Based on facility policy review, medical record review, review of hospital records, review of Emergency Medical Services (EMS) documentation, interview, and review of hospice documentation, the facility failed to establish mechanisms for documenting and communicating the resident's wishes for end of life care to staff responsible for the resident's care and failed to honor those wishes for 3 of 23 residents (Resident #3, Resident #1, Resident #2) reviewed. The facility's failure to honor the residents' and/or representative(s) wishes to refuse resuscitative measures and life sustaining treatment for [REDACTED].#1, and #2 placed the residents in Immediate Jeopardy (IJ) (A situation in which the provider's noncompliance with one or more requirements of participation has caused or is likely… …
F578 citations in Tennessee
Advance directives · Resident Rights Deficiencies
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.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Tennessee cites F578 more often than its own record predicts
1.46 times the share F578 takes of citations nationally.
Of every deficiency written in Tennessee in 2025, this is the portion that was F578.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Tennessee surveyors wrote
F578 findings written in Tennessee, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on facility policy review, medical record review, and interview, the facility failed to provide written information on how to formulate an Advance Directive for 13 of 24 (Residents #2, #7, #9, #10, #12, #19, #30, #35, #36, #42, #46, #48, and #55) sampled residents. The findings include: 1. Review of the facility policy titled, Advanced Directives, dated [DATE], revealed .Advance directives will be respected in accordance with state law and facility policy.Advance Directive . …
The short window
Recent years
| Year | Share of Tennessee citations | vs expected |
|---|---|---|
| 2023 | 1.49% | 1.39× |
| 2024 | 1.46% | 1.49× |
| 2025 | 1.38% | 1.46× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Tennessee surveyors cite →
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