Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
Antioch TN Opco, LLC
ANTIOCH, TN · 110 certified beds · Last Life Safety survey August 2, 2023
CMS Certification Number 445170 · first certified January 1985
Ownership
Independently operated (no chain recorded by CMS) · For profit - Corporation
- New ownershipOwnership changed July 1, 2025 (change of ownership)from EBENEZER HOME OF TENNESSEE INC
Position within TN
32 citations — more than 99% of the 303 certified nursing homes in TN. Compared within TN rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated
The latest survey found 19 citations; the earlier surveys on file averaged 6.5. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
The window is open now: October 2024 to April 2027. This facility’s last Life Safety survey was August 2023. Facilities in TN are typically surveyed 15–44 months after the last one (median 32), measured over 322 consecutive surveys in the last two years of CMS records.
A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to about three years in Virginia. How the window is measured
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4 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities cited for sprinkler inspection and testing in CMS’s current file are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.
Emergency preparedness
16 of the 32 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index
Physical environment (health survey)
5 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 32 Life Safety citations above. The Physical Environment Index
- F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F-0584 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.
- F-0880 Provide and implement an infection prevention and control program.
How that compares
Compared with the median facility in TN, and nationally. Surveyors differ markedly between states, so the TN figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 32 |
| Median facility in TN | 8 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| April 18, 2018 | 2 |
| May 2, 2019 | 11 |
| August 2, 2023 | 19 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 3 | 2023-08-02 |
| E-0024 | Establish policies and procedures for volunteers. | 2 | 2023-08-02 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 2 | 2023-08-02 |
| K-0324 | Provide properly protected cooking facilities. | 2 | 2023-08-02 |
| E-0026 | Establish roles under a Waiver declared by secretary. | 2 | 2023-08-02 |
| K-0920 | Ensure proper usage of power strips and extension cords. | 2 | 2019-05-02 |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | 2 | 2023-08-02 |
| K-0712 | Have simulated fire drills held at unexpected times. | 1 | 2023-08-02 |
What the citations cover
- Emergency Preparedness Deficiencies 16
- Smoke Deficiencies 7
- Gas, Vacuum, and Electrical Systems Deficiencies 4
- Miscellaneous Deficiencies 3
- Other 2
| Category | Citations |
|---|---|
| Emergency Preparedness Deficiencies | 16 |
| Smoke Deficiencies | 7 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 4 |
| Miscellaneous Deficiencies | 3 |
| Egress Deficiencies | 1 |
| Services Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
August 2, 2023 — 19 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0009 | Include a process for Emergency Preparedness collaboration. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0015 | Address subsistence needs for staff and patients. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0020 | Establish policies and procedures including evacuation. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0022 | Establish policies and procedures for sheltering. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0024 | Establish policies and procedures for volunteers. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0025 | Create arrangements with other facilities to receive patients. | Deficient, Provider has date of correction (August 28, 2023) |
| E-0026 | Establish roles under a Waiver declared by secretary. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0029 | Develop a communication plan. | Deficient, Provider has date of correction (August 28, 2023) |
| E-0030 | List the names and contact information of those in the facility. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0031 | Provide emergency officials' contact information. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0032 | Provide primary/alternate means for communication. | Deficient, Provider has date of correction (August 23, 2023) |
| E-0033 | Establish methods for sharing information. | Deficient, Provider has date of correction (August 28, 2023) |
| E-0034 | Provide a means of sharing information on occupancy/needs. | Deficient, Provider has date of correction (August 28, 2023) |
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has date of correction (August 23, 2023) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (August 25, 2023) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (August 23, 2023) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (August 23, 2023) |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has date of correction (August 23, 2023) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (August 25, 2023) |
May 2, 2019 — 11 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0006 | Conduct risk assessment and an All-Hazards approach. | Deficient, Provider has date of correction (April 29, 2019) |
| E-0024 | Establish policies and procedures for volunteers. | Deficient, Provider has date of correction (April 29, 2019) |
| E-0026 | Establish roles under a Waiver declared by secretary. | Deficient, Provider has date of correction (April 29, 2019) |
| K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | Deficient, Provider has date of correction (April 29, 2019) |
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has date of correction (May 1, 2019) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (April 30, 2019) |
| K-0363 | Install corridor and hallway doors that block smoke. | Deficient, Provider has date of correction (May 9, 2019) |
| K-0521 | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | Deficient, Provider has date of correction (May 9, 2019) |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has date of correction (April 29, 2019) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (May 7, 2019) |
| K-0920 | Ensure proper usage of power strips and extension cords. | Deficient, Provider has date of correction (June 7, 2019) |
April 18, 2018 — 2 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (April 20, 2018) |
| K-0920 | Ensure proper usage of power strips and extension cords. | Deficient, Provider has date of correction (April 16, 2018) |
Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.