01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-17 | 4 | 2025-12-17 | 4 |
| Cycle 2 | 2023-08-16 | 10 | 2023-08-16 | 3 |
| Cycle 3 | 2019-12-10 | 1 | 2019-12-10 | 1 |
CMS CCN 4452632026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Tri State Health And Rehabilitation Center
600 Shawanee Rd · Harrogate, TN 37752 · Claiborne County
Certified beds116CMS provider file
Recent citation rows23current 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
23 rows in the current release
5 rows carry G–L scope/severity codes; 5 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-12-17 · HEALTHF0602Severity D · isolated; 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: Past Non-Compliance · 2025-11-21 · complaint2025-12-17 · 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 · 2026-01-242025-12-17 · 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 · 2026-01-242025-12-17 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2026-01-242025-12-17 · 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 · 2026-01-062025-12-17 · 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 · 2026-01-022025-12-17 · 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 · 2025-12-292025-12-17 · FIREK0918Severity F · widespread; 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 · 2025-12-292024-09-26 · 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 · 2024-10-19 · complaint2024-09-26 · HEALTHF0656Severity E · pattern; 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 · 2024-10-19 · complaint2024-09-26 · HEALTHF0678Severity K · pattern of immediate jeopardy
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Correction field: Deficient, Provider has date of correction · 2024-10-19 · complaint2024-09-26 · HEALTHF0726Severity K · pattern of immediate jeopardy
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2024-10-19 · complaint2024-09-26 · 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 · 2024-10-19 · complaint2024-09-26 · 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 · 2024-10-19 · complaint2024-09-26 · HEALTHF0842Severity E · pattern; 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 · 2024-10-19 · complaint2024-09-26 · 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 · 2024-10-19 · complaint2023-08-16 · HEALTHF0693Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Correction field: Deficient, Provider has date of correction · 2023-09-162023-08-16 · HEALTHF0812Severity D · isolated; 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 · 2023-08-282023-08-16 · 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 · 2023-09-122023-08-16 · FIREK0700Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.
Correction field: Deficient, Provider has date of correction · 2023-09-122023-08-16 · FIREK0754Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Provide properly sized and located linen or trash receptacles.
Correction field: Deficient, Provider has date of correction · 2023-09-122019-12-10 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2019-12-102019-12-10 · FIREK0761Severity F · widespread; 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 · 2020-01-2103 / 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 |
|---|---|---|---|
| 2024-09-26 | Fine | $7,426 | 0 |
| 2024-09-26 | Fine | $7,426 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ROCKY TOP HEALTHCARE LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 10/17/2023
- ABBOTT, SWATIIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- AGWUNOBI, JOHNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- ALBRECHTSEN, TYLERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- BLOUIN, ANNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- CHRISTENSEN, CHRISTOPHERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- PARKINSON, MARKIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- PORT, BARRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- SHAW, DARENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- SMITH, BARRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- SNAPPER, SUZANNEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2023
- BURNAM, SOONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2023
- BURTON, SPENCERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2023
- PORT, BARRYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2023
- SATO, AMIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/09/2024
- SNAPPER, SUZANNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2023
- THATCHER, BRENTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2023
- SMITH, MAGENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
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 hours3.44per resident day
RN hours0.73per resident day
Weekend nurse hours2.92per resident day
Staff turnover38.5%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.