Above 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 Gassville Therapy And Living during CMS and state inspections, most recent first.
A resident, who was cognitively intact and required assistance for oral hygiene, was found to have dentures with a white residue left unsecured on a bedside table without access to a denture cup or oral care supplies. The resident confirmed they did not receive assistance with denture care and could not reach the denture cup. The facility's administrator acknowledged the issue.
The facility failed to maintain a clean and safe environment in several resident rooms, with issues such as damaged wall trims, unemptied trash cans, and stained floors and toilets. Maintenance and administrative staff were unaware of these deficiencies, and no repair requests had been made.
The facility failed to revise care plans for two residents with indwelling catheters to include securement devices, leading to potential catheter-related trauma. One resident with severe cognitive impairment and a perineal wound was observed without a securement device, and staff were uncertain about its necessity. Another resident with moderate cognitive impairment expressed discomfort due to the catheter pulling and preferred a securement device, which was not documented or ordered. Additionally, a resident with limited mobility due to hemiplegia and hemiparesis had no interventions for a contracture, despite staff acknowledging the need for such measures.
A facility was found to have left a treatment cart and a shower room unlocked, exposing residents to potential chemical hazards. The shower room contained various personal care products and cleaning supplies, while the treatment cart held medical supplies and medications. Staff confirmed that both should have been secured to prevent resident access, as per facility policy.
The facility failed to use securement devices for catheters in two residents, leading to potential discomfort and risk of catheter-related trauma. One resident with severe cognitive impairment and multiple diagnoses, including a urinary tract infection, was observed without a securement device, despite care plan interventions. Another resident with moderate cognitive impairment and heart failure also lacked a securement device, expressing discomfort from catheter pulling. Staff confirmed the absence of securement devices and related documentation, contrary to facility policy.
A resident with muscular dystrophy and benign prostatic hyperplasia reported being left in a wet bed for over 45 minutes due to delayed call light response. The facility's investigation was inadequate, as it did not include interviews with other cognitively intact residents or all staff involved. The Social Activity Director and DON admitted to not conducting a thorough investigation, violating the facility's grievance policy.
A resident with moderate cognitive impairment and a self-care performance deficit was not provided with necessary grooming assistance, resulting in embarrassment due to unshaved facial hair. Despite the facility's policy to shave residents on shower days, staff interviews and observations confirmed the resident had not been shaved as scheduled, highlighting a lapse in care and dignity.
A resident with hemiplegia and hemiparesis was prescribed a pureed texture diet, but the facility failed to prepare the food to the required consistency. Observations revealed that the pureed food was either gritty or too runny, not meeting the pudding-like consistency needed to prevent aspiration. The dietary manager acknowledged the inconsistency, which was contrary to the facility's recipes.
The facility was found to have deficiencies in food storage and handling, including expired and unlabeled items in the refrigerator and cross-contamination during lunch service. The Dietary Manager confirmed these issues, which contravened the facility's food service and storage policy.
Failure to Ensure Dignity and Oral Hygiene for Resident with Dentures
Penalty
Summary
The facility failed to ensure the dignity and proper oral hygiene of a resident who was dependent on dental appliances. The resident, who was cognitively intact and required setup or clean-up assistance for oral hygiene, was observed leaving their dentures on a bedside table with a white cake-like residue adhered to them. The dentures were unsecured and left without an accessible denture cup or oral care supplies. This situation was observed when the resident left their room to attend a facility activity and upon their return, they placed the dentures back in their mouth without any cleaning. During an interview, the resident confirmed that they did not receive assistance with denture care between meals or at night and could not reach the denture cup placed on the sink. The resident also indicated that they were not provided with a soft toothbrush or setup assistance for oral care. The facility's administrator and the Director of Nursing acknowledged the issue, with the administrator indicating that the facility would ensure the resident was offered denture care.
Environmental Deficiencies in Resident Rooms
Penalty
Summary
The facility failed to maintain a clean and safe environment for residents, as evidenced by several observations during environmental rounds. In five resident rooms, there were issues such as discolored and damaged wall and door trims, unemptied trash cans, and overflowing isolation bags obstructing bathroom sinks. Additionally, there were ground-in brownish/blackish debris and clear stains on the floors in front of toilets, and dark stains around the edges of toilet bowls. These conditions were observed on multiple occasions, indicating a lack of timely cleaning and maintenance. Interviews with facility staff revealed a lack of awareness and communication regarding these issues. The Maintenance staff indicated that repairs are made upon request, but no requests had been made for the observed damages. The Administrator was unaware of the extent of the environmental deficiencies and attributed some of the toilet stains to hard water, noting that some toilets had been replaced but not the floors underneath. The facility acknowledged the need to improve trash removal, including hazardous waste, from resident rooms.
Failure to Revise Care Plans for Catheter Securement and Contracture Interventions
Penalty
Summary
The facility failed to revise the care plans for two residents with indwelling catheters to include securement devices, which are necessary to prevent catheter-related trauma. Resident #9, who has severe cognitive impairment and a perineal wound, was observed without a securement device on multiple occasions. The staff, including a CNA and an RN, confirmed the absence of a securement device and expressed uncertainty about its necessity due to the resident's skin condition. However, the facility's policy mandates the use of securement devices to reduce friction and movement at the insertion site. Similarly, Resident #25, with moderate cognitive impairment, was also observed without a securement device for their catheter. The resident expressed discomfort due to the catheter pulling and indicated a preference for a securement device. The RN confirmed the lack of documentation or orders for a securement device, despite the facility's policy requiring it. The Director of Nursing acknowledged that securement devices should be used if the resident desires them to prevent the catheter from being pulled out. Additionally, the facility failed to implement interventions for a contracture in Resident #42, who has limited mobility due to hemiplegia and hemiparesis. The resident was observed with a contracted left hand and reported pain and lack of interventions since admission. Staff, including a CNA and the MDS Coordinator, confirmed the absence of interventions and emphasized the importance of addressing contractures to prevent worsening conditions. The facility's policy requires care plans to include specific interventions to maintain or improve mobility and range of motion, which was not adhered to in this case.
Unlocked Treatment Cart and Shower Room Pose Chemical Hazard
Penalty
Summary
The facility was found to have left an extra treatment cart unlocked and a whirlpool next to the secure unit unlocked with the key inside the doorknob, exposing residents to potential chemical hazards. During an observation, a surveyor noted that the shower room next to the secure unit was left unlocked, with various personal care products and cleaning supplies left out in the open. These included lotions, shaving cream, body wash, and a medicine cup containing an unidentified white cream. Interviews with staff, including an LPN and a CNA, confirmed that the shower room should have been locked and cleaned immediately after use to prevent resident access to potentially harmful chemicals. Additionally, the surveyor observed an unlocked treatment cart at the end of a hallway, which contained various medical supplies and medications, including insulin needles, zinc oxide cream, gas relief pills, and other pharmaceuticals. An LPN confirmed that the cart should have been locked to prevent resident access to its contents. The facility's policy on storage and medications requires that all drugs and biologicals be stored securely and that carts should not be left unattended if open or potentially accessible to others. The facility's failure to secure the shower room and treatment cart posed a risk of residents accessing hazardous chemicals and medications. The Material Safety Data Sheets provided by the facility highlighted the potential dangers of ingestion or contact with these substances, emphasizing the need for secure storage to prevent accidental exposure or ingestion by residents.
Failure to Use Catheter Securement Devices for Residents
Penalty
Summary
The facility failed to provide appropriate catheter care by not using a securement device for two residents with Foley catheters. Resident #9, who has diagnoses including hemiplegia, hemiparesis from a stroke, acute kidney disease, and benign prostatic hyperplasia with urinary tract infection symptoms, was observed on multiple occasions without a securement device for their catheter. The care plan for Resident #9 included interventions for the Foley catheter but did not specify the use of a securement device. Interviews with staff revealed uncertainty about the cause of a peri-wound and a lack of orders or documentation regarding the securement device. Similarly, Resident #25, diagnosed with acute kidney failure and congestive heart failure, was also observed without a securement device for their catheter. The resident expressed discomfort due to the catheter pulling and indicated a preference for a securement device. The care plan for Resident #25 also lacked orders for a securement device, and staff confirmed the absence of such documentation. The facility's policy on catheter care specifies the use of a leg band to secure the catheter, which was not adhered to in these cases.
Inadequate Investigation of Resident Grievance on Call Light Response
Penalty
Summary
The facility failed to ensure that a resident's grievances regarding call light response times were thoroughly investigated, violating the resident's rights. The resident, who was cognitively intact, reported an incident where they were left in a wet bed for over 45 minutes after requesting assistance. The resident expressed dissatisfaction with the response from staff, including a CNA who was reportedly dismissive and left the room without completing the task. The resident's grievance was documented, but the investigation was inadequate as it did not include interviews with other cognitively intact residents or all staff involved. The grievance investigation was conducted by the Social Activity Director, who admitted to not interviewing any other cognitively intact residents or the other staff members involved in the incident. The Director of Nursing also confirmed that no additional staff or residents were interviewed, acknowledging that a thorough investigation should have included these steps. The grievance log indicated that a call light audit was performed and staff were counseled, but the investigation lacked comprehensive input from all parties involved. The Administrator was unaware of the extent of the investigation and did not ensure that a thorough investigation was conducted. The facility's grievance policy requires that all grievances be investigated with accounts from all individuals involved, but this was not followed. The failure to conduct a thorough investigation into the resident's grievance about call light response times highlights a deficiency in the facility's handling of resident complaints and adherence to resident rights.
Failure to Provide Grooming Assistance
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living, specifically grooming, for a resident with moderate cognitive impairment and a self-care performance deficit. The resident, who is dependent on staff for showering and grooming, expressed embarrassment and discomfort due to not being shaved for over a week. Observations by the surveyor confirmed the presence of two-inch facial hair on the resident's chin over several days, indicating a lack of grooming assistance. Interviews with facility staff, including a CNA, the MDS Coordinator, and the DON, revealed that residents are expected to be shaved on shower days, which are scheduled for Mondays and Thursdays, and as needed in between. However, the resident had not been shaved according to this schedule. The DON acknowledged that the lack of shaving is a dignity issue and noted that the July bath sheets, which document grooming activities, had not been checked recently, further indicating a lapse in the facility's adherence to its policy on supporting activities of daily living.
Improper Pureed Food Consistency for Resident
Penalty
Summary
The facility failed to ensure that pureed food was processed to the correct consistency for a resident with specific dietary needs. Resident #9, who has hemiplegia and hemiparesis due to a stroke, was prescribed a pureed texture diet with honey consistency. However, during observations, it was noted that the pureed food prepared for the resident did not meet the required consistency. The dietary staff processed polish sausage, zucchini and squash, and red beans and rice, but the resulting textures were either gritty with small pieces or too runny, failing to achieve the pudding-like consistency necessary to prevent aspiration. The dietary manager confirmed that the pureed foods should have a mashed potato or pudding-like consistency without lumps or particles, as per the facility's recipes. Despite this, the food served to Resident #9 was not properly prepared, with the zucchini and squash being soupy and the red beans and rice containing pieces of beans. This inconsistency in food preparation was observed during a meal where the resident was assisted by a CNA, highlighting the facility's failure to adhere to dietary requirements for residents with specific needs.
Deficiencies in Food Storage and Handling
Penalty
Summary
The facility failed to adhere to proper food storage and handling protocols, as observed during a survey. In the kitchen's walk-in refrigerator, several items were either expired or improperly labeled. Specifically, a pint of lime juice and a half bag of purple cabbage were found to be expired, and a full bag of green leaf romaine lettuce was not dated. These findings were confirmed by the Dietary Manager, indicating a lapse in the facility's food storage practices. During lunch service, further deficiencies were noted in food handling procedures. The surveyor observed cross-contamination when the pureed vegetable and bean scoops were placed in the puree sausage steam table bin. Additionally, a dietary staff member was seen touching food with their fingers while plating, which was acknowledged as cross-contamination by the Dietary Manager. The facility's policy on food service and storage requires that all opened containers be dated and sealed, and that a first-in, first-out system be used, which was not followed in these instances.
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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.
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Nursing homes near Gassville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Twin Lakes Therapy And Living | 6.3 mi | ★★★★★ | 0 | 0 |
| Hiram Shaddox Health And Rehab | 6.6 mi | ★★★★★ | 0 | 0 |
| Care Manor Nursing And Rehab | 6.9 mi | ★★★★★ | 5 | 0 |
| Lake Forest Senior Living At Mountain Home | 8.5 mi | ★★★★★ | 0 | 0 |
| Creekside At The Springs | 11 mi | ★★★★★ | 0 | 0 |
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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.