Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Harlan Health And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with significant dental issues and cognitive deficits experienced severe pain and substantial weight loss due to the facility's failure to develop and implement a comprehensive care plan addressing dental needs and related nutrition concerns. The care plan lacked enrollment in the in-house dental program, did not ensure timely follow-up on dental referrals, and delayed necessary speech therapy assessment, resulting in unaddressed pain and ongoing weight loss.
A resident with Huntington's disease and significant dental issues experienced severe, unplanned weight loss over several months due to the facility's failure to address dental pain, adjust diet consistency, and provide adequate nutritional interventions. Despite ongoing documentation of weight loss and decreased intake, the care plan and dietary approaches were not revised, and referrals for dental and speech therapy were delayed until after surveyor involvement.
A resident with significant dental issues did not receive timely dental care or extractions over a nine-month period, despite ongoing pain and severe weight loss. Staff observed and reported oral pain, but documentation and physician notification were lacking, and multiple attempts to arrange dental care were unsuccessful or not properly followed up. The resident was not seen by the facility's dental provider during routine visits, and therapy assessments were delayed until after surveyor involvement.
The facility did not maintain an adequate supply of safe, unexpired potable water for all residents in the event of a water outage, due to lack of a clear policy and confusion among staff regarding responsibility for monitoring water expiration dates. Only a small portion of the stored water was drinkable, falling short of the industry standard for emergency preparedness.
The facility did not provide timely Notice of Medicare Non-Coverage (NOMNC) to two residents or their representatives before Medicare benefits ended. In both cases, the required notice was either delivered after coverage had ended or was not properly explained, and there was no documentation to confirm that timely notification or adequate explanation was given.
Several residents reported and were observed receiving meals that were not at safe or appetizing temperatures, with food items such as sausage and eggs served below required standards. Residents described food as often cold and unpalatable, and staff confirmed issues with equipment, such as a malfunctioning plate warmer, contributed to the problem.
Staff did not follow food safety and hand hygiene protocols during meal service, including touching plate surfaces and food with gloved hands, not changing gloves between tasks, and handling utensils improperly after answering the phone, contrary to facility policy.
Failure to Implement Comprehensive Dental and Nutrition Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan to address a resident's dental needs, which were directly related to significant weight loss and pain. The resident, admitted with Huntington's disease and cognitive communication deficits, was assessed upon admission as having obvious cavities, broken, discolored, and missing teeth. The care plan included dental consults as indicated but did not specify enrollment in the facility's in-house dental program, nor did it ensure follow-through on external dental referrals. Despite a dental referral for extractions, there was no documented evidence that staff contacted the oral surgery clinic for several months, and communication only occurred after surveyor intervention. The resident experienced ongoing dental pain, rated as 10/10, and severe weight loss of 20% over six months, with a total loss of 42 pounds over a longer period. The care plan identified the risk for altered nutrition and hydration due to poor dental status and called for speech or occupational therapy as indicated. However, an order for speech therapy was not obtained until prompted by surveyors, and the resident had not been assessed by speech therapy prior to that point. Observations confirmed the resident's poor oral condition and significant weight loss. Interviews with facility staff, including the MDS Coordinator, Administrator, and DON, confirmed that the care plan was not fully individualized or implemented to meet the resident's needs. Supervisory checks and staff education were described as processes to ensure care plan adherence, but these were not effectively applied in this case. The Administrator acknowledged that the resident should have been included in the facility's dental program, and the omission was an oversight.
Failure to Address Dental Needs and Weight Loss in Resident with Huntington's Disease
Penalty
Summary
The facility failed to maintain acceptable parameters of nutritional status for a resident with Huntington's disease and significant dental issues, resulting in severe and sustained unplanned weight loss. Despite documented evidence of dental pain and broken or missing teeth, the facility did not timely address the need for dental care or adjust the resident's diet consistency to accommodate these issues. The resident remained on a regular diet for an extended period, even as meal intake declined and weight loss became severe. Multiple assessments and dietary profiles noted ongoing weight loss and decreased meal consumption, but failed to address the underlying dental problems or the appropriateness of the diet provided. Staff interviews revealed that oral pain was observed during care, and the resident himself indicated that dental pain made it difficult to eat and caused hunger. However, there was no evidence that these concerns were effectively communicated or acted upon by the interdisciplinary team, and referrals for dental care and speech therapy were delayed until after surveyor intervention. The facility's policies did not clearly define responsibilities for monitoring weights or responding to weight loss, and care plan interventions were not revised in response to the resident's declining nutritional status. Documentation showed that significant weight loss occurred over several months, with the resident losing over 40 pounds, yet the care plan and dietary interventions remained largely unchanged. Observations also indicated inadequate assistance with eating, further contributing to the resident's nutritional decline.
Failure to Provide Needed Dental Care Resulting in Pain and Severe Weight Loss
Penalty
Summary
The facility failed to provide or obtain necessary dental care for a resident over a nine-month period, despite clear evidence of multiple broken teeth requiring extraction. The resident, who had Huntington's Disease and a cognitive communication deficit, was not on hospice or an end-stage diagnosis. Initial assessments documented obvious cavities and broken teeth, and the care plan identified poor dental status as a contributing factor to altered nutrition and hydration. Despite this, the resident did not receive timely dental interventions, and referrals to both external and in-house dental providers were either not completed or not followed up effectively. The facility's own dental provider visited multiple times, but the resident was not seen during these visits. During this period, the resident experienced ongoing dental pain, as confirmed by direct interviews and observations, and suffered severe, unplanned weight loss exceeding 20% over six months and 24% over nine months. Staff interviews revealed that oral pain was observed during care, but documentation of pain and physician notification was lacking. The resident's pain and difficulty eating were corroborated by both the resident and staff, yet there was no evidence of consistent or effective follow-up to address these issues. The care plan called for therapy evaluations as indicated, but a speech therapy assessment was not ordered until after surveyor intervention. Attempts to arrange for dental extractions through an oral surgeon were documented in a separate notebook rather than the medical record, and most attempts consisted of leaving messages without successful contact for months. Additional efforts to find alternative providers were limited and ceased after initial refusals. The facility's leadership acknowledged that the resident should have been included in the routine dental program and that documentation and follow-up were insufficient. The resident's physician was not notified of the dental pain, and there was no evidence of pain management or timely dental intervention documented in the medical record.
Failure to Maintain Adequate Emergency Potable Water Supply
Penalty
Summary
The facility failed to ensure the availability of safe drinking water for all residents in the event of a loss of normal water supply. During interviews, the Administrator acknowledged that there was no policy in place to address water availability during such emergencies, although her expectation was to have enough drinkable water for three days for each resident. Review of the Emergency Preparedness Plan indicated the industry standard is 1.5 gallons of water per person per day, but observation revealed that out of 1,368 gallons of stored water, 1,248 gallons had expired, leaving only 120 gallons of drinkable water available for 132 residents. Further investigation revealed confusion among staff regarding responsibility for monitoring the expiration dates of the potable water supply. The Maintenance Director believed it was the Dietary Manager's responsibility, while the Dietary Manager thought it was the Maintenance Director's duty, despite being responsible for ordering the water. The Corporate Registered Dietician stated that the Dietary Manager was advised to check the water annually and was reminded monthly to monitor expiration dates. However, the lack of a clear policy and defined responsibilities led to the deficiency in maintaining an adequate and safe emergency water supply.
Failure to Provide Timely Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to provide the required Notice of Medicare Non-Coverage (NOMNC) to residents or their representatives before Medicare coverage ended, as mandated by facility policy and CMS guidelines. In one instance, a resident's Medicare coverage ended on 12/07/2024, but the NOMNC was not signed by the family member until 12/09/2024, two days after coverage had already ended. The Business Office Manager stated that she had verbally informed the family member and mailed the NOMNC, but there was no documentation to support this, and the family member reported not being aware of the coverage ending or receiving the notice in the mail. In another case, a resident's Medicare coverage ended on 03/07/2025, but the NOMNC remained unsigned by the resident or their representative as of 03/21/2025. The Business Office Manager indicated that the notice was mailed and the representative was verbally informed, but the representative stated he was not notified prior to the end of coverage and did not understand how to complete the form when it was received after coverage had ended. No evidence was provided to show that the required notice and explanation were given in a timely manner.
Failure to Serve Food at Safe and Appetizing Temperatures
Penalty
Summary
The facility failed to ensure that food and drinks served to residents were palatable, attractive, and maintained at safe and appetizing temperatures for five of 35 sampled residents. Observations during breakfast meals revealed that items such as sausage, eggs, biscuits, oatmeal, milk, and juices were not at acceptable temperatures, with specific temperature readings below required standards. Residents reported during council meetings and interviews that their food was often cold, sometimes sitting in the hallway for up to 20 minutes before being served. Multiple residents expressed dissatisfaction with the temperature, taste, and texture of the food, noting that it was frequently not warm and sometimes unpalatable. Review of the facility's dietary policy indicated that hot foods should be kept above 140°F and cold foods below 41°F, with pork specifically required to be at 150°F. However, test trays measured sausage and eggs well below these thresholds. Staff interviews confirmed that the tray line was on schedule, but the plate warmer was not functioning correctly, particularly in the middle row, which contributed to the temperature issues. Dietary staff acknowledged the importance of serving food at safe temperatures for both infection control and resident satisfaction, but the observed practices did not meet these standards.
Failure to Follow Food Safety and Hand Hygiene Protocols During Meal Service
Penalty
Summary
Staff failed to adhere to professional standards for food service safety during meal preparation and delivery. Observations revealed that a cook touched the surface areas of plates with gloved hands while removing them from the plate warmer and while arranging food on the plates. The same gloved hand was used to move pot roast and place a roll on the plate, without changing gloves between tasks. Additionally, a dietary aide answered the telephone and then continued to work on the tray line without washing hands or changing gloves, touching the inside of spoons and the prongs of forks in the process. Interviews with staff and management confirmed awareness that these actions could lead to contamination and illness among residents. The facility's policies required staff to avoid touching food contact surfaces, use utensils for serving food, and perform hand hygiene between tasks, but these procedures were not followed. The census at the time was 132 residents, and the failure to comply with established food safety and hand hygiene protocols was directly observed during the survey.
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 19 citations issued within 25 miles in the last 12 months — 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 Harlan
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lee Health And Rehab Center | 15.1 mi | ★★★★★ | 1 | 0 |
| Tri Cities Rehabilitation And Healthcare Center | 19.1 mi | ★★★★★ | 0 | 0 |
| Hancock Manor Nursing Home | 19.9 mi | ★★★★★ | 8 | 0 |
| Mountain View Rehabilitation And Healthcare Center | 21.7 mi | ★★★★★ | 2 | 0 |
| Hyden Health And Rehabilitation Center | 23.8 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Harlan 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.