Map showing the location of Tsali Care Center in Cherokee, North Carolina
267 Tsali Care Way, Cherokee, NC, 28719

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • North CarolinaAbove only 22% of peers417 rated homes · average 2.9★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.9 vs NC avg
  • StaffingCan add or remove a star5★+2.3 vs NC avg
  • Quality measuresCan add or remove a star2★−1.2 vs NC avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersNC avg2.9★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover5★Top 10%NC avg2.7★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments2★Above only 8% of peersNC avg3.2★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff6.03hrsTop 2%NC avg3.78Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only1.17hrsTop 4%NC avg0.59Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better42%Above 68% of peersNC avg50%RN turnover46%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$188,170Above only 6% of peersNC avg$45,050Fines · denials8 · 2
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
69citations
10inspection dates
4actual harm (G–I)
0immediate jeopardy (J–L)
Aug 1, 2025most recent

Citations by monthSep 2022 – Aug 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Aug 1, 20252 citationsCycle 1worst D · no actual harm
  1. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Sep 21, 2025
  2. F676Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.Quality of Life and CareD · isolatedCorrected Sep 8, 2025
Apr 10, 20257 citationsCycle 1worst G · actual harm$15,028
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected May 1, 2025
  2. F657Develop 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 PlanningD · isolatedCorrected May 1, 2025
  3. F622Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.Resident RightsD · isolatedCorrected May 1, 2025
  4. F563Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.Resident RightsD · isolatedCorrected May 1, 2025
  5. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected May 1, 2025
  6. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected May 1, 2025
  7. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected May 1, 2025
Oct 18, 20242 citationsCycle 2worst F · no actual harm
  1. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryF · widespreadCorrected Nov 18, 2024
  2. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Nov 8, 2024
Aug 22, 202418 citationsCycle 1worst G · actual harm
  1. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareG · isolatedCorrected Sep 25, 2024
  2. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesD · isolatedCorrected Sep 25, 2024
  3. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected Sep 25, 2024
  4. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceE · patternCorrected Sep 25, 2024
  5. F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Sep 25, 2024
  6. F838Conduct 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.AdministrationF · widespreadCorrected Sep 25, 2024
  7. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Sep 25, 2024
  8. 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.Resident RightsD · isolatedCorrected Sep 25, 2024
  9. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Sep 25, 2024
  10. F565Honor the resident's right to organize and participate in resident/family groups in the facility.Resident RightsE · patternCorrected Sep 25, 2024
  11. F568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.Resident RightsD · isolatedCorrected Sep 25, 2024
  12. F578Honor 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.Resident RightsE · patternCorrected Sep 25, 2024
  13. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsF · widespreadCorrected Sep 25, 2024
  14. F584Honor 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 RightsD · isolatedCorrected Sep 25, 2024
  15. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Sep 25, 2024
  16. F645PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care PlanningD · isolatedCorrected Sep 25, 2024
  17. F657Develop 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 PlanningD · isolatedCorrected Sep 25, 2024
  18. F908Keep all essential equipment working safely.EnvironmentalF · widespreadCorrected Sep 25, 2024
Jul 31, 20242 citationsCycle 2worst G · actual harm$12,542, $118,938, payment denial
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Nov 7, 2024
  2. F725Provide 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 ServicesE · patternCorrected Sep 25, 2024
Apr 17, 20242 citationsCycle 2worst E · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected May 4, 2024
  2. F557Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.Resident RightsE · patternCorrected May 4, 2024
Oct 13, 20234 citationsCycle 3worst E · no actual harm
  1. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationE · patternCorrected Nov 6, 2023
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningE · patternCorrected Nov 6, 2023
  3. F725Provide 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 ServicesE · patternCorrected Nov 6, 2023
  4. F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Nov 6, 2023
Sep 21, 20234 citationsCycle 3worst F · no actual harm
  1. F570Assure the security of all personal funds of residents deposited with the facility.Resident RightsF · widespreadCorrected Oct 22, 2023
  2. F568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.Resident RightsD · isolatedCorrected Oct 20, 2023
  3. F567Honor the resident's right to manage his or her financial affairs.Resident RightsD · isolatedCorrected Oct 22, 2023
  4. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsD · isolatedCorrected Oct 22, 2023
Jul 13, 202317 citationsCycle 2worst G · actual harm$17,999, $3,728, payment denial, $3,728, $8,070, $8,137
  1. F645PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care PlanningD · isolatedCorrected Aug 15, 2023
  2. F573Let each resident or the resident's legal representative access or purchase copies of all the resident's records.Resident RightsE · patternCorrected Aug 15, 2023
  3. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Aug 15, 2023
  4. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsE · patternCorrected Nov 6, 2023
  5. F565Honor the resident's right to organize and participate in resident/family groups in the facility.Resident RightsE · patternCorrected Aug 15, 2023
  6. F572Give residents a notice of rights, rules, services and charges.Resident RightsE · patternCorrected Aug 15, 2023
  7. F574The resident has the right to receive notices in a format and a language he or she understands.Resident RightsE · patternCorrected Aug 15, 2023
  8. F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.Resident RightsE · patternCorrected Aug 15, 2023
  9. F578Honor 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.Resident RightsD · isolatedCorrected Aug 15, 2023
  10. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsE · patternCorrected Aug 15, 2023
  11. F656Develop 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 PlanningD · isolatedCorrected Aug 15, 2023
  12. F679Provide activities to meet all resident's needs.Quality of Life and CareE · patternCorrected Aug 15, 2023
  13. F680Ensure the activities program is directed by a qualified professional.Quality of Life and CareE · patternCorrected Aug 15, 2023
  14. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareG · isolatedCorrected Aug 15, 2023
  15. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Aug 15, 2023
  16. F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.Quality of Life and CareD · isolatedCorrected Aug 15, 2023
  17. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Aug 15, 2023
Sep 23, 202211 citationsCycle 3worst F · no actual harm
  1. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Oct 14, 2022
  2. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsD · isolatedCorrected Oct 14, 2022
  3. F585Honor 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.Resident RightsD · isolatedCorrected Oct 14, 2022
  4. F656Develop 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 PlanningD · isolatedCorrected Oct 14, 2022
  5. F676Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.Quality of Life and CareD · isolatedCorrected Oct 14, 2022
  6. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Oct 14, 2022
  7. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Oct 14, 2022
  8. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected Oct 14, 2022
  9. F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Oct 14, 2022
  10. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Oct 14, 2022
  11. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected Oct 14, 2022

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined6.03hrsTop 2%+2.25 vs NC avg
  • Registered nursesRN hours only1.17hrsTop 4%+0.58 vs NC avg
  • Licensed practical nursesLPN hours0.77hrs
  • Nurse aidesCNA hours4.09hrs
  • Weekend nursingAll staff on Saturdays and Sundays5.61hrs
  • North Carolina average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better42%Above 68% of peersNC avg 50%
  • RN turnoverRegistered nurses only46%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy72 certified beds · ~70 residents a day97%Top 5%NC avg 83%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $188,170In fines
  • 8Fines
  • 2Payment denials
  • $45,050NC avg in fines
Above only 6% of peersFewer fines than 6% of rated homes in North Carolina

Actions on record

  1. Apr 10, 2025Civil money penalty$15,028
  2. Jul 31, 2024Civil money penalty$12,542
  3. Jul 31, 2024Civil money penalty$118,938
  4. Jul 31, 2024Denial of payment for new admissionsfrom Aug 29, 2024
  5. Jul 13, 2023Civil money penalty$17,999
  6. Jul 13, 2023Civil money penalty$3,728
  7. Jul 13, 2023Denial of payment for new admissionsfrom Aug 15, 2023
  8. Jul 13, 2023Civil money penalty$3,728
  9. Jul 13, 2023Civil money penalty$8,070
  10. Jul 13, 2023Civil money penalty$8,137

Ownership

As filed with CMS

Structure

Ownership type
Non profit - Corporation
Chain
Independent
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Operational or managerial control
  • Cherokee Indian Hospital Authority
Corporate officers
  • Casey Cooper
Managing employees
  • Jonathan Dando

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 345475 · 267 Tsali Care Way, Cherokee, NC, 28719.
  • Percentiles compare this facility with every rated nursing home in North Carolina and Swain County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

Own or manage a facility?

Claim your free listing to correct details, reply to reviews, and show your verified badge.

Claim your facility

Read our latest articles