Average — CMS composite of the measures below.
The next survey window likely opens around March 2027
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 J G Alexander Nursing Center during CMS and state inspections, most recent first.
Survey Results Not Readily Accessible to Residents: The facility failed to ensure residents had ready access to the most recent State survey results. Seven cognitively intact residents in Resident Council said they did not know where the survey results were located, and staff reported the results had been moved from a visible bulletin board to a desk near the visitor sign-in area by the exit, where they were not readily seen from the main resident areas. An observation confirmed the survey results book was separated from the resident living space and not easily accessible.
Failure to Use EBP During Catheter Care: A resident with a Foley catheter and a wound was observed receiving perineal and catheter care from a CNA who wore gloves but not a gown, despite the resident being on EBP. The CNA later confirmed she did not wear a gown, and the resident reported that not all staff wore gowns during catheter care. Interviews with an LPN, RN, and DON confirmed that gowns and gloves were required for high-contact care under the facility’s EBP policy.
A resident with Alzheimer's Disease and Dementia experienced a significant weight loss of 33 pounds, or 17% of their body weight, due to the facility's failure to notify the physician and implement dietary recommendations. The resident was persistently drowsy, affecting their oral intake, and dietary supplements recommended by the RD were not administered. The DON confirmed the oversight, and the Medical Director was unaware of the weight loss, which delayed necessary medical interventions.
A resident experienced significant weight loss due to the facility's failure to implement RD interventions and follow up on psychiatric services. The resident, who was lethargic and unable to intake appropriate nutrition, lost over 10% of their body weight in six months. Despite recommendations for nutritional supplements, these were not administered, and the resident's meal intake was consistently low. The Medical Director was unaware of the weight loss, and psychiatric follow-up was delayed.
A resident with Alzheimer's Disease and Dementia was prescribed Rexulti and Trileptal for behavioral health needs, but the facility failed to attempt a Gradual Dose Reduction (GDR) for over ten months. The resident exhibited excessive drowsiness, missed meals, and experienced significant weight loss. Facility policy required GDRs unless clinically contraindicated, but no documentation of such attempts was found. Interviews confirmed that a GDR should have been attempted within six months of medication initiation.
The facility failed to properly label and dispose of expired food items in the kitchen, as observed during a tour with the Dietary Manager. Several items in refrigerators and freezers were found opened and unlabeled, and some were past their use-by dates. The Administrator acknowledged the issue, attributing it to recent changes in kitchen staff and food providers.
The facility failed to honor residents' rights and dignity by denying requests for additional bed rails and posting personal care instructions at the head of residents' beds. A resident who had undergone hip replacement surgery and another resident requested additional bed rails for assistance, but the facility denied these requests without proper documentation. Additionally, personal care instructions were inappropriately posted at the head of a resident's bed, violating their dignity.
The facility failed to maintain a bed rail maintenance log, leading to a deficiency. Two residents expressed concerns about inadequate bed rail setups, with one resident experiencing falls and another requesting additional support for repositioning. The facility's policy required regular maintenance, but staff only addressed issues upon complaint, and no maintenance log was kept. Consents for bed rail use were signed but did not specify the number of rails, leading to unmet resident needs.
A resident with Alzheimer's and Dementia was not reassessed by a psychiatric provider for ten months after being prescribed Rexulti and Trileptal, leading to excessive drowsiness, missed meals, and significant weight loss. Facility staff confirmed that a psychiatric consultation was not initiated until requested by the resident's son, despite facility policy indicating the need for such follow-up.
The facility's QAPI committee failed to sustain corrective actions for food storage deficiencies, leading to a repeat citation during a survey. Despite initial corrective actions, the facility did not maintain oversight, particularly after transitioning to an independent kitchen and experiencing staff turnovers. Food items were found unlabeled, undated, and expired during kitchen inspections.
The facility did not post daily nurse staffing information in a prominent and readable format as required. Observations during a survey revealed the absence of postings on two out of four days. Interviews with staff, including the DON and an RN, showed a misunderstanding of the requirement, as they believed the information only needed to be available upon request rather than visibly posted.
Survey Results Not Readily Accessible to Residents
Penalty
Summary
The facility failed to ensure residents had ready access to the most recent State survey results for all 57 residents living in the facility. The resident rights guide stated residents have the right to review the results of the most recent survey and any plans to correct deficiencies, and the facility policy stated the results of the most recent inspection would be posted and available for residents and family members to review. During a Resident Council meeting, seven residents with BIMS scores of 13 to 15, indicating they were cognitively intact, stated they did not know where the State survey results were located and were unaware of how to review them. Staff interviews and observation showed the survey results had been moved from a glass bulletin board near the administrative offices to the foyer near the exit, behind doors on a desk near the visitor sign-in area. The Activities Director and Social Services Director both reported they were unsure when the results were moved and acknowledged the location was not readily visible to residents in the main resident areas. An observation confirmed the survey results book was in the foyer near the exit, separated from the primary resident living areas and not readily accessible without leaving the resident space.
Failure to Use Enhanced Barrier Precautions During Catheter Care
Penalty
Summary
Provide and implement an infection prevention and control program was deficient when the facility failed to implement Enhanced Barrier Precautions (EBP) during care for one resident reviewed for perineal and catheter care. The resident had been admitted and later readmitted with diagnoses including neuromuscular dysfunction of the bladder, had a physician’s order for a Foley catheter, and the MDS indicated the resident was cognitively intact, had an indwelling catheter, and had one unhealed Stage 3 pressure ulcer/injury. During observation, a CNA provided perineal and catheter care while the resident’s Foley catheter was secured to the thigh and the brief was open for care, but the CNA wore gloves only and did not wear a gown. The CNA later confirmed she had completed incontinent and catheter care without a gown and acknowledged the resident had a Foley catheter and a wound. The resident reported staff provided catheter care frequently, but not all staff wore gowns when providing care. The facility’s EBP policy stated residents with indwelling medical devices or wounds were to have staff wear gowns and gloves during high-contact care, and interviews with an LPN, RN, and DON confirmed the resident was on EBP and that gowns and gloves were expected during catheter care and other high-contact activities.
Failure to Notify Physician and Implement Dietary Recommendations
Penalty
Summary
The facility failed to notify the physician of a significant change in condition for a resident who experienced a 33-pound weight loss, which was 17% of their total body weight. The resident, who had Alzheimer's Disease and Dementia, was observed to be persistently drowsy, affecting their oral intake. Despite dietary recommendations from the Registered Dietitian (RD) to implement a house supplement, these were not followed, delaying necessary medical interventions and contributing to continued weight loss. Observations and interviews revealed that the resident frequently fell asleep during meals or slept through mealtime, resulting in a meal intake of only 0-25% on several days. The resident's family member and Resident Representative expressed concerns about the resident's psychiatric status and requested a psychiatric consultation. The RD's notes indicated significant weight loss over several months, and recommendations for dietary supplements were not implemented due to turnover among facility dietitians. The Director of Nursing (DON) confirmed that the dietary recommendations were not received and implemented as they should have been. The Medical Director was unaware of the resident's weight loss and had not been informed by nursing staff. The resident was on multiple psychotropic medications, which could have contributed to lethargy and appetite issues. The failure to notify the physician and implement dietary recommendations resulted in a lack of timely medical intervention for the resident's significant weight loss.
Failure to Address Significant Weight Loss in Resident
Penalty
Summary
The facility failed to ensure that a resident did not experience significant weight loss, as evidenced by a resident losing over 10% of their body weight in six months. The resident, who was lethargic and unable to intake appropriate nutrition, did not have Registered Dietitian (RD) interventions implemented when ordered. The resident's family member expressed concern about the weight loss, which was approximately 20 pounds since the resident's discharge from a behavioral health hospital. Observations showed the resident was often asleep during meal times, missing meals, and not receiving the necessary nutritional intake. The facility did not follow up with psychiatric services for the resident after their discharge from a behavioral health hospital, despite the resident's son requesting a psychiatric consultation. The Director of Nursing confirmed that a psychiatric consultation for medication management had not been initiated until the request was made. The Medical Director was unaware of the resident's weight loss and had not been informed by the nursing staff, despite the resident being prescribed multiple psychotropic medications that could cause lethargy and affect appetite. Record reviews revealed that the resident had experienced significant weight loss over several months, with recommendations for nutritional supplements not being implemented. The resident's meal intake was documented to be between 0-25% on several days, and there was no documentation that the recommended MedPass supplements were administered. The resident's Minimum Data Set indicated significant weight loss and severe cognitive impairment, with no current orders for the recommended nutritional supplements.
Failure to Implement Gradual Dose Reduction for Psychotropic Medications
Penalty
Summary
The facility failed to ensure that a resident received a Gradual Dose Reduction (GDR) for psychotropic medications as required. The resident, diagnosed with Alzheimer's Disease and Dementia, was prescribed Rexulti and Trileptal for behavioral health needs in April 2024. However, no GDR was attempted for over ten months. The resident exhibited excessive drowsiness, missed multiple meals, and experienced significant weight loss exceeding 10% over six months. Observations revealed the resident was often asleep during meal times and in common areas, and interviews with staff confirmed that a GDR had not been attempted since the resident's return from a behavioral health hospital. The facility's policy required that residents on psychotropic drugs receive GDRs and behavioral interventions unless clinically contraindicated. The policy specified that dose reductions should occur in modest increments over adequate periods to minimize withdrawal symptoms and monitor symptom recurrence. Despite this, the resident's medical records showed no documentation of a GDR attempt for the prescribed medications. Interviews with the Director of Nursing and the Medical Director confirmed that a GDR should have been attempted within six months of the resident being placed on psychotropic medications. The Medical Director noted that a GDR for Rexulti was initiated only after the deficiency was identified.
Improper Food Labeling and Storage in Facility Kitchen
Penalty
Summary
The facility failed to adhere to its Food Storage Labeling policy, resulting in improperly labeled and expired food items being stored in the kitchen. During an initial tour with the Dietary Manager, several items in the refrigerators and freezers were found to be opened and unlabeled, including packages of sliced ham, bacon bits, and shredded cheddar cheese. Additionally, some items, such as sliced roast beef and a fire-braised pork loin, were past their use-by or freeze-by dates. In the dry storage room, a container of Real Lemon Juice was opened but not refrigerated as required by the manufacturer. The Dietary Manager confirmed these items were expired and collected them for disposal. Interviews with the Certified Dietary Manager and Registered Dietitian revealed that kitchen staff are expected to follow federal guidelines and facility policies to prevent foodborne illness. The Administrator acknowledged awareness of the expired items and explained that changes in kitchen staff and food providers might have contributed to the issue. The facility had recently added a new kitchen and changed food providers, which may have led to expired foods being delivered. Despite these changes, the Administrator expressed confidence in the competence of the current kitchen staff.
Failure to Honor Residents' Rights and Dignity
Penalty
Summary
The facility failed to honor residents' rights and dignity by not accommodating requests for additional bed rails and by posting personal care instructions at the head of residents' beds. Resident #5, who had undergone elective hip replacement surgery, requested a second bed rail to assist with turning and to feel safer at night. Despite her repeated requests and the acknowledgment of staff, including a CNA and the Therapy Director, the facility denied her request, citing state regulations. The facility's policy did not specify the use of only one bed rail, and there was no documentation supporting the decision to limit bed rails. Similarly, Resident #54, who had been at the facility for nearly a year, requested an additional bed rail to assist with turning. The facility denied this request as well, with staff stating that only one bed rail was allowed unless deemed necessary. The Director of Nursing confirmed that the facility limited bed rails to one per resident for safety reasons but lacked documentation to support this decision. Alternative positioning aids were not considered for Resident #54, who had intact cognition and no extremity impairments. Additionally, Resident #39 was observed with signage at the head of the bed containing personal care instructions, which included the resident's name. The Administrator and DON confirmed that such signage violated the resident's dignity and should not be displayed. The signage had been in place for an extended period, and the DON was unaware of its presence. The facility's failure to honor residents' requests for bed rails and the inappropriate posting of personal care instructions led to the deficiency in honoring residents' rights and dignity.
Failure to Maintain Bed Rail Maintenance Log
Penalty
Summary
The facility failed to maintain a record log of bed rail maintenance for two residents, leading to a deficiency. The facility's policy required regular maintenance and inspection of bed rails every six months, as per the manufacturer's recommendations. However, the maintenance staff did not perform routine checks on the bed rails unless a specific complaint was logged. This lack of proactive maintenance was confirmed by the Maintenance Director and the Administrator, who both acknowledged the absence of a maintenance log for bed rails. The Administrator was unaware of the requirement to maintain such a log, indicating a gap in compliance with the facility's policy and regulatory expectations. Resident #5, who had a history of falls and was preparing for a hip replacement, expressed concerns about the safety and adequacy of her bed rail setup. She had only one bed rail, which she found loose, and had requested an additional rail for safety and assistance with turning. Similarly, Resident #54, who had been in the facility for nearly a year, requested an additional bed rail to aid in repositioning but was denied. Both residents had signed consents for bed rail use, but the consents did not specify the number of rails to be used, leading to confusion and unmet needs for the residents. These events highlight the facility's failure to ensure proper installation, use, and maintenance of bed rails, as well as inadequate communication and documentation regarding residents' needs and consents.
Failure to Provide Timely Psychiatric Follow-Up
Penalty
Summary
The facility failed to provide necessary behavioral health services for a resident, leading to significant health issues. The resident, diagnosed with Alzheimer's Disease and Dementia, was prescribed Rexulti and Trileptal for behavioral health needs but had not been reassessed by a psychiatric provider for ten months. This lack of follow-up resulted in the resident exhibiting excessive drowsiness, missing meals, and experiencing a significant weight loss of over ten percent in six months. Observations noted the resident frequently asleep during meals and in common areas, with family members expressing concern over the resident's condition. Interviews with facility staff, including a Registered Nurse and the Director of Nursing, confirmed that a psychiatric consultation had not been initiated until requested by the resident's son. The Medical Director acknowledged that a psychiatric follow-up should have occurred within 90 days of the resident's discharge from a behavioral health hospital. The facility's policy indicated that symptoms such as being prescribed an antipsychotic medication and experiencing mood changes warranted a psychiatric consultation, which was not adhered to in this case.
Failure to Sustain Food Storage Corrective Actions
Penalty
Summary
The facility's Quality Assurance and Performance Improvement (QAPI) committee failed to sustain corrective actions to prevent the recurrence of a previously cited deficiency related to food storage. During an annual recertification survey, the facility was cited for failing to label and date food stored in the refrigerator and freezer, a deficiency that had been previously identified in an earlier survey. The facility's policy on QAPI emphasized the need for ongoing monitoring and oversight to prevent such recurrences, but the committee did not maintain these efforts effectively. The deficiency was observed during kitchen inspections, where food items were not labeled or dated, and expired foods were not discarded. Despite initial corrective actions and audits following the last survey, these efforts were not sustained, particularly after the facility transitioned to an independent kitchen and experienced multiple turnovers in kitchen staff, including the kitchen director. The Registered Nurse overseeing QAPI was unaware of the ongoing issues, indicating a lapse in communication and monitoring within the facility's QAPI processes.
Failure to Post Daily Nurse Staffing Information
Penalty
Summary
The facility failed to comply with the requirement to post daily nursing staffing information in a clean and readable format in a prominent place readily accessible to residents and visitors. During a survey, it was observed that the facility did not post the required staffing information on two out of four survey days. The facility's policy, revised in September 2022, mandates the posting of the facility name, current date, total number and actual hours worked by nursing staff per shift, and resident census at the beginning of each shift. However, observations on multiple occasions revealed the absence of such postings. Interviews with facility staff, including the Director of Nursing (DON) and a Registered Nurse (RN), indicated a misunderstanding of the requirement. The DON and Administrator were unaware that the staffing information needed to be visibly posted daily, believing instead that it only needed to be available upon request. The RN confirmed that while she filled out the staffing information daily, it was kept in a binder rather than being posted. This lack of visible posting led to the deficiency noted by the surveyors.
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Illustrative
What surveyors actually found near you
We read the 21 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.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Union
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hilltop Manor Health And Rehabilitation Center | 2.2 mi | ★★★★★ | 1 | 0 |
| Neshoba County Nursing Home | 14.4 mi | ★★★★★ | 10 | 1 |
| Choctaw Residential Center | 15.8 mi | ★★★★★ | 2 | 0 |
| Bedford Care Center Of Newton | 16.9 mi | ★★★★★ | 1 | 0 |
| Reginald P White Nursing Facility | 23.5 mi | ★★★★★ | 2 | 0 |
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