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 Erwin Health Care Center during CMS and state inspections, most recent first.
A resident with severe cognitive impairment and dependent on staff for eating assistance was not served their lunch meal at the same time as another resident at the same table. Staff distributed meal trays in no specific order, resulting in a nine-minute delay before the second resident received their meal. Both an LPN and the DON confirmed that this practice did not align with the facility's expectation to promote dignity by serving residents at the same table simultaneously.
A resident with severe cognitive impairment and vision loss did not have their vision impairment addressed in their care plan, despite requiring assistance with meals, hygiene, and mobility. Staff interviews and record reviews confirmed the omission, which was not in accordance with facility policy.
Garbage and refuse were not properly contained in one dumpster, with the dumpster door left open and various discarded items such as broken furniture, pallets, and boxes left in the surrounding area. The CDM and MD confirmed the area was not maintained in a sanitary or orderly condition, and the items had not been removed due to competing priorities.
Staff did not assist two residents with severe cognitive impairment and self-care deficits with hand hygiene before meals, despite facility policy and care plan requirements. This was confirmed through observation and interviews with an LPN and the DON.
The facility failed to use the least restrictive interventions or restraint devices for four residents, resulting in extended use of restraints. Despite policies requiring weekly reviews to decrease restraints, residents with severe cognitive impairments were placed in restrictive devices without attempts to reduce or eliminate them. Interviews confirmed the facility's failure to adhere to its restraint policy.
The facility failed to use the least restrictive interventions or restraint devices for four residents, resulting in extended use of restraints. Despite the facility's policy to use the least restrictive safety device, residents with severe cognitive impairments were placed in restraints for extended periods without successful reduction attempts. Interviews confirmed the facility's continued use of restraints for resident safety, failing to adhere to the policy.
Failure to Serve Meals Simultaneously Compromises Resident Dignity
Penalty
Summary
During a lunch meal service, a resident with severe cognitive impairment and dependent on staff for eating assistance was not served their meal at the same time as another resident seated at the same table. The first resident, who also had severe cognitive impairment and required substantial staff assistance, received their meal tray and began eating without difficulty after staff setup. However, the second resident waited an additional nine minutes before receiving their meal tray, despite being present at the table and ready to eat. Staff interviews confirmed that meal trays were distributed in no specific order, and the delay in serving the second resident was acknowledged as a concern regarding resident dignity. The LPN and DON both confirmed that the facility's expectation was for residents at the same table to be served simultaneously to promote dignity during dining. Observations and interviews indicated that this expectation was not met during the observed meal service.
Failure to Address Vision Impairment in Care Plan
Penalty
Summary
The facility failed to implement a person-centered care plan addressing vision impairment for a resident with severe cognitive impairment and multiple diagnoses, including dementia and glaucoma. The facility's policy requires the development and implementation of a comprehensive care plan for each resident based on their assessment, but review of the resident's care plan showed that vision impairment was not included as a problem or addressed in the plan. Interviews with CNAs confirmed that the resident required assistance with opening food items, toileting, personal hygiene, and activities of daily living due to vision impairment. The LPN MDS Coordinator also confirmed that the resident's vision impairment was not developed on the care plan, despite the resident's documented need for supervision or assistance with eating, personal hygiene, and mobility.
Improper Disposal and Containment of Garbage and Refuse
Penalty
Summary
The facility failed to properly contain garbage and refuse in one of two outside dumpsters, specifically dumpster A, and did not maintain the surrounding area in a sanitary and orderly condition. Observations revealed that dumpster A's front right sliding door was propped open, exposing its contents, and the area behind the dumpster contained various discarded items including a broken wooden chair, multiple broken wooden pallets, a broken shower chair, a basketball goal, several empty five-gallon buckets, wet and disintegrating cardboard boxes, and broken wheelchairs. The Certified Dietary Manager confirmed these findings, and the Maintenance Director acknowledged that the items behind the dumpster were considered garbage that needed to be hauled off but had not been removed due to other priorities.
Failure to Provide Hand Hygiene Assistance Before Meals
Penalty
Summary
Staff failed to provide hand hygiene assistance to two residents with severe cognitive impairment and self-care deficits prior to meal service. Both residents required substantial or total assistance with personal hygiene, as documented in their care plans and medical records. During meal observations, a CNA delivered and set up meal trays for these residents without assisting them with hand hygiene before they began eating. Interviews with an LPN and the Director of Nursing confirmed that hand hygiene assistance was not provided to these residents before their meals, which was contrary to the facility's policy requiring staff to ensure residents' hands are washed before and after meals. The deficiency was identified through policy review, direct observation, and staff interviews.
Failure to Use Least Restrictive Restraints
Penalty
Summary
The facility failed to recognize and use the least restrictive interventions or restraint devices for the least amount of time, affecting four residents. The facility's policy stated that the least restrictive safety device or restraint should be used to ensure resident safety, with the interdisciplinary team meeting weekly to decrease safety devices and restraints if no incidents occurred in the last 30 days. However, the facility did not adhere to this policy, resulting in residents being placed in restraints that were not the least restrictive for extended periods. Resident #13 was admitted with severe cognitive impairment and required assistance with activities of daily living. Despite the facility's policy, the resident was placed in a vest restraint in bed for 26 weeks without attempts to reduce or eliminate the restraint. Similarly, Resident #21, with severe cognitive impairment, was placed in a lowrider wheelchair with a pelvic restraint and a vest restraint in bed. The facility did not attempt to reduce these restraints, and the resident was unable to remove the self-release belt upon request. Resident #18, with severe cognitive impairment and a history of being very active, was placed in a lowrider with a self-releasing clip belt and a vest restraint in bed. Despite multiple attempts to reduce the restraints, the facility continued their use for 32 weeks. Resident #9, who was moderately cognitively impaired, was placed in a lowrider with a pelvic restraint and a vest restraint in bed after being found on a bed frame. The facility's failure to use the least restrictive interventions or restraint devices for the least amount of time was confirmed by interviews with facility staff.
Removal Plan
- Immediate action(s) taken for the resident(s) found to have been affected include: Resident #18 - Interdisciplinary team completed assessment for safe restraint reduction, restraint was discontinued in the chair and bed, new order for out of bed in lowrider with dycem, family and staff made aware, resident moved into private room, care plan updated, medical director approved.
- Immediate action(s) taken for the resident(s) found to have been affected include: Resident #21 - Interdisciplinary team completed assessment for safe restraint reduction, restraint was discontinued in chair, new order for out of bed in rock-n-go with dycem, family and staff made aware, care plan updated, therapy screen requested for chair evaluation, new order for out of bed in low rider with dycem, family and staff made aware, care plan updated.
- Resident #13: discharged from facility.
- Resident #9: discharged from facility.
- A new policy established Restraint Free Environment for the facility and education of the new policy was implemented.
- All rooms were evaluated to ensure no restraints were being used, restraints were removed and placed in the DON office.
- Education was given on the new policy Restraint Free Environment to all clinical staff, providers, and therapy department managers, and will be completed with all other remaining clinical staff before next scheduled shift.
- Future employees will be educated as part of new hire orientation on restraint free environment and will reoccur quarterly.
- A copy of the Restraint Free Environment policy was sent via mail to the residents' families.
- Education on all aspects of the requirements for restraint use was provided by the Clinical Consultant to all clinical management team members and was 100% completed.
- The Clinical Consultant is available to facility clinical administration 24 hours a day, 7 days a week.
- Interdisciplinary Team restraint reduction meeting minutes showed review and agreement with discontinuation of restraints for Resident #18 and Resident #21.
- Observation confirmed residents were in appropriate seating arrangements without restraints.
- Interviews confirmed 100% of clinical staff and providers were educated on the new policy.
- Responsible parties of all residents were notified of the new policy.
- 100% of administrative staff were educated on all aspects of the requirements for restraint use by the Clinical Consultant.
- Ongoing contractual agreement for clinical consulting services to be provided to the facility.
Failure to Use Least Restrictive Restraints
Penalty
Summary
The facility failed to recognize and use the least restrictive interventions or restraint devices for the least amount of time, affecting four residents. The facility's policy required the use of the least restrictive safety device or restraint to ensure resident safety, with the interdisciplinary team meeting weekly to decrease safety devices and restraints if no incidents occurred in the last 30 days. However, the facility did not adhere to this policy, resulting in residents being placed in restraints that were not the least restrictive for extended periods. Resident #13, who had severe cognitive impairment and required assistance with activities of daily living, was placed in a vest restraint in bed for 26 weeks without successful attempts at reduction. Similarly, Resident #21, with severe cognitive impairment and poor trunk control, was placed in a lowrider with a pelvic restraint and a vest restraint in bed. Despite attempts to reduce the restraint, the resident continued to slide down in the chair, and the restraint was not successfully reduced. Resident #18, also with severe cognitive impairment, was placed in a lowrider with a self-releasing clip belt and a vest restraint in bed for 32 weeks, with no successful reduction attempts. Resident #9, who was moderately cognitively impaired, was placed in a lowrider with a pelvic restraint and a vest restraint in bed after a fall. Attempts to reduce the restraint were unsuccessful, and the resident continued to experience hallucinations and unsafe ambulation. Interviews with facility staff confirmed that the facility continued to use restraints for the safety of the residents, failing to recognize and use the least restrictive interventions or restraint devices for the least amount of time.
Removal Plan
- Immediate action(s) taken for the resident(s) found to have been affected include: Resident #18 - Interdisciplinary team completed assessment for safe restraint reduction, restraint was discontinued in the chair and bed, new order for out of bed in lowrider with dycem, family and staff made aware, resident moved into private room, care plan updated, medical director approved.
- Immediate action(s) taken for the resident(s) found to have been affected include: Resident #21 - Interdisciplinary team completed assessment for safe restraint reduction, restraint was discontinued in chair, new order for out of bed in rock-n-go with dycem, family and staff made aware, care plan updated, therapy screen requested for chair evaluation, new order for out of bed in low rider with dycem, family and staff made aware, care plan updated.
- Resident #13: discharged from facility.
- Resident #9: discharged from facility.
- A new policy established Restraint Free Environment for the facility and education of the new policy was implemented.
- Identification of other residents having the potential to be affected was accomplished by evaluating all rooms to ensure no restraints were being used, removing restraints from clean linen room and placing them in the DON office.
- Education on the new policy Restraint Free Environment was provided to all clinical staff, providers, and therapy department managers, and will be included in new hire orientation and reoccur quarterly.
- A copy of the Restraint Free Environment policy was sent via mail to the residents' families.
- Education on all aspects of the requirements for restraint use was provided by the Clinical Consultant to all clinical management team members.
- The Clinical Consultant is available to facility clinical administration.
- Review of Interdisciplinary Team restraint reduction meeting minutes showed agreement with discontinuation of restraints and new orders for residents.
- Observation confirmed the removal and secure storage of restraint devices in the DON's office.
- Interviews confirmed 100% of clinical staff and providers were educated on the new policy.
- Responsible party notification of new policy letters sent to all residents' responsible parties.
- 100% of administrative staff were educated on all aspects of the requirements for restraint use by the Clinical Consultant.
- Ongoing contractual agreement for clinical consulting services to be provided to the facility.
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 38 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) |
|---|---|---|---|---|
| Center On Aging And Health | 0.9 mi | ★★★★★ | 10 | 0 |
| Christian Care Center Of Unicoi County | 1 mi | ★★★★★ | 4 | 0 |
| Four Oaks Health Care Center | 11.9 mi | ★★★★★ | 3 | 0 |
| Lakebridge, A Waters Community, Llc | 12.7 mi | ★★★★★ | 0 | 0 |
| The Waters Of Johnson City, Llc | 14.6 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Erwin Health Care 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.