Tri State Health and Rehabilitation Center
600 Shawanee Rd, Harrogate, TN 37752 · Claiborne County · (423) 869-5376
116 certified beds, about 101 residents a day · For profit - Corporation · Medicare and Medicaid since 1991
CMS abuse icon: cited for abuse in a recent inspection Certified for Medicaid Certified for Medicare
Overall
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 445263 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on December 17, 2025, inspectors cited 4 health deficiencies (the Tennessee average is 4.4, the national average 9.2).
Of 15 health citations since December 2019, 5 were rated as actual harm or immediate jeopardy to residents (5 immediate jeopardy).
CMS lists 2 fines totaling $14,852 in the last three years; the largest was $7,426, and the latest is dated September 26, 2024.
Nurses and nurse aides worked 3.44 hours per resident per day, against 3.80 across Tennessee and 3.86 nationally. Registered nurses accounted for 0.73 of those hours.
38.5% of nursing staff left within the year CMS measured (Tennessee average 48.9%).
CMS links it to The Ensign Group, an affiliated group of 344 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
112/19
208/23
809/24
412/25
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 15 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
5K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
8D
2E
0F
Potential for minimal harm
0A
0B
0C
December 17, 2025Standard inspection, Complaint inspection · 4 citations
- D Protect each resident from the wrongful use of the resident's belongings or money.
Inspectors wroteBased on facility policy review, medical record review, electronic mail (email) communication review, facility documentation review, observation, and interviews the facility failed to protect residents' rights to be free from misappropriation of narcotic medications for 1 resident (Resident #17) of 19 residents reviewed for misappropriation. The facility was cited at F-602 as Past Non-Compliance. Non-compliance began on 11/10/2025 and ended on 11/21/2025.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on facility policy review, medical record review, observation, and interviews, the facility failed to follow a Physician's order for 1 resident (Resident #9) of 19 residents reviewed for medication administration.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on facility policy review, medical record review, observations, and interviews, the facility failed to ensure the safety of 1 resident (Resident #9) of 19 residents reviewed for accidents.
- D 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.
Inspectors wroteBased on facility policy review, review of manufacturer guidelines, medical record review, observation, and interview the facility failed to store insulin pens appropriately for 3 residents (Resident #15, #25 and #78) on 1 medication cart of 3 medication carts observed for medication storage.
September 26, 2024Complaint inspection · 8 citations
- K Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Inspectors wroteBased on facility policy review, medical record review, facility investigation review, and interview, the facility failed to ensure a resident's end of life wishes were honored and failed to identify staff were not appropriately trained and certified in Cardio-Pulmonary Resuscitation (CPR) before performing CPR for 4 residents (Resident #3, #8, #9, and #10) of 5 residents reviewed for Cardio-Pulmonary Resuscitation (CPR) and code status. The facility failed to ensure staff followed Resident #3's end of life wishes and failed to ensure staff were trained and certified before performing CPR on Resident #8 on [DATE], Resident # 9 on [DATE], and on Resident #10 on [DATE]. [...]
- K Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Inspectors wroteBased on facility policy review, job description review, medical record review, employee time punch review, and interview, the facility failed to provide competent and proficient nursing staff to assure resident safety an attain or maintain the highest practicable level of wellbeing of residents when nursing staff failed to honor the end of life wishes, failed to ensure nursing staff were knowledgeable of a code status, met specific competency requirements, and understood their job responsibilities related to Cardio-Pulmonary Resuscitation (CPR), Do Not Resuscitate (DNR) Status, and life saving measures for 4 of 5 residents (Resident #3, #8, #9, and #10) reviewed for CPR. [...]
- K Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Inspectors wroteBased on facility policy review, job description review, facility document review, Quality Assurance and Performance Improvement (QAPI) Plan review, QAPI Meeting Minutes review, and interviews, the facility's Administration failed to provide effective leadership and oversight after 1 resident's (Resident #3) end of life wishes were not honored and 4 staff members who were not trained or certified in Cardio-Pulmonary Resuscitation (CPR) and life sustaining measures performed CPR on 3 residents (Residents #8, #9, and #10) from 6/2024-9/2024 of 5 residents reviewed for CPR. The facility's Administration failed to identify the non-compliance and develop and implement effective processes through the facility's Quality Assurance and Performance Improvement (QAPI) committee. [...]
- K Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Inspectors wroteBased on facility documentation review, facility policy review, job description review, and interview, the facility's Governing Body failed to identify non-compliance and implement effective corrective action plans through the facility's Quality Assurance and Performance Improvement (QAPI) program, failed to provide effective leadership and oversight to the facility and the facility's administration to ensure all nursing staff, including Certified Nursing Assistants (CNAs), were educated on the code or Cardiopulmonary Resuscitation (CPR) process when Resident #3's end of life wishes for Do Not Resuscitate (DNR) were not honored on [DATE], when CPR was performed on 3 residents (Residents #8, #9, and #10) from [DATE] through [DATE] by 4 CNAs who were not trained or certified in CPR life sustaining measures, and when the facility failed to identify, educate, and put action steps in place [...]
- K Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspectors wroteBased on facility document review, facility policy review, job description review, Quality Assurance and Performance Improvement (QAPI) Plan review, QAPI Meeting Minutes review, and interviews, the facility's QAPI committee failed to ensure an effective QAPI program that identified quality deficiencies, implement performance improvement activities to address quality concerns, and perform a root cause analysis related to residents' code status', end of life wishes, and staff performing Cardio-Pulmonary Resuscitation efforts who were not trained or certified in CPR. [...]
- E Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to develop and implement a care plan to include the code status for 4 residents (Residents #3, #8, #9, and #10) of 5 residents reviewed for care plans.
- E Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on job description review, medical record review, facility documentation review, and interview, the facility failed to ensure medical records regarding Cardio-Pulmonary Resuscitation (CPR) were complete and accurate for 4 residents (Residents #3, #8, #9, and #10) of 5 resident medical records reviewed for CPR.
- D Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Inspectors wroteBased on medical record review, facility investigation review, observations, and interviews the facility failed to ensure 2 residents (Resident #1 and Resident #2) were free from abuse of 5 sampled residents.
August 16, 2023Standard inspection · 2 citations
- D 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.
Inspectors wroteBased on medical record review, observation, and interview the facility failed to follow physician's orders for a tube feeding for 1 resident (#35) of 6 residents reviewed for tube feeding.
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on facility policy review, observation, and interview the facility failed to ensure 1 of 4 kitchen employees wore Personal Protective Equipment (PPE) appropriately while in the kitchen workspace.
December 10, 2019Standard inspection · 1 citation
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on medical record review, observation, and interview the facility failed to follow a physician's order for 1 resident (#24) of 1 resident reviewed for tracheostomy care.
Fire safety inspections
8 fire safety citations on file: 4 on December 17, 2025, 3 on August 16, 2023, 1 on December 10, 2019.
Every fire safety citation8 citations
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Have generator or other power source capable of supplying service within 10 seconds.
- D Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- D Install corridor and hallway doors that block smoke.
- D Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.
- D Provide properly sized and located linen or trash receptacles.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| September 26, 2024 | Fine | $7,426 |
| September 26, 2024 | Fine | $7,426 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Tennessee | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.44 | 3.80 | 3.86 |
| Registered nurses | 0.73 | 0.60 | 0.69 |
| All nursing staff on weekends | 2.92 | 3.31 | 3.42 |
| Nurse aides | 1.95 | ||
| Licensed practical nurses | 0.76 | ||
| Nursing staff turnover (share who left in a year) | 38.5% | 48.9% | 45.8% |
| Registered nurse turnover | 38.9% | 43.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.33 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.65 on weekdays and 2.92 on weekends, 20% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.76 in April to June 2025 to 3.44 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.44 | 0.73 | 3.65 | 2.92 | 0.0% | 0 of 90 | 101 |
| Oct to Dec 2025 | 3.79 | 0.72 | 3.99 | 3.28 | 0.0% | 0 of 92 | 91 |
| Jul to Sep 2025 | 3.63 | 0.75 | 3.83 | 3.11 | 0.0% | 0 of 92 | 90 |
| Apr to Jun 2025 | 3.76 | 0.71 | 3.98 | 3.20 | 0.0% | 0 of 91 | 92 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Tennessee, Jan to Mar 2026 | 3.75 | 0.56 | 3.95 | 3.27 | 4.0% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Tennessee | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 9.7 | 14.0 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.6 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.3 | 1.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.0 | 3.4 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.5 | 1.7 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 19.7 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.7 | 5.0 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 12.2 | 16.9 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 25.3 | 22.6 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 17.0 | 11.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.4 | 1.7 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.6 | 1.6 | 1.8 |
Owners and operators
Legal business name: RAVEN LAKE HEALTHCARE INC. CMS links this home to The Ensign Group, a group of 344 nursing homes averaging 3.2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Rocky Top Healthcare LLC | 5% or greater direct ownership interest | Organization | 100% | 10/17/2023 |
| Abbott, Swati | Corporate director | Individual | 10/17/2023 | |
| Agwunobi, John | Corporate director | Individual | 10/17/2023 | |
| Albrechtsen, Tyler | Corporate director | Individual | 10/17/2023 | |
| Blouin, Ann | Corporate director | Individual | 10/17/2023 | |
| Christensen, Christopher | Corporate director | Individual | 10/17/2023 | |
| Parkinson, Mark | Corporate director | Individual | 10/17/2023 | |
| Port, Barry | Corporate director | Individual | 10/17/2023 | |
| Shaw, Daren | Corporate director | Individual | 10/17/2023 | |
| Smith, Barry | Corporate director | Individual | 10/17/2023 | |
| Snapper, Suzanne | Corporate director | Individual | 10/17/2023 | |
| Burnam, Soon | Corporate officer | Individual | 10/17/2023 | |
| Burton, Spencer | Corporate officer | Individual | 10/17/2023 | |
| Port, Barry | Corporate officer | Individual | 10/17/2023 | |
| Sato, Ami | Corporate officer | Individual | 09/09/2024 | |
| Snapper, Suzanne | Corporate officer | Individual | 10/17/2023 | |
| Thatcher, Brent | Corporate officer | Individual | 10/17/2023 | |
| Smith, Magen | Operational/managerial control | Individual | 01/01/2024 | |
| Pannocchia, Luis | Adp of the SNF | Individual | 02/07/2025 | |
| Smith, Magen | Adp of the SNF | Individual | 02/06/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 5 problems in this area, most recently on December 17, 2025: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 3 problems in this area, most recently on September 26, 2024: "Administer the facility in a manner that enables it to use its resources effectively and efficiently."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 2 problems in this area, most recently on December 17, 2025: "Protect each resident from the wrongful use of the resident's belongings or money."
- When is the care plan meeting, and can family attend it?Inspectors cited 2 problems in this area, most recently on September 26, 2024: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.92 hours per resident per day, below the Tennessee average of 3.31.
Other nursing homes nearby
- Middlesboro Nursing and Rehabilitation Facility Middlesboro, 6.7 mi · 5 of 5 stars · 2 citations
- Buchanan Place New Tazewell, 9.5 mi · 2 of 5 stars · 18 citations
- Claiborne Health and Rehabilitation Center Tazewell, 9.5 mi · 3 of 5 stars · 11 citations
- Mountain View Rehabilitation and Healthcare Center Pineville, 12.3 mi · 4 of 5 stars · 20 citations
- Ridgeview Terrace of Life Care Rutledge, 22 mi · 4 of 5 stars · 11 citations
- Willow Ridge Center Maynardville, 23.7 mi · 2 of 5 stars · 11 citations
- Hancock Manor Nursing Home Sneedville, 23.8 mi · 4 of 5 stars · 4 citations
- Harlan Health and Rehabilitation Center Harlan, 24 mi · 1 of 5 stars · 11 citations
Tennessee contacts for a concern about a nursing home
These are the official offices in Tennessee. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Tennessee Health Facilities Commission, Division of Licensure and Regulation, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Tennessee Long-Term Care Ombudsman, Department of Disability and Aging, 877-236-0013. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
Common questions
- What is Tri State Health and Rehabilitation Center's Medicare star rating?
- CMS rates Tri State Health and Rehabilitation Center 1 out of 5 stars overall, with 1 for health inspections, 2 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Tri State Health and Rehabilitation Center get at its last inspection?
- 4 health deficiencies at the standard inspection on December 17, 2025. The Tennessee average is 4.4.
- Has Tri State Health and Rehabilitation Center been fined?
- Yes. CMS lists 2 fines totaling $14,852 in the last three years.
- Does Tri State Health and Rehabilitation Center accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Tri State Health and Rehabilitation Center?
- CMS lists 20 owners and managers, and links the home to The Ensign Group. Legal business name: RAVEN LAKE HEALTHCARE INC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.