Cycle 1
Health 2023-10-03 · Fire 2023-10-03
27 health deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
6 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Hermitage, TN
The Mckendree Post Acute & Rehabilitation
1-star overall rating with 1-star inspections with Special Focus status with abuse icon flag with $252,242 in total fines with 27 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
4347 Lebanon Road, Hermitage, TN
(615) 871-8200
Overall
1 / 5
CMS overall stars
Health inspections
1 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
180
Certified beds
Average residents
172
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
Hill Valley Healthcare
Operator or chain grouping
Approved since
2009-01-13
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
40 facilities
Chain averages 2 overall / 2 health / 2 staffing / 4 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.55
Registered nurse staffing · state 0.61 · national 0.68
LPN hours / resident day
0.97
Licensed practical nurse staffing · state 1.09 · national 0.87
Aide hours / resident day
2.07
Nurse aide staffing · state 2.15 · national 2.35
Total nurse hours
3.58
All reported nurse hours · state 3.85 · national 3.89
Licensed hours
1.52
RN + LPN hours · state 1.70 · national 1.54
Weekend hours
3.28
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.50
Weekend registered nurse coverage · state 0.40 · national 0.47
Physical therapist
0.11
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.51
CMS adjusted RN staffing hours
Adjusted total hours
3.31
CMS adjusted total nurse staffing hours
Case-mix index
1.48
Higher values indicate more complex resident acuity
RN turnover
42%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
55%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
4,879
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
38.26
Composite VBP score used to determine payment impact.
Payment multiplier
0.9914
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
4.04
Baseline 21.65% · Performance 19.56% · Measure score 4.04 · Achievement 4.04 · Improvement 4.02
Healthcare-associated infections
8.03
Baseline 6.15% · Performance 5.44% · Measure score 8.03 · Achievement 8.03 · Improvement 5.68
Total nurse turnover
3.23
Baseline 98.39% · Performance 70.92% · Measure score 3.23 · Achievement 0 · Improvement 3.23
Adjusted total nurse staffing
0
Baseline 3.41 hours · Performance 3.19 hours · Measure score 0 · Achievement 0 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.76% |
10.72%
About the same
|
No Different than the National Rate · Eligible stays 171 · Observed rate 10.53% · Lower 95% interval 8.1% |
| Discharge to community | 50.77% |
50.57%
0.2 pts better
|
No Different than the National Rate · Eligible stays 140 · Observed rate 46.43% · Lower 95% interval 42.25% |
| Medicare spending per beneficiary | 0.97 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 98.94% |
95.27%
3.7 pts better
|
Numerator 93 · Denominator 94 |
| Falls with major injury | 1.08% |
0.77%
0.3 pts worse
|
Numerator 1 · Denominator 93 |
| Discharge self-care score | 54.93% |
53.69%
1.2 pts better
|
Numerator 39 · Denominator 71 |
| Discharge mobility score | 26.76% |
50.94%
24.2 pts worse
|
Numerator 19 · Denominator 71 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 93 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 5.44% |
7.12%
1.7 pts better
|
No Different than the National Rate · Eligible stays 81 · Observed rate 1.23% · Lower 95% interval 2.85% |
| Staff COVID-19 vaccination coverage | 1.3% |
8.2%
6.9 pts worse
|
Numerator 2 · Denominator 154 |
| Staff flu vaccination coverage | 31.84% |
42%
10.2 pts worse
|
Numerator 57 · Denominator 179 |
| Discharge function score | 47.89% |
56.45%
8.6 pts worse
|
Numerator 34 · Denominator 71 |
| Transfer of health information to provider | 82.61% |
95.95%
13.3 pts worse
|
Numerator 19 · Denominator 23 |
| Transfer of health information to patient | 77.27% |
96.28%
19 pts worse
|
Numerator 34 · Denominator 44 |
| Resident COVID-19 vaccinations up to date | 25.93% |
25.2%
0.7 pts better
|
Numerator 14 · Denominator 54 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.9 |
1.6
0.3 pts worse
|
1.9
About the same
|
Long Stay · 20240701-20250630 · Adjusted 1.9 · Observed 1.7 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.8 |
1.6
0.8 pts better
|
1.8
1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 37.9% |
89.9%
52 pts worse
|
93.4%
55.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 44.9% · Q2 39.7% · Q3 34.0% · Q4 33.1% · 4Q avg 37.9% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 79.9% |
94.5%
14.6 pts worse
|
95.5%
15.6 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 79.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 4.1% |
3.6%
0.5 pts worse
|
3.3%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 2.7% · Q3 5.7% · Q4 5.8% · 4Q avg 4.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 28.5% |
11.8%
16.7 pts worse
|
11.4%
17.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 41.2% · Q2 38.2% · Q3 18.5% · Q4 15.0% · 4Q avg 28.5% |
| Percentage of long-stay residents who lose too much weight | 13.1% |
6.2%
6.9 pts worse
|
5.4%
7.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.5% · Q2 6.5% · Q3 19.8% · Q4 14.3% · 4Q avg 13.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 18.4% |
32.2%
13.8 pts better
|
19.6%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 21.0% · Q2 17.6% · Q3 15.9% · Q4 19.2% · 4Q avg 18.4% |
| Percentage of long-stay residents who received an antipsychotic medication | 14.3% |
18.1%
3.8 pts better
|
16.7%
2.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 14.4% · Q2 12.3% · Q3 13.2% · Q4 17.1% · 4Q avg 14.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 16.6% |
19.9%
3.3 pts better
|
16.3%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.0% · Q2 14.3% · Q3 19.5% · Q4 24.5% · 4Q avg 16.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 13.5% |
15.3%
1.8 pts better
|
14.9%
1.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 10.0% · Q2 12.4% · Q3 15.0% · Q4 16.5% · 4Q avg 13.5% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.6% |
0.9%
0.3 pts better
|
1.0%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.0% · Q2 0.5% · Q3 0.5% · Q4 0.5% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.4% |
1.9%
1.5 pts better
|
1.7%
1.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.7% · Q2 0.7% · Q3 0.0% · Q4 0.0% · 4Q avg 0.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 26.3% |
20.2%
6.1 pts worse
|
19.8%
6.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.1% · Q2 25.6% · Q3 30.2% · Q4 20.0% · 4Q avg 26.3% |
| Percentage of long-stay residents with pressure ulcers | 6.4% |
5.4%
1 pts worse
|
5.1%
1.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.4% · Q2 7.0% · Q3 5.3% · Q4 5.1% · 4Q avg 6.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 3.4% |
79.6%
76.2 pts worse
|
81.7%
78.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 3.0% · Q3 2.8% · Q4 4.7% · 4Q avg 3.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 11.3% |
11.2%
0.1 pts worse
|
12.0%
0.7 pts better
|
Short Stay · 20240701-20250630 · Adjusted 11.3% · Observed 12.7% · Expected 12.5% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.7% |
1.6%
0.1 pts worse
|
1.6%
0.1 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 1.1% · Q2 1.0% · Q3 0.9% · Q4 3.3% · 4Q avg 1.7% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 8.0% |
79.8%
71.8 pts worse
|
79.7%
71.7 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 8.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.3% |
22.2%
4.1 pts worse
|
23.9%
2.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 26.3% · Observed 27.1% · Expected 24.6% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2019-06-19 · Fire 2019-06-19
6 health deficiencies
Top issue: Environmental (1 deficiency)
9 fire-safety deficiencies
Top issue: Emergency Preparedness (6 deficiencies)
Cycle 3
Health 2018-06-06 · Fire 2018-06-06
4 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
6 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2023-10-03
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-03
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-03
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-03
K753 · Miscellaneous Deficiencies
Fire Safety
Have restrictions on the use of highly flammable decorations.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-03
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-11-13
D · Potential for more than minimal harm
2023-10-03
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2023-11-13
D · Potential for more than minimal harm
2019-06-19
E15 · Emergency Preparedness Deficiencies
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
E20 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures including evacuation.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
E22 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for sheltering.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
E29 · Emergency Preparedness Deficiencies
Fire Safety
Develop a communication plan.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
E30 · Emergency Preparedness Deficiencies
Fire Safety
List the names and contact information of those in the facility.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
E33 · Emergency Preparedness Deficiencies
Fire Safety
Establish methods for sharing information.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
K131 · Construction Deficiencies
Fire Safety
Meet requirements for sections of health care facilities separated by fire resistive construction.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
K251 · Egress Deficiencies
Fire Safety
Conform to length requirements for dead end corridors.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2019-08-02
D · Potential for more than minimal harm
2018-06-06
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2018-06-20
D · Potential for more than minimal harm
2018-06-06
K133 · Construction Deficiencies
Fire Safety
Install a two-hour-resistant firewall separation.
Corrected 2018-06-20
D · Potential for more than minimal harm
2018-06-06
K311 · Smoke Deficiencies
Fire Safety
Have an enclosure around a vertical opening shaft.
Corrected 2018-06-20
D · Potential for more than minimal harm
2018-06-06
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2018-06-20
D · Potential for more than minimal harm
2018-06-06
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2018-06-20
D · Potential for more than minimal harm
2018-06-06
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2018-06-20
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-11-20
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-12-03
K · Immediate jeopardy
2023-10-03
F700 · Quality of Life and Care Deficiencies
Health
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Corrected 2023-11-03
J · Immediate jeopardy
2023-10-03
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-11-03
J · Immediate jeopardy
2023-10-03
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-11-03
G · Actual harm
2023-10-03
F726 · Nursing and Physician Services Deficiencies
Health
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected 2023-11-01
F · Potential for more than minimal harm
2023-10-03
F569 · Resident Rights Deficiencies
Health
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Corrected 2024-01-22
F · Potential for more than minimal harm
2023-10-03
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-11-03
F · Potential for more than minimal harm
2023-10-03
F908 · Environmental Deficiencies
Health
Keep all essential equipment working safely.
Corrected 2023-11-07
D · Potential for more than minimal harm
2023-10-03
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-11-01
D · Potential for more than minimal harm
2023-10-03
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F623 · Resident Rights Deficiencies
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-11-14
D · Potential for more than minimal harm
2023-10-03
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-11-14
D · Potential for more than minimal harm
2023-10-03
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-11-14
D · Potential for more than minimal harm
2023-10-03
F697 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate pain management for a resident who requires such services.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F699 · Quality of Life and Care Deficiencies
Health
Provide care or services that was trauma informed and/or culturally competent.
Corrected 2023-11-02
D · Potential for more than minimal harm
2023-10-03
F742 · Quality of Life and Care Deficiencies
Health
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Corrected 2023-11-03
D · Potential for more than minimal harm
2023-10-03
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2023-11-02
D · Potential for more than minimal harm
2023-10-03
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2023-11-07
F · Potential for more than minimal harm
2019-06-19
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2019-08-02
F · Potential for more than minimal harm
2019-06-19
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2019-08-02
F · Potential for more than minimal harm
2019-06-19
F908 · Environmental Deficiencies
Health
Keep all essential equipment working safely.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2019-07-23
D · Potential for more than minimal harm
2019-06-19
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2019-08-02
D · Potential for more than minimal harm
2019-06-19
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2019-08-02
D · Potential for more than minimal harm
2018-06-06
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2018-07-20
D · Potential for more than minimal harm
2018-06-06
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2018-07-20
D · Potential for more than minimal harm
2018-06-06
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2018-07-20
D · Potential for more than minimal harm
2018-06-06
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2018-07-20
Penalties and ownership
What sits behind the stars
$252,242
2023-10-03
Fine
Fine · fine $252,242
Fine
$0
2023-10-03
Payment Denial
Payment Denial · denial start 2023-11-09 · 74 days
74 day denial
Ownership
Tn 2 SNF Operations Holdings LLC
5% Or Greater Direct Ownership Interest · Organization
Garafola, Joseph
Operational/Managerial Control · Individual
Idels, Shimon
Corporate Officer · Individual
Lion 26 Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Sabrina 1818 Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Saessy Irrevocable Trust
5% Or Greater Indirect Ownership Interest · Organization
Tatiriq Irrevocable Trust
5% Or Greater Indirect Ownership Interest · Organization
Nearby options
Other facilities in reach
#1
Heartland
Nashville, TN
3-star overall rating with 2-star inspections with $7,901 in total fines with 8 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#2
Life Care Center Of Old Hickory Village
Old Hickory, TN
3-star overall rating with 2-star inspections with $13,520 in total fines with 12 recent health deficiencies
#3
Cedar Creek Post Acute
Mount Juliet, TN
1-star overall rating with 1-star inspections with $211,244 in total fines with 5 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
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