Holston Rehabilitation And Care Center
Inspection Findings
F-Tag F0602
F 0602
Protect each resident from the wrongful use of the resident's belongings or money.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, medical record review, facility investigation review, personal file review, and interview,
the facility failed to protect a resident's rights to be free from misappropriation and/or exploitation when money totaling $23.11 was taken from 1 resident (Resident #43) of 22 residents reviewed for misappropriation. The findings include:Review of the facility policy titled, Abuse, Neglect, Misappropriation of Resident Property, Suspicious Injuries of Unknown Source, Exploitation, undated, revealed .Misappropriation of Resident Property means the deliberate misplacement, exploitation, or wrongful, temporary, or permanent use of a resident's belongings or money without the resident's consent .Review of
the medical record revealed Resident #43 was admitted to the facility on [DATE REDACTED] with diagnoses including Hereditary and Idiopathic Neuropathy, Respiratory Disorders, and Muscle Wasting and Atrophy. Review of
an admission Minimum Data Set (MDS) assessment dated [DATE REDACTED], revealed Resident #43 scored a 15 on
the Brief Interview for Mental Status (BIMS) assessment which indicated the resident was cognitively intact.Review of the facility investigation documentation dated 2/10/2025, revealed Resident #43 informed
the Director of Nursing (DON) .2 nights ago, approximately 2/8/2025 she noticed a black card laying on her bedside table. The resident could not retrieve it until yesterday, noticing it to be the card that ordained her to marry people. Resident thought this was odd because the card is usually in her purse. She then noticed that her debit card and 2 credit cards were missing . The DON notified the facility Administrator of the alleged misappropriation. The facility started an investigation. 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.
Residents Affected - Few
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.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
F-Tag F0644
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.
F-Tag F0656
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.
F-Tag F0657
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.
F-Tag F0684
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.
F-Tag F0689
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.
F-Tag F0695
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.
F-Tag F0814
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.
F-Tag F0880
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.
HOLSTON REHABILITATION AND CARE CENTER in KINGSPORT, TN inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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.