Nursing Care Index

Ascension Living Alexian Village Tennessee

Signal Mountain, Hamilton County, Tennessee · CCN 445123 · Non-profit (Corporation) · part of Ascension Living (12 facilities, chain average 2.8 stars)

CMS rates Ascension Living Alexian Village Tennessee 1 of 5 overall as of August 2026. 114 certified beds, 89 residents a day on average. 28 citations on record from the current inspection cycles, 5 at immediate jeopardy; 2 fines totalling $226,846 and 1 payment denial.

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★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★★★☆ 4 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay2 / 5 of 5

Staffing

Total nurse staffing4.04784 hours per resident per day
Registered nurses0.66379 hours per resident per day
Weekend total3.75175 hours per resident per day
Nursing staff turnover49% (registered nurses 50%)
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
2025-12-10
complaint survey
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
G Actual harm that is not immediate jeopardy; isolated Past Non-Compliance
2025-11-17
2025-12-10 Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Resident Rights Deficiencies · tag F0557
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-29
2025-12-10 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
2025-12-29
2025-12-10 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
2025-12-29
2025-12-10 Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies · tag F0692
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-29
2025-12-10 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-29
2025-12-10 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
2025-12-29
2025-12-10 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
2025-12-29
2024-09-25 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
2024-10-12
2024-09-25 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
2024-10-12
2024-09-25 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
2024-10-12
2024-08-07
complaint survey
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-01
2024-08-07
complaint survey
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-01
2024-08-07
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-01
2023-12-13
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-01-12
2023-12-13
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-12
2023-12-13
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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-12
2023-10-11
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
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
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
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies · tag F0835
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Protect each resident from the wrongful use of the resident's belongings or money.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0602
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-21
2023-10-11
complaint survey
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
2023-11-21
2023-10-11
complaint survey
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Quality of Life and Care Deficiencies · tag F0700
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-21
2019-11-20 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
2019-12-20

Fines and payment denials

DatePenaltyAmount
2025-12-08Fine$12,438
2023-10-11Payment denial for 63 days from 2023-11-10
2023-10-11Fine$214,408

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
Ascension Health Senior Care
Organization
5% or greater direct ownership interest100%2014-07-01
Ascension Health Senior Care
Organization
adp of the snf2015-07-01
Health Dimensions Consulting Inc.
Organization
adp of the snf2019-08-02
House Healthcare Solutions LLC
Organization
adp of the snf2025-06-10
Medical Solutions LLC
Organization
adp of the snf2025-06-16
The Rose Group, Inc.
Organization
adp of the snf2025-06-16
Musgrave, Lisa
Individual
adp of the snf2024-01-01
Nieckula, Gregory
Individual
adp of the snf2017-11-01
Shadbolt, Erin
Individual
adp of the snf2024-01-01
Simmons, Teddie
Individual
adp of the snf2025-03-28
Shadbolt, Erin
Individual
corporate director2024-01-01
Musgrave, Lisa
Individual
corporate officer2024-01-01
Nieckula, Gregory
Individual
operational/managerial control2017-11-01
Simmons, Teddie
Individual
operational/managerial control2025-03-28

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 Hamilton County.