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 Center On Aging And Health during CMS and state inspections, most recent first.
Failure to Obtain Informed Consent for Psychotropic Medications: The facility administered multiple psychotropic and related medications to several residents with dementia, anxiety, depression, psychotic disorders, and severe or moderate cognitive impairment, but the records contained no informed consent forms and no documentation that the residents or their representatives were informed in advance of the risks and benefits, options, and alternatives to treatment. The Administrator confirmed there was no psychotropic medication policy and no psychotropic medication consent forms for any residents.
PHI Left Visible on Medication Cart Computers: An LPN and an RN walked away from medication carts with computer screens left open and visible to the public. Resident identifiers and medical information, including names, MRNs, room numbers, and photos, were displayed on the screens for multiple residents, despite facility policy requiring PHI safeguards and staff to log off when leaving the work area.
Failure to provide nail and foot care. A resident with dementia, DM, depression, psychotic disorders, severe cognitive impairment, and dependence on staff for personal hygiene and mobility had long, untrimmed fingernails with debris underneath and toenails that were long, curled over the toes, and jagged. The CNA said she cleaned nails on bath days but did not provide nail or foot care to residents with DM, while the RN and WCN confirmed the nails and toenails needed trimming and could not explain why care had not been provided; the DON confirmed the care was not provided.
Failure to Provide Foot and Nail Care: A resident with cancer diagnoses, hospice involvement, and dependence for ADLs was found with thick crusted skin on both feet and severely overgrown, curled toenails. Weekly skin checks did not include foot evaluations, staff said hospice handled bathing and foot care, and the DON confirmed the resident had not received foot and nail care or been seen by podiatry.
Unlocked Wound Treatment Cart Left Unattended: A wound treatment cart containing topical medications and supplies was observed unlocked and unattended on two occasions, once in the East hallway and again outside the nurse's station near the North Hall. The WCN said she had not been there since Friday, an LPN stated the cart is not to be unlocked, and the DON confirmed the cart was unlocked and its contents were accessible to unauthorized staff or visitors.
A resident with a history of repeated falls and mobility issues was identified as high risk for falls and experienced two unwitnessed falls. Although several fall prevention interventions were implemented, the facility failed to develop and document a care plan addressing the resident's fall risk and the interventions used, as required by facility policy.
Failure to Obtain Informed Consent for Psychotropic Medications
Penalty
Summary
The facility failed to obtain informed consent for psychotropic medications administered to 5 residents reviewed for unnecessary medications. For Resident #21, the record showed diagnoses including dementia with behavioral disturbance, delusional disorder, and psychotic disorder, with a BIMS score of 0 indicating severe cognitive impairment. Orders and MAR documentation showed administration of Brexpiprazole, Divalproex Sodium, Memantine, and Sertraline, but the record contained no informed consent form and no documentation that the resident or representative had been informed in advance of the risks and benefits, options, and alternatives to treatment. Resident #33 had diagnoses including dementia, cognitive communication deficit, and generalized anxiety disorder, with a BIMS score of 12 indicating moderate cognitive impairment. The record showed administration of Trazodone, Sertraline, Memantine, and Alprazolam, but there was no informed consent form and no documentation that the resident or representative had been informed in advance of the risks and benefits, options, and alternatives to treatment. Resident #8 had diagnoses including dementia with psychotic disturbance, psychotic disorder with delusions, generalized anxiety disorder, and depression, with a BIMS score of 3 indicating severe cognitive impairment. The record showed administration of Alprazolam, Donepezil, Memantine, Risperidone, Sertraline, and Trazodone, but there was no informed consent form and no documentation of advance discussion of risks, benefits, options, and alternatives. Resident #42 had diagnoses including dementia, diabetes, depression, and psychotic disorders, with a BIMS score of 5 indicating severe cognitive impairment. The record showed administration of Escitalopram Oxalate, Quetiapine Fumarate, and Xanax, but there was no informed consent form and no documentation that the resident or representative had been informed in advance of the risks and benefits, options, and alternatives to treatment. Resident #3 had diagnoses including dementia with agitation, post-traumatic stress disorder, and generalized anxiety disorder, with a BIMS score of 2 indicating severe cognitive impairment. The record showed administration of Depakote Sprinkles, Diazepam, and Mirtazapine, but there was no informed consent form and no documentation that the resident or representative had been informed in advance of the risks and benefits, options, and alternatives to treatment. During interview, the Administrator confirmed the facility did not have a psychotropic medication policy and did not have psychotropic medication consent forms for any residents.
PHI Left Visible on Medication Cart Computers
Penalty
Summary
The facility failed to keep residents' personal and medical records private and confidential when PHI was left visible on medication cart computer screens in public view. Facility policy required appropriate physical and technical safeguards to protect PHI, staff to log off workstations when leaving the work area, and computer monitors to be positioned so unauthorized persons could not easily view information on the screen. During observation on 4/13/2026 at 11:41 AM, the 200 South Hall medication cart computer was open with 16 residents' identifiers, including picture, name, medical number, wing, and room number, visible on the screen in view of the public. LPN C stated she had walked away from the medication cart and did not safeguard the PHI. A second observation on 4/14/2026 at 1:44 PM found the East Hall medication cart computer displaying resident information, including name, medical record number, and room number, visible on the screen and in view of the public. RN D stated she had just walked away and would have normally locked her screen, and she confirmed she walked away from the medication cart and did not safeguard PHI. The residents whose information was visible included individuals with diagnoses such as fractures, diabetes, COPD, dementia, stroke-related weakness, sepsis, renal disease, and other chronic conditions.
Failure to Provide Nail and Foot Care
Penalty
Summary
Provide care and assistance to perform activities of daily living for any resident who is unable. The facility failed to ensure nail care was provided to Resident #42, who was admitted with diagnoses including dementia, diabetes, depression, and psychotic disorders. The comprehensive MDS assessment showed the resident had severe cognitive impairment and was dependent on staff for personal hygiene and mobility. The care plan included assessing fingers and toes for warmth and addressing ADL deficits, and facility skin check documents showed foot evaluations were completed during the review period. During observation, Resident #42 was lying upright in bed with long, untrimmed fingernails that had a brown substance underneath them. The resident’s toenails were long, curled over the tips of the toes, and jagged, while bilateral heel protectors were in use with the toes visible. The resident stated, "I would feel better if my nails and toes were done [trimmed and cleaned]." A CNA stated she provided nail and foot care on bath days and cleaned residents’ nails, but did not provide foot or nail care to residents with diabetes. An RN observed the nails and toenails and confirmed they needed to be trimmed, stating nursing and wound care mainly handled trimming toes and nails, but could not explain why the care had not been provided. The WCN also could not explain why the resident’s nails and toenails had not been cleaned or trimmed, and the DON confirmed the resident’s nail and foot care had not been provided.
Failure to Provide Foot and Nail Care
Penalty
Summary
Provide appropriate foot care was not ensured for Resident #25, who was admitted with diagnoses of malignant neoplasm of the brain, palliative care, and melanoma of the neck and scalp. The resident’s MDS showed a BIMS score of 15, indicating cognitive intactness, and the resident required maximum assistance to total dependence with ADLs. The hospice care plan directed that ADLs be adjusted to the resident’s changing abilities, but weekly skin assessments for March and April 2026 did not include completed foot evaluations. During observation, the resident was found resting in bed with significant foot and nail care concerns. The right foot had a thick layer of dried yellow crusted skin over the great toe and between all four digits, and the toenails were thick, long, and curled, with one nail curling about 3/4 inch and resting against the great toe and others curling over or under adjacent toes. The left foot also had short nails with a thick layer of dried crusted skin over the great toe and between all four digits. Staff interviews reflected that hospice was doing bathing and foot care, that the resident was not on the podiatry list initially, and that nursing, skin checks, and admission assessments should have addressed the feet; the DON confirmed the resident had not received foot and nail care and had not been seen by podiatry.
Unlocked Wound Treatment Cart Left Unattended
Penalty
Summary
The facility failed to ensure 1 of 1 wound treatment carts containing topical medications and supplies was locked and secured in accordance with facility policy. The policy titled, Security of Medication Cart, stated the nurse must secure the cart to prevent unauthorized entry, the cart must be locked before entering a resident's room, and carts must be securely locked at all times when out of the nurse's view. During an observation on 4/13/2026 at 11:09 AM in the East hallway, surveyors found a treatment cart unlocked and unattended against the wall, with the cart doors facing the opposite side of the hall and accessible to unauthorized staff and visitors. The WCN stated at 11:11 AM that the cart had been unlocked and that she had not been there since Friday. On 4/15/2026 at 9:03 AM, the cart was again observed unlocked and unattended outside the nurse's station adjacent to the North Hall, with the cart doors facing the nurse's station and accessible to unauthorized staff and visitors. An LPN stated the cart is not to be unlocked and that nursing staff do not normally leave it open. The DON later confirmed the cart was unlocked and unattended and that its contents were accessible to unauthorized staff or visitors.
Failure to Develop and Document Fall Risk Care Plan
Penalty
Summary
The facility failed to develop and implement a care plan addressing fall risk for one resident who had a documented history of repeated falls, muscle weakness, and difficulty walking. Despite the resident being identified as high risk for falls through a Fall Risk Evaluation and experiencing two unwitnessed falls during their stay, the care plan did not include any mention of fall risk, the falls that occurred, or the interventions that were put in place. The facility's policy required holistic care plans with specific goals, objectives, and interventions, but this was not followed for the resident in question. Prior to and after the falls, several interventions were implemented, such as a yellow dot sticker to alert staff, non-slip strips, bilateral bedrails, encouragement to use a wheelchair, and provision of a reacher. However, these interventions were not documented in the resident's care plan. Interviews with facility staff confirmed that while interventions were in place, they were not reflected in the care plan, and the resident's risk for falls was not documented as required.
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 28 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 Erwin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Christian Care Center Of Unicoi County | 0.1 mi | ★★★★★ | 4 | 0 |
| Erwin Health Care Center | 0.9 mi | ★★★★★ | 0 | 0 |
| Four Oaks Health Care Center | 11.8 mi | ★★★★★ | 3 | 0 |
| Lakebridge, A Waters Community, Llc | 12.2 mi | ★★★★★ | 0 | 0 |
| The Waters Of Johnson City, Llc | 14.1 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Center On Aging And Health.
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.