01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2022-01-20 | 7 | 2022-01-20 | 0 |
| Cycle 2 | 2019-05-15 | 0 | 2019-05-15 | 0 |
| Cycle 3 | 2018-06-27 | 8 | 2018-06-27 | 5 |
CMS CCN 4455182026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Waynesboro Post Acute & Rehabilitation
104 J V Mangubat Drive · Waynesboro, TN 38485 · Wayne County
Certified beds109CMS provider file
Recent citation rows20current 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
20 rows in the current release
7 rows carry G–L scope/severity codes; 0 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-10-22 · 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 · 2025-11-17 · complaint2025-10-22 · 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 · 2025-11-17 · complaint2025-10-22 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-11-17 · complaint2025-10-22 · HEALTHF0842Severity F · widespread; 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 · 2025-11-17 · complaint2022-01-20 · 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 · 2022-02-142022-01-20 · HEALTHF0640Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Correction field: Deficient, Provider has date of correction · 2022-02-142022-01-20 · HEALTHF0761Severity E · pattern; 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 · 2022-02-142018-06-27 · FIREE0015Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2018-07-222018-06-27 · FIREE0020Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2018-07-222018-06-27 · FIREE0026Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Correction field: Deficient, Provider has date of correction · 2018-07-222018-06-27 · FIREE0036Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Establish emergency prep training and testing.
Correction field: Deficient, Provider has date of correction · 2018-07-222018-06-27 · FIREE0037Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2018-07-222018-06-27 · HEALTHF0580Severity G · isolated actual harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2018-07-272018-06-27 · HEALTHF0657Severity G · isolated actual 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 · 2018-07-272018-06-27 · 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 · 2018-07-272018-06-27 · HEALTHF0686Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2018-07-272018-06-27 · HEALTHF0689Severity G · isolated actual 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 · 2018-07-272018-06-27 · HEALTHF0806Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Correction field: Deficient, Provider has date of correction · 2018-07-272018-06-27 · HEALTHF0835Severity G · isolated actual harm
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 · 2018-07-272018-06-27 · HEALTHF0867Severity G · isolated actual harm
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 · 2018-07-2703 / 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 |
|---|---|---|---|
| 2025-10-22 | Fine | $8,788 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- TN 2 SNF OPERATIONS HOLDINGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 06/17/2024
- BERGIN, MILESIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/17/2024
- IDELS, SHIMONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/17/2024
- BERGIN, MILESIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/17/2024
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 hours3.53per resident day
RN hours0.47per resident day
Weekend nurse hours3.07per resident day
Staff turnover26.1%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.