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 Community Care Of Rutherford during CMS and state inspections, most recent first.
A resident with dementia and Afib experienced significant medication errors, including missed doses of Eliquis and incorrect administration of Donepezil, due to the facility's failure to follow proper medication management protocols and communication lapses.
Failure to Ensure Resident Free from Significant Medication Errors
Penalty
Summary
The facility failed to ensure that a resident was free from significant medication errors. Resident #3, who had diagnoses including dementia, major depressive disorder, heart failure, and atrial fibrillation (Afib), was admitted to the facility and had specific medication orders for Donepezil and Eliquis. However, after a hospital discharge, the facility did not properly resume the resident's Eliquis medication, resulting in 43 missed doses in February 2024. Additionally, the resident was administered both 10mg and 5mg doses of Donepezil simultaneously for 31 days, which was not in accordance with the physician's orders. The facility's policies required incident reporting, physician notification, and proper documentation for medication errors, but these protocols were not followed. Interviews with the family member, unit manager, director of nursing (DON), and nurse practitioner (NP) revealed that there was a lack of communication and verification of medication orders. The DON admitted that the 5mg Donepezil dose was incorrectly added to the existing 10mg dose, and this error was not documented as a medication error. The NP and DON confirmed that the resident's blood thinner medication was not resumed as ordered after the hospital discharge, and there was no monitoring for blood thinner side effects for 25 shifts in February and 36 shifts in March. The facility's failure to properly manage and verify medication orders led to significant medication errors, putting the resident at risk for adverse health outcomes.
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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.
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Nursing homes near Murfreesboro
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Nhc Healthcare, Murfreesboro | 5.7 mi | ★★★★★ | 5 | 0 |
| Stone River Post Acute | 7.3 mi | ★★★★★ | 4 | 0 |
| Adamsplace, Llc | 7.7 mi | ★★★★★ | 7 | 0 |
| Stones River Manor, Inc | 8.5 mi | ★★★★★ | 0 | 0 |
| Tennessee Veterans Home | 9.9 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.