Average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Life Care Center Of Old Hickory Village during CMS and state inspections, most recent first.
Failure to Complete Annual N-95 Fit Testing: The facility failed to follow its infection prevention and control program when staff were not fit-tested for N-95 respirators annually as required by policy and CDC/OSHA guidance. The IP said fit testing was done by the SDC, but the SDC stated she had never been fit-tested and had not completed fit testing for staff. The CSD reported being fit-tested, but not within the past year, and the Former IP said he was no longer at the facility and was unsure anyone was trained to perform fit testing after he left.
Medication Error Rate Exceeded Due to Cardiac Medications Given Without Current Vital Signs: An LPN administered multiple cardiac and antihypertensive medications with hold parameters to several residents without obtaining current vital signs immediately before administration. The MARs showed the documented BP and HR values were from earlier times or prior shifts rather than at the time the meds were given, and the pharmacist, Medical Director, and DON all stated vital signs should be obtained before giving medications with hold parameters.
Late Medicare Non-Coverage Notice: The facility failed to issue a NOMNC on time for a resident whose Medicare-covered services ended before the form was signed by a family member. The resident had encephalopathy and speech/language deficits following cerebral infarction, and the SSD stated she was responsible for beneficiary notices but could not explain why the notice was delivered after coverage ended. The DON had no knowledge of the requirements, and the ED stated the notice should have been issued in the required timeframe.
A resident with impaired cognition and a high risk for falls was left unattended in a wheelchair in her room, despite care plan interventions requiring close monitoring and supervision. The resident experienced an unwitnessed fall, resulting in her arm becoming lodged in the wheelchair wheel and sustaining a severe avulsion wound that required surgical intervention. Staff failed to follow care plan directives, did not document required monitoring, and did not address the role of the wheelchair in the incident, leading to actual harm.
The facility did not ensure that residents and their representatives were involved in the care planning process, as required by policy. For three residents with complex medical and cognitive needs, there was no evidence of care planning conferences or participation by representatives, and staff interviews confirmed that required meetings were not consistently held or documented.
Failure to Complete Annual N-95 Fit Testing
Penalty
Summary
The facility failed to implement its infection prevention and control program when all facility staff were not fit-tested for N-95 respirator masks annually as required by the facility policy and CDC guidance. The facility policy titled, Area of Focus: Fit Testing, stated that fit testing must be performed initially before an employee is required to wear a respirator and repeated at least annually, and the CDC document cited the OSHA requirement for annual respirator fit testing and repeat testing when facial changes could affect fit. During interviews, the Infection Preventionist stated N-95 fit testing was performed by the Staff Development Coordinator, but the Staff Development Coordinator stated she had never had a fit test done and had not completed N-95 fit testing for staff. The Central Supply Director stated they had been fit-tested, but not in the last year, and the Former IP stated he had not worked at the facility for over a year and was not sure anyone was trained to complete N-95 fit testing after he left. The DON stated fit testing should be completed initially upon hire and once a year, and the ED stated he expected it to be completed by the IP and SDC.
Medication Error Rate Exceeded Due to Cardiac Medications Given Without Current Vital Signs
Penalty
Summary
The facility failed to ensure the medication error rate remained at 5 percent or less. Surveyors identified 4 medication errors out of 30 opportunities during medication administration, affecting 4 residents and resulting in a medication error rate of 13.33%. The deficiency involved administration of medications with hold parameters without obtaining current vital signs immediately before administration. Resident #37 had diagnoses including essential hypertension and a history of TIA and cerebral infarction without residual effects. The resident had an order for amlodipine besylate 5 mg twice daily with instructions to hold for SBP less than 100 mmHg or HR less than 60 bpm. During observation, an LPN administered the medication without obtaining vital signs first. The LPN stated she relied on vital signs obtained around 5:00 AM and did not believe an additional set was required before giving the cardiac medication. The MAR documented blood pressure and pulse values, but the record showed those values were from 6:30 AM, not from the time of administration. Resident #110 had a diagnosis of diastolic CHF and an order for carvedilol 3.125 mg daily with hold parameters for SBP less than 100 mmHg or HR less than 60 bpm. The LPN administered the medication without obtaining current vital signs and stated she used earlier shift vital signs instead. The MAR documented blood pressure and pulse values from 4:30 PM the prior day, and there were no documented vital signs at the time of administration. Resident #97, who had heart failure and hypertensive heart disease with heart failure, received metoprolol tartrate 25 mg twice daily with hold parameters, and the LPN again administered the medication without obtaining current vital signs. The MAR documented a blood pressure reading from the prior day and contained no documented heart rate. Resident #129, who had chronic systolic CHF and essential hypertension, had an order for losartan potassium 25 mg daily with hold parameters. The LPN administered the medication without obtaining current vital signs, relying on values documented earlier that morning rather than at the time of administration. During interviews, the pharmacist stated nurses should obtain vital signs within 30 minutes prior to administering medications with hold parameters because geriatric residents can change quickly. The Medical Director stated she expected nurses to obtain ordered vital signs when administering medications with hold parameters. The DON stated she expected the LPN to obtain vital signs immediately before administering any drug with hold parameters. The Administrator stated he would defer his expectations of medication administration to the DON.
Late Medicare Non-Coverage Notice
Penalty
Summary
The facility failed to issue a beneficiary notification timely for one resident reviewed for beneficiary notices. Facility policy stated that the Notice of Medicare Non-Coverage (NOMNC) is to be given to Medicare beneficiaries at least two days before the end of a Medicare-covered Part A stay or when Part B therapies are ending, and the notice informs beneficiaries of the right to an expedited review by a Quality Improvement Organization. Resident #128 was admitted on 03/17/2026 and discharged on 04/07/2026. The resident’s discharge MDS showed a BIMS score of 15, indicating intact cognition, and the resident’s medical history included encephalopathy and other speech and language deficits following cerebral infarction. The resident’s Notice of Medicare Non-Coverage showed that Medicare coverage ended on 04/06/2026, but the form was signed by a family member on 04/07/2026. The resident’s Notice of Resident Transfer or Discharge was also dated 04/07/2026 and signed by the family member that same day. During interview, the SSD stated she was responsible for beneficiary notifications and usually issued NOMNCs a week before they were due, but she could not explain why the signature and delivery date were after the coverage end date. The DON stated she had no knowledge of the beneficiary notification requirements, and the ED stated he expected the NOMNC to be issued in the time required and that it was not appropriate for a resident to sign the NOMNC the day after services ended.
Failure to Prevent Accident Hazards and Ensure Supervision Resulting in Resident Harm
Penalty
Summary
The facility failed to identify and eliminate accident hazards and did not provide adequate supervision to prevent a serious fall and injury for a resident with a history of repeated falls, impaired cognition, and significant physical limitations. The resident, who was dependent on staff for transfers and used a wheelchair for mobility, was left unattended in her room in her wheelchair, contrary to multiple care plan interventions that specified she should not be left alone in this situation and should be monitored closely at the nurse station or dayroom. Despite these documented interventions, staff left the resident unsupervised, resulting in an unwitnessed fall where her right arm became lodged in the wheel of the wheelchair, causing a large avulsion wound that required hospital transfer and surgical repair. Review of facility policies and the resident's care plan revealed clear directives for staff to provide close monitoring, avoid leaving the resident unattended in her wheelchair, and to document frequent checks, especially given her high fall risk and cognitive impairment. Multiple staff interviews confirmed that the resident was left alone in her room in her wheelchair, and that monitoring and documentation of supervision were not consistently performed as required by the care plan. Additionally, the facility's investigation did not address the role of the wheelchair in the incident, nor did it include measurements of the injury, and there was no evidence that the care plan was updated to address the identified hazards related to wheelchair use. Staff actions following the fall also deviated from facility policy, as a CNA removed the resident's arm from the wheelchair wheel before a licensed nurse assessed the injury, which was not in accordance with the facility's protocol for post-fall assessment. Interviews with the DON and other staff revealed a lack of clarity and consistency in monitoring practices, documentation, and adherence to care plan interventions. The facility did not provide documentation of required 30-minute monitoring checks, and there was no evidence of a performance improvement plan following the incident. These failures resulted in actual harm to the resident.
Failure to Involve Residents and Representatives in Care Planning Process
Penalty
Summary
The facility failed to ensure that residents and/or their representatives were involved in the care planning process as required by both facility policy and federal regulations. Review of facility policy indicated that residents and their representatives must be given the opportunity to participate in the development, review, and revision of the care plan, and that care planning meetings should be held at times conducive to resident participation. However, for three sampled residents, there was a lack of evidence that care planning conferences were conducted with resident or representative involvement. For example, one resident's family member reported not participating in care plan meetings following a significant event, and the facility was unable to provide documentation of care conference meetings for other residents during required intervals. Medical record reviews showed that residents with significant cognitive impairments and complex medical histories, such as anxiety, blindness, repeated falls, traumatic brain dysfunction, dementia, and chronic conditions, did not have documented participation in care planning by themselves or their representatives. Interviews with facility staff, including the Social Service Director and Director of Nursing, revealed inconsistencies and assumptions regarding the frequency and documentation of care plan conferences, with the DON acknowledging that care conference meetings had likely not been conducted as required due to missing documentation.
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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 Old Hickory
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Creekside Center For Rehabilitation And Healing | 2.9 mi | ★★★★★ | 0 | 0 |
| The Mckendree Post Acute & Rehabilitation | 4.5 mi | ★★★★★ | 1 | 0 |
| Alta Heights Post Acute | 4.6 mi | ★★★★★ | 9 | 0 |
| Nhc Healthcare, Hendersonville | 4.8 mi | ★★★★★ | 2 | 0 |
| Heartland | 5.3 mi | ★★★★★ | 3 | 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 October 2026) and official state health department websites.