Above average — CMS composite of the measures below.
The next survey window likely opens around February 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 The Waters Of Union City , Llc during CMS and state inspections, most recent first.
A resident with a PICC line, osteomyelitis, sepsis, diabetes, and heart failure did not have documented NS and heparin flushes on the MAR while receiving IV antibiotics. Facility policy required SASH flushing for PICC maintenance, but the MAR showed blank/unsigned flush entries, and the DON and RN confirmed the flush orders should have been scheduled rather than listed PRN.
Failure to use EBP during PICC line medication administration: An RN administered an IV antibiotic through a resident’s PICC line without wearing a gown, despite the resident being ordered for EBP due to the PICC and osteomyelitis. Observation also found no EBP signage in the room, and both the RN and DON stated that PPE should have been used for the IV medication administration.
The facility failed to inform residents about their rights to refuse treatment and formulate advance directives, affecting eight residents. The 'Acknowledgement of Advanced Directive Discussion' forms were not completed correctly, and staff interviews confirmed a lack of awareness regarding the need for responsible parties to fill out forms for cognitively impaired residents.
A resident with multiple diagnoses, including Parkinson's and Dementia, was prescribed Seroquel and Lexapro without proper monitoring for behaviors or side effects, contrary to the facility's policy. The DON confirmed the lack of monitoring orders, acknowledging the oversight.
The facility did not properly monitor the temperatures of personal refrigerators in resident rooms, risking foodborne illness. A resident's refrigerator lacked a thermometer, and another's was above the acceptable temperature range. Staff acknowledged the issue but did not discard food items as required by policy.
PICC Flushes Not Documented or Scheduled Correctly
Penalty
Summary
Provide for the safe, appropriate administration of IV fluids when needed was not met for one resident with a PICC line. Resident #66 was admitted with orthopedic aftercare, osteomyelitis, sepsis, diabetes, and heart failure. The facility policy for PICC maintenance flushing stated that the SASH method was to be used for intermittent medications or fluids through an open-ended PICC, using saline, medication, saline, and heparin. The resident’s physician orders included IV ceftriaxone and daptomycin, along with heparin flush solution and normal saline flush solution for PICC maintenance. Review of the MAR showed blank and unsigned documentation for normal saline and heparin flushes from 3/12/2026 through 3/16/2026, indicating the flushes had not been administered. The care plan stated the resident had a PICC line in the right upper arm and that the PICC was to be flushed with normal saline per MD orders and IV tubing and port flushed per facility protocol. During interview, the DON stated the SASH protocol was followed for PICC flushing and confirmed the normal saline and heparin orders should have had times to administer rather than being listed as PRN. The DON also confirmed there was no additional information verifying the flushes were given. RN A stated PICC lines are normally flushed with 10 cc normal saline and 5 cc heparin and agreed the flush times should have been scheduled with the medication, but were listed as PRN.
Failure to Use EBP During PICC Line Medication Administration
Penalty
Summary
The facility failed to ensure infection prevention and control when RN A did not use appropriate PPE during IV medication administration through a PICC line for a resident with osteomyelitis of the right ankle and foot, heart failure, and sepsis. The resident had physician orders for Normal Saline flushes for PICC maintenance, daily IV daptomycin for osteomyelitis, and Enhanced Barrier Precautions every shift for osteomyelitis/IV PICC. The facility policy stated that residents with indwelling medical devices, including central venous catheters, were to use gown and gloves during high-contact care activities such as device care or use. During observation of medication administration, RN A prepared and administered the IV antibiotic through the PICC line while using gloves and hand hygiene at various steps, but did not wear a gown. The observation also noted there was no EBP signage on the door or in the room to indicate the resident was on EBP. In interview, RN A stated the resident should have been on EBP and that PPE should have been worn during IV medication administration; the DON also stated that EBP should have been used during medication administration via a PICC line.
Failure to Provide Advance Directive Information
Penalty
Summary
The facility failed to provide residents with information regarding their rights to refuse medical or surgical treatment and to formulate an advance directive. This deficiency was identified for eight residents who were reviewed for advance directives. The facility's policy, titled 'Guidelines for Resident Rights-Advanced Directive(s)', mandates that residents' rights related to advance directives must be explained and documented. However, the review of medical records revealed that the 'Acknowledgement of Advanced Directive Discussion' forms for these residents were not filled out completely or correctly. This issue was consistent across multiple residents, regardless of their cognitive status, as indicated by their Brief Interview for Mental Status (BIMS) scores. Interviews with facility staff, including the Admissions Director and the Director of Social Services, confirmed that the forms were not filled out correctly upon admission. The Admissions Director was unaware that the responsible party should complete the advance directive form if a resident had cognitive deficits. Similarly, the Director of Social Services acknowledged that the responsible party should have been notified to fill out the form when residents were unable to do so due to cognitive impairments. This oversight affected residents with varying degrees of cognitive impairment, as evidenced by their BIMS scores, ranging from severely impaired to cognitively intact.
Failure to Monitor Psychoactive Medication Effects
Penalty
Summary
The facility failed to ensure proper monitoring of behavior and side effects for psychoactive medications prescribed to a resident. The facility's policy on psychotropic medication, dated August 18, 2023, mandates daily monitoring of psychotropic drug use for adverse side effects and the presence of target behaviors. However, a review of the medical records for a resident admitted with diagnoses including Parkinson's Disease, Psychosis, Dementia, and Diabetes, revealed that the resident was receiving anti-psychotic and anti-depressant medications without any documented monitoring for behaviors or side effects. The resident was prescribed Seroquel, an anti-psychotic medication, in varying doses throughout the day, and Lexapro, an anti-depressant, once daily. Despite these prescriptions, there were no orders for behavior or side effect monitoring documented in the medical records. During an interview, the Director of Nurses confirmed the absence of such monitoring orders and acknowledged that the facility should have been conducting daily monitoring of these medications.
Failure to Monitor Refrigerator Temperatures in Resident Rooms
Penalty
Summary
The facility failed to properly monitor the temperatures of personal refrigerators in resident rooms, which could potentially lead to foodborne illness transmission. The facility's policy requires that all personal refrigerators have a thermometer and that temperatures are recorded daily to ensure they remain at or below 41 degrees Fahrenheit. However, observations revealed that Resident #10's refrigerator was full of food items but lacked a thermometer, and Resident #27's refrigerator had a temperature of 60 degrees Fahrenheit with no food items present. Certified Nursing Assistant (CNA) A confirmed the absence of a thermometer in Resident #10's refrigerator and acknowledged that the temperature of Resident #27's refrigerator was above the acceptable range. During interviews, CNA A and the Director of Nursing (DON) both stated that the refrigerator temperatures should be between 35-41 degrees Fahrenheit. The DON indicated that nursing staff is responsible for checking these temperatures and that any food items in a refrigerator with an out-of-range temperature should be discarded. Despite this, CNA A did not discard the food items in Resident #10's refrigerator, indicating a lapse in following the facility's policy and procedures for maintaining safe food storage conditions.
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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 Union City
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Union City Health And Rehabilitation | 0.2 mi | ★★★★★ | 3 | 1 |
| Obion County Nursing Home | 5.2 mi | ★★★★★ | 3 | 0 |
| Vanayer Senior Living And Rehabilitation | 10.6 mi | ★★★★★ | 4 | 0 |
| Fulton Nursing And Rehabilitation, Llc | 10.7 mi | ★★★★★ | 0 | 0 |
| Diversicare Of Martin | 10.8 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.