Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

MAGNOLIA CREEK NURSING AND REHABILITATION

COVINGTON, TN · 156 certified beds · Last Life Safety survey December 9, 2021

CMS Certification Number 445461 · first certified October 2002

Ownership

Operated by SIMCHA HYMAN & NAFTALI ZANZIPER · For profit - Individual

No change of ownership on CMS record since January 1, 2016, when the records begin.

27
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
6
Inspection & testing records
Of the citations on file

Position within TN

27 citations — more than 96% 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

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 0 citations; the earlier surveys in the window averaged 13.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Past the typical window (March 2023 to August 2025). Most TN facilities have been surveyed by November 2026. This facility’s last Life Safety survey was December 2021. Facilities in TN are typically surveyed 15–44 months after the last one (median 33), measured over 279 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 three years in Maryland. How the window is measured

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Which alerts

1 inspection-and-testing tag has 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 ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

13 of the 27 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)

8 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 27 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-0880 Provide and implement an infection prevention and control program.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • 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-0924 Put firmly secured handrails on each side of hallways.

How that compares

Citations on file over three years

Compared with the median facility in TN, and nationally. Surveyors differ markedly between states, so the TN figure is the meaningful one.

This facility27TN median8National median11
Citations on file over three years, compared
MeasureCitations
This facility27
Median facility in TN8
Median facility nationally11

Survey history

Citations at each Life Safety survey
222018-1052019-0802021-12
Citations at each Life Safety survey
Survey dateCitations
October 25, 201822
August 21, 20195
December 9, 20210

Most-cited tags

Most-cited tags at this facility
K-03212K-03722E-00291E-00201K-09201K-05111E-00351K-07811
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22019-08-21
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.22019-08-21
E-0029Develop a communication plan.12018-10-25
E-0020Establish policies and procedures including evacuation.12018-10-25
K-0920Ensure proper usage of power strips and extension cords.12018-10-25
K-0511Have properly installed electrical wiring and gas equipment.12019-08-21
E-0035Provide family notifications of emergency plan.12018-10-25
K-0781Have restrictions on the use of portable space heaters.12018-10-25

What the citations cover

Citations by CMS category
  • Emergency Preparedness Deficiencies 13
  • Smoke Deficiencies 7
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Miscellaneous Deficiencies 2
  • Other 2
Citations by CMS category
CategoryCitations
Emergency Preparedness Deficiencies13
Smoke Deficiencies7
Gas, Vacuum, and Electrical Systems Deficiencies3
Miscellaneous Deficiencies2
Egress Deficiencies1
Services Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

August 21, 2019 — 5 citations

Citations issued on August 21, 2019
TagWhat the surveyor checksStatus
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (October 5, 2019)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (October 5, 2019)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (October 5, 2019)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (October 5, 2019)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (October 5, 2019)

October 25, 2018 — 22 citations

Citations issued on October 25, 2018
TagWhat the surveyor checksStatus
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (December 4, 2018)
E-0009Include a process for Emergency Preparedness collaboration.Deficient, Provider has date of correction (December 4, 2018)
E-0020Establish policies and procedures including evacuation.Deficient, Provider has date of correction (December 4, 2018)
E-0022Establish policies and procedures for sheltering.Deficient, Provider has date of correction (December 4, 2018)
E-0024Establish policies and procedures for volunteers.Deficient, Provider has date of correction (December 4, 2018)
E-0029Develop a communication plan.Deficient, Provider has date of correction (January 11, 2019)
E-0031Provide emergency officials' contact information.Deficient, Provider has date of correction (December 4, 2018)
E-0032Provide primary/alternate means for communication.Deficient, Provider has date of correction (December 4, 2018)
E-0034Provide a means of sharing information on occupancy/needs.Deficient, Provider has date of correction (November 23, 2018)
E-0035Provide family notifications of emergency plan.Deficient, Provider has date of correction (January 11, 2019)
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (November 23, 2018)
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (November 23, 2018)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (January 10, 2019)
K-0222Add 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.Deficient, Provider has date of correction (November 23, 2018)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (November 23, 2018)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (November 23, 2018)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (December 4, 2018)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (December 4, 2018)
K-0781Have restrictions on the use of portable space heaters.Deficient, Provider has date of correction (December 4, 2018)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (December 4, 2018)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (November 23, 2018)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (November 23, 2018)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.