Ascension Living Alexian Village Tennessee
671 Alexian Way, Signal Mountain, TN 37377 · Hamilton County · 114 certified beds · avg 89 residents/day · certified since Jun 1, 1978
Part of chain: ASCENSION LIVING (12 facilities, chain avg rating 2.8★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Oct 11, 2023 · F-0657 · triggered by a complaint
The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required.
Why it matters: Delays or gaps in care planning mean staff may work without a clear, current roadmap for the resident's daily care and treatment.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Nov 21, 2023 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Oct 11, 2023 · F-0658 · triggered by a complaint
The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Why it matters: Care that falls below professional standards can directly harm a resident's health and recovery.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Nov 21, 2023 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Oct 11, 2023 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Nov 21, 2023 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Oct 11, 2023 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Nov 21, 2023 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Oct 11, 2023 · F-0835 · triggered by a complaint
The facility was not managed in a way that uses its money, staff, and resources effectively and efficiently to care for residents.
Why it matters: Poor administration often shows up as understaffing, supply shortages, and care problems across the whole facility.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Nov 21, 2023 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Dec 10, 2025 · F-0760 · triggered by a complaint
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
Why it matters: A serious medication error can cause real harm, hospitalization, or worse.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Nov 17, 2025 (Past Non-Compliance)
All citations in the current public record (28)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Dec 10, 2025 | ▲ G · Actual harm, one-off | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not treat residents with respect and dignity, or did not let them keep and use their own personal belongings. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Sep 25, 2024 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Sep 25, 2024 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Sep 25, 2024 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Aug 7, 2024 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint |
| Aug 7, 2024 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. · from a complaint |
| Aug 7, 2024 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Dec 13, 2023 | E · Potential for harm, repeated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Dec 13, 2023 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Dec 13, 2023 | D · Potential for harm, one-off | The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. · from a complaint |
| Oct 11, 2023 | ▲ J · Immediate jeopardy, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint |
| Oct 11, 2023 | ▲ J · Immediate jeopardy, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Oct 11, 2023 | ▲ J · Immediate jeopardy, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Oct 11, 2023 | ▲ J · Immediate jeopardy, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Oct 11, 2023 | ▲ J · Immediate jeopardy, one-off | The facility was not managed in a way that uses its money, staff, and resources effectively and efficiently to care for residents. · from a complaint |
| Oct 11, 2023 | F · Potential for harm, facility-wide | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Oct 11, 2023 | E · Potential for harm, repeated | The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint |
| Oct 11, 2023 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Oct 11, 2023 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint |
| Oct 11, 2023 | D · Potential for harm, one-off | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. · from a complaint |
| Nov 20, 2019 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (3 → 8).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2019 | 1 | 0 | D |
| 2023 | 13 | 5 | J ▲ |
| 2024 | 6 | 0 | D |
| 2025 | 8 | 1 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
2 fines totaling $226,846, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| Dec 8, 2025 | Fine | $12,438 |
| Oct 11, 2023 | Fine | $214,408 |
| Oct 11, 2023 | Payment Denial | 63 days from Nov 10, 2023 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Tennessee avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.51 | 3.62 | 3.95 | top 10% in Tennessee; top 23% in the U.S. |
| Registered Nurse hours | 0.74 | 0.57 | 0.69 | top 18% in Tennessee; top 32% in the U.S. |
| Weekend total nurse staffing | 4.18 | 3.15 | 3.50 | top 9% in Tennessee; top 18% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.46 | 0.39 | 0.48 | top 29% in Tennessee; top 39% in the U.S. |
| Total nursing staff turnover (%) | 49.0 | 48.9 | 45.8 | top 48% in Tennessee; bottom 39% in the U.S. |
| RN turnover (%) | 50.0 | 43.2 | 42.9 | bottom 37% in Tennessee; bottom 39% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.05, RN 0.66, weekend 3.75. Staffing rating: 4/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 2/5 · short-stay residents: 5/5
Who owns this facility
Non profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Ascension Health Senior Care | Organization | 5% or Greater Direct Ownership Interest | 100% | 07/01/2014 |
| Ascension Health Senior Care | Organization | ADP of the SNF | NOT APPLICABLE | 07/01/2015 |
| Health Dimensions Consulting INC | Organization | ADP of the SNF | NOT APPLICABLE | 08/02/2019 |
| House Healthcare Solutions LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/10/2025 |
| Medical Solutions LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/16/2025 |
| Musgrave, Lisa | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2024 |
| Musgrave, Lisa | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2024 |
| Nieckula, Gregory | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/01/2017 |
| Nieckula, Gregory | Individual | ADP of the SNF | NOT APPLICABLE | 11/01/2017 |
| Shadbolt, Erin | Individual | Corporate Director | NOT APPLICABLE | 01/01/2024 |
| Shadbolt, Erin | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2024 |
| Simmons, Teddie | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/28/2025 |
| Simmons, Teddie | Individual | ADP of the SNF | NOT APPLICABLE | 03/28/2025 |
| The Rose Group, INC | Organization | ADP of the SNF | NOT APPLICABLE | 06/16/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What were the findings behind this administration citation, and what has leadership changed since?"
- "What systems do you use to prevent medication errors, and what happens when one occurs?"
- "How do you train staff to treat residents with dignity, and how do you protect residents' personal belongings?"
- "Can you give me examples of how you adjust daily routines and room setups to fit each resident's preferences?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Life Care Center of Red Bank | 2.7 mi | Chattanooga, TN | ★★☆☆☆ | 2/5 | |
| Siskin Subacute West | 6.7 mi | Chattanooga, TN | ★★★★★ | 5/5 | |
| Life Care Center of Hixson | 8.0 mi | Hixson, TN | ★☆☆☆☆ | 1/5 | |
| NHC Healthcare, Chattanooga | 8.3 mi | Chattanooga, TN | ★★★★☆ | 3/5 | |
| NHC Healthcare Rossville | 11.5 mi | Rossville, GA | ★★☆☆☆ | 1/5 | |
| Life Care Center of East Ridge | 12.8 mi | Chattanooga, TN | ★★★☆☆ | 3/5 | |
| Soddy-Daisy Health Care Center | 13.1 mi | Soddy-Daisy, TN | ★★★☆☆ | 3/5 | |
| Pruitthealth - Fort Oglethorpe | 13.6 mi | Fort Oglethorpe, GA | ★★★☆☆ | 3/5 | |
| The Health Center at Standifer Place | 13.6 mi | Chattanooga, TN | ★★★★☆ | 4/5 | |
| Center for Advanced Rehab at Parkside, the | 13.7 mi | Rossville, GA | ★★★☆☆ | 3/5 | |
| NHC Healthcare Ft Oglethorpe | 14.5 mi | Fort Oglethorpe, GA | ★★★★★ | 4/5 | |
| Chattanooga Health and Rehab Center | 15.6 mi | Chattanooga, TN | ★☆☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 445123.