Below average — CMS composite of the measures below.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Cherokee County Health And Rehabilitation Center during CMS and state inspections, most recent first.
Food was not consistently served palatable or at the proper temperature for several residents. Four residents reported hot items tasting cold, lukewarm, or not hot, and one resident said a meal tasted raw and lacked seasoning. Observation of a test tray found a hot item at 134.2 degrees F and a salad at 63.0 degrees F, and staff confirmed a cook did not follow the standardized recipe when preparing the flatbread.
Unclean ovens, drawers, and improper food storage: During a kitchen inspection, two convection ovens were found with heavy dried and burned food spills, grease, and debris, and two drawers storing food service equipment were also unclean. Food in the walk-in refrigerator was uncovered or stored in an unlabeled, undated container, and several items in the walk-in freezer were placed directly on the floor. The DM confirmed the findings and stated food should be covered, dated, labeled, and stored off the floor.
The facility did not provide two residents and their representatives with written transfer notices containing all required information during emergent hospital transfers. Instead of specifying the actual medical reasons for transfer, the notices used a generic statement, and there was no documentation in the EMR that written notices were given, only that representatives were notified by phone.
Failure to Process Family Concern as a Grievance: A resident’s family member requested a meeting with admin and voiced concerns about the resident’s discharge condition, including a pressure ulcer and being discharged in soiled clothing. The facility did not log the concern as a grievance, did not document a complete investigation, and did not show that the family member was informed of the results, despite the facility’s grievance policy requiring investigation and timely response.
Incorrect PASSR Level II Coding on MDS Assessments: Two residents had MDS assessments coded No for PASSR Level II status despite PASRR Level II determinations showing serious mental illness diagnoses. One resident had vascular dementia, PTSD, and bipolar disorder with moderate cognitive impairment on the MDS, and the other had bipolar disorder, mood disorder, major depressive disorder, anxiety disorder, and panic disorder with a cognitively intact BIMS score. Staff interviews confirmed both MDS entries should have been marked Yes.
An LPN prepared medications for two residents and handed them to another nurse, who administered them without observing the preparation or verifying the contents. The LPN then documented the administrations in the eMAR even though the other nurse gave the medications. The DON stated nurses were expected to administer medications they prepared themselves, and the ADON stated nurses could not administer medication if they could not verify all rights of medication administration.
Failure to honor a resident’s request for bed-to-wheelchair transfers. A resident with muscle weakness, difficulty walking, and a stage IV sacral ulcer was assessed as moderately cognitively impaired and dependent on staff for all care, with orders for mechanical-lift transfers. Records showed no documented transfers or refusals, and staff interviews confirmed that encouragement to get up and refusals were not documented. The resident stated a desire to be out of bed and later said staff had not offered assistance.
A resident on restorative nursing after PT and OT discharge did not receive restorative care as prescribed. Restorative notes showed ROM and transfer exercises, but they lacked required details such as reps, weights, theraband colors, and whether pegboard hand weights were used. The CNRA also confirmed that ambulation with a RW and max assist of two was not documented as attempted or explained when not done, and that the resident did not receive restorative nursing twice weekly as ordered. The DON confirmed the documentation did not show the PT and OT maintenance plans were being followed or the resident's response to care.
A resident with ESRD receiving dialysis had no documented post-dialysis VS or assessment when returning to the facility. The resident’s orders and care plan required VS checks and monitoring of the dialysis access site, but the dialysis binder showed only pre-dialysis documentation, and the UM confirmed staff did not complete the required post-assessment, including access site checks.
Medication error rate exceeded the allowed threshold when an LPN administered incorrect dosages to two residents during observed med passes. One resident received 20 meq of potassium chloride instead of the ordered 40 meq, and another resident received one spray of fluticasone in each nostril instead of two sprays in each nostril as ordered. The LPN confirmed the errors, and the DON stated meds were to be administered as ordered by the physician.
Food Served at Improper Temperature and Not Prepared per Recipe
Penalty
Summary
The facility failed to serve food that was palatable and at an acceptable temperature for four residents reviewed for food palatability. R5, who had a BIMS score of 9 out of 15 and was moderately cognitively impaired, stated that hot foods on the meal tray tasted cold and that trays had previously been served last when the resident was in a room at the end of the hall. R47, who had a BIMS score of 14 out of 15, stated the hot foods on the tray tasted lukewarm. R144, who had a BIMS score of 13 out of 15, stated the food did not taste good and that the hot foods tasted cold. R139, who had a BIMS score of 15 out of 15, stated the hot foods did not taste hot and reported that the meatloaf and squash tasted like they were raw and had no seasoning. Facility records showed policies requiring food to be delivered promptly, served at preferable temperatures, and prepared using standardized recipes. Resident council minutes also documented prior concerns about food palatability, including fish being tough and food being too salty. During observation of a test tray placed in an enclosed meal delivery cart, hot foods on the kitchen tray line were at acceptable temperatures before delivery, but after the last resident meal was delivered, the chicken alfredo spinach flatbread on the test tray registered 134.2 degrees F and the salad registered 63.0 degrees F. The dietary manager stated the salad temperature was too high and expected salads to be served at 50 degrees F or lower. The facility’s recipe for chicken spinach alfredo flatbread listed baby spinach, flatbread, alfredo sauce, roasted chicken breast, and mozzarella cheese. The cook who prepared the item stated that fajita chicken strips were used instead of roasted chicken breast and that pepper, onion powder, garlic powder, and salt were added to the alfredo sauce and chicken, which were not listed in the recipe. The cook confirmed the recipe was not followed, and the dietary manager confirmed the staff were expected to follow recipes when preparing menu items.
Unclean ovens, drawers, and improper food storage
Penalty
Summary
The facility failed to ensure two kitchen convection ovens and two kitchen drawers used to store food preparation and service equipment were kept clean. During the initial kitchen inspection, the interior cooking compartments and doors of the two ovens were observed to have a heavy accumulation of dried and burned food spills, grease, and debris. The inner storage compartments of two kitchen drawers containing serving scoops, serving spoons, scissors, metal ice/food scoops, and thermometers were also observed to be unclean with dried substances and loose food debris. The facility also failed to ensure food was stored off the floor and that stored food was labeled, dated, and covered. In the walk-in refrigerator, a box of sausage patties was stored uncovered and open to air, and cheese slices removed from their original packaging were stored in an undated and unlabeled container. In the walk-in freezer, a box of bread sticks, a box of dinner rolls, a box of cheese omelets, and a box of churros were stored directly on the freezer floor. The Dietary Manager confirmed the observations and stated the ovens and drawers should be cleaned each week and as needed, and that food should be completely covered, dated, labeled, and stored off the floor.
Failure to Provide Required Written Transfer Notices with Specific Reasons
Penalty
Summary
The facility failed to provide residents and their representatives with written notices of transfer that included all required information during emergent transfers to the hospital. Specifically, for two residents who experienced acute medical events requiring hospital transfer, there was no documentation that written transfer notices were given to either the residents or their representatives at the time of transfer. In both cases, the facility's documentation only indicated that the representatives were notified by phone, and there was no evidence in the electronic medical record (EMR) that written notices were provided as required by facility policy. Additionally, the transfer notices that were completed did not specify the actual medical reasons for the transfers. Instead, the notices used a generic statement of "inability to meet resident's needs" rather than detailing the specific clinical circumstances, such as allergic skin reaction with difficulty breathing or symptoms like pallor, diaphoresis, lethargy, low blood pressure, and urinary issues. Interviews with facility staff, including the DON, confirmed the lack of documentation and the omission of specific reasons for transfer in the written notices.
Failure to Process Family Concern as a Grievance
Penalty
Summary
The facility failed to identify a family concern as a grievance for one resident who had been admitted for a five-day respite stay and later discharged home with home health services. The resident’s family member requested a meeting with facility administration and voiced concerns about the resident’s physical condition at discharge, including that the resident had developed a pressure ulcer during the stay and was discharged wearing only a tee shirt and adult diaper, arriving home completely saturated with urine. The family member stated no response was received regarding the resolution of the concerns. Record review showed the facility’s grievance policy required all concerns, complaints, and grievances voiced to the facility to be assessed and investigated, with results provided to the resident or family member within ten working days. However, the grievance/concern log for 2023 did not show any grievance or concern filed for the resident. The facility’s undated administrative notes from the meeting documented that the unit manager interviewed staff present on the day of discharge, but the document did not include statements from those staff members and did not show that the family member was informed of the investigation results. The DON stated the family member’s concern should have been considered a grievance and acknowledged the grievance procedure was not followed.
Incorrect PASSR Level II Coding on MDS Assessments
Penalty
Summary
The facility failed to ensure accurate MDS assessments were submitted for two residents by incorrectly coding the PASSAR Level II status as No. Review of the facility policy on Resident Assessment - Coordination with PASARR Program stated that recommendations from a PASARR Level II determination and/or evaluation report are to be incorporated into the resident’s assessment, care planning, and transitions of care. The RAI Manual excerpt reviewed by surveyors stated that assessment information must be validated for accuracy by the interdisciplinary team and that only required assessments submitted to iQIES are to be considered when determining prior assessments. For one resident, the admission record showed diagnoses including vascular dementia, PTSD, and bipolar disorder. The resident’s significant change MDS with an ARD of 10/10/2025 indicated the resident could not complete the BIMS, had moderate cognitive impairment, and was marked No for whether the resident was currently considered by the state level II PASRR process to have serious mental illness and/or intellectual disability or a related condition. The resident’s PASRR Level II Service Determination dated 11/07/2025 identified serious mental illness diagnoses of bipolar disorder and PTSD. For the second resident, the admission record listed bipolar disorder, mood disorder, major depressive disorder, anxiety disorder, and panic disorder. The annual MDS with an ARD of 01/28/2025 showed a BIMS score of 14 and was also marked No for PASSR Level II status, while the PASRR Level II Service Determination dated 03/18/2019 identified serious mental illness diagnoses including PTSD, panic disorder, bipolar disorder, major depressive disorder, anxiety disorder, and mood disorder. During interview, the Social Services Director stated the second resident should have been marked Yes, and the Social Services Assistant stated the first resident was level II and the MDS should have been marked Yes.
Medication Administration Not Performed by Preparing Nurse
Penalty
Summary
The facility failed to follow professional standards of practice for medication administration when an LPN prepared medications for residents and then handed them to another nurse to administer. During an observation, LPN2 prepared eight pills and a cup of clear fluid for R21 and gave them to UM5, who entered the room and administered the medications without observing the preparation or verifying the contents of the cup. The medications included nitrofurantoin 100 mg, vitamin C 500 mg, atorvastatin 40 mg, famotidine 20 mg, sertraline 100 mg, buspirone 7.5 mg, memantine 10 mg, propranolol 20 mg, and polyethylene glycol mixed with water. LPN2 then asked UM5 whether R21 had taken all of the medications and signed the medications as administered in the eMAR. A second observation showed the same practice with R132, when LPN2 prepared six pills and an inhaler and handed them to UM5, who administered them without observing the preparation or verifying the medications. The pill cup contained atorvastatin 10 mg, two 5 mg melatonin tablets, fenofibrate 160 mg, hydrocodone-acetaminophen 10/325 mg, and sucralfate 1 gm, and the inhaler was Bryna (budesonide/formoterol fumarate) 160 mg/4.5 mcg, given as 2 puffs. LPN2 again signed the medications as administered in the eMAR. LPN2 stated UM5 administered the medications because he/she was helping out due to a time crunch, and later stated [he/she] did not want this [racial slur] in his/her room. The DON stated nurses were expected to administer medications they prepared themselves, while the Administrator was unsure whether one nurse could hand another nurse a cup of pills to administer. The ADON stated nurses could not administer medication if they could not verify all the rights of medication administration.
Failure to Honor Resident Requests for Bed-to-Wheelchair Transfers
Penalty
Summary
The facility failed to honor a resident’s requests to be transferred from bed to wheelchair for one of five residents reviewed for ADL assistance. The resident was admitted with diagnoses including stage IV sacral ulcer, klebsiella pneumonia, muscle weakness, and difficulty walking. The quarterly MDS assessed the resident as moderately cognitively impaired with a BIMS score of 11 out of 15, and the resident was dependent on staff for all areas of care and required two-plus people with a mechanical lift for transfers. The care plan directed staff to encourage activities and socialization and to use a mechanical lift for all transfers, but the resident was not care planned for refusal of care or transfers. Review of documentation showed no evidence that the resident had been transferred from bed to wheelchair via mechanical lift during September and October 2025, and there was no documented evidence of refusal of transfers. The ADL sheet for November 2025 showed the resident was dependent on staff for all care needs and did not refuse any cares. Restorative notes from 11/17/2025 through 12/11/2025 did not show documentation that the resident was encouraged to increase strength by getting out of bed or that the resident refused those recommendations. During interviews, the resident stated being in bed since admission and expressed a desire to be out of bed and in the wheelchair, later stating staff had not offered assistance. Staff interviews revealed the restorative aide had encouraged transfers but failed to document the guidance or refusals, a student nurse said the resident refused to get up but this refusal was not documented, and the unit manager stated staff should offer transfers, document refusals, and was unaware the resident had requested help to use the computer in the room.
Restorative Nursing Documentation Did Not Match PT/OT Maintenance Program
Penalty
Summary
The facility failed to ensure that one resident receiving restorative services received the restorative care prescribed by PT and OT during the restorative nursing program. The resident was discharged from PT and OT and was then placed on restorative nursing programs for OT twice weekly and PT twice weekly. The PT maintenance program directed restorative staff to have the resident perform seated therapeutic exercises with 1-2 pound weights, sit-to-stand transfers three times with max assist of two, and attempts to ambulate to tolerance with a rolling walker and max assist of two with a wheelchair nearby. The OT maintenance program directed stretching with therabands, bending a therapy bar, bicep curls with 2 pound weights, and pegboard exercise with wrist weights. The resident stated that during rehab he/she spent most of the time doing arm and leg exercises and only a short time standing, and said he/she wanted to work on standing and pivoting to the chair. Restorative nursing documentation showed sessions with ROM and transfer exercises, but the notes did not consistently identify the specific exercises completed as directed by PT and OT. The documentation did not show the number of repetitions completed, the color of theraband used, the weight of dumbbells or ankle weights used, or whether hand weights were used with the pegboard exercise. The CNRA confirmed that the restorative documentation did not include the required specific details and did not document why the PT-directed ambulation with a rolling walker and max assist of two was not attempted or the reason it was not attempted. The documentation also showed a refusal to participate without stating the reason for the refusal. During review, the CNRA confirmed that the resident had not received restorative nursing two times per week as ordered. The DON reviewed the records and confirmed that the restorative nursing documentation lacked specific information showing that the PT and OT maintenance program instructions were being implemented as directed and lacked documentation of the resident's response or refusal.
Failure to Document Post-Dialysis Assessment and Access Site Monitoring
Penalty
Summary
The facility failed to document monitoring and assessment of a resident’s dialysis access site and failed to document the resident’s condition when he/she returned to the facility after dialysis treatment. The resident had end stage renal disease and was receiving dialysis on Monday, Wednesday, and Friday. The resident’s physician orders required vital signs prior to and upon return from dialysis and observation of the pressure dressing to the left upper arm for signs of increased bleeding. The care plan also identified potential complications related to dialysis and directed staff to check vital signs and the shunt when the resident returned from dialysis, along with monitoring for signs of infection, clotting, swelling, pain, redness, drainage, shortness of breath, chest pain, nausea, vomiting, and skin changes. On observation, the resident returned from the dialysis center, and the dialysis binder contained a communication form showing vital signs were taken before leaving for dialysis, but there was no documentation of vital signs or any assessment when the resident returned. Review of the resident’s communication sheets in the binder showed no documented evidence that the resident was assessed upon return, including vital signs. The facility’s dialysis communication log instructed staff to take vital signs before departure and upon arrival from dialysis and to chart them on departure and arrival, but the unit manager confirmed that nurses failed to follow the instruction sheet and did not complete a post-assessment of the resident, including vital signs and assessment of the dialysis access site.
Medication Error Rate Exceeded Allowed Threshold
Penalty
Summary
The facility failed to ensure a medication error rate of less than 5%, with observation of 35 medication administration opportunities showing two medication errors for an error rate of 5.71%. During medication administration observations, LPN 2 administered incorrect dosages to two residents. The facility policy titled, Medication Administration, dated 11/2022, stated medications are to be prepared, administered, and documented only by licensed nurses in accordance with current Alabama Board of Nursing licensure and as ordered by the physician. One resident had diagnoses including anxiety disorder, hypokalemia, dysphagia, edema, major depressive disorder, and dementia, and the MAR showed an order for potassium chloride ER 40 meq daily at bedtime. During observation, LPN 2 removed potassium chloride 10-meq capsules from the medication cart and administered two 10-meq capsules to the resident, then documented the medication as completed. Another resident had diagnoses including mood disorder and anxiety disorder, and the MAR showed an order for fluticasone propionate nasal suspension 50 mcg/act, two sprays in each nostril two times daily for nasal congestion. During observation, LPN 2 administered only one spray in each nostril and then documented the order as completed. LPN 2 later confirmed both medication administrations were not given as ordered, and the DON stated medications were to be administered as ordered by the physician.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the citations issued around you in the last 12 months — including the immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Centre
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Collinsville Healthcare & Rehab | 13.4 mi | ★★★★★ | 0 | 0 |
| Piedmont Health Care Center | 18 mi | ★★★★★ | 0 | 0 |
| Northside Health Care | 19.1 mi | ★★★★★ | 0 | 0 |
| Crowne Health Care Of Ft Payne | 20.2 mi | ★★★★★ | 0 | 0 |
| Crossville Health And Rehabilitation, Llc | 20.7 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Cherokee County Health And Rehabilitation Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.