Not rated by CMS — ratings are suppressed for new or low-volume facilities.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Cherokee Trails Nursing Home during CMS and state inspections, most recent first.
Two residents who smoked, one with hepatic encephalopathy and acute respiratory failure and another with cellulitis, severe sepsis, and chronic ulcers, reported that a CNA made rude, profane comments during staff-assisted smoking breaks, making one feel talked down to and upset. Other smoking residents reported hearing staff say it was a hassle to take them outside, though without recalling specifics or reporting distress. The CNA denied using inappropriate language, while the DON affirmed expectations for professional, non-profane communication and acknowledged that such behavior could cause emotional distress. The ADM investigated the allegations, and facility records documented that the CNA was discharged for speaking to residents in a manner that could be perceived as inappropriate and for inappropriate behavior, contrary to the facility’s resident rights policy requiring courtesy, consideration, and respect.
Three residents were found to be living in unsafe and unsanitary conditions, including a torn mattress, broken or missing toilet seats, and a persistent foul odor caused by hidden moldy food. Staff interviews revealed that maintenance issues were not addressed promptly due to staff turnover, and some residents' behaviors made it difficult for housekeeping to maintain cleanliness. Maintenance logs showed no recent requests, despite facility policy requiring daily cleaning and prompt repairs.
Several residents who required mechanical lifts for transfers were observed using slings that were faded, had unraveling straps, or were missing labels. Staff interviews revealed that slings were used despite visible wear, and some staff were unaware that bleaching slings could compromise their safety. Manufacturer guidelines and facility policy requiring removal of damaged slings were not consistently followed.
The facility did not ensure that four direct care staff members, including an ADON, an AD, and two CNAs, received annual mandatory training on effective communication as required by facility policy. Personnel files showed gaps in annual training, and interviews revealed confusion over responsibility for tracking and ensuring completion of these trainings, especially following a switch to a new online training system.
Three CNAs did not receive required annual compliance and ethics training, as shown by personnel file reviews and staff interviews. The facility's HR and interim Administrator were unclear about responsibility for annual training, and a recent change in the online training system contributed to the oversight.
Three CNAs did not receive required annual behavioral health training due to lapses in tracking and responsibility, as revealed by record review and staff interviews. The facility's policy and assessment mandate annual training, but a recent change in the online training system and unclear assignment of duties led to missed trainings.
A resident with a wound requiring enhanced barrier precautions received wound care assistance from an MDS Coordinator who failed to wear a gown, as required by facility policy, and only wore gloves despite signage and PPE supplies being present. The MDS Coordinator had received recent training on EBP but did not follow protocol during the care activity.
The facility did not provide required annual HIV training to three staff members, including an AD, DOR, and CNA, due to unclear responsibility for tracking annual trainings and issues with a recent transition to a new online training system. Personnel files and staff interviews confirmed the deficiency, which was contrary to the facility's own training policy and assessment.
A staff member did not receive required annual dementia training due to lapses in the facility's training program and unclear responsibility for tracking annual education. The deficiency was identified through record review and staff interviews, which revealed that the training was not completed as required by facility policy.
The facility did not post daily nurse staffing information in a location that was clearly visible and accessible to residents and visitors, as required. Instead, postings were placed on a wall near the SW office, which was not easily seen by those entering the facility. Staff responsible for the postings and the interim Administrator were unaware of the visibility requirement and there was no policy in place to guide proper posting.
A resident with severe cognitive impairment and multiple health issues slid out of her wheelchair during transport due to improper securement by the facility's van driver. The incident occurred when the driver had to brake suddenly, and the resident was not adequately secured with the shoulder and lap belt harness. Interviews and observations indicated that the van drivers were not properly trained on securement procedures, and the maintenance director responsible for training had not received adequate training himself.
The facility failed to ensure two CNAs were certified in Texas, as required by state law. CNA I and CNA J worked multiple shifts with expired certifications, despite the facility's knowledge of the issue. The Administrator attempted to assist CNA I with renewal, but issues persisted. This deficiency could risk residents receiving care from unqualified staff.
Failure to Treat Smoking Residents With Dignity and Respect
Penalty
Summary
The deficiency involves failure to ensure residents were treated with dignity and respect during staff-assisted smoking breaks. A female resident with hepatic encephalopathy, acute respiratory failure, morbid obesity, and intact cognition (BIMS 14) required varying levels of assistance with ADLs and had a care plan identifying her as a smoker who needed assistance to and from the smoking area. A male resident with cellulitis of the left lower limb, severe sepsis with septic shock, non-pressure chronic ulcers, and moderately impaired cognition (BIMS 12) was independent in ADLs and had a care plan indicating he smoked and required supervised smoking due to noncompliance with facility policy. During a smoking break, both residents reported that a CNA made rude comments about taking them outside to smoke, including telling the male resident that he was always hassling her about smoking and telling the female resident that she did her the same “damn” way, which the female resident stated made her feel talked down to and upset. Additional interviews with three other residents who smoked indicated they had heard staff say it was a hassle taking them outside to smoke, though they could not recall specific dates, times, or staff names and reported no distress from those incidents. The CNA involved denied using inappropriate language or telling residents their care was a hassle. The DON stated that staff were expected to maintain professional behavior, including not cursing or using inappropriate language, and acknowledged that a CNA talking down to or using inappropriate language around a resident could put the resident at risk for emotional distress. The administrator reported responsibility for investigating allegations of abuse and neglect and described investigating the allegation that the CNA used inappropriate language and talked down to the two residents. Facility documentation showed that the CNA was discharged for speaking to residents in a manner that could be perceived as inappropriate language or talking down to residents, and for inappropriate behavior, in the context of a facility policy stating residents have the right to be treated with courtesy, consideration, and respect.
Failure to Maintain Safe and Sanitary Resident Environment
Penalty
Summary
The facility failed to provide a safe, clean, and sanitary environment for three residents as observed during the survey. One resident, who had severe cognitive impairment and was at risk for falls and infections, was found to have a torn mattress exposing foam and a broken toilet seat in his room. The resident was unaware of the broken items and reported no complications, but a CNA confirmed that such conditions could cause injury or infection. The CNA also stated that maintenance issues were not being addressed in a timely manner due to changes in maintenance staff. Another resident, who was cognitively intact and had diagnoses including emphysema and diabetes, was found in a room with a persistent foul sour odor. The odor was traced to a moldy avocado hidden among personal items. Staff interviews revealed that the resident often resisted room cleaning and hid items, making it difficult for housekeeping to maintain cleanliness. The housekeeping supervisor confirmed that daily cleaning was the standard, but some residents' behaviors impeded this process, and the presence of old food could have led to illness. A third resident, with severe cognitive impairment and incontinence, was observed to have a toilet with no seat, despite requiring assistance with toileting. The new maintenance director had not yet reviewed maintenance logs, and the administrator acknowledged that previous maintenance requests were not being completed. Review of the maintenance logbook showed no requests for the current or previous year, and facility policy required daily cleaning to maintain a sanitary environment. The facility's resident rights document also affirmed the right to a safe, clean, and comfortable environment.
Failure to Remove Damaged Mechanical Lift Slings from Service
Penalty
Summary
The facility failed to ensure that the environment was free from accident hazards by not removing worn and damaged mechanical lift slings from service for three residents who required mechanical lifts for transfers. Observations revealed that several residents were transferred or left sitting in wheelchairs with mechanical lift slings that were faded, had unraveling straps, or were missing labels. Staff interviews confirmed that slings were being used despite visible signs of wear, including faded colors and fraying, and that the color of the straps was not being used as an indicator of safety. Some staff were unaware that bleaching the slings could damage them and compromise their safety. Record reviews indicated that the affected residents had significant physical and cognitive impairments, requiring full assistance for transfers and daily living activities. Care plans for these residents specified the use of mechanical lifts for all transfers. Despite this, observations showed that slings in poor condition were still in use, and staff did not consistently follow manufacturer guidelines for inspecting and removing slings that showed signs of deterioration, such as fading or damage from improper laundering. Interviews with staff, including CNAs, laundry aides, and supervisors, revealed a lack of awareness regarding the manufacturer's instructions, which explicitly stated that slings should not be bleached and that faded or damaged slings should be immediately removed from service. The facility's own policy emphasized the right of residents to a safe environment, but this was not upheld due to the continued use of unsafe lift slings. The failure to remove these slings from service was directly observed and confirmed through staff interviews and record reviews.
Failure to Provide Annual Effective Communication Training to Direct Care Staff
Penalty
Summary
The facility failed to provide annual mandatory training on effective communication to four out of fourteen employees reviewed, including the Assistant Director of Nursing (ADON), Activities Director (AD), and two Certified Nursing Assistants (CNA A and CNA F). Personnel file reviews showed that while these staff members had completed effective communication training at some point, they did not receive the required annual training as stipulated by facility policy. The last recorded training dates for these employees did not align with the annual requirement, with some having only completed the training shortly after hire and not subsequently. Interviews with the Human Resources (HR) staff and the interim Administrator revealed a lack of clarity regarding responsibility for ensuring annual training compliance. HR indicated she was responsible for orientation training but was unsure about ongoing annual training responsibilities. The interim Administrator stated that HR was responsible for required trainings but was unaware that some staff had missed their annual training. The facility had recently transitioned to a new online training program, which contributed to the oversight in tracking and completing all required trainings. Facility policy and assessment documents confirmed that annual training on effective communication was required for all direct care staff.
Failure to Provide Annual Compliance and Ethics Training to Staff
Penalty
Summary
The facility failed to provide the required annual compliance and ethics training to three certified nursing assistants (CNAs) as evidenced by personnel file reviews. CNA A, hired on 9/3/2020, had not completed annual compliance and ethics training, with the last training recorded on 2/23/2024. CNA B, hired on 5/23/2023, had not completed annual training since 5/23/2023. CNA F, hired on 2/8/2024, had last completed the training on 2/9/2024, with no evidence of annual training thereafter. These findings were based on a review of training records and personnel files. Interviews with the HR staff and interim Administrator revealed a lack of clarity regarding responsibility for ensuring annual training was completed. The HR representative stated she was responsible for new hire training but was unsure who oversaw annual training. The interim Administrator indicated that the facility had recently changed to a new online training program and did not realize that some required trainings were missing from staff profiles. The facility's own assessment and policy documents confirmed that annual compliance and ethics training is required for all staff, but this was not consistently implemented.
Failure to Provide Annual Behavioral Health Training to Staff
Penalty
Summary
The facility failed to provide mandatory annual behavioral health training to three certified nursing assistants (CNAs) as required by facility policy and federal regulations. Record review showed that CNA A, CNA B, and CNA F did not complete annual behavioral health training within the required timeframe. Specifically, CNA A had not completed annual training since her last session in February 2024, CNA B had not completed training since May 2023, and CNA F had not completed training since February 2024. The facility's own assessment and policy require annual training for all staff, including behavioral health and trauma-informed care, but this was not consistently implemented. Interviews with the HR representative and interim Administrator revealed a lack of clarity regarding responsibility for ensuring annual training compliance. The HR representative was responsible for orientation training but was unsure who oversaw annual training, and the interim Administrator was not aware that some employees had missed their annual training. The facility had recently changed to a new online training program, which contributed to the oversight, as not all required trainings were included in staff profiles. This lapse resulted in staff not receiving the necessary behavioral health training as mandated by the facility's policy and assessment.
Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
The facility failed to maintain proper infection prevention and control practices for one resident and one staff member. Specifically, a resident with a history of osteomyelitis, pressure ulcer, and surgical amputations was on enhanced barrier precautions (EBP) due to a wound. During wound care, the MDS Coordinator assisted by only wearing gloves and not a gown, despite signage and PPE supplies being present at the resident's door. The MDS Coordinator also sat on the floor while assisting with care. The resident's care plan indicated a risk for infection and required wound care per physician orders, and the facility's EBP policy required both gown and gloves for high-contact care activities involving wounds. Interviews with the MDS Coordinator revealed she was aware of the EBP requirements but failed to follow them during the incident, stating she did not notice the signage or PPE container. The ADON and DON confirmed that staff are trained on infection control and EBP, and that the MDS Coordinator had received recent training, as indicated by inservice records. The interim Administrator also confirmed the expectation for staff to wear both gown and gloves when providing care to residents on EBP, including those with wounds.
Failure to Ensure Annual HIV Training for Staff
Penalty
Summary
The facility failed to develop, implement, and maintain an effective training program for new and existing staff, as evidenced by the lack of annual HIV training for three employees: the Activities Director (AD), Director of Rehabilitation (DOR), and a Certified Nursing Assistant (CNA B). Personnel records showed that the AD and DOR had not received annual HIV training, with their last training completed on the same date, and CNA B had not received annual HIV training since their hire date. Interviews with the Human Resources (HR) staff revealed uncertainty regarding responsibility for ensuring annual trainings, and the interim Administrator was unaware that some employees had missed required trainings. The facility had recently transitioned to a new online training program, which contributed to the oversight in completing all required trainings. Facility documentation, including the facility assessment and training policy, indicated that the training program was supposed to include orientation and ongoing training for all staff, with specific mention of HIV training as a required component. The policy required that training be completed prior to staff independently providing services and annually thereafter. The failure to ensure annual HIV training for the identified staff members was confirmed through record review and staff interviews.
Failure to Provide Required Annual Dementia Training to Staff
Penalty
Summary
The facility failed to develop, implement, and maintain an effective training program for one of fourteen employees reviewed for training. Specifically, the Dietary Manager (DM) did not receive annual dementia training as required. The DM was hired on 2/15/2024 and completed dementia training on 2/16/2024, but there was no evidence of annual retraining. Interviews with the Human Resources (HR) staff revealed uncertainty about who was responsible for ensuring annual trainings, and the interim Administrator was not aware that some employees had missed required annual trainings. The facility had recently changed to a different online training program, which contributed to the oversight in completing all required trainings. Record reviews showed that the facility's assessment and policy required ongoing and annual training for all staff, including dementia management. The policy specified that training requirements should be met prior to staff independently providing services and annually thereafter. Despite these requirements, the DM did not receive the mandated annual dementia training, resulting in noncompliance with facility policy and regulatory expectations.
Failure to Prominently Post Daily Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that daily nurse staffing information was posted in a prominent and readily accessible location for residents and visitors on two consecutive days. Observations revealed that the staffing postings were placed on a wall by the social worker (SW) office, which was not clearly visible from the front entrance, making it difficult for individuals entering the facility to see the information. Interviews with the HR staff member responsible for posting the information and the interim Administrator confirmed that they were unaware of the requirement for the posting to be visible to all upon entry and that there was no facility policy addressing the proper placement of the daily staff posting.
Inadequate Supervision and Securement During Resident Transport
Penalty
Summary
The facility failed to ensure adequate supervision and the use of assistance devices to prevent accidents for a resident during transport. The resident, who had severe cognitive impairment and was a fall risk, slid out of her wheelchair when the van driver had to brake suddenly. The incident occurred because the transport staff did not properly secure the resident with the shoulder and lap belt harness, leading to the resident sliding out of her wheelchair. The resident involved was an elderly female with multiple diagnoses, including cerebrovascular disease, hypertension, and chronic kidney disease. She required supervision or assistance for transfers and was considered a fall risk. During the transport incident, the resident was not properly secured in the van, which resulted in her sliding out of the wheelchair when the driver had to make an abrupt stop. The resident refused further medical assessment after the incident, although she later showed signs of bruising and reported pain. Interviews and observations revealed that the van drivers were not adequately trained on how to secure residents properly in the van. The maintenance director, who was responsible for training the van drivers, had not been trained himself. The facility's failure to ensure proper training and securement procedures placed residents at risk of injury during transport.
Failure to Ensure CNA Certification Compliance
Penalty
Summary
The facility failed to ensure that two Certified Nursing Assistants (CNAs), identified as CNA I and CNA J, were appropriately certified to practice in the State of Texas. This deficiency was identified through interviews and record reviews, which revealed that both CNAs had expired certifications. CNA I's certification had expired, and despite attempts to renew it, he faced issues with the credentialing system due to incorrect information. The facility's Administrator was aware of the issue and attempted to assist CNA I in resolving it, but the problem persisted. CNA I continued to work eight shifts as a CNA during the period when his certification was expired. Similarly, CNA J's certification was also expired, and the facility's records indicated that CNA J worked thirteen shifts as a CNA during this time. The facility's job description for CNAs requires them to be certified in good standing with the state, which was not the case for CNA I and CNA J. The failure to ensure that these staff members were properly certified could place residents at risk of receiving care from unqualified personnel.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Rusk
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Arbors Healthcare And Rehabilitation Center | 2.5 mi | — | 18 | 0 |
| Legacy At Jacksonville | 11.9 mi | — | 7 | 0 |
| Avir At Jacksonville | 12.6 mi | — | 1 | 0 |
| Twin Oaks Health And Rehabilitation Center | 14.2 mi | — | 12 | 0 |
| Wells Ltc Nursing & Rehabilitation | 24.8 mi | — | 14 | 1 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.