01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-06-10 | 4 | 2026-06-10 | 3 |
| Cycle 2 | 2022-02-25 | 8 | 2022-02-25 | 3 |
| Cycle 3 | 2019-12-11 | 13 | 2019-12-11 | 13 |
CMS CCN 4454952026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Collierville Nursing And Rehabilitation, Llc
490 West Poplar Avenue · Collierville, TN 38017 · Shelby County
Certified beds114CMS provider file
Recent citation rows44current CMS citation release
Penalty rows0current 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
44 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-10 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-07-022026-06-10 · 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 · 2026-07-022026-06-10 · FIREK0223Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2026-07-012026-06-10 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2026-07-012026-06-10 · FIREK0781Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have restrictions on the use of portable space heaters.
Correction field: Deficient, Provider has date of correction · 2026-07-012026-02-13 · HEALTHF0609Severity D · isolated; 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 · 2026-02-16 · complaint2025-11-18 · HEALTHF0609Severity D · isolated; 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 · 2025-11-21 · complaint2022-02-25 · FIREE0001Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2022-04-272022-02-25 · FIREE0004Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2022-04-272022-02-25 · 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 · 2022-04-272022-02-25 · 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 · 2022-04-012022-02-25 · HEALTHF0607Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2022-04-012022-02-25 · 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 · 2022-04-012022-02-25 · 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 · 2022-04-012022-02-25 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2022-04-012022-02-25 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2022-04-012022-02-25 · HEALTHF0791Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
Correction field: Deficient, Provider has date of correction · 2022-04-012022-02-25 · HEALTHF0880Severity F · widespread; 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 · 2022-04-012019-12-11 · FIREE0001Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2020-01-252019-12-11 · HEALTHF0569Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Correction field: Deficient, Provider has date of correction · 2020-01-042019-12-11 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2020-01-042019-12-11 · 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 · 2020-01-042019-12-11 · HEALTHF0657Severity E · pattern; 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 · 2020-01-042019-12-11 · 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 · 2020-01-0403 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- COLLIERVILLE NURSING AND REHABILITATION LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 10/13/2018
- HYMAN, SIMCHAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST50% · since 10/13/2018
- MOUGHRABIEH, MOHAMADIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2022
- CLEARVIEW HEALTHCARE MANAGEMENT TN LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/12/2018
- CROWDUS, KENNETHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/09/2026
- MOUGHRABIEH, MOHAMADIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2022
- VUJANOVIC, MICKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/12/2018
- CLEARVIEW HEALTHCARE MANAGEMENT TN LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/23/2026
- CROWDUS, KENNETHIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/09/2026
- MOUGHRABIEH, MOHAMADIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2022
- VUJANOVIC, MICKIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/12/2018
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 hours3.39per resident day
RN hours0.44per resident day
Weekend nurse hours3.03per resident day
Staff turnover50.0%CMS reported field
06 / LOCAL RECORDS
Open the Collierville ledger →