Hearth Record

Tsali Care Center

A nursing home in Cherokee, North Carolina 28719

267 Tsali Care Way, Cherokee, North Carolina 28719. (828) 497-5048.

  • A candidate for CMS’s special focus list
CMS’s own record, on Care Compare

Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.

The short answer

Record last released by CMS on Oct 28, 2026.

The last 24 months 58 citations in 7 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). Every month

Each figure’s source sits beside it, in its section below.

What these words mean7
Star ratings
CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
Inspection (survey)
A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
Deficiency, citation, violation
What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
Scope and severity (A to L)
CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
Nurse staffing hours
The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
Fines and payment denials
A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
Capacity
The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.

What did inspectors find?

27 health citations at the latest inspection cycle

The North Carolina average is 4.6.

Last standard inspection Aug 1, 2025.

Most serious in three years: actual harm (G), at a complaint inspection on Apr 10, 2025

Source:

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

58 citations in 7 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.

58 citations by month over the last 3 years. Each cell is one month.
JanFebMarAprMayJunJulAugSepOctNovDec
2023 Dec
2024 JanFebMarAprMayJunJulAugSepOctNovDec
2025 JanFebMarAprMayJunJulAugSepOctNovDec
2026 JanFebMarAprMayJunJulAugSepOctNov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most
Source:

Hearth Record drew this from the dates and levels in the source’s own records.

All 58 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 16 came from complaint inspections.

Source:

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Aug 6, 2026: complaint inspection1 citation

  • Provide the required documentation or notification related to the resident’s needs, appeal rights, or bed-hold policies.

    Rule F0628. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 11, 2026.

Aug 1, 2025: standard inspection24 citations

  • Ensure that residents are fully informed and understand their health status, care and treatments.

    Rule F0552. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

  • Allow residents to self-administer drugs if determined clinically appropriate.

    Rule F0554. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

  • Reasonably accommodate the needs and preferences of each resident.

    Rule F0558. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • 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.

    Rule F0578. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

  • Keep residents’ personal and medical records private and confidential.

    Rule F0583. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • 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.

    Rule F0585. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident’s ability to function.

    Rule F0605. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

    Rule F0636. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

    Rule F0644. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • PASARR screening for Mental disorders or Intellectual Disabilities

    Rule F0645. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Ensure services provided by the nursing facility meet professional standards of quality.

    Rule F0658. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

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

    Rule F0677. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • 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.

    Rule F0688. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

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

    Rule F0689. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Provide safe, appropriate dialysis care/services for a resident who requires such services.

    Rule F0698. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Provide care or services that was trauma informed and/or culturally competent.

    Rule F0699. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • 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.

    Rule F0761. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Provide or obtain dental services for each resident.

    Rule F0791. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Administer the facility in a manner that enables it to use its resources effectively and efficiently.

    Rule F0835. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

  • Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

    Rule F0867. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jan 2, 2026.

  • Provide and implement an infection prevention and control program.

    Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

  • Develop and implement policies and procedures for flu and pneumonia vaccinations.

    Rule F0883. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 8, 2025.

Aug 1, 2025: standard and complaint inspection2 citations

  • Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Rule F0550. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 21, 2025.

  • Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

    Rule F0676. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 8, 2025.

Apr 10, 2025: complaint inspection7 citations

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

    Rule F0689. G: actual harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • Honor the resident’s right to receive visitors of his or her choosing, at the time of his or her choosing.

    Rule F0563. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • 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.

    Rule F0622. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Rule F0657. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Rule F0686. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • Ensure that residents are free from significant medication errors.

    Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

  • Provide and implement an infection prevention and control program.

    Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 1, 2025.

Oct 18, 2024: complaint inspection2 citations

  • Provide safe, appropriate dialysis care/services for a resident who requires such services.

    Rule F0698. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 8, 2024.

  • Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

    Rule F0804. F: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 18, 2024.

Aug 22, 2024: standard inspection18 citations

  • Provide safe, appropriate pain management for a resident who requires such services.

    Rule F0697. G: actual harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Rule F0550. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Honor the resident’s right to organize and participate in resident/family groups in the facility.

    Rule F0565. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Properly hold, secure, and manage each resident’s personal money which is deposited with the nursing home.

    Rule F0568. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0578. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

    Rule F0582. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0584. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Rule F0623. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0625. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • PASARR screening for Mental disorders or Intellectual Disabilities

    Rule F0645. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Rule F0657. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0726. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Rule F0755. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Ensure medication error rates are not 5 percent or greater.

    Rule F0759. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0761. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • 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.

    Rule F0838. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Provide and implement an infection prevention and control program.

    Rule F0880. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

  • Keep all essential equipment working safely.

    Rule F0908. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 25, 2024.

Jul 31, 2024: complaint inspection2 citations

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

    Rule F0689. G: actual harm. From a complaint. Correction date, as CMS recorded it: Nov 7, 2024.

  • Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Rule F0725. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 25, 2024.

Apr 17, 2024: complaint inspection2 citations

  • Honor the resident’s right to be treated with respect and dignity and to retain and use personal possessions.

    Rule F0557. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 4, 2024.

  • Provide and implement an infection prevention and control program.

    Rule F0880. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 4, 2024.

Is it certified, and in good standing?

  • Certified for Medicare and Medicaid since Apr 18, 1996.
  • A candidate for CMS’s special focus list, which CMS keeps for homes with a history of serious problems.
  • No abuse icon from CMS.
  • No change of ownership in the last 12 months.
  • CMS lists its ownership as non profit, corporation.
  • 100 certified beds.
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

  • 4 fines in the last three years, $157,555 in all.
  • 1 Medicare payment denial in the last three years.
  • 16 citations in the last three years came from complaint inspections.
Source:

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Fines and payment denials, newest first
DateKindAmount
Jul 31, 2025Fine$11,047
Apr 10, 2025Fine$15,028
Jul 31, 2024Medicare payment denialNot given
Jul 31, 2024Fine$118,938
Jul 31, 2024Fine$12,542

Who does the caring?

5.86 nurse hours per resident per day

The North Carolina average is 3.87.

CMS publishes staffing about four months after the fact.

Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
MeasureThis homeNorth Carolina average
Nurse hours per resident per day5.863.87
Of which registered nurses1.190.62
At weekends5.343.40
Nursing staff turnover49.2%48.7%
Registered nurse turnover26.3%45.7%
Administrators who left0Not given

Who owns it?

  • Cherokee Indian Hospital Authority runs it.
  • 25 owners or officers are people: Pamela Brady (runs it (operational or managerial control)); Pamela Brady (on the governing body (managing control)); Richard A Bunio (runs it (operational or managerial control)); Richard A Bunio (on the governing body (managing control)); Richard A Bunio (additional disclosable party (controls, leases property to, or provides services to the home)); Michelle Tenhengel-Deville (runs it (operational or managerial control)); Michelle Tenhengel-Deville (additional disclosable party (controls, leases property to, or provides services to the home)); Adele Madden (runs it (operational or managerial control)); Adele Madden (on the governing body (managing control)); Michele Houston (runs it (operational or managerial control)); Jacob Reed (runs it (operational or managerial control)); Marcia Hollifield (runs it (operational or managerial control)); Marcia Hollifield (on the governing body (managing control)); Carmaleta Monteith (runs it (operational or managerial control)); Carmaleta Monteith (on the governing body (managing control)); Sonya Wachacha (runs it (operational or managerial control)); Sonya Wachacha (on the governing body (managing control)); Jonathan Dando (corporate officer); Barbara Lambert (runs it (operational or managerial control)); Ahll-Sha Stephens (runs it (operational or managerial control)); Ahll-Sha Stephens (on the governing body (managing control)); Mary Beth Dorgan (runs it (operational or managerial control)); Casey Cooper (corporate officer, 0%); Barbara Parker (runs it (operational or managerial control)); Barbara Parker (on the governing body (managing control)).
  • No private-equity firm among the owners CMS lists.
  • No real-estate investment trust among the owners CMS lists.
Source:

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
OrganisationRoleShareSince
Cherokee Indian Hospital AuthorityRuns it (operational or managerial control)0%Jan 1, 2002
Cherokee Indian Hospital AuthorityAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2002

How do residents fare?

  • CMS rates its quality measures 1 of 5 (North Carolina average 3.5).
Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
MeasureRating
Overall rating1 of 5
Health inspections1 of 5
Staffing5 of 5
Quality measures1 of 5

How does it compare nearby?

  • Among the 12 nearest homes, within 28.2 miles, this one had the 1st most health citations at the latest inspection cycle (27; the middle value was 4.5).
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
PlaceMiles awayCitations, latest cycle
Tsali Care Center This nursing home27
Mountain View of Bryson City8.19
Vero Health & Rehab of Sylva9.97
Skyland Care Center9.90
Maggie Valley Health and Rehabilitation Center13.94
Autumn Care of Waynesville18.56
Skyland Terrace and Rehabilitation20.23
Macon Valley Nursing and Rehabilitation Center21.90
Smoky Mountain Health and Rehabilitation Center22.13
Smoky Mountain Health and Rehabilitation Center24.87
Silver Bluff26.05
Eckerd Living Center28.24

What the record doesn’t say

  • Complaints that didn’t lead to a citation aren’t published.
  • Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
  • CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
  • Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.

Sources

  • Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

    Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.

Source:

This copy of the record was made on Nov 5, 2026.

From the home

The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.

Replies

None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.

Paid listing

None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.

How to read a record

Four things every record does, shown on an example record made up for this guide.

An example record, made up for this guide

An example nursing home

Made up for this guide: no real place is shown

Not fully inspected in over two years (CMS flag)

11 health citations at the latest inspection cycle

The state average is 14.3.

Source:

CMS, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

From the homeNone yet. Replies and paid listings aren’t open, and when they open they will sit here, below the record.

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Who published it, when, and how often it changes sit beside each fact, with a link to the agency’s own file.

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