KINGSPORT, TN - Federal health inspectors identified nine deficiencies at Holston Rehabilitation and Care Center during a complaint investigation completed on November 17, 2025, including a citation for failing to properly dispose of garbage and refuse at the facility.
Improper Waste Disposal Cited Under Federal Standards
The Centers for Medicare & Medicaid Services (CMS) cited Holston Rehabilitation and Care Center under regulatory tag F0814, which falls under the Nutrition and Dietary Deficiencies category. The citation specifically addressed the facility's failure to dispose of garbage and refuse properly.
Inspectors determined the deficiency represented a Scope/Severity Level E, indicating a pattern of non-compliance. While no actual harm to residents was documented at the time of the inspection, investigators found the conditions carried potential for more than minimal harm to the facility's residents.
The distinction between "no actual harm" and "potential for more than minimal harm" is significant in federal nursing home oversight. Level E indicates the problem was not an isolated incident but rather a pattern observed across the facility, raising concerns about systemic issues in the facility's sanitation protocols.
Health Risks of Improper Waste Management in Care Facilities
Proper garbage and refuse disposal in nursing home settings is not merely a housekeeping concern — it is a critical infection control measure. Nursing home residents, many of whom have compromised immune systems, chronic wounds, or respiratory conditions, face elevated risks when exposed to improperly managed waste.
Accumulated or improperly handled garbage in a care facility can attract pests including rodents, flies, and cockroaches, all of which are known vectors for disease transmission. Bacterial contamination from decaying organic waste can contribute to the spread of pathogens such as E. coli, Salmonella, and Clostridium difficile — organisms that pose particular danger to elderly and immunocompromised individuals.
Federal regulations under 42 CFR §483.60 require that nursing facilities maintain sanitary conditions in all areas where food is prepared, served, and stored, and that waste generated in these areas is handled according to established safety protocols. Proper waste disposal includes maintaining sealed containers, regular removal schedules, and separation of medical waste from general refuse.
Nine Total Deficiencies Identified
The waste disposal citation was one of nine deficiencies identified during the complaint investigation at Holston Rehabilitation and Care Center. The volume of citations during a single inspection suggests inspectors found multiple areas where the facility fell short of federal standards for resident care and facility operations.
Complaint investigations differ from routine annual surveys in that they are typically triggered by specific concerns reported to state or federal regulators. The fact that inspectors identified nine separate deficiencies during this type of targeted review indicates issues extending beyond the original complaint.
Correction Timeline
Holston Rehabilitation and Care Center reported correcting the waste disposal deficiency as of December 5, 2025, approximately 18 days after the inspection. The facility's status is listed as "Deficient, Provider has date of correction," meaning the facility has acknowledged the problem and reported implementing changes.
However, reported corrections are subject to verification during subsequent inspections. A facility's self-reported correction date does not guarantee that the underlying issues have been fully resolved or that new protocols will be sustained over time.
Industry Standards for Facility Sanitation
Accreditation bodies and federal guidelines establish clear expectations for waste management in skilled nursing facilities. Best practices include daily removal of waste from resident care areas, use of leak-proof and labeled containers for different waste streams, staff training on proper disposal procedures, and routine audits of sanitation compliance.
Facilities are expected to maintain written policies and procedures governing waste disposal and to ensure that all staff members — from dietary workers to nursing aides — understand their responsibilities in maintaining a sanitary environment.
Families of residents at Holston Rehabilitation and Care Center can review the full inspection report, including all nine deficiencies, through the CMS Care Compare website or by requesting records directly from the Tennessee Department of Health. These reports provide detailed findings from the inspection and any plans of correction submitted by the facility.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Holston Rehabilitation and Care Center from 2025-11-17 including all violations, facility responses, and corrective action plans.
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