01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-10 | 8 | 2025-12-10 | 2 |
| Cycle 2 | 2024-09-25 | 6 | 2024-09-25 | 3 |
| Cycle 3 | 2019-11-20 | 14 | 2019-11-20 | 1 |
CMS CCN 4451232026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Ascension Living Alexian Village Tennessee
671 Alexian Way · Signal Mountain, TN 37377 · Hamilton County
Certified beds114CMS provider file
Recent citation rows34current CMS citation release
Penalty rows3current 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
34 rows in the current release
6 rows carry G–L scope/severity codes; 5 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-12-10 · HEALTHF0557Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0725Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Past Non-Compliance · 2025-11-17 · complaint2025-12-10 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-12-292025-12-10 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-12-092025-12-10 · FIREK0712Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-12-292024-09-25 · HEALTHF0584Severity D · isolated; 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 · 2024-10-122024-09-25 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-10-122024-09-25 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-10-122024-09-25 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-10-112024-09-25 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-10-112024-09-25 · FIREK0923Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2024-10-102024-08-07 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-09-01 · complaint2024-08-07 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2024-09-01 · complaint2024-08-07 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-09-01 · complaint2023-12-13 · HEALTHF0609Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-01-12 · complaint2023-12-13 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2024-01-12 · complaint2023-12-13 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2024-01-12 · complaint2023-10-11 · 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 · 2023-11-21 · complaint2023-10-11 · HEALTHF0602Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Deficient, Provider has date of correction · 2023-11-21 · 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 |
|---|---|---|---|
| 2025-12-08 | Fine | $12,438 | 0 |
| 2023-10-11 | Fine | $214,408 | 0 |
| 2023-10-11 | Payment Denial | $0 | 63 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ASCENSION HEALTH SENIOR CAREOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 07/01/2014
- SHADBOLT, ERINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- MUSGRAVE, LISAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2024
- NIECKULA, GREGORYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2017
- SIMMONS, TEDDIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/28/2025
- ASCENSION HEALTH SENIOR CAREOrganization · ADP OF THE SNFNOT APPLICABLE · since 07/01/2015
- HEALTH DIMENSIONS CONSULTING INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 08/02/2019
- HOUSE HEALTHCARE SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/10/2025
- MEDICAL SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/16/2025
- THE ROSE GROUP, INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/16/2025
- MUSGRAVE, LISAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- NIECKULA, GREGORYIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/01/2017
- SHADBOLT, ERINIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- SIMMONS, TEDDIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/28/2025
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 hours4.05per resident day
RN hours0.66per resident day
Weekend nurse hours3.75per resident day
Staff turnover49.0%CMS reported field
06 / LOCAL RECORDS
Open the Tennessee ledger →Other published facilities nearby
No second facility in the same city met the directory rule.