Average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Mabry Health Care during CMS and state inspections, most recent first.
Walk-In Freezer Not Maintained in Proper Repair: The dietary area walk-in freezer was observed at 9 degrees F, outside the facility’s policy range, with heavy ice buildup on the floor, shelving, door surfaces, fan housing, and food packaging. The ice prevented the door from closing fully, and the door had a broken gasket, condensation, and warping. The DM confirmed the freezer had been out of range and in disrepair for about two months, and the Maintenance Director stated the issue had been present since about February and had worsened over time.
Failure to implement fall interventions was identified for two residents with severe cognitive impairment and diagnoses including dementia, diabetes, schizophrenia, and HTN. The care plans listed gripper strips or non-skid strips by the bed and, for one resident, an anti-roll back device on the wheelchair, but observations showed these items were not in place, and the Administrator confirmed the missing interventions.
EBP was not implemented for a resident with an indwelling foley catheter. The facility policy required gowns and gloves for high-contact care for residents with catheters, but during a transfer with a mechanical lift, two CNAs wore gloves only and did not don gowns. The DON confirmed the resident should have been on EBP, and the posted EBP sign outside the room was labeled for another resident.
A facility failed to label the enteral feeding bag for a resident receiving nutrition through a gastric tube, despite having a policy in place for enteral feeding management. Observations and interviews with staff, including an LPN and the DON, confirmed the oversight, which was acknowledged by the DON.
A facility failed to ensure an expiration date was visible on a bottle of Ferrous Sulfate on a medication cart. The bottle, which was opened and available for use, lacked a visible expiration date. This was confirmed by an LPN and the DON, who acknowledged that medications should have expiration dates to ensure proper usage.
The facility failed to properly contain garbage and refuse as required by their policy. An observation revealed that the dumpster used for waste disposal lacked an intact drain plug, leaving its contents exposed to the elements and potential pests. Dietary staff confirmed the absence of the drain plug, acknowledging the improper containment of the dumpster's contents.
Walk-In Freezer Not Maintained in Proper Repair
Penalty
Summary
The facility failed to maintain kitchen equipment in good repair to store food under sanitary conditions and at proper temperatures. During the initial tour of the dietary department, the walk-in freezer was observed with an external and internal temperature of 9 degrees Fahrenheit, above the facility policy range of -10 to 0 degrees Fahrenheit. Ice was accumulated throughout the unit, including on the floor, shelving, interior door surfaces, fan housing, and the exterior of two bags of queso cheese. The ice buildup on the freezer floor prevented the door from closing completely, leaving a visible gap along the seal, and the freezer door was observed to be in disrepair with a broken gasket seal, visible condensation, and warping of the door structure. The Dietary Manager confirmed the freezer temperature was out of range, the door did not close properly, ice had accumulated on the floor, shelving, and food packaging, and the door had been in disrepair for approximately two months. The Maintenance Director stated the freezer door had been in disrepair since approximately February 2026 and had worsened recently. A project proposal dated 3/25/2026 showed an estimate for freezer door repair, and the Maintenance Director stated a work order had been placed in March 2026 with bids collected, but the bid was not approved until the day the issue was brought to the surveyor's attention.
Failure to Implement Fall Interventions in Care Plans
Penalty
Summary
The facility failed to implement the comprehensive care plan’s fall interventions for 2 residents reviewed for accidents. The facility policy on incidents/accidents/falls stated that after a fall, the resident’s care plan would be addressed to ensure needed points of focus had measurable goals with appropriate interventions in place, and that each fall needed a new care plan intervention. The policy on baseline and comprehensive care plans stated that the comprehensive care plan would expand on the resident’s risks, goals, and interventions using a person-centered approach to achieve the highest level of functioning and greatest degree of comfort and safety. Resident #1 was admitted with diagnoses including dementia, diabetes mellitus, and hypertension, and a Significant Change in Status MDS assessment showed severe cognitive impairment with a BIMS score of 3. The comprehensive care plan identified the resident as at risk for falls and included an intervention for gripper strips to both sides of the bed, but observations on 5/4/2026 and 5/5/2026 showed no non-skid strips on either side of the bed. Resident #66 was admitted with diagnoses including diabetes mellitus, schizophrenia, dementia, and hypertension, and a quarterly MDS assessment showed severe cognitive impairment with a BIMS score of 5. The comprehensive care plan identified the resident as at risk for falls and included interventions for anti-roll back to the wheelchair and non-skid strips to the floor next to the bed, but observations on 5/4/2026 and 5/5/2026 showed no non-skid strips next to the bed, and an observation on 5/6/2026 showed the resident in a wheelchair without an anti-roll back device. The Administrator confirmed these items were not present even though they were listed on both residents’ comprehensive care plans.
EBP Not Used for Resident With Foley Catheter
Penalty
Summary
The facility failed to maintain infection control practices when staff did not implement Enhanced Barrier Precautions (EBP) for a resident with an indwelling foley catheter. The facility policy titled, Enhanced Barrier Precautions, dated 8/2025, stated EBP should be used during high-contact resident care activities for residents with wounds and/or indwelling medical devices, including urinary catheters, and that examples of high-contact care requiring gown and glove use include dressing, bathing, and changing briefs. Resident #20 was admitted with diagnoses including COPD, rheumatoid arthritis, and CKD, and a quarterly MDS assessment showed a BIMS score of 14, indicating the resident was cognitively intact. The current physician's orders dated 5/6/2026 included an order for an indwelling foley catheter, but there was no physician's order for EBP. During observation on 5/6/2026, a sign outside the resident's room indicated EBP, but it was labeled for the resident in B bed rather than Resident #20. CNA A and CNA B were observed transferring Resident #20 with a mechanical lift while a foley catheter drainage bag was visible; both staff wore gloves but did not don gowns. Both CNAs stated Resident #20 should have been on EBP because of the catheter, and the DON/IP confirmed the resident should have been under EBP and that the CNAs were trained on EBP and knew it was needed.
Failure to Label Enteral Feeding Bag
Penalty
Summary
The facility failed to ensure that the tube feeding formula was appropriately labeled for a resident who was receiving enteral nutrition through a gastric tube. The resident, who had a medical history including traumatic brain injury, seizures, stroke, and dysphagia, was admitted to the facility and was receiving artificial nutrition via a gastric tube. A physician's order specified the type and rate of the formula to be administered. However, during multiple observations, it was noted that the feeding bag was not labeled with the name of the formula being infused. Interviews with facility staff, including an LPN and the Director of Nursing, confirmed that the feeding bag should have been labeled with the type of formula. Despite the facility's policy on enteral feeding management, the feeding bag for this resident was observed on several occasions without the required labeling. This oversight was acknowledged by the Director of Nursing, indicating a failure in adhering to the facility's guidelines for enteral feeding management.
Medication Expiration Date Not Visible on Medication Cart
Penalty
Summary
The facility failed to ensure that an expiration date was visible on an over-the-counter house stock medication bottle during a review of medication storage. Specifically, a bottle of Ferrous Sulfate on the C Hall medication cart did not have an expiration date visible, despite being opened and available for immediate resident use. This was observed during a facility survey, and the absence of the expiration date was confirmed by an LPN. The Director of Nursing also confirmed that medications stored in the medication carts should have expiration dates present to ensure they are used within their expiration period.
Improper Containment of Garbage and Refuse
Penalty
Summary
The facility failed to ensure proper containment of garbage and refuse as per their policy. During an observation of the outside dumpster area, it was noted that the dumpster used for waste disposal lacked an intact drain plug. This deficiency left the dumpster's contents exposed to the elements and potential pests. The facility's policy requires that all waste receptacles have drain plugs securely in place to prevent leaks, environmental contamination, and health hazards. Dietary staff confirmed the absence of the drain plug, acknowledging that the dumpster's contents were not properly contained.
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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 Gainesboro
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Celina Health And Rehabilitation Center | 15.2 mi | ★★★★★ | 0 | 0 |
| Signature Healthcare Of Putnam County | 16.4 mi | ★★★★★ | 0 | 0 |
| Red Boiling Springs Tn Opco Llc | 16.4 mi | ★★★★★ | 7 | 0 |
| Nhc Healthcare, Cookeville | 16.5 mi | ★★★★★ | 0 | 0 |
| Grandview Post Acute | 17.4 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 August 2026) and official state health department websites.