Below average — CMS composite of the measures below.
A standard survey is most likely before around December 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 Cumberland Valley Nursing & Rehabilitation Center during CMS and state inspections, most recent first.
Kitchen staff were observed handling and preparing food without proper beard restraints in place, despite a facility policy requiring hair restraints, including beard restraints, to prevent hair from contacting exposed food. A cook and another dietary staff member both stated facial hair was supposed to be covered, and the ADM and DON confirmed staff were expected to follow the policy.
Failure to Treat a Resident with Dignity and Respect: A resident with major depressive disorder, anxiety disorder, and intact cognition was dependent on staff for several ADLs and had a care plan addressing yelling and verbally degrading comments. During a transfer, a SRNA responded to the resident's screaming by saying the resident was having a temper tantrum like a five-year-old, which the SRNA later acknowledged was inappropriate.
Failure to provide nail care for two dependent residents. One resident with DM, diabetic neuropathy, hemiplegia, and impaired personal hygiene had long fingernails on repeated observations, and staff acknowledged the nails were not cleaned or trimmed as expected. Another resident with DM and morbid obesity was also observed with long, dirty fingernails on multiple occasions, and the resident stated staff had not offered nail care. Staff interviews showed confusion about responsibility for cleaning and trimming nails, with SRNAs and nurses each describing different roles for diabetic and non-diabetic residents.
A facility failed to develop a comprehensive care plan for a resident with a history of inappropriate sexual behavior. Despite multiple incidents involving the resident and other residents, the facility did not update the care plan to include necessary interventions like supervision and monitoring. Interviews with staff revealed inconsistencies in understanding and implementing these interventions, leaving other residents vulnerable to further incidents.
A facility failed to provide adequate supervision to prevent sexual abuse, resulting in multiple incidents involving inappropriate behavior by a resident. Despite initial incidents, the facility did not assess the resident's risk or implement effective interventions, leading to further occurrences. The facility's policies on abuse prevention and resident rights were not effectively followed, placing residents at risk and resulting in a deficiency.
The facility failed to provide documented evidence of food handler safety certifications for three Dietary Aides who were observed handling food during meal preparation. Despite local health department requirements, the facility's acting management believed only cooks needed certification. A Health Department Employee confirmed that all food handlers should be certified, but the facility could not provide the necessary documentation.
The facility failed to meet food safety standards, with observations of undated and improperly stored food, uncovered plates with debris, and staff not following hair restraint policies. An employee used a dirty plate, handled food without gloves, and carried tray covers against his shirt, all contrary to facility policies.
Kitchen Staff Observed Without Proper Beard Restraints
Penalty
Summary
The facility failed to ensure proper food handling practices were followed when kitchen staff with facial hair were observed handling food without beard restraints in place. An undated facility policy titled Employee Sanitary Practices stated that all employees will wear hair restraints, including beard restraints, to prevent hair from contacting exposed food. During an observation of the kitchen on 09/09/2025 at 10:47 AM, Cook 1 was checking the temperatures of food items while his mustache was not covered by a hair restraint. A second observation on 09/09/2025 at 11:15 AM showed [NAME] 2 assisting with food preparation and retrieving items from the refrigerator to place on residents' trays while his mustache was uncovered. During interviews, [NAME] 1 stated the facility expected staff to cover facial hair with beard restraints and that the restraint should have been covering all facial hair, and [NAME] 2 stated he did not realize his beard restraint was not covering his mustache but it was supposed to. The Assistant Dietary Manager, Administrator, and DON all stated that staff should follow the facility policy regarding beard restraints.
Failure to Treat a Resident with Dignity and Respect
Penalty
Summary
The facility failed to ensure that a resident was treated with dignity and respect. The resident, admitted in April 2024, had diagnoses of major depressive disorder and anxiety disorder, and a quarterly MDS showed a BIMS score of 15, indicating intact cognition. The resident was dependent on staff for personal hygiene, moving from lying to sitting on the side of the bed, and chair/bed to chair transfers. The care plan noted a history of verbally degrading comments to others and yelling at staff, with an intervention directing staff to be reassuring and listen to the resident's concerns. During an observed transfer attempt, a SRNA stated the resident began screaming while being assisted into a wheelchair, and the SRNA responded by telling the resident that having a temper tantrum like a five-year-old was not helping the situation. The SRNA acknowledged the comment was inappropriate. The resident later stated they had no concerns with staff and did not recall the comment, while the SSD reported the resident had said staff were not listening and was upset, though not fearful or unsafe. The Administrator stated staff were expected to treat residents with respect and dignity.
Failure to Provide Nail Care for Dependent Residents
Penalty
Summary
The facility failed to ensure dependent residents received assistance with activities of daily living by not providing nail care for two residents. One resident had diagnoses including type 2 diabetes mellitus with diabetic neuropathy, hemiplegia and hemiparesis following cerebral infarction affecting the left dominant side, and stiffness of the left hand. The resident’s MDS indicated dependence on staff for personal hygiene, and the care plan directed staff to provide nail care per licensed staff or a podiatrist and to assist with hygiene. Observations on multiple days showed the resident had long fingernails, and staff interviews confirmed the nails had not been cleaned or trimmed as expected. The second resident had diagnoses including type 2 diabetes mellitus and morbid obesity. The resident’s MDS indicated dependence on staff for personal hygiene, and the care plan directed staff to provide hygiene and to attempt to keep the resident’s nails short and clean as allowed. During repeated observations, the resident was seen with long, dirty fingernails, and the resident stated staff had not offered nail care and wanted the nails cleaned and trimmed. Staff interviews and observations confirmed the nails remained long and dirty and had not been cleaned or trimmed that day. Interviews with the UC, SRNA, LPN, Administrator, and DON showed inconsistent understanding of who was responsible for nail care, with staff stating SRNAs cleaned all residents’ nails and nurses trimmed diabetic residents’ fingernails. The SRNA acknowledged responsibility for cleaning the residents’ fingernails but stated he had not done so. The Administrator and DON stated they expected aides to keep residents’ nails clean and trimmed, and nurses to trim diabetic residents’ fingernails.
Failure to Implement Comprehensive Care Plan for Resident with Inappropriate Behavior
Penalty
Summary
The facility failed to develop and implement a Comprehensive Person-Centered Care Plan (CCP) for residents, specifically for a resident with a history of inappropriate sexual behavior. This deficiency was identified through multiple incidents involving the resident, who was observed engaging in inappropriate sexual conduct with other residents. Despite these incidents, the facility did not adequately update the resident's CCP to include necessary interventions such as supervision and monitoring to prevent further occurrences. The first incident occurred when the resident was found with his hand under another resident's shirt. Although the facility placed the resident on increased monitoring for a short period, the CCP was not updated to include specific interventions for supervision or monitoring to address the resident's inappropriate behavior. Subsequent incidents involved the same resident being found in compromising situations with other residents, yet the CCP still lacked necessary interventions to manage the resident's behavior effectively. Interviews with facility staff revealed a lack of clarity and consistency in understanding and implementing the necessary interventions. The facility's failure to update the CCP with appropriate measures, such as 1:1 monitoring, left other residents vulnerable to further incidents. The deficiency highlights the facility's inability to adequately address and manage the resident's behavior through a comprehensive care plan, leading to repeated incidents of inappropriate conduct.
Removal Plan
- R33 was placed on 1:1 monitoring.
- R33 was referred to the hospital's behavioral health unit.
- R33 and R58 were placed on acute charting to identify any signs or symptoms of psychosocial decline.
- R58 was referred for psychiatric services.
- A stop sign was hung on R58's door.
Inadequate Supervision Leads to Repeated Incidents of Sexual Abuse
Penalty
Summary
The facility failed to ensure adequate supervision to prevent sexual abuse for three residents, leading to multiple incidents involving inappropriate sexual behavior by one resident. The first incident occurred when a resident was found with his hands under another resident's shirt. Despite this, the facility did not assess the resident's risk for inappropriate sexual behaviors or implement effective interventions to prevent further incidents. The facility's care plan for the resident included monitoring for disruptive behavior, but there was no evidence of increased monitoring or interventions to prevent the resident from entering other residents' rooms uninvited. Subsequent incidents involved the same resident being found in another resident's room, engaging in inappropriate sexual behavior. The facility again failed to implement effective interventions or update the care plan to address the resident's behavior. The facility's documentation lacked evidence of assessments for the capacity to consent to sexual activity for the involved residents, and there was no documented evidence of the resident's behaviors during monitoring periods. Interviews with staff and family members revealed a lack of communication and understanding of the incidents and the measures taken to address them. The facility's policies on abuse prevention and resident rights were not effectively implemented, as evidenced by the repeated incidents and lack of appropriate interventions. The facility's failure to provide adequate supervision and implement effective interventions placed residents at risk for sexual abuse, leading to the identification of Immediate Jeopardy. The facility's actions and inactions in response to the incidents did not align with their policies, resulting in a deficiency in ensuring a safe environment for residents.
Deficiency in Food Handler Certification for Dietary Aides
Penalty
Summary
The facility failed to employ staff with the appropriate competencies and skill sets to carry out the functions of the food and nutrition service, as required by state regulations. Specifically, the facility did not provide documented evidence of valid food handler safety certifications for three Dietary Aides (DA 1, DA 2, and DA 3), who were observed handling food during meal preparation. The local health department mandates that all individuals who handle food must obtain a food handler safety card to ensure food safety standards are maintained. During interviews, the Assistant Food and Nutritional Services Manager and the Regional Food and Nutritional Services Manager both stated that only cooks were required to maintain food handler certifications, not the Dietary Aides. However, a Health Department Employee confirmed that everyone handling food should be certified, and there should be a copy of the certification on file. Despite requests from the State Survey Agency Surveyor, the facility was unable to provide the necessary documentation for the three Dietary Aides, indicating a deficiency in meeting the required food safety standards.
Food Safety and Sanitation Deficiencies
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed during a survey. In the kitchen, food items were found undated, improperly labeled, or stored in a manner that could lead to contamination. Specifically, baking powder was stored past its use-by date, and cereal containers were either missing dates or had broken seals. Additionally, plates in the warmer were uncovered and had debris on them. An employee, identified as [NAME] 1, was observed using a dirty plate to serve food, although it was later set aside after being questioned. The Assistant Food and Nutritional Services Manager acknowledged that outdated or undated food should not be on the shelf or served to residents, and that plates should be covered to maintain cleanliness. Further observations revealed that [NAME] 1 did not comply with the facility's policy on hair restraints, as his beard and mustache were not fully covered, and his bandana did not adequately restrain his hair. Additionally, [NAME] 1 used a thermometer without cleaning it and handled food without gloves, which was against the facility's policy. Another incident involved [NAME] 1 and a Dietary Aide improperly handling chicken without gloves, which was not sanitary. Lastly, [NAME] 1 was seen carrying tray covers against his shirt, which he admitted should not have happened. These actions and inactions contributed to the facility's failure to meet food safety standards.
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Illustrative
What surveyors actually found near you
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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.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Burkesville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Clinton County Care And Rehabilitation Center | 14.7 mi | ★★★★★ | 0 | 0 |
| Signature Healthcare Of Monroe County Rehab And We | 18.4 mi | ★★★★★ | 0 | 0 |
| Celina Health And Rehabilitation Center | 18.5 mi | ★★★★★ | 7 | 0 |
| Pickett Care And Rehabilitation Center | 19.8 mi | ★★★★★ | 0 | 0 |
| Metcalfe Nursing And Rehabilitation Center | 20 mi | ★★★★★ | 2 | 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.