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

LIFE CARE CENTER OF OLD HICKORY VILLAGE

OLD HICKORY, TN · 124 certified beds · Last Life Safety survey September 14, 2022

CMS Certification Number 445509 · first certified June 2012

Ownership

Operated by LIFE CARE CENTERS OF AMERICA · For profit - Limited Liability company

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

2
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
1
Inspection & testing records
Of the citations on file

Position within TN

2 citations — more than 7% 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

When is the next survey likely?

Past the typical window (December 2023 to May 2026). Most TN facilities have been surveyed by August 2027. This facility’s last Life Safety survey was September 2022. 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

Physical environment (health survey)

2 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 2 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.

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 facility2TN median8National median11
Citations on file over three years, compared
MeasureCitations
This facility2
Median facility in TN8
Median facility nationally11

Survey history

Citations at each Life Safety survey
22018-0502019-0502022-09
Citations at each Life Safety survey
Survey dateCitations
May 23, 20182
May 15, 20190
September 14, 20220

Most-cited tags

Most-cited tags at this facility
K-03511K-03531
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0351Install an approved automatic sprinkler system.12018-05-23
K-0353Inspect, test, and maintain automatic sprinkler systems.12018-05-23

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies2

Every citation on file

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

May 23, 2018 — 2 citations

Citations issued on May 23, 2018
TagWhat the surveyor checksStatus
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (June 30, 2018)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 30, 2018)

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