Above average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
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 Life Care Center Of Morristown during CMS and state inspections, most recent first.
An LPN failed to perform hand hygiene between administering medications to two residents, one with chronic medical conditions and another with dementia and mental health diagnoses. The LPN confirmed not performing hand hygiene before preparing and administering medications, contrary to facility policy, and the DON confirmed staff are expected to follow hand hygiene protocols.
A facility failed to accurately reconcile controlled medications for a resident under hospice care, leading to a deficiency. The resident's ABHR cream, containing Ativan, Benadryl, Haldol, and Reglan, was diverted by an LPN who took it home accidentally. The facility was unaware of the diversion until the LPN's spouse returned the medication, revealing a lapse in the facility's system for accounting and reconciling controlled substances.
A water leak from a shower room into a resident's room compromised the safety and homelike environment in an LTC facility. The leak, noticed after a shower mixing valve replacement, led staff to place blankets to absorb water. Despite reports, maintenance was unaware of the issue, and the leak persisted until the shower room was declared out of order.
The facility failed to complete significant change assessments within the required 14-day period for three residents admitted to hospice services, as per CMS guidelines. Interviews confirmed the assessments were not completed on time, indicating non-compliance with the RAI Version 3.0 Manual.
A resident with severe cognitive impairment was struck in the face by another resident's foot in a LTC facility. Both residents had Alzheimer's Disease and Dementia, with no prior history of altercations. The incident occurred when one resident, seated in a reclined chair, scooted down and kicked the other resident. Neither resident sustained injuries, and the facility conducted an investigation involving law enforcement.
The facility failed to accurately complete MDS assessments for three residents, missing documentation on hospice services, restraint usage, and falls. A resident with Alzheimer's and Osteoarthritis had a restraint not captured in the MDS. Another resident receiving hospice care and using a lap buddy restraint was not documented in several assessments. A third resident with liver cirrhosis and under hospice care had falls not recorded. The MDS Coordinator confirmed these inaccuracies.
Failure to Perform Hand Hygiene During Medication Administration
Penalty
Summary
A deficiency occurred when a Licensed Practical Nurse (LPN) failed to perform hand hygiene during medication administration for a resident. The facility's hand hygiene policy, dated 7/7/2025, requires associates to perform hand hygiene before and after contact with residents and after contact with objects and surfaces in the resident's environment. During an observation, the LPN was seen exiting one resident's room after administering medication without performing hand hygiene, then unplugging the computer, moving the medication cart, preparing medications for another resident, and entering the next resident's room to administer medications, again without performing hand hygiene. The residents involved included one with chronic conditions such as Chronic Obstructive Pulmonary Disease, Type 2 Diabetes Mellitus, and Hypertension, and another with Dementia, Depression, and Anxiety, who was cognitively intact according to a recent assessment. The LPN confirmed during an interview that hand hygiene was not performed prior to preparing and administering medications to the second resident. The Director of Nursing also confirmed that staff are expected to perform hand hygiene between residents during medication administration.
Failure to Reconcile Controlled Medications
Penalty
Summary
The facility failed to ensure controlled medications were accurately reconciled for a resident, leading to a deficiency in pharmaceutical services. The resident, who was under hospice care, had a prescription for a compounded ABHR cream containing Ativan, Benadryl, Haldol, and Reglan, intended for topical application to manage agitation related to a psychotic disorder. The medication was supposed to be stored securely in a double-locked container in the refrigerator, accessible only to authorized personnel. An incident occurred when the spouse of an LPN returned 30 individual dose syringes of the resident's ABHR cream to the facility, which had been taken home by the LPN. The LPN admitted to taking the medication out of the lock box in the refrigerator and accidentally taking it home, claiming it was intended to be administered to the resident. The facility was unaware of the medication diversion until it was returned by the LPN's spouse, indicating a lapse in the facility's system for accounting and reconciling controlled substances. The facility's policies required a system to account for the receipt and disposition of controlled medications, including periodic reconciliation and prompt identification of any loss or potential diversion. However, the facility did not detect the diversion of the resident's medication until it was returned, highlighting a failure in the implementation of these policies. The medication administration records (MARs) for the resident were documented as if the medication had been administered, despite the diversion, further indicating discrepancies in the facility's medication management practices.
Removal Plan
- Notification of the physician, responsible party, and local and state agencies.
- Initiated an inventory of all resident's medications with a MAR for each resident's current orders.
- Initiated an investigation interview for drug diversion questionnaire with all licensed nurses and began re-education on various policies related to medication management and abuse prevention.
- A Quality Assurance Performance Improvement (QAPI) meeting was held, with the Interdisciplinary Team and conducted a root cause analysis to determine what correctional actions needed to be taken.
- The DON/ADON received reeducation on Controlled Substance Procedure Review Process, Work Tol, and Detailed Summary from the Regional Department of Clinical Services.
- The Administrator reviewed all the Concern and Comment forms for allegations of Abuse/Neglect/Misappropriation with no reported concerns identified.
- Residents with a BIMS assessment of 9 or greater were interviewed related to the medication administration and treatment by the facility staff. Residents with a BIMS assessment of 8 or less had their medical record reviewed for any signs/symptoms documented that may have indicated they had not received their ordered medications.
- LPN A was terminated.
- The DON/ADON/Designee will audit 2 random residents per medication cart with a controlled substance ordered to ensure the controlled substance procedure is followed. Any disciplinary action needed will be conducted immediately. All audits will be reported to the QAPI committee meeting.
- The DON/ADON/Designee will conduct a 100% audit of all residents' medications and compare the medications accounted for, available, and match the MAR. The audits will be reported to the QAPI committee.
Water Leak Compromises Resident's Room Environment
Penalty
Summary
The facility failed to maintain a safe and homelike environment when water leaked under the baseboard into a resident's room from an adjacent shower room. The issue was identified during an observation and interview with a resident who reported that water sometimes leaked from the shower room, and staff had placed blankets on the floor to absorb the water. The resident, who was unable to get out of bed, was unaware of the blankets until informed by staff. The leak was reportedly noticed by staff every time the shower was used, affecting only the resident's room. Interviews with various staff members, including a Licensed Practical Nurse, the Director of Housekeeping, and the Maintenance Director, revealed that the leak began after a shower mixing valve was replaced. Despite the leak being reported, there was confusion about whether a maintenance request had been submitted. The Maintenance Director was unaware of the issue and stated that the shower did not leak before the valve replacement. The Director of Nursing later declared the shower room out of order. The deficiency was confirmed by the Administrator and the Maintenance Director, who acknowledged that the water leak did not provide a safe homelike environment.
Failure to Complete Timely Significant Change Assessments for Hospice Admissions
Penalty
Summary
The facility failed to complete significant change assessments for three residents who were admitted to hospice services, as required by the Centers for Medicare and Medicaid Services (CMS) Resident Assessment Instrument (RAI) Version 3.0 Manual. According to the manual, a significant change in status Minimum Data Set (MDS) assessment must be completed within 14 days of a resident's enrollment in a hospice program. However, for Resident #15, the MDS assessment was still in progress and had not been submitted for approval within the required timeframe. Similarly, Resident #17 was admitted to hospice services, but a significant change in status MDS was never completed within the 14-day requirement. Additionally, Resident #2, who was admitted to hospice services with a terminal prognosis of Alzheimer's disease, did not have a significant change in status assessment completed within the 14-day period following their admission to hospice. Interviews with the MDS Coordinator confirmed that the assessments for these residents were not completed within the required timeframe, indicating a failure to adhere to the CMS guidelines for significant change assessments.
Resident-to-Resident Altercation Due to Cognitive Impairment
Penalty
Summary
The facility failed to protect a resident from physical abuse by another resident. Resident #135, who had severe cognitive impairment due to Alzheimer's Disease and Dementia, was struck in the face by Resident #136's foot. Resident #136 also had severe cognitive impairment and was diagnosed with Dementia and Alzheimer's Disease. The incident occurred when Resident #136, while seated in a reclined chair, scooted to the bottom and swung her foot, hitting Resident #135 in the face. Both residents had no prior history of altercations, and neither sustained injuries from the incident. The facility's policy on abuse prevention was reviewed, and it was noted that Resident #135 had been experiencing increased aggression and agitation, possibly due to being taken off antipsychotic medication. The comprehensive care plan for Resident #135 included interventions such as psychiatric visits and treatment for a urinary tract infection. Resident #136's care plan also noted dementia-related behaviors and included interventions like frequent checks and psychiatric visits. The facility conducted an investigation and involved law enforcement. The police report confirmed the altercation, noting that both residents had diminished mental capacity and that Resident #135 was asleep upon the officers' arrival. Interviews with facility staff, including the Director of Nursing and a Licensed Practical Nurse, confirmed the physical contact between the residents and that neither sustained injuries. The facility's response included separating the residents and implementing measures to prevent further incidents.
Inaccurate MDS Assessments for Hospice, Restraints, and Falls
Penalty
Summary
The facility failed to accurately complete Minimum Data Set (MDS) assessments for three residents, leading to deficiencies in documenting the use of hospice services, restraints, and falls. Resident #46, who was admitted with diagnoses including Hypertension, Alzheimer's Dementia, and Osteoarthritis, had a physician's order for a soft posey belt restraint, which was not captured in the MDS assessment during the 7-day look-back period. Similarly, Resident #2, admitted with diagnoses such as Failure to Thrive, Dementia, and Repeated Falls, was receiving hospice services and had orders for a lap buddy restraint, yet these were not documented in multiple MDS assessments over several months. Resident #17, with diagnoses including Cirrhosis of the Liver, Atrial Fibrillation, and Hepatic Encephalopathy, was admitted to hospice services and experienced falls, but these were not recorded in the quarterly MDS assessments. The MDS Coordinator confirmed the inaccuracies in the assessments for all three residents, acknowledging that the necessary information regarding hospice services, restraint usage, and falls was not captured as required by the CMS Resident Assessment Instrument (RAI) Version 3.0 Manual.
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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 Morristown
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Heritage Center, The | 1.7 mi | ★★★★★ | 0 | 0 |
| Jefferson Park At White Pine | 10.9 mi | — | 1 | 0 |
| Ridgeview Terrace Of Life Care | 11.2 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Jefferson City | 11.5 mi | ★★★★★ | 0 | 0 |
| Jefferson City Health And Rehab Center | 11.7 mi | ★★★★★ | 0 | 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.