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Complaint Investigation

Holston Rehabilitation And Care Center

November 17, 2025 · Kingsport, TN · 3641 Memorial Blvd
Citations 9
CMS Rating 2/5
Beds 204
Provider ID 445295
Healthcare Facility
Holston Rehabilitation And Care Center
Kingsport, TN  ·  View full profile →
Inspection Summary

HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN — inspection on November 17, 2025.

Found 9 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0602
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Potential for More Than Minimal Harm

During the facility investigation Certified Nursing Assistant (CNA) V was suspended on 2/10/2025 pending the investigation after the CNA was identified as a possible suspect.

Continued review revealed the facility substantiated the abuse and terminated CNA V on 2/27/2025 for misappropriation of resident property.Review of a receipt dated 2/26/2025 revealed Resident #43 was reimbursed for personal funds lost.

During an interview on 9/24/2025 at 9:12 AM, Resident #43 confirmed her debit card and 2 credit cards were taken by the facility CNA without her permission with $23.11 stolen.

Continued interview revealed the facility did reimburse her for the $23.11 after the theft was identified.

During an interview on 9/24/2025 at 2:35 PM, the Administrator confirmed the facility substantiated the allegation of misappropriation on Resident #43.

The Administrator stated the $23.11 was reimbursed to Resident #43 by the facility.

The Administrator further confirmed the facility employed CNA V was responsible for the misappropriation of Resident #43 property.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

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Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0644 during a standard health inspection conducted on 2025-11-17.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0656 during a standard health inspection conducted on 2025-11-17.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0657 during a standard health inspection conducted on 2025-11-17.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

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Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0684 during a standard health inspection conducted on 2025-11-17.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0689 during a standard health inspection conducted on 2025-11-17.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Scope/Severity Level G: isolated, actual harm that is not immediate jeopardy.

Actual harm to residents was documented as a result of this deficiency.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0695 during a standard health inspection conducted on 2025-11-17.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide safe and appropriate respiratory care for a resident when needed.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0814 during a standard health inspection conducted on 2025-11-17.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Dispose of garbage and refuse properly.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

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Federal health inspectors cited HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-11-17.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 9 deficiencies cited during this inspection of HOLSTON REHABILITATION AND CARE CENTER.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-12-05.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in KINGSPORT, TN, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from HOLSTON REHABILITATION AND CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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