Average — CMS composite of the measures below.
The next survey window likely opens around April 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 Generations Center Of Spencer during CMS and state inspections, most recent first.
Delayed reporting of abuse allegations: The facility failed to report multiple abuse allegations to the state agency within the required 2-hour timeframe. Incidents involved a resident-to-resident sexual contact allegation, a resident-to-resident physical contact allegation, a physical abuse allegation involving a resident and a CNA, a mental abuse allegation, and a verbal abuse allegation between roommates. The DON stated staff were expected to report allegations immediately, but the Administrator repeatedly said she believed allegations without harm could be reported within 24 hours.
Resident-to-resident verbal abuse occurred when one resident with severe cognitive impairment and agitation repeatedly threatened another resident with violence during smoking break and dining room interactions. The threatened resident, who had schizophrenia and anxiety disorder with intact cognition, stated they felt threatened and abused, and staff witnesses confirmed the resident’s aggressive, abusive language and threats to kill or seriously harm the other resident.
Failure to protect two roommates after a verbal abuse allegation. An LPN and CNA heard one resident yell at the other and accuse the roommate of taking money, but no separation, increased supervision, room change, or documented interventions were implemented when the event occurred. Staff later confirmed they were unaware of the incident during the following days, and the DON and Administrator stated there was no documentation of protective actions taken.
Medication administration errors exceeded the 5% threshold, with 2 errors in 31 opportunities. One resident received 10 ml of levetiracetam instead of the ordered 7.5 ml for epilepsy, and an RN administered insulin lispro without priming the Humalog KwikPen for a resident with type 2 DM. The DON stated the ordered doses should have been followed and the error rate should have remained below 5%.
The facility failed to properly contain garbage and refuse in water-sealed dumpsters, leading to unsanitary conditions. Two dumpsters used for waste disposal were surrounded by scattered garbage, including used exam gloves and broken plastic cups. Both dumpsters were not leak-proof, with Dumpster 1 having a crack and Dumpster 2 missing a plug. The Dietary Manager confirmed these issues, acknowledging the unsanitary state of the garbage area.
Two residents experienced multiple falls due to incomplete investigations and inadequate supervision. The facility failed to document critical details such as witness statements and staff involvement, leading to deficiencies in accident prevention. Interviews confirmed that the fall investigations were incomplete, contributing to the facility's failure to ensure a safe environment.
A facility failed to implement a documented fall intervention for a resident with moderate cognitive impairment. Despite the care plan specifying a visual reminder to lock wheelchair brakes, observations revealed the absence of such reminders in the resident's room and bathroom. Interviews confirmed the intervention was not executed as planned.
The facility failed to update care plans for two residents, leading to discrepancies in documented care interventions. One resident's care plan did not reflect an increased frequency of a nutritional supplement, while another resident's care plan inaccurately listed a fall intervention that was no longer in use. These oversights were confirmed by facility coordinators during interviews and observations.
The facility failed to maintain accurate medical records for two residents, leading to deficiencies in documentation. One resident's MAR lacked an order for a nutritional supplement, despite staff confirming its administration. Another resident experienced significant weight loss, but there was no documentation of physician notification. The DON confirmed the records were incomplete, highlighting a failure to adhere to facility policy.
Delayed reporting of abuse allegations
Penalty
Summary
The facility failed to timely report allegations of abuse to the state survey agency within the required timeframe for 6 of 6 incidents reviewed. The incidents involved Residents #31, #40, #57, #18, #29, and #36, and the report states that the Administrator misunderstood the reporting requirements for abuse. The facility policy titled, Abuse, Neglect and Exploitation, required reporting of alleged violations to the Administrator, state agency, adult protective services, and other required agencies within specified timeframes, including immediately, but not later than 2 hours after the allegation is made if the events involve abuse or result in serious bodily injury. Resident #31 was admitted with diagnoses including dementia with behavioral disturbances, schizoaffective disorder-bipolar type, agoraphobia with panic disorder, anxiety disorder, PTSD, and borderline intellectual functioning. The resident had a BIMS score of 13, indicating intact cognition. The report stated that the resident told a CNA that a roommate's family member touched the resident's breast, staff became aware of the allegation on 04/08/2026 at 11:30 PM, and the report was submitted to the state survey agency on 04/09/2026 at 10:17 AM, more than 10 hours later. The DON stated the allegation was not reported within the required timeframe because of staff interpretation of the guidelines and regulations, and the Administrator stated she believed she had 24 hours to report because there was no harm. Resident #40 had severe dementia with psychotic disturbances, major depressive disorder, and anxiety disorder, with a BIMS score of 3. Resident #9 had major depressive disorder and unspecified dementia, with a BIMS score of 6. The report stated that Resident #9 placed a hand on Resident #40's breast in the dining room, staff became aware at 4:30 PM, the Abuse Coordinator was notified four days later, and the report was submitted to the state survey agency five days after staff became aware. The DON and Administrator both stated they believed the report could be made within 24 hours if there was no harm. Resident #57 had schizophrenia, dementia, anxiety disorder, and atrial fibrillation, with a BIMS score of 11. The report stated that the Abuse Coordinator was notified of a physical abuse allegation on 12/11/2025 at 2:27 PM, and the report was submitted to the state survey agency on 12/12/2025 at 10:54 AM, more than 20 hours later. Resident #18 had bipolar disorder and unspecified intellectual disabilities, with a BIMS score of 5, and Resident #49 had schizophrenia and anxiety disorder, with a BIMS score of 13. The report stated that Resident #18 yelled at Resident #49, saying, "If I had a knife I would cut you," the Abuse Coordinator was notified at approximately 8:28 PM, and the report was submitted to the state survey agency more than 20 hours after the incident. Resident #29 had vascular dementia, major depressive disorder, high risk heterosexual behavior, and expressive language disorder, with a BIMS score of 9. The report stated that Resident #29 grabbed a CNA's buttocks and the CNA slapped the resident on the buttocks; the incident was reported to the Administrator more than five hours later and submitted to the state survey agency more than 20 hours after it occurred. Resident #36 had generalized anxiety, heart failure, and type 2 diabetes, with a BIMS score of 15, and Resident #67 had schizoaffective disorder, bipolar type, and hypertension, with a BIMS score of 10. The report stated that Resident #67 yelled at Resident #36 accusing the roommate of taking $5.00, staff became aware on 12/19/2025, and the report was submitted that same day at 4:39 PM after the incident had occurred earlier in the month. Interviews with the Administrator, DON, SSD, CNA, and LPN reflected that staff were expected to report allegations immediately, but the Administrator repeatedly stated she believed allegations without harm could be reported within 24 hours.
Resident-to-Resident Verbal Abuse
Penalty
Summary
The facility failed to protect one resident’s right to be free from verbal abuse by another resident. Resident #18, who was admitted on 04/02/2026 and had diagnoses including bipolar disorder and unspecified intellectual disabilities, had a BIMS score of 5 on the 04/13/2026 MDS, indicating severe cognitive impairment. Resident #18’s care plan identified restlessness and agitation that affected mood, behavior, socialization, and daily care. Resident #49, admitted on 09/13/2024, had diagnoses including schizophrenia and anxiety disorder. The resident’s 03/24/2026 quarterly MDS showed a BIMS score of 13, indicating intact cognition. The resident’s care plan noted multiple mental health diagnoses that caused daily challenges with mood, behavior, socialization, activities, and daily care, and also noted recent statements about emotional distress related to interactions with peers. On 04/03/2026, while waiting for a smoke break and later at the gazebo, Resident #18 verbally threatened Resident #49, stating that if they had a butcher knife, they would cut Resident #49’s throat. On 04/05/2026, during the evening meal, Resident #18 again became verbally aggressive toward Resident #49 and made threatening statements, including that they would cut Resident #49’s throat and knock Resident #49’s head off. Witness statements from CNA #11, CNA #16, and Janitor #17 confirmed that Resident #18 yelled at, cursed at, and threatened Resident #49, and Resident #49 stated they felt threatened and felt like they had been abused.
Failure to Protect Residents After Verbal Abuse Allegation
Penalty
Summary
The facility failed to immediately implement protective measures after an allegation of resident-to-resident verbal abuse involving two roommates. On 12/13/2025, an LPN and CNA heard one resident yelling at the other and accusing the roommate of taking $5.00. The incident was later reported to administration, Social Services, and the MHNP, but the record showed no documented separation of the residents, no increased supervision, no room change, and no other protective interventions between the incident and when management became aware of it on 12/19/2025. Resident #67 had diagnoses including schizoaffective disorder, bipolar type, and hypertension, with a BIMS score of 10 indicating moderate cognitive impairment. The resident’s care plan identified schizoaffective disorder and anxiety disorder with daily changes in mood, behavior, and socialization, and interventions to redirect the resident during increased anxiety and hallucinations. Resident #36 had diagnoses including generalized anxiety, heart failure, and type 2 diabetes, with a BIMS score of 15 indicating intact cognition. The resident’s care plan also reflected communication and confusion-related needs. Staff interviews confirmed that the incident was not acted on as a protective event at the time it occurred. The LPN stated she de-escalated the situation but did not separate the residents, update the care plan, document the incident, or put interventions in place. Other nursing staff stated they were unaware of the incident during the days that followed and would have separated the residents or increased monitoring if they had known. The DON and Administrator both stated there was no documentation of interventions and could not identify any actions taken to protect the resident who was involved in the altercation.
Medication Administration Errors Exceeded 5 Percent
Penalty
Summary
The facility failed to keep the medication error rate at 5% or less during a medication administration observation, with 2 errors out of 31 opportunities for a 6.45% error rate affecting 2 of 5 residents observed. One resident had an active order for levetiracetam oral solution 100 mg/ml, 7.5 ml by mouth twice daily for epilepsy, but during observation an RN prepared and administered 10 ml instead of the ordered dose. A second resident had an active order for insulin lispro subcutaneous solution pen-injector to be given per sliding scale for type 2 diabetes mellitus. During observation, an RN prepared the Humalog KwikPen, turned the dose selector to 4 units, and proceeded to administer it without priming the pen; when questioned, the RN stated the pen did not have to be primed. The DON stated the resident should not have received 10 ml of levetiracetam, the insulin pen should have been primed, and the expected medication error rate was less than 5%.
Improper Garbage Disposal and Unsanitary Conditions
Penalty
Summary
The facility failed to properly contain garbage and refuse in water-sealed dumpsters and maintain the garbage storage area in a safe and sanitary condition. The facility's undated Waste Disposal Procedure policy requires that all garbage, trash, and other non-infectious waste be stored and disposed of in a manner that prevents disease transmission, nuisance creation, and breeding places for insects and rodents. During an observation and interview with the Dietary Manager, it was noted that the facility had two dumpsters for waste disposal, both of which were surrounded by scattered garbage, including used exam gloves, broken plastic cups, and pieces of cardboard and paper. Additionally, both dumpsters had visible sunlight entering from the bottom, indicating they were not leak-proof. Dumpster 1 had a horizontal crack with rust on the bottom, and Dumpster 2 had a waste drain without a plug. The Dietary Manager confirmed these issues, acknowledging that the dumpsters were not leak-proof and the garbage area was not maintained in a safe and sanitary condition.
Incomplete Fall Investigations Lead to Deficiencies in Resident Safety
Penalty
Summary
The facility failed to conduct thorough investigations of falls for two residents, leading to deficiencies in accident prevention and supervision. Resident #67, who had multiple falls and required extensive assistance due to poor safety awareness and unsteady gait, experienced two falls that were not properly investigated. The fall packets for these incidents lacked witness statements, did not identify staff involved, and failed to document critical details such as who found the resident or the last time the resident was observed or toileted. Resident #323, with a history of falls and diagnoses including congestive heart failure and vascular dementia, also experienced multiple unwitnessed falls. The fall packets for these incidents were incomplete, missing witness statements, and lacking information on who discovered the resident or alerted the nurse. One significant incident involved the resident falling in a secured courtyard area, resulting in multiple injuries and a subsequent hospital visit. The investigation did not include details on how long the resident had been outside or who observed the fall. Interviews with facility staff, including the Director of Nursing and the Falls Coordinator, confirmed that the fall investigations for both residents were incomplete. The facility's policy on fall investigations was not fully adhered to, as critical components such as root cause analysis and comprehensive documentation were missing. This lack of thorough investigation and documentation contributed to the facility's failure to ensure a safe environment free from accident hazards.
Failure to Implement Fall Intervention for Resident
Penalty
Summary
The facility failed to implement a person-centered care plan for a resident with a history of falls, specifically related to fall interventions. The resident, who was admitted and readmitted with diagnoses including Dementia, Depression, and Lack of Coordination, had a care plan intervention to place a visual reminder in their room to lock wheelchair brakes. Despite this intervention being documented in the care plan, observations on two separate occasions revealed that no visual reminders were present in the resident's room or bathroom. Interviews with the Falls Coordinator and Care Plan Coordinator confirmed that a sign was intended to be placed as a fall intervention following an incident. However, during a follow-up observation and interview, it was confirmed that the visual reminder was not present, indicating a failure to implement the care plan as documented. The resident's moderate cognitive impairment, as indicated by a BIMS score of 9, underscores the importance of such interventions to ensure their safety.
Failure to Update Care Plans for Residents
Penalty
Summary
The facility failed to revise the comprehensive care plans for two residents, leading to deficiencies in care documentation. Resident #25, who has severe cognitive impairment due to Alzheimer's Disease, had a physician's order to increase the administration of a nutritional supplement, Med Pass, from twice a day to three times a day. However, the care plan was not updated to reflect this change, as confirmed by the MDS Coordinator during an interview. This oversight indicates a lapse in ensuring that the care plan accurately reflects the resident's current medical orders and needs. Similarly, Resident #323, who has moderate cognitive impairment and a history of falls, had discrepancies in their care plan regarding fall interventions. The care plan listed a geri chair as an active fall intervention, although it was no longer in use or present in the resident's room. Instead, grab bars were installed on both sides of the resident's bed, but the care plan was not updated to reflect this change. The Falls Coordinator and Care Plan Coordinator confirmed these discrepancies during interviews and observations, highlighting a failure to maintain accurate and current care plans for residents with specific needs.
Deficiencies in Medical Record Documentation
Penalty
Summary
The facility failed to maintain accurate and complete medical records for two residents, leading to deficiencies in documentation. For one resident, the medical record did not include an order for a nutritional supplement, Med Pass, which was supposed to be administered twice daily. Despite the resident's weight gain being documented in nursing and dietary notes, the Medication Administration Record (MAR) lacked the necessary order, indicating a gap in record-keeping. Interviews with staff confirmed the resident received the supplement, but the Director of Nursing acknowledged the incomplete and inaccurate medical record. Another resident experienced significant weight loss, but there was no documentation of physician notification regarding this change. The resident had been hospitalized and returned with a notable decrease in weight. Although the Restorative Nurse stated that the Medical Director was informed of the weight loss, this notification was not documented in the medical record. The Medical Director expected to be notified of weight changes monthly, and the Director of Nursing confirmed the expectation to document such notifications, highlighting the deficiency in maintaining complete records. These deficiencies in documentation reflect a failure to adhere to the facility's policy, which requires all services and changes in a resident's condition to be documented accurately. The lack of proper documentation could hinder effective communication among the interdisciplinary team and impact the quality of care provided to the residents.
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 citations issued around you in the last 12 months — including the 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
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 Spencer
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Nhc Healthcare, Sparta | 12 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Sparta | 13.9 mi | ★★★★★ | 0 | 0 |
| Willow Branch Health And Rehabilitation | 16.7 mi | ★★★★★ | 0 | 0 |
| Bledsoe County Nursing Home | 17.8 mi | — | 0 | 0 |
| Nhc Healthcare, Mcminnville | 18.1 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Generations Center Of Spencer.
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.