01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2023-08-02 | 17 | 2023-08-02 | 19 |
| Cycle 2 | 2019-05-02 | 2 | 2019-05-02 | 11 |
| Cycle 3 | 2018-04-18 | 9 | 2018-04-18 | 5 |
CMS CCN 4451702026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Antioch Tn Opco, Llc
500 Hickory Hollow Terrace · Antioch, TN 37013 · Davidson County
Certified beds110CMS provider file
Recent citation rows63current CMS citation release
Penalty rows2current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
63 rows in the current release
10 rows carry G–L scope/severity codes; 5 carry J–L. 12 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-10-09 · HEALTHF0600Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-11-18 · complaint2025-10-09 · HEALTHF0610Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-11-18 · complaint2025-10-09 · HEALTHF0689Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-11-18 · complaint2023-08-24 · FIREE0015Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2023-10-10 · complaint2023-08-24 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2023-10-10 · complaint2023-08-24 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2023-10-10 · complaint2023-08-02 · FIREE0009Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Include a process for Emergency Preparedness collaboration.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0015Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0020Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0022Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures for sheltering.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0024Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures for volunteers.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0025Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Create arrangements with other facilities to receive patients.
Correction field: Deficient, Provider has date of correction · 2023-08-282023-08-02 · FIREE0026Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0029Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop a communication plan.
Correction field: Deficient, Provider has date of correction · 2023-08-282023-08-02 · FIREE0030Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0031Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide emergency officials' contact information.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0032Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide primary/alternate means for communication.
Correction field: Deficient, Provider has date of correction · 2023-08-232023-08-02 · FIREE0033Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish methods for sharing information.
Correction field: Deficient, Provider has date of correction · 2023-08-282023-08-02 · FIREE0034Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide a means of sharing information on occupancy/needs.
Correction field: Deficient, Provider has date of correction · 2023-08-282023-08-02 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2023-08-23 · complaint2023-08-02 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2023-08-23 · complaint2023-08-02 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2023-08-23 · complaint2023-08-02 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2023-08-23 · complaint2023-08-02 · HEALTHF0625Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2023-08-23 · complaint03 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-10-09 | Fine | $125,418 | 0 |
| 2023-10-10 | Fine | $7,342 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ANTIOCH TN HOLDCO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 07/01/2025
- KENIGSBERG, MAXIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 07/01/2025
- KENIGSBERG, MAXIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2025
- KENIGSBERG, MAXIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2025
- REHMAN, FAIZAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2025
- SANTOS, ARMANDOIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2025
- KENIGSBERG, MAXIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/01/2025
- REHMAN, FAIZAIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/01/2025
- SANTOS, ARMANDOIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/01/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours—per resident day
RN hours—per resident day
Weekend nurse hours—per resident day
Staff turnover—%CMS reported field
06 / LOCAL RECORDS
Open the Antioch ledger →