{"schema_version":"1.0.0","facility":{"id":"cms-445319","ccn":"445319","name":"Elk River Health & Nursing Center of Winchester","source_name":"ELK RIVER HEALTH & NURSING CENTER OF WINCHESTER","facility_types":["skilled_nursing_facility","nursing_home"],"primary_type":"skilled_nursing_facility","universe":"cms_certified_nursing_homes","source_type_label":"Medicare and Medicaid","status":"active","status_label":"Active CMS certification","status_evidence":"VERIFIED","state":"TN","address":{"line1":"32 Memorial Drive","city":"Winchester","state":"TN","zip":"37398","county_name":"Franklin County","county_fips":"47051","county_method":"name_match","ssa_county_code":"250","urban":false},"location":{"lat":35.177,"lon":-86.094,"method":"cms_published_coordinates"},"phone":"9319670200","certification":{"authority":"CMS","ccn":"445319","program":"Medicare and Medicaid","medicare":true,"medicaid":true,"first_approved":"1993-10-01","certified_beds":80,"resides_in_hospital":false,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/445319"},"licenses":[],"license_note":"State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.","capacity":{"certified_beds":80,"avg_residents_per_day":56.1},"ownership_type":"Non profit - Other","ownership_class":"non_profit","legal_business_name":"ELK RIVER HEALTH & NURSING CENTER OF WINCHESTER, LLC","flags":{"ccrc":false,"abuse_icon":false,"high_performing":false,"inspection_over_2y":false,"changed_ownership_12mo":false,"resident_family_council":"Resident","sprinklers_all_areas":"Yes"},"ratings":{"overall":{"value":4},"health_inspection":{"value":4},"quality_measures":{"value":3},"long_stay_qm":{"value":4},"short_stay_qm":{"value":2},"staffing":{"value":2},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":1.75645,"lpn_hprd":1.25305,"rn_hprd":0.62668,"licensed_hprd":1.87973,"total_nurse_hprd":3.63619,"weekend_total_nurse_hprd":3.06212,"weekend_rn_hprd":0.39624,"pt_hprd":0.02522,"nursing_turnover_pct":72.5,"rn_turnover_pct":50,"administrators_left":1,"case_mix_index":1.53148,"case_mix_index_ratio":1.08596,"case_mix_total_nurse_hprd":4.23618,"adjusted_total_nurse_hprd":3.32208,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2025-07-30","cycle1_deficiencies":3,"cycle1_score":12,"cycle2_date":"2024-04-03","cycle23_deficiencies":5,"cycle23_score":32,"total_weighted_score":17},"cms_penalty_counts":{"fines":0,"fine_total":0,"payment_denials":0,"total":0},"chain":{"id":"cms-chain-532","cms_chain_id":"532","name":"TWIN RIVERS HEALTH & REHABILITATION"},"operator_id":"op-elk-river-health-and-nursing-center-of-winchester-llc","first_seen":"2026-11-07T00:15:24.640Z","last_changed":"2026-11-07T00:15:24.640Z","profile_url":"https://www.medicare.gov/care-compare/details/nursing-home/445319","provenance":[{"source_id":"cms_provider_info","source_record_id":"445319","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["name","address","phone","certification","certified_beds","ownership_type","legal_business_name","chain"],"evidence_class":"VERIFIED","status":"current"},{"source_id":"cms_provider_info","source_record_id":"445319","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["ratings","staffing","health_survey_score"],"evidence_class":"VERIFIED","status":"current","note":"Five-Star ratings and PBJ staffing apply to the CMS-certified universe only."}],"inspection_summary":{"count":6,"health_count":3,"fire_count":3,"complaint_count":1,"latest_date":"2025-07-30","latest_standard_health":"2025-07-30","earliest_date":"2021-12-14","window_note":"CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.","evidence_class":"VERIFIED"},"deficiency_summary":{"count":35,"health_count":9,"fire_count":26,"open_count":0,"actual_harm_count":0,"immediate_jeopardy_count":0,"serious_count":0,"complaint_count":1,"by_severity":{"potential":35},"by_scope_severity":{"D":34,"F":1},"by_concept":{"emergency_preparedness":17,"environment_life_safety":9,"resident_rights":1,"clinical_care":6,"food_nutrition":2},"type_ids":["cms-e0004","cms-e0006","cms-e0015","cms-e0024","cms-e0026","cms-e0032","cms-e0034","cms-e0035","cms-e0037","cms-e0039","cms-k0232","cms-k0321","cms-k0372","cms-k0741","cms-k0761","cms-k0918","cms-k0921","cms-f0609","cms-f0641","cms-f0657","cms-e0030","cms-e0033","cms-k0324","cms-k0351","cms-f0812","cms-f0656","cms-f0684","cms-f0695","cms-f0814","cms-e0020","cms-f0693"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":0,"fines":0,"fine_total":0,"payment_denials":0},"ownership_summary":{"disclosures":31,"organizations":4,"individuals":24,"not_available":false}},"row":{"id":"cms-445319","ccn":"445319","name":"Elk River Health & Nursing Center of Winchester","types":["skilled_nursing_facility","nursing_home"],"status":"active","state":"TN","city":"Winchester","zip":"37398","county_fips":"47051","county_name":"Franklin County","address":"32 Memorial Drive","beds":80,"residents":56.1,"ownership":"non_profit","operator_id":"op-elk-river-health-and-nursing-center-of-winchester-llc","operator_name":"Elk River Health & Nursing Center of Winchester, LLC","chain_id":"cms-chain-532","chain_name":"Twin Rivers Health & Rehabilitation","lat":35.177,"lon":-86.094,"overall":4,"health_rating":4,"staffing_rating":2,"qm_rating":3,"nurse_hprd":3.64,"turnover":72.5,"inspections":6,"last_inspection":"2025-07-30","deficiencies":35,"serious":0,"ij":0,"open":0,"penalties":0,"fines_total":0,"deficiency_type_ids":["cms-e0004","cms-e0006","cms-e0015","cms-e0024","cms-e0026","cms-e0032","cms-e0034","cms-e0035","cms-e0037","cms-e0039","cms-k0232","cms-k0321","cms-k0372","cms-k0741","cms-k0761","cms-k0918","cms-k0921","cms-f0609","cms-f0641","cms-f0657","cms-e0030","cms-e0033","cms-k0324","cms-k0351","cms-f0812","cms-f0656","cms-f0684","cms-f0695","cms-f0814","cms-e0020","cms-f0693"],"universe":"cms","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"operator":{"id":"op-elk-river-health-and-nursing-center-of-winchester-llc","name":"Elk River Health & Nursing Center of Winchester, LLC","legal_name":"ELK RIVER HEALTH & NURSING CENTER OF WINCHESTER, LLC","facility_count":1,"states":["TN"],"match_method":"exact_normalized_legal_name","evidence_class":"CORROBORATED"},"chain":{"id":"cms-chain-532","name":"Twin Rivers Health & Rehabilitation","cms_chain_id":"532","facility_count":11,"states":["TN"],"cms_reported":{"facility_count":11,"avg_overall_rating":3.8,"avg_health_inspection_rating":4,"avg_staffing_rating":2.3,"avg_qm_rating":3.6}},"ownership":[{"owner_type":"individual","owner_name":"Don Bradley","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"BRADLEY, DON"},{"owner_type":"individual","owner_name":"William Burton","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"BURTON, WILLIAM"},{"owner_type":"individual","owner_name":"Kathleen Kupchynsky","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"KUPCHYNSKY, KATHLEEN"},{"owner_type":"individual","owner_name":"Dorothy Phillips","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"PHILLIPS, DOROTHY"},{"owner_type":"individual","owner_name":"John Sheehan","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"SHEEHAN, JOHN"},{"owner_type":"individual","owner_name":"Margaret Sheehan","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2022-12-15","owner_name_raw":"SHEEHAN, MARGARET"},{"owner_type":"individual","owner_name":"Frank Smith","role":"managing_control","role_raw":"MANAGING CONTROL - GOVERNING BODY","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"SMITH, FRANK"},{"owner_id":"org-ocoee-foundation-inc","owner_type":"organization","owner_name":"Ocoee Foundation Inc","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01"},{"owner_id":"org-pioneer-consulting-llc","owner_type":"organization","owner_name":"Pioneer Consulting LLC","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01"},{"owner_id":"org-twin-rivers-health-and-rehabilitation-llc","owner_type":"organization","owner_name":"Twin Rivers Health & Rehabilitation LLC","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01"},{"owner_type":"individual","owner_name":"Don Bradley","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"BRADLEY, DON"},{"owner_type":"individual","owner_name":"William Burton","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"BURTON, WILLIAM"},{"owner_type":"individual","owner_name":"Clinton Davis","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"DAVIS, CLINTON"},{"owner_type":"individual","owner_name":"Michelle Holcombe","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"HOLCOMBE, MICHELLE"},{"owner_type":"individual","owner_name":"Kathleen Kupchynsky","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"KUPCHYNSKY, KATHLEEN"},{"owner_type":"individual","owner_name":"Douglas Malin","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-28","owner_name_raw":"MALIN, DOUGLAS"},{"owner_type":"individual","owner_name":"Dorothy Phillips","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"PHILLIPS, DOROTHY"},{"owner_type":"individual","owner_name":"John Sheehan","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"SHEEHAN, JOHN"},{"owner_type":"individual","owner_name":"Margaret Sheehan","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"SHEEHAN, MARGARET"},{"owner_type":"individual","owner_name":"Frank Smith","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"SMITH, FRANK"},{"owner_type":"individual","owner_name":"John Sheehan","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-07","owner_name_raw":"SHEEHAN, JOHN"},{"owner_type":"individual","owner_name":"Margaret Sheehan","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2022-12-15","owner_name_raw":"SHEEHAN, MARGARET"},{"owner_id":"org-ocoee-foundation-inc","owner_type":"organization","owner_name":"Ocoee Foundation Inc","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01"},{"owner_id":"org-ocoee-winchester-property-investment-llc","owner_type":"organization","owner_name":"Ocoee Winchester Property Investment LLC","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01"},{"owner_id":"org-pioneer-consulting-llc","owner_type":"organization","owner_name":"Pioneer Consulting LLC","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2025-04-14"},{"owner_id":"org-twin-rivers-health-and-rehabilitation-llc","owner_type":"organization","owner_name":"Twin Rivers Health & Rehabilitation LLC","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2025-04-14"},{"owner_type":"individual","owner_name":"Clinton Davis","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"DAVIS, CLINTON"},{"owner_type":"individual","owner_name":"Ephraim Gammada","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-28","owner_name_raw":"GAMMADA, EPHRAIM"},{"owner_type":"individual","owner_name":"Michelle Holcombe","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"HOLCOMBE, MICHELLE"},{"owner_type":"individual","owner_name":"Douglas Malin","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2024-02-28","owner_name_raw":"MALIN, DOUGLAS"},{"owner_type":"individual","owner_name":"John Sheehan","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-04-01","owner_name_raw":"SHEEHAN, JOHN"}],"inspections":[{"id":"cms-445319-20250730-fire","ccn":"445319","date":"2025-07-30","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":17,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0004","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0006","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0015","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0024","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0026","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0032","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0034","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0035","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0037","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-e0039","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0232","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0321","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0372","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0741","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0761","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0918","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"},{"t":"cms-k0921","ss":"D","sl":2,"cs":"corrected","cd":"2025-09-13","std":1,"tv":"New"}]},{"id":"cms-445319-20250730-health","ccn":"445319","date":"2025-07-30","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint","Health Standard"],"cycles":[1,2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":3,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0609","ss":"D","sl":2,"cs":"corrected","cd":"2025-08-30","cmp":1,"std":1},{"t":"cms-f0641","ss":"D","sl":2,"cs":"corrected","cd":"2025-08-30","std":1},{"t":"cms-f0657","ss":"D","sl":2,"cs":"corrected","cd":"2025-08-30","std":1}]},{"id":"cms-445319-20240403-fire","ccn":"445319","date":"2024-04-03","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":4,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0030","ss":"D","sl":2,"cs":"corrected","cd":"2024-04-26","std":1,"tv":"New"},{"t":"cms-e0033","ss":"D","sl":2,"cs":"corrected","cd":"2024-04-26","std":1,"tv":"New"},{"t":"cms-k0324","ss":"D","sl":2,"cs":"corrected","cd":"2024-04-26","std":1,"tv":"New"},{"t":"cms-k0351","ss":"D","sl":2,"cs":"corrected","cd":"2024-04-26","std":1,"tv":"New"}]},{"id":"cms-445319-20240403-health","ccn":"445319","date":"2024-04-03","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":5,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0656","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-03","std":1},{"t":"cms-f0684","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-03","std":1},{"t":"cms-f0695","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-03","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-03","std":1},{"t":"cms-f0814","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-03","std":1}]},{"id":"cms-445319-20211214-fire","ccn":"445319","date":"2021-12-14","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":5,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0004","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1,"tv":"New"},{"t":"cms-e0020","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1,"tv":"New"},{"t":"cms-e0026","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1,"tv":"New"},{"t":"cms-e0033","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1,"tv":"New"},{"t":"cms-e0034","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1,"tv":"New"}]},{"id":"cms-445319-20211214-health","ccn":"445319","date":"2021-12-14","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0693","ss":"D","sl":2,"cs":"corrected","cd":"2022-01-05","std":1}]}],"deficiency_types":{"cms-e0004":{"code":"E-0004","title":"Develop and maintain an Emergency Preparedness Program (EP).","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0006":{"code":"E-0006","title":"Conduct risk assessment and an All-Hazards approach.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0015":{"code":"E-0015","title":"Address subsistence needs for staff and patients.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0024":{"code":"E-0024","title":"Establish policies and procedures for volunteers.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0026":{"code":"E-0026","title":"Establish roles under a Waiver declared by secretary.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0032":{"code":"E-0032","title":"Provide primary/alternate means for communication.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0034":{"code":"E-0034","title":"Provide a means of sharing information on occupancy/needs.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0035":{"code":"E-0035","title":"Provide family notifications of emergency plan.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0037":{"code":"E-0037","title":"Establish staff and initial training requirements.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0039":{"code":"E-0039","title":"Conduct testing and exercise requirements.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0232":{"code":"K-0232","title":"Have corridors or aisles that are unobstructed and are at least 8 feet in width.","category":"Egress Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0321":{"code":"K-0321","title":"Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0372":{"code":"K-0372","title":"Ensure smoke barriers are constructed to a 1 hour fire resistance rating.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0741":{"code":"K-0741","title":"Have posted \"No-smoking\" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0761":{"code":"K-0761","title":"To conduct inspection, testing and maintenance of fire doors by qualified individuals.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0918":{"code":"K-0918","title":"Have generator or other power source capable of supplying service within 10 seconds.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0921":{"code":"K-0921","title":"Ensure that testing and maintenance of electrical equipment is performed.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0609":{"code":"F-0609","title":"Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0641":{"code":"F-0641","title":"Ensure each resident receives an accurate assessment.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0657":{"code":"F-0657","title":"Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-e0030":{"code":"E-0030","title":"List the names and contact information of those in the facility.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0033":{"code":"E-0033","title":"Establish methods for sharing information.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0324":{"code":"K-0324","title":"Provide properly protected cooking facilities.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0351":{"code":"K-0351","title":"Install an approved automatic sprinkler system.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0812":{"code":"F-0812","title":"Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-f0656":{"code":"F-0656","title":"Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0684":{"code":"F-0684","title":"Provide appropriate treatment and care according to orders, resident’s preferences and goals.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0695":{"code":"F-0695","title":"Provide safe and appropriate respiratory care for a resident when needed.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0814":{"code":"F-0814","title":"Dispose of garbage and refuse properly.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-e0020":{"code":"E-0020","title":"Establish policies and procedures including evacuation.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-f0693":{"code":"F-0693","title":"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.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"}},"penalties":[],"state_actions":[],"record_urls":{"cms_provider_info":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","cms_ownership":"https://data.cms.gov/provider-data/api/1/datastore/query/y2hd-n93e/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","cms_health_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/r5ix-sfxw/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","cms_fire_safety_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/ifjz-ge4w/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","cms_penalties":"https://data.cms.gov/provider-data/api/1/datastore/query/g6vv-u9sr/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D","cms_inspection_dates":"https://data.cms.gov/provider-data/api/1/datastore/query/svdt-c123/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=445319&conditions%5B0%5D%5Boperator%5D=%3D"},"compact_keys":{"t":"deficiency_type_id","ss":"scope_severity_code","sl":"severity_level (1–4)","cs":"correction_status","cd":"correction_date","cmp":"complaint","std":"standard survey","ic":"infection control","idr":"under IDR","iidr":"under IIDR","tv":"tag version"},"benchmarks":{"state":{"key":"TN","overall_rating":3.1,"health_inspection_rating":3,"qm_rating":3.7,"staffing_rating":2.5,"avg_residents_per_day":83.4,"cycle1_health_deficiencies":4.3,"cycle1_fire_deficiencies":3.6,"nurse_aide_hprd":2.14,"lpn_hprd":1.08,"rn_hprd":0.5969,"licensed_hprd":1.68,"total_nurse_hprd":3.81924,"weekend_total_nurse_hprd":3.32104,"weekend_rn_hprd":0.39,"pt_hprd":0.08,"nursing_turnover_pct":48.6,"rn_turnover_pct":43.2,"administrators_left":0.6,"case_mix_index":1.48006,"fines":0.5,"fine_amount":20665,"processing_note":"CMS State and US Averages"},"nation":{"key":"NATION","overall_rating":3,"health_inspection_rating":2.8,"qm_rating":3.7,"staffing_rating":3,"avg_residents_per_day":85.7,"cycle1_health_deficiencies":9.2,"cycle1_fire_deficiencies":4.4,"nurse_aide_hprd":2.35,"lpn_hprd":0.86,"rn_hprd":0.69164,"licensed_hprd":1.55,"total_nurse_hprd":3.90085,"weekend_total_nurse_hprd":3.43303,"weekend_rn_hprd":0.48,"pt_hprd":0.07,"nursing_turnover_pct":45.3,"rn_turnover_pct":42.5,"administrators_left":0.5,"case_mix_index":1.41025,"fines":0.9,"fine_amount":30351,"processing_note":"CMS State and US Averages"}},"geo":{"state":{"code":"TN","name":"Tennessee"},"county":{"fips":"47051","name":"Franklin County"},"zip":"37398","city":"Winchester"},"related":{"same_operator":[],"same_operator_total":0,"same_chain":[{"id":"cms-445308","ccn":"445308","name":"Trenton Health and Rehabilitation Center, LLC","address":"2036 Highway 45 Bypass","city":"Trenton","state":"TN","zip":"38382","beds":50,"overall":5,"inspections":6,"last_inspection":"2026-01-22","deficiencies":11,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445320","ccn":"445320","name":"Elk River Health & Rehabilitation of Fayetteville","address":"4081 Thornton Taylor Parkway","city":"Fayetteville","state":"TN","zip":"37334","beds":79,"overall":3,"inspections":6,"last_inspection":"2025-09-10","deficiencies":22,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445321","ccn":"445321","name":"Elk River Health and Nursing Center of Ardmore, Ll","address":"24623 Union Hill Road","city":"Ardmore","state":"TN","zip":"38449","beds":79,"overall":4,"inspections":6,"last_inspection":"2026-02-20","deficiencies":27,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445322","ccn":"445322","name":"Wood Village","address":"520 Old Highway 68","city":"Sweetwater","state":"TN","zip":"37874","beds":89,"overall":4,"inspections":6,"last_inspection":"2026-06-03","deficiencies":11,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445404","ccn":"445404","name":"Ocoee Transitional Care Center LLC","address":"2320 East Lamar Alexander Pkwy","city":"Maryville","state":"TN","zip":"37804","beds":76,"overall":3,"inspections":7,"last_inspection":"2026-07-15","deficiencies":29,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility"]},{"id":"cms-445435","ccn":"445435","name":"Woodbury Health and Rehabilitation Center","address":"119 West High Street","city":"Woodbury","state":"TN","zip":"37190","beds":82,"overall":3,"inspections":6,"last_inspection":"2026-04-22","deficiencies":19,"serious":2,"ij":1,"open":0,"fines_total":13870,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445445","ccn":"445445","name":"Celina Health and Rehabilitation Center","address":"120 Pitcock Lane","city":"Celina","state":"TN","zip":"38551","beds":78,"overall":4,"inspections":6,"last_inspection":"2025-09-04","deficiencies":16,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-445459","ccn":"445459","name":"Hancock Manor Nursing Home","address":"1423 Main Street","city":"Sneedville","state":"TN","zip":"37869","beds":50,"overall":4,"inspections":6,"last_inspection":"2026-09-10","deficiencies":8,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]}],"same_chain_total":10,"same_site_review":[],"nearby":[{"id":"cms-445222","ccn":"445222","name":"Southern Tenn Medical Center SNF","address":"629 Hospital Road","city":"Winchester","state":"TN","zip":"37398","beds":46,"overall":1,"inspections":6,"last_inspection":"2025-09-04","deficiencies":21,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":0.5},{"id":"cms-445145","ccn":"445145","name":"Heritage Place Care & Rehabilitation LLC","address":"1360 Bypass Road","city":"Winchester","state":"TN","zip":"37398","beds":132,"overall":2,"inspections":6,"last_inspection":"2026-04-08","deficiencies":42,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":1.2}]}}