01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-04-11 | 17 | 2024-04-11 | 4 |
| Cycle 2 | 2021-11-16 | 2 | 2021-11-16 | 4 |
| Cycle 3 | 2019-03-20 | 4 | 2019-03-20 | 1 |
CMS CCN 4452922026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Beech Tree Health And Rehabilitation
240 Hospital Lane Po Box 300 · Jellico, TN 37762 · Campbell County
Certified beds110CMS provider file
Recent citation rows32current 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
32 rows in the current release
8 rows carry G–L scope/severity codes; 7 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-07-30 · HEALTHF0600Severity G · isolated actual harm
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 no plan of correction · complaint2024-04-11 · HEALTHF0568Severity F · widespread; potential for more than minimal harm
Resident Rights Deficiencies
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0600Severity K · pattern of 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 · 2024-08-282024-04-11 · HEALTHF0609Severity K · pattern of immediate jeopardy
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 · 2024-05-242024-04-11 · HEALTHF0610Severity K · pattern of immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0641Severity E · pattern; 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 · 2024-05-242024-04-11 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0656Severity K · pattern of immediate jeopardy
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 · 2024-05-242024-04-11 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
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 · 2024-05-242024-04-11 · HEALTHF0732Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0744Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · 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 · 2024-05-242024-04-11 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0835Severity K · pattern of immediate jeopardy
Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0837Severity K · pattern of immediate jeopardy
Administration Deficiencies
Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Correction field: Deficient, Provider has date of correction · 2024-05-242024-04-11 · HEALTHF0867Severity K · pattern of immediate jeopardy
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 · 2024-05-242024-04-11 · HEALTHF0880Severity E · pattern; 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 · 2024-05-242024-04-11 · 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 · 2024-05-132024-04-11 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-05-132024-04-11 · 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 · 2024-05-132024-04-11 · FIREK0521Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2024-05-132023-10-03 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
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 · 2023-10-20 · complaint2021-11-16 · FIREE0006Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Correction field: Deficient, Provider has date of correction · 2021-12-2003 / 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 |
|---|---|---|---|
| 2024-04-11 | Fine | $138,802 | 0 |
| 2024-04-11 | Payment Denial | $0 | 110 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- JELLICO TN HOLDCO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/15/2019
- AREM, JEFFREYIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/15/2019
- HERSKOWITZ, DAVIDIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/15/2019
- KASPER, AARONIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/15/2019
- MOSKOWITZ, ISAACIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/15/2019
- CHOUDHURY, RUHULIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2022
- HERSKOWITZ, DAVIDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/15/2019
- WELSH, BENTONIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/24/2024
- CHOUDHURY, RUHULIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2022
- HERSKOWITZ, DAVIDIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/15/2019
- WELSH, BENTONIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/24/2024
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 hours3.29per resident day
RN hours0.48per resident day
Weekend nurse hours3.09per resident day
Staff turnover44.7%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.