Deficiency Index

Cordova Wellness and Rehabilitation Center

Cordova, Tennessee · CCN 445218

16 surveys since 2011, 3 of them producing a finding at harm level or worse.

Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.

Citations on record
90
Surveys
16
Harm or worse
3
Immediate jeopardy
0
The record, 2011–2026
’11’15’20’25’26
No harm recordedHarm or worseNot surveyed
Harm or worse3

Findings where a surveyor recorded actual harm to a resident.

Beyond CMS’s monthly file13/16

Older surveys no longer in CMS’s monthly file or on Care Compare. They are shown here.

The facility

Certified beds
240
Ownership
For profit - Limited Liability company
Chain
AHAVA HEALTHCARE
County
Shelby
Medicare-certified since
1989

CMS ratings

Overall
3
Health inspection
3
Staffing
2
Quality measures
2

CMS’s own Five-Star ratings.

Compared with similar facilities

Not shown for this facility: too few citations in window (n=15, floor 20).

Last survey on record

Apr 15, 2026

208 days ago.

Counts surveys with at least one finding. A clean survey leaves no record here, so the real gap may be shorter.

Staffing

MeasureThis facilityPeer median
Nurse hours per resident day3.613.56
Registered-nurse hours per resident day0.36—
Annual nurse turnover44.2%48.6%

As reported by the facility to CMS, beside the peer-group median.

Enforcement

No fines, payment denials or special-focus designation on the current CMS record.

Severity of recent findings

Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
SeverityIsolatedPatternWidespread
Immediate jeopardyJ—K—L—
Actual harmG—H—I—
No harm, potential for more than minimalD866.7%E325.0%F18.3%
No harm, potential for minimalA—B—C—
CMS’s current file: 12 of the 90 citations on record.

Most frequently cited here

In CMS’s current monthly file.

  • F6952×

    Provide safe and appropriate respiratory care for a resident when needed.

  • F5781×

    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.

  • F6411×

    Ensure each resident receives an accurate assessment.

  • F6771×

    Provide care and assistance to perform activities of daily living for any resident who is unable.

  • F6891×

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

In the surveyor’s words

From the most serious findings on record at Cordova Wellness and Rehabilitation Center, in the surveyor’s own words.

  • No harm, potential for more than minimal, widespreadF812Jun 23, 2022

    Based on policy review, observation, and interview, the facility failed to ensure food was stored, prepared, and served under sanitary conditions as evidenced by opened, unlabeled, undated food in the walk-in cooler and in the dry storage area, a mop lying in a bucket of dirty water near the stove during meal preparation, a dirty kitchen floor, a dirty deep fryer, a dirty convection toaster, a dirty food slicer, a scoop lying in the sugar bin, a Styrofoam cup lying in the raisin bran bin, carbon build-up on 2 sauté pans, opened, undated, unlabeled food items in the cooler, a dirty plate warmer, dirty 3-tiered cart, and a dirty tray line conveyor in the serving line area. The facility had a census of 133 with 105 of those residents receiving a tray from the kitchen. […]

  • No harm, potential for more than minimal, patternF677Jun 23, 2022

    Based on policy review, medical record review, observation, and interview, the facility failed to ensure Activities of Daily Living (ADL) assistance were provided related to nail care, skin care, and facial hair for 4 of 6 sampled residents (Resident #27, #41, #58, and #115) reviewed for ADLs. The findings include: Review of the facility's policy titled, .Fingernails/Toenails, Care of, dated 10/2017, revealed .The proper care of fingernails .The purpose of this procedure is to clean the nail bed, to keep the nails trimmed, and to prevent infections. […]

  • No harm, potential for more than minimal, patternF693Jun 23, 2022

    Based on policy review, medical record review, observation, and interview, the facility failed to ensure enteral feedings with automatic flushes were infusing at the correct rate and failed to ensure enteral feedings and automatic flush bags were correctly labeled for 3 of 3 sampled residents (Resident #17, #65, and #94) reviewed for enteral feedings. The findings include: Review of the facility's undated policy titled, Care and treatment of [MEDICAL RECORD OR PHYSICIAN ORDER] . Review of the medical record, revealed Resident #17 was admitted to facility on 2/24/2022 with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . Review of the significant change Minimum Data Set (MDS) dated [DATE], revealed Resident #17 was assessed with [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

  • No harm, potential for more than minimal, patternF695Jun 23, 2022

    Based on policy review, medical record review, observation, and interview, the facility failed to provide the necessary respiratory care and services when a [CONDITION(S)] tubing condensation collection bag was lying on the floor, humidification bottles were on the floor, a dusty fan was blowing on a resident's [CONDITION(S)], and there were no physician orders for oxygen for 4 of 4 sampled residents (Resident #23, #41, #44 and #45) reviewed for oxygen therapy. The findings include: Review of the facility's policy titled, .[CONDITION(S)] [[CONDITION(S)]] Care, dated 10/2017, revealed .Our policy is to provide care for the resident with a [CONDITION(S)] present to prevent nosocomial infections . […]

  • No harm, potential for more than minimal, patternF684Aug 11, 2021

    Based on policy review, medical record review, and interview, the facility failed to administer the prescribed medication for 3 of 3 sampled residents (Resident #1, #2 and #3) reviewed for physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] The findings include: Review of the facility's undated policy titled, .Medication Administration, revealed .This facility will provide medications under the direction of the prescribing medical practitioner .DOCUMENTATION .Record the name, dose, route, and time of medication on the Medication Administration Record [MEDICAL RECORD OR PHYSICIAN ORDER] . Review of the medical record, revealed Resident #1 was admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

Read 23 findings in full →The most serious and the most recent: 23 of 90 on record.

Every survey on record

FindingsAt actual harm or above

  • Apr 15, 2026Standard4 findings
  • Mar 17, 2026Complaint1 finding
  • Jun 23, 2022Standard7 findings
  • Aug 11, 2021Complaint2 findings
  • May 6, 2021Complaint1 finding
  • May 2, 2019Complaint1 finding
  • Nov 8, 2018Standard3 findings
  • Dec 5, 2017Standard and complaint4 findings
Show the 8 earlier surveys
  • Oct 6, 2016Standard and complaint9 findings
  • Sep 24, 2015Standard and complaint18 findings · 1 harm
  • Jul 29, 2015Complaint4 findings
  • Jul 31, 2014Standard9 findings
  • Feb 4, 2013—1 finding
  • Oct 4, 2012—11 findings
  • Aug 24, 2011—1 finding · 1 harm
  • Jul 7, 2011—14 findings · 1 harm

Surveys that found no deficiencies are not in CMS’s files and do not appear here.

Comparable facilities

The nearest facilities to this one in the same peer group, by weighted findings.

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