Nursing Care Index

Tsali Care Center

Cherokee, Swain County, North Carolina · CCN 345475 · Non-profit (Corporation) · not part of a chain

CMS rates Tsali Care Center 2 of 5 overall as of August 2026. 100 certified beds, 78 residents a day on average. 82 citations on record from the current inspection cycles, 4 involving actual harm; 4 fines totalling $157,555 and 1 payment denial.

On record

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★☆☆☆ 2 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★★★★ 5 of 5
Quality measures★★☆☆☆ 2 of 5
Quality: long-stay / short-stay2 / 2 of 5

Staffing

Total nurse staffing6.13529 hours per resident per day
Registered nurses1.2955 hours per resident per day
Weekend total5.548 hours per resident per day
Nursing staff turnover47.2% (registered nurses 31.3%)
Administrators who left1

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2025-08-01 Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies · tag F0835
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-01-02
2025-08-01 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-01-02
2025-08-01 Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · tag F0552
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-02
2025-08-01 Allow residents to self-administer drugs if determined clinically appropriate.
Resident Rights Deficiencies · tag F0554
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-02
2025-08-01 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights Deficiencies · tag F0578
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-01-02
2025-08-01 Keep residents' personal and medical records private and confidential.
Resident Rights Deficiencies · tag F0583
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-08
2025-08-01 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies · tag F0585
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-08
2025-08-01 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-08
2025-08-01 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-08
2025-08-01
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-21
2025-08-01 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Resident Assessment and Care Planning Deficiencies · tag F0636
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01
complaint survey
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Quality of Life and Care Deficiencies · tag F0676
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Quality of Life and Care Deficiencies · tag F0688
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-01-02
2025-08-01 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide care or services that was trauma informed and/or culturally competent.
Quality of Life and Care Deficiencies · tag F0699
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-08-01 Provide or obtain dental services for each resident.
Quality of Life and Care Deficiencies · tag F0791
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-08
2025-04-10
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
Resident Rights Deficiencies · tag F0563
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Resident Rights Deficiencies · tag F0622
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2025-04-10
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-05-01
2024-10-18
complaint survey
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-11-18
2024-10-18
complaint survey
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-08
2024-08-22 Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0697
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-09-25
2024-08-22 Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Administration Deficiencies · tag F0838
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-09-25
2024-08-22 Keep all essential equipment working safely.
Environmental Deficiencies · tag F0908
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-09-25
2024-08-22 Honor the resident's right to organize and participate in resident/family groups in the facility.
Resident Rights Deficiencies · tag F0565
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-25
2024-08-22 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights Deficiencies · tag F0578
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-25
2024-08-22 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-25
2024-08-22 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 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.
Nursing and Physician Services Deficiencies · tag F0726
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-08-22 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-25
2024-07-31
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2024-11-07
2024-07-31
complaint survey
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-25
2024-04-17
complaint survey
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Resident Rights Deficiencies · tag F0557
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-04
2024-04-17
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-04
2023-10-13
complaint survey
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-06
2023-10-13
complaint survey
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-06
2023-10-13
complaint survey
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-06
2023-10-13
complaint survey
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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-06
2023-09-21
complaint survey
Assure the security of all personal funds of residents deposited with the facility.
Resident Rights Deficiencies · tag F0570
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-10-22
2023-09-21
complaint survey
Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-10-22
2023-09-21
complaint survey
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-10-20
2023-09-21
complaint survey
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Resident Rights Deficiencies · tag F0569
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-10-22
2023-07-13 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-06
2023-07-13 Honor the resident's right to organize and participate in resident/family groups in the facility.
Resident Rights Deficiencies · tag F0565
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Give residents a notice of rights, rules, services and charges.
Resident Rights Deficiencies · tag F0572
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
Resident Rights Deficiencies · tag F0573
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 The resident has the right to receive notices in a format and a language he or she understands.
Resident Rights Deficiencies · tag F0574
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Resident Rights Deficiencies · tag F0577
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Ensure the activities program is directed by a qualified professional.
Quality of Life and Care Deficiencies · tag F0680
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-08-15
2023-07-13 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights Deficiencies · tag F0578
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Quality of Life and Care Deficiencies · tag F0740
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15
2023-07-13 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-08-15

Fines and payment denials

DatePenaltyAmount
2025-07-31Fine$11,047
2025-04-10Fine$15,028
2024-07-31Payment denial for 81 days from 2024-08-29
2024-07-31Fine$118,938
2024-07-31Fine$12,542

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Cherokee Indian Hospital Authority
Organization
operational/managerial control2019-10-01
Cooper, Casey
Individual
corporate officer2002-09-09
Dando, Jonathan
Individual
w-2 managing employee2002-09-09

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Swain County.