Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 713026 (X3) Date Survey Completed 04/27/2026
Name of Provider or Supplier Bogalusa Rehabilitation Hospital Street Address, City, State 621 Columbia Street, Bogalusa, LA
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
K0353 Sprinkler System - Maintenance and Testing
CFR(s): NFPA 101

Sprinkler System - Maintenance and Testing Automatic sprinkler and standpipe systems are inspected, tested, and maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintaining of Water-based Fire Protection Systems. Records of system design, maintenance, inspection and testing are maintained in a secure location and readily available. a) Date sprinkler system last checked _____________________ b) Who provided system test ____________________________ c) Water system supply source __________________________ Provide in REMARKS information on coverage for any non-required or partial automatic sprinkler system. 9.7.5, 9.7.7, 9.7.8, and NFPA 25


This STANDARD is not met as evidenced by:
Based on visual observation the facility failed to assure that the sprinkler system was inspected and tested in accordance with the approved maintenance and testing program in NFPA 25. The sprinkler system gives a sense of security to offer an advance warning in fire and/or smoke emergency. This deficient practice could potentially affect ten of ten patients. Findings: During the facility tour on April 27, 2026 between the hours of 9:15 a.m. to 11:00 a.m. the documented sprinkler quarterly inspections were lacking at time of survey. The interview with the Administrator revealed the facility was unaware the quarterly sprinkler inspections were lacking from the last year.