Average — CMS composite of the measures below.
A standard survey is most likely before 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 The Green House Cottages Of Belle Meade during CMS and state inspections, most recent first.
Staff did not follow hand hygiene protocols while serving meals, as CNAs failed to change gloves or wash hands between serving different residents and after touching potentially contaminated items. During meal preparation for modified diets, a CNA used utensils that were placed on unclean counters and then reused, despite both the CNA and Dietary Manager acknowledging the counters were not cleaned and utensils were contaminated.
A resident with severe cognitive impairment received a PRN antianxiety medication that was not reviewed and updated every 14 days as required. Staff interviews revealed that the DON, LPN, and Medical Director were unaware of the 14-day review and renewal requirement for PRN psychotropic medications, resulting in a lapse in proper medication management and documentation.
A nurse failed to remove and discard PPE before leaving the room of a resident on Enhanced Barrier Precautions for a hip incision infection and a urinary drainage device. The nurse exited the room wearing gloves and a gown to retrieve supplies, then disposed of the gown in the hallway, contrary to infection control protocols. Both nurses involved acknowledged that PPE should be discarded inside the room to prevent cross-contamination.
A resident with severe cognitive impairment and high fall risk was injured when a CNA failed to follow the care plan requiring two staff for dressing assistance. The resident fell from the bed, resulting in a broken femur and hospitalization. The incident highlighted a lapse in compliance with safety protocols.
The facility failed to provide a meaningful program of activities for five residents, leading to boredom and lack of engagement. Observations revealed no activities taking place, and staff confirmed they lacked time to conduct them. The Activity Director admitted to relying on cottage staff for day-to-day activities, which were not being carried out.
The facility failed to ensure proper hand sanitation by an LPN before and after administering medication to residents. The LPN was observed administering medication without sanitizing hands and acknowledged the importance of hand sanitation but did not follow the protocol. The DON confirmed the requirement for hand sanitation and the responsibility for staff training.
The facility failed to ensure a resident who required assistance with personal hygiene was regularly offered to have fingernails cleaned. The resident was observed with long fingernails and a brown substance under them on multiple occasions. The care plan did not address fingernail care, and the CNA indicated that nail care is performed on shower days or as needed.
The facility failed to ensure that pureed food was prepared to a smooth, lump-free consistency for residents requiring pureed diets. Observations revealed meals with improperly blended food particles, and the facility lacked a policy on specialized diets, contributing to the deficiency.
Failure to Maintain Hand Hygiene and Food Utensil Sanitation During Meal Service
Penalty
Summary
Staff failed to follow proper hand hygiene protocols during meal service, as observed when multiple CNAs did not remove gloves or perform hand hygiene between serving different residents. One CNA was seen retrieving a plate from a resident's room and then delivering a plate to another room without changing gloves or washing hands, and subsequently began feeding a resident in the dining room after removing gloves but without handwashing. Another CNA touched a used coffee cup with gloved hands and continued to distribute dinner plates without changing gloves or sanitizing hands. Interviews with the involved CNAs confirmed awareness of the correct procedures, but acknowledged that gloves were not changed and hands were not washed as required between residents or after contact with potentially contaminated items. Additionally, during meal preparation for residents on modified diets, a CNA used a spatula that was repeatedly placed on an unclean counter and then used to mix and serve food, despite the counter not being cleaned or having a barrier. The same utensils were washed and sanitized, but then placed again on the unclean counter and reused. Both the CNA and the Dietary Manager confirmed that the counters had not been cleaned and that utensils should not have been used after contamination, indicating a failure to maintain proper food safety and sanitation standards during meal preparation.
Failure to Review and Update PRN Psychotropic Medication Orders Every 14 Days
Penalty
Summary
The facility failed to ensure that an as needed (PRN) psychotropic medication, specifically an antianxiety medication, was reviewed and updated every 14 days for a resident with severe cognitive impairment. The resident was admitted with an order for an antianxiety medication to be administered as needed for anxiety. Documentation showed that the medication was started and continued for several months, with a pharmacy medication regimen review recommending continuation past 14 days due to the resident's anxiety. However, a subsequent medication review did not indicate whether the medication should be continued and lacked signatures from the attending physician or the Director of Nursing (DON). Interviews with facility staff revealed a lack of awareness regarding the requirement to review and rewrite PRN psychotropic medication orders every 14 days. The Nurse Practitioner acknowledged the need for 14-day reviews, while the DON and an LPN were unsure of the renewal schedule. The Medical Director also indicated he was not aware of the 14-day review requirement for PRN medications and did not change the orders during his reviews. This lack of consistent review and documentation led to the deficiency identified during the survey.
Failure to Discard PPE Before Exiting EBP Room
Penalty
Summary
The facility failed to ensure proper disposal of personal protective equipment (PPE) in accordance with Enhanced Barrier Precautions (EBP) for a resident with a right hip incision infection and a medical device to drain urine directly from the kidney. The resident was cognitively intact and had care orders and a care plan specifying the use of disposable gloves and gowns during high-contact care. During an observation, two registered nurses donned gowns and gloves before providing care, but one nurse left the resident's room wearing the same PPE to retrieve additional supplies from a supply closet and then returned to the room. The nurse later disposed of her gown in a hallway garbage can rather than inside the resident's room. Interviews with both nurses confirmed that supplies for EBP should be stored inside the resident's room and that PPE should be discarded before exiting the room to prevent the transmission of bacteria. Both nurses acknowledged the error and stated that used PPE could have been contaminated. Facility policy required the infection prevention and control program to prevent the transmission of diseases and infections, but this protocol was not followed during the observed incident.
Failure to Follow Care Plan Results in Resident Injury
Penalty
Summary
The facility failed to ensure staff followed a resident's care plan, resulting in a serious incident involving a resident with severe cognitive impairment. The resident, who required maximum assistance with activities of daily living (ADLs) due to dementia and was at high risk for falls, was being assisted by a single Certified Nursing Assistant (CNA) for upper body dressing. Despite the care plan indicating the need for two staff members, the CNA attempted to assist the resident alone, leading to the resident sliding off the bed and sustaining a major injury. The incident occurred when the CNA sat the resident on the side of the bed while waiting for a second staff member to assist. The resident attempted to stand and fell to the floor, resulting in a broken femur and subsequent hospitalization. The care plan had clearly outlined the need for two staff members for dressing assistance and the use of a mechanical lift for transfers, which was not adhered to during the incident. Witness statements and interviews revealed that the CNA did not follow the care plan and attempted to manage the resident's dressing without the required assistance. The bed was not in the lowest position, which contributed to the resident's fall. The facility's failure to provide adequate supervision and assistance as per the care plan led to the resident's injury, highlighting a significant lapse in compliance with safety protocols.
Removal Plan
- The Interdisciplinary Team changed resident #1 upper body dressing assistance from 1 staff assist to 2 staff assist.
- Staff was educated of Resident #1 changing from a 1 person assist to 2-person assist with upper body dressing ADL.
- The Administrator/Designee initiated an in-service for all direct care staff for following the care plan for ADLs, specifically dressing.
- The Director of Nursing/designee physically assessed all 12 residents who need 2-person assistance with dressing assistance with the potential for neglect with no negative findings.
- Minimum Data Set (MDS) Coordinators began reviewing all resident ADL care plans for accuracy. Any care plans that required updates were completed.
- Director of Nursing/Designee monitored ADL care by observation of 6 residents to ensure staff is following care plan for ADL assistance to prevent accidents.
- Administrator/Designee will provide a binder to each cottage identifying residents who require 2 persons assist with ADLs.
- The Director of Nursing/designee initiated an in-service for all direct care staff that bed height is appropriate for resident and staff during dressing ADLs.
Failure to Provide Meaningful Activities for Residents
Penalty
Summary
The facility failed to provide a meaningful program of activities for five sampled residents, as observed by the surveyor. On multiple occasions, the surveyor noted the absence of activities in various cottages, including Cottage 2, Cottage 900, Cottage 3, and Cottage 600. Residents expressed dissatisfaction with the lack of activities, citing boredom and a lack of engagement. The activity calendar was either missing or lacked specific details about the activities planned for each day. Staff members, including CNAs, confirmed that activities were infrequent and that they did not have the time to conduct them. The Activity Director admitted that while a newsletter was provided, the actual implementation of activities was left to the cottage staff, who often did not follow through. Residents #4, #10, #66, #80, and #120 were specifically mentioned as being affected by the lack of activities. Resident #66 and Resident #10 expressed their dissatisfaction during lunch, while Resident #80 and Resident #120 mentioned that they mostly watched television and had no other activities to engage in. Resident #4 was observed in bed, expressing a desire for activities and stating that none were provided. The care plans for these residents indicated a need for social interaction and engagement, which was not being met. For example, Resident #80's care plan highlighted the importance of group activities and social interactions, but these were not being provided. Staff members, including CNAs, reported that they were expected to conduct activities but did not have the time or support to do so. The Activity Director acknowledged that she occasionally conducted events but relied on the cottage staff for day-to-day activities. The Administrator confirmed that there had been discussions about the need for the Activity Director to ensure activities were being completed. Despite these discussions, the surveyor observed that no activities were taking place, and there were no records of attendance for any activities. The facility's failure to provide a structured and meaningful activity program resulted in residents experiencing boredom and a lack of engagement, contrary to their care plans and individual needs.
Failure to Ensure Proper Hand Sanitation During Medication Administration
Penalty
Summary
The facility failed to ensure proper hand sanitation by a Licensed Practical Nurse (LPN) before and after administering medication to residents. On 04/23/2024 at 8:25 am, the LPN was observed administering medication to a resident without sanitizing hands, then proceeded to the medication cart and administered medications to another resident without hand sanitation. Additionally, the LPN retrieved a medication from another cottage and administered it without sanitizing hands upon return. When questioned, the LPN acknowledged the importance of hand sanitation but failed to follow the protocol during the observed instances. On 04/24/2024, the Director of Nursing (DON) confirmed that nurses are required to sanitize their hands before and after administering medications and between residents. The DON also stated that it is their responsibility, or a designee's, to ensure staff are trained in proper handwashing and infection control. An in-service document from the Administrator emphasized the importance of infection control and handwashing per guidelines, yet the observed actions of the LPN did not align with these standards.
Failure to Provide Regular Fingernail Care
Penalty
Summary
The facility failed to ensure a resident who required assistance with personal hygiene was regularly offered to have fingernails cleaned to maintain good grooming and hygiene. Resident #47 was observed on multiple occasions with 0.5 inch long fingernails and a brown substance under the nails on both hands. Certified Nursing Assistant (CNA) #4 indicated that CNAs are responsible for nail care unless the resident is diabetic or on blood thinners, in which case nurses handle it. The care plan for Resident #47, initiated on 03/09/2024, noted the resident required supervision with bathing but did not address fingernail care. The resident's bathing task sheet showed they received showers on specific dates but refused on one occasion, and there was no indication that nail care was provided during these times.
Failure to Ensure Proper Consistency of Pureed Food
Penalty
Summary
The facility failed to ensure that pureed food was prepared to a smooth, lump-free consistency for residents requiring pureed diets. During observations on two separate occasions, meals containing pureed chicken fettucine, bread, peaches, eggs, sausage/biscuit combination, and super cereal were found to contain particles of food that had not been completely blended. Certified Nursing Assistants (CNAs) responsible for preparing and serving these meals acknowledged the presence of food particles and described the food as not meeting the expected consistency of pureed diets. The Dietary Manager and Clinical Manager confirmed that the food items were grainy and not smooth, with the bread being too thick and gummy. Additionally, it was revealed that the facility did not have a policy concerning specialized diets, specifically pureed food. The Consultant confirmed the absence of such a policy, which contributed to the improper preparation of pureed meals. This lack of policy and improper food preparation practices posed a risk to residents who required pureed diets to minimize the risk of choking or other complications.
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Illustrative
What surveyors actually found near you
We read the 41 citations issued within 25 miles in the last 12 months — including the 1 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.
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Nursing homes near Paragould
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Greene Acres Nursing Home | 2 mi | ★★★★★ | 6 | 0 |
| Monette Manor, Llc | 13.5 mi | ★★★★★ | 11 | 0 |
| Ridgecrest Health And Rehabilitation | 13.7 mi | ★★★★★ | 3 | 0 |
| Lakeside Health And Rehab | 16.1 mi | ★★★★★ | 5 | 0 |
| Arkansas Continued Care Hospital Of Jonesboro | 17.9 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.