01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-10-16 | 5 | 2024-10-16 | 7 |
| Cycle 2 | 2021-12-01 | 3 | 2021-12-01 | 1 |
| Cycle 3 | 2019-03-27 | 6 | 2019-03-27 | 3 |
CMS CCN 4453432026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Signature Healthcare Of South Pittsburg Rehab & We
201 East 10Th Street · South Pittsburg, TN 37380 · Marion County
Certified beds165CMS provider file
Recent citation rows25current 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
25 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-10-16 · 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 · 2024-10-242024-10-16 · 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 · 2024-11-042024-10-16 · 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 date of correction · 2024-11-04 · complaint2024-10-16 · 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 · 2024-11-04 · complaint2024-10-16 · 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 · 2024-11-042024-10-16 · 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 · 2024-11-042024-10-16 · FIREK0232Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
Correction field: Deficient, Provider has date of correction · 2024-10-242024-10-16 · FIREK0293Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2024-10-242024-10-16 · 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 · 2024-10-242024-10-16 · 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 · 2024-10-242024-10-16 · FIREK0741Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2024-10-242024-10-16 · 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 · 2024-10-242023-09-21 · 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: Past Non-Compliance · 2023-06-09 · complaint2023-09-21 · 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 · 2023-09-26 · complaint2023-09-21 · HEALTHF0635Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
Correction field: Past Non-Compliance · 2023-09-10 · complaint2021-12-01 · 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 · 2021-12-312021-12-01 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2021-12-312021-12-01 · 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 · 2021-12-312021-12-01 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2021-12-312019-03-27 · 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 · 2019-04-182019-03-27 · 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 · 2019-05-042019-03-27 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2019-05-042019-03-27 · HEALTHF0840Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
Correction field: Deficient, Provider has date of correction · 2019-05-042019-03-27 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2019-04-1503 / 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 |
|---|---|---|---|
| 2024-10-16 | Fine | $12,149 | 0 |
| 2023-09-21 | Fine | $7,901 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LP CR HOLDINGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 11/01/2007
- AGEMO HOLDINGS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/01/2016
- JJLA LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/01/2007
- LPSNF II LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/01/2016
- WHEATEN LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/01/2007
- STEIER III, ELMERIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/01/2007
- LOVE, DOYLEIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 02/01/2021
- HARRISON, JOHNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/01/2007
- LOVE, DOYLEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2021
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 hours3.36per resident day
RN hours0.80per resident day
Weekend nurse hours2.75per resident day
Staff turnover25.0%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.