Below average — CMS composite of the measures below.
A standard survey is most likely before around December 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 Southern Tenn Medical Center Snf during CMS and state inspections, most recent first.
The facility failed to offer advance directive information and assistance to 3 residents on admission, despite policy requiring written information, inquiry about existing directives, and documentation of the offer or decision. Two residents were cognitively intact based on BIMS scores, and one had moderate cognitive impairment; none of the records contained documentation of an advance directive or that the residents or representative were offered help to formulate one. The DON confirmed the lack of documentation and stated the facility had not provided advance directive education or the opportunity to any residents for several months.
Failure to Provide NOMNC and ABN for Discharged Residents: The facility did not provide the required NOMNC or ABN for 3 residents reviewed for beneficiary notification. One resident had severe cognitive impairment and was discharged via EMS stretcher, while two other residents were cognitively intact and discharged home, including one with home health. The MDS RN stated ABNs had not been given to any residents for several months and that no residents receiving Medicare Part A skilled services had received a NOMNC since 2024; the Administrator confirmed the omission.
Missing Medicare, Advance Directive, and COVID-19 Documentation: The facility failed to document NOMNCs and ABNs for three residents discharged from skilled services, failed to document that three residents were offered help with advance directives, and failed to document COVID-19 vaccine education or offers for five residents. Staff also confirmed the facility had not offered COVID-19 education or vaccination to employees since 2022, and the Administrator acknowledged the missing documentation and lack of identified action plans.
QAPI failed to identify ongoing deficiencies involving resident rights, Medicare notices, and COVID-19 vaccine documentation. A resident was not offered the opportunity to formulate an advance directive, several residents did not receive required NOMNC or ABN notices, and five residents lacked documented COVID-19 education or declination forms. Staff also confirmed the facility had not offered the COVID-19 vaccine to employees since 2022, and the deficiencies were not reflected in recent QAPI minutes or addressed through action plans.
Failure to document COVID-19 vaccine education and offers: The facility did not document education or vaccine offers for 5 sampled residents, including residents with UTI, cirrhosis, fractures, dementia, MI, and cognitive impairment, and no declination forms were in the charts. The IP stated the residents had declined, but she did not obtain declinations or document education because she believed it was no longer required. Staff COVID-19 education and vaccine offers had not been provided in several years, and the IP, Employee Health Nurse, and HR Director confirmed the facility had not offered staff COVID-19 vaccines since 2022.
A resident admitted with pressure ulcer of the sacral region and UTI had an indwelling urinary catheter documented in the care plan, progress notes, and direct observations, but the chart contained no physician order for the catheter. The DON confirmed the missing order, and facility policy required physician-documented indications and catheter details for indwelling urinary catheter use.
Failure to Offer Advance Directive Information on Admission
Penalty
Summary
The facility failed to ensure that 3 residents were offered the opportunity to formulate an advance directive upon admission. Facility policy stated that residents or their representatives would be provided written information about advance directives, asked about any existing advance directives prior to or upon admission, and offered assistance in establishing one if none existed, with documentation of the offer and the resident’s decision in the medical record. However, review of the records for Resident #4, Resident #11, and Resident #17 showed no documentation of an advance directive and no documentation that the facility offered assistance or the opportunity to formulate one. Resident #4 was admitted with diagnoses including cerebral infarction, type 2 diabetes mellitus, and muscle weakness, and an admission MDS showed a BIMS score of 13, indicating the resident was cognitively intact. Resident #11 was admitted with diagnoses including cirrhosis of the liver, diabetes, and acute respiratory failure, and had an admission BIMS score of 15, also indicating cognitive intactness. Resident #17 was admitted with diagnoses including urinary tract infection, muscle wasting, and chronic kidney disease, and had an admission BIMS score of 12, indicating moderate cognitive impairment. During interview, the DON confirmed there was no documentation that these residents had advance directives or that the facility educated or offered them the opportunity to formulate advance directives, and stated the facility had not provided such education or opportunity to any residents for several months.
Failure to Provide NOMNC and ABN for Discharged Residents
Penalty
Summary
The facility failed to provide the required Notice of Medicare Non-Coverage (NOMNC) and Advanced Beneficiary Notice (ABN) for 3 residents reviewed for beneficiary notification. Resident #3 was admitted with diagnoses including myocardial infarction and muscle weakness, and a 5-day MDS assessment showed a BIMS score of 4, indicating severe cognitive impairment. A nursing progress note dated 8/26/2025 documented that the resident left the unit to be discharged home and was transferred out via EMS stretcher, but the medical record contained no NOMNC or ABN for the resident or resident representative. Resident #5 was admitted with diagnoses including chronic kidney disease, severe protein calorie malnutrition, and muscle weakness, and an admission MDS showed a BIMS score of 13, indicating cognitive intactness. A nursing progress note dated 8/29/2025 documented discharge to home, but the record contained no NOMNC or ABN. Resident #33 was admitted with diagnoses including congestive heart failure and muscle weakness, and an admission MDS showed a BIMS score of 14, also indicating cognitive intactness. A nursing progress note dated 7/31/2025 documented discharge to home with home health accompanied by spouse and son, and the record contained no NOMNC or ABN. During interviews, the MDS RN stated these residents had not been provided a NOMNC or ABN, that ABNs had not been provided to any residents for several months, and that no residents receiving Medicare Part A skilled services had been given a NOMNC since 2024; the Administrator confirmed these findings.
Missing Medicare, Advance Directive, and COVID-19 Documentation
Penalty
Summary
The facility failed to maintain required discharge and billing documentation for three residents who were discharged from skilled services. Resident #3 was admitted with diagnoses including myocardial infarction and muscle weakness, had severe cognitive impairment on the BIMS, and was discharged by EMS; Resident #5 was admitted with chronic kidney disease, severe protein calorie malnutrition, and muscle weakness, and was discharged home; Resident #33 was admitted with congestive heart failure and muscle weakness, was cognitively intact on the BIMS, and was discharged home with home health and family. The medical records for all three residents did not contain a Notice of Medicare Non-Coverage (NOMNC) or an Advanced Beneficiary Notice (ABN). The MDS RN stated these residents had not been provided a NOMNC or ABN, and also stated the staff had not provided ABNs to any residents for several months and had not provided NOMNCs to residents receiving Medicare Part A skilled services since 2024. The facility also failed to document that residents were offered assistance with advance directives. Resident #4 was admitted with cerebral infarction, diabetes, and muscle weakness and was cognitively intact on the BIMS; Resident #11 was admitted with cirrhosis of the liver, diabetes, and acute respiratory failure and was cognitively intact on the BIMS; Resident #17 was admitted with urinary tract infection, muscle wasting, and chronic kidney disease and had moderate cognitive impairment on the BIMS. None of these three residents had documentation of an advance directive or documentation that the facility offered assistance or an opportunity to formulate one. The facility policy stated residents or their representatives were to be provided written information about advance directives and offered assistance if they had not established one. The DON confirmed there was no documentation in the records showing the residents had been educated or offered assistance to formulate an advance directive, and stated staff had not provided education to any residents on their right to formulate an advance directive for several months. The facility further failed to document COVID-19 vaccination education and offering of the vaccine for five residents, and had not offered the COVID-19 vaccine to staff since 2022. Resident #7, Resident #11, Resident #19, Resident #24, and Resident #32 all had medical records without documentation that COVID-19 education was provided, that the vaccine was offered, or that declination forms were signed. The Infection Preventionist stated the residents had been educated and declined the vaccine, but also stated she did not obtain declination signatures or document education because she believed it was no longer required. She further stated the facility had not offered COVID education or the vaccine to staff in several years. The Employee Health Nurse and Human Resources Director confirmed the facility had not offered COVID-19 education or vaccination to staff since 2022, and the Administrator confirmed the facility had not provided residents the opportunity to formulate advance directives, had not provided ABNs or NOMNCs, and had not documented resident or staff COVID-19 education or staff vaccination offers.
QAPI Failed to Identify Missing Advance Directive, Medicare Notice, and COVID-19 Vaccine Documentation
Penalty
Summary
The facility's leadership and QAPI Committee failed to identify and address multiple ongoing quality deficiencies involving resident rights, Medicare notice requirements, and COVID-19 vaccination documentation. Facility policy required the QAPI Committee to review quality issues and implement responsive action plans, but the Administrator confirmed the deficiencies had not been identified by the committee, were not included in the prior 3 months of QAPI minutes, and no action plans had been developed. The Administrator also stated the committee met monthly and included the Administrator, DON, Infection Preventionist, Medical Director, Social Worker, MDS Coordinator, and Therapy Director. The facility failed to obtain or offer the opportunity to formulate an advance directive for 3 of 3 sampled residents. The DON confirmed there was no documentation showing that Resident #4, Resident #11, and Resident #17 had been educated about or offered the opportunity to formulate an advance directive. The DON further stated staff had not provided education to any residents on their right to formulate an advance directive for several months, and the facility had failed to offer any resident or resident representative this opportunity for an unknown period of time. The facility also failed to provide required NOMNC and ABN documentation to 3 of 3 sampled residents, and staff had not provided ABNs to any residents in the facility. The MDS RN and Administrator confirmed Resident #3, Resident #5, and Resident #33 did not receive NOMNC or ABN notices, and the Administrator stated NOMNCs had not been provided to any residents receiving Medicare Part A skilled services since 2024. In addition, the facility failed to document COVID-19 vaccine education or declination forms for 5 residents, and had not offered the COVID-19 vaccine to staff since 2022. The Infection Preventionist stated education had been provided to the five residents, but she could not produce documentation, did not obtain declination forms, and had not documented education when residents declined. The Employee Health Nurse and Human Resources Director confirmed the facility had not offered COVID-19 education or vaccination to staff in several years.
Failure to Document COVID-19 Vaccine Education and Offers
Penalty
Summary
The facility failed to document education to residents and staff regarding COVID-19 vaccination, failed to document offering the COVID vaccine to residents and completing declination forms when the vaccine was declined, and failed to offer staff COVID-19 vaccines. This affected all staff and 5 of 5 sampled residents reviewed: Resident #7, #11, #19, #24, and #32. Facility policy titled Infection Prevention and Control Plan stated that counseling and continued education are provided as appropriate and that staff have responsibilities in preventing the spread of infection. The policy titled Managing COVID-19 Post PHE stated the facility will encourage staff and residents to remain up to date with recommended COVID-19 vaccine doses, provide education to resident/representative on COVID-19 vaccination, offer COVID-19 vaccinations to all residents, and document the offering, acceptance/refusal, and administration in the medical record. CDC guidance reviewed stated that people who live or work in LTC settings should get an updated COVID-19 vaccine. Medical record review showed no documentation that education was provided or that the vaccine was offered to Resident #7, who had UTI, muscle weakness, abnormal gait, and moderate cognitive impairment; Resident #11, who had cirrhosis of the liver, acute respiratory failure, and type 2 diabetes and was cognitively intact; Resident #19, who had a left femur fracture and abnormal gait and was cognitively intact; Resident #24, who had dementia, left femur fracture, need for assistance with personal care, and pain; or Resident #32, who had myocardial infarction and unsteadiness on feet. No signed declination forms were found for any of these residents. The Infection Preventionist stated education had been provided and all five residents declined the vaccine, but she did not ask them to sign declination forms or document education because she believed it was no longer required. She also stated the facility had not offered COVID education or the vaccine to staff in several years, and the Employee Health Nurse and Human Resources Director confirmed the facility had not offered COVID-19 education or vaccines to staff since 2022.
Missing Physician Order for Indwelling Urinary Catheter
Penalty
Summary
The facility failed to obtain a physician's order for the use of an indwelling urinary catheter for Resident #12, who was admitted with diagnoses including pressure ulcer of the sacral region and urinary tract infection. The facility policy titled Foley Catheter stated that insertion of an indwelling urinary catheter should only be used for appropriate indications and that the indications should be documented by the physician in the catheter order, along with the date and time of insertion, staff inserting, catheter type, size, and proper technique. Review of the resident's baseline care plan and progress notes showed the resident had an indwelling urinary catheter in place, and observations on multiple dates confirmed the catheter was secured to the bottom of the bed in a dignity bag. However, review of physician orders for the relevant period showed no order for the indwelling urinary catheter. During interview, an LPN stated the resident had an indwelling urinary catheter, and the DON confirmed there was not a physician's order for it, stating it was her expectation that staff obtain a physician's order when a resident is admitted with an indwelling urinary catheter.
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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 Winchester
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Elk River Health & Nursing Center Of Winchester | 0.3 mi | ★★★★★ | 0 | 0 |
| Heritage Place Care & Rehabilitation Llc | 0.5 mi | ★★★★★ | 0 | 0 |
| Signature Healthcare Of Monteagle Rehab & Wellness | 15.4 mi | ★★★★★ | 14 | 0 |
| Nhc Healthcare, Tullahoma | 16 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Tullahoma | 16.2 mi | ★★★★★ | 5 | 0 |
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