin sweep in mid-April.
  • A resident with severely impaired cognition was left completely unmonitored for pressure injuries in March and April 2025, which led to the development of an unstageable ulcer on their left heel and another on their left elbow.
• F 0580 (Failure to Notify Physicians or Families): The facility repeatedly failed to notify medical providers or responsible family members of dangerous clinical changes:
  • A resident experienced severe orthostatic hypotension, passing out completely in physical therapy on November 21, 2024, after their standing blood pressure registered as too low to read. Despite therapy staff warning nurses, the physician was not notified of this life-threatening blood pressure drop until November 25, 2024—a four-day delay.
  • A resident’s family member was left completely in the dark regarding diagnostic tests for a gastrostomy tube and was never informed when a new, active wound developed on the resident’s lower right leg.
• F 0585 (Grievance Resolution Failures): For four out of seven months reviewed, the facility failed to track, investigate, or resolve resident council grievances. Repeated complaints regarding late meals, cold food, and broken equipment went unanswered, with staff admitting they failed to follow up.
• F 0550 (Voter Rights Violations): During the November 2024 election, the facility failed to assist three cognitively intact residents who explicitly wanted to vote with obtaining absentee ballots or registering, directly violating their constitutional and residency rights.

Those inspection findings are separate from the allegations made by either family, and the inspection report reviewed by WALB does not conclude those deficiencies caused the injuries or deaths described by the families.

In a response to WALB’s request for comment, PruittHealth Palmyra gave the following:

“PruittHealth – Palmyra remains committed to providing safe, high‑quality, and compassionate care. We have submitted a comprehensive corrective action plan to address the concerns identified and are working closely with regulators throughout this process. Our focus is on ensuring that every patient receives the care and dignity they deserve.”

Statement from PruittHealth

PruittHealth communications sent WALB the following statement:

“At PruittHealth, the safety, dignity, and well-being of our patients and residents remain our highest priorities.

We understand that concerns about a loved one’s care are deeply personal, and we take those concerns seriously. While privacy laws prevent us from discussing individual circumstances, we carefully review concerns brought to our attention and work closely with families, caregivers, and regulatory agencies as appropriate. For more than 55 years, we have been committed to serving Georgia families, and our teams remain focused every day on providing compassionate, high-quality care to our patients and residents.”     

If you have a story or a tip regarding an elder care facility in South Georgia, contact [email protected] .

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