01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2023-09-19 | 6 | 2023-09-19 | 2 |
| Cycle 2 | 2019-12-18 | 0 | 2019-12-18 | 1 |
| Cycle 3 | 2018-10-31 | 10 | 2018-10-31 | 3 |
CMS CCN 4454792026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Life Care Center Of Gray
791 Old Gray Station Road · Gray, TN 37615 · Washington County
Certified beds133CMS provider file
Recent citation rows22current CMS citation release
Penalty rows1current 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
22 rows in the current release
4 rows carry G–L scope/severity codes; 4 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-06-20 · 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 · 2024-07-12 · complaint2024-04-12 · HEALTHF0603Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Correction field: Deficient, Provider has date of correction · 2024-05-12 · complaint2024-04-12 · HEALTHF0609Severity J · isolated 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 · 2024-05-12 · complaint2024-04-12 · 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 · 2024-05-12 · complaint2024-04-12 · 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 · 2024-05-12 · complaint2024-04-12 · HEALTHF0675Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Honor each resident's preferences, choices, values and beliefs.
Correction field: Deficient, Provider has date of correction · 2024-05-12 · complaint2023-09-19 · 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 · 2023-11-03 · complaint2023-09-19 · 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 · 2023-11-032023-09-19 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2023-11-03 · complaint2023-09-19 · HEALTHF0812Severity F · widespread; 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 · 2023-11-032023-09-19 · HEALTHF0814Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2023-11-032023-09-19 · 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 · 2023-11-032023-09-19 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2023-11-032023-09-19 · FIREK0761Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2023-11-032019-12-18 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2019-12-182018-10-31 · HEALTHF0646Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Correction field: Deficient, Provider has date of correction · 2018-12-152018-10-31 · 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 · 2018-12-152018-10-31 · HEALTHF0759Severity E · pattern; 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 · 2018-12-152018-10-31 · HEALTHF0921Severity C · widespread; potential for minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2018-12-152018-10-31 · FIREK0211Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2018-12-152018-10-31 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2018-12-152018-10-31 · FIREK0918Severity D · isolated; 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 · 2018-12-1503 / 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 |
|---|---|---|---|
| 2024-04-12 | Fine | $10,039 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SWANKER, RICHARDIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST25% · since 07/01/2006
- LEE, ASHLEYIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 05/11/2009
- CROSS, CINDYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/24/2004
- PRESTON, FORRESTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/24/2004
- SWANKER, RICHARDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2006
- THURMOND, JOANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/24/2004
- LIFE CARE CENTERS OF AMERICA, INC.Organization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/24/2005
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 hours3.40per resident day
RN hours0.61per resident day
Weekend nurse hours2.80per resident day
Staff turnover33.3%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.