The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited April 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
Nursing home report
Tsali Care Center
Cherokee, NC · Medicare-certified · 100 beds
Needs attention
Special Focus candidateNon-profit
Data as of July 1, 2026
2 of 5 overall
Tsali Care Center in Cherokee, NC has a 2-star overall rating, with a 1-star health inspection rating and 2-star quality measures rating, but 5-star staffing at 6.14 hours per resident per day, above the 4.1 federal benchmark. It is an SFF Candidate/special focus facility and had $157,555 in fines over the last 24 months, with recent inspection citations for accident hazards/supervision, pain management, and pressure ulcer care.
Facility ratings
Health inspections
Staffing
6.1353 hrs/resident/day
Quality measures
Last inspection: August 1, 2025Penalties, last 24 months: $157,555special focus facility
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 6.1353.
Staffing detail
- Registered nurses
- 1.30
- Licensed practical nurses
- 0.61
- Nurse aides
- 4.23
- Weekend nursing
- 5.55
Hours per resident per day.
Total staff turnover: 47%
Registered nurse turnover: 31%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
19.4%10.9%Improving
Residents with a fall causing major injury
4.8%8.8%Worsening
Residents with pressure ulcers (bedsores)
12.9%13.4%Worsening
Residents with a urinary tract infection
4.9%0%Improving
Residents who lost too much weight
7.4%5.2%Improving
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
17%12.1%Improving
Residents whose ability to walk got worse
20.5%10.2%Improving
Long-stay residents on antianxiety or sleep medication
20%19.7%No change
Short-stay residents newly given an antipsychotic
0%5%Worsening
Residents with a long-term catheter
0%2%Worsening
Residents with new or worsening incontinence
32.9%33.7%Worsening
Residents with depressive symptoms
9.8%7%Improving
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—74.6%—
Long-stay residents given the pneumonia vaccine
82.3%100%Improving
Short-stay residents given the seasonal flu vaccine
—38.5%—
Short-stay residents given the pneumonia vaccine
57.1%80%Improving
What the inspectors found
The home failed to provide safe, appropriate pain management for a resident who needed it. Cited August 2024 — isolated incident, actual harm.
View the original federal record
F-Tag 697 — 42 CFR §483.25(k) — S/S: G
The nursing home failed to provide proper pressure ulcer care and failed to prevent new pressure sores from developing. Cited July 2023 — isolated incident, actual harm.
View the original federal record
F-Tag 686 — 42 CFR §483.25(b) — S/S: G
The home failed to run its operations effectively and efficiently using its available resources. Cited August 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 835 — 42 CFR §483.70 — S/S: F
The home failed to have an ongoing quality review group that finds problems and makes corrective plans. Cited August 2025 — widespread issue, potential for harm.
View the original federal record
F-Tag 867 — 42 CFR §483.75 — S/S: F
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 26 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $11,047 was recorded.
- PENALTY
A federal fine of $15,028 was recorded.
- INSPECTION
Health inspection found 7 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 2 health deficiencies.
See what inspectors found
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $118,938 was recorded.
- PENALTY
A federal fine of $12,542 was recorded.
Penalties & enforcement
On record with Medicare: 4 fines · $157,555 in total fines · 1 payment denial.
- $11,047
Federal fine
Jul 31, 2025
- $15,028
Federal fine
Apr 10, 2025
- 81 days
Medicare/Medicaid payment denial
Jul 31, 2024
- $118,938
Federal fine
Jul 31, 2024
- $12,542
Federal fine
Jul 31, 2024
Operator & ownership
Recent ownership change · Oct 1, 2019
Now operated by Cherokee Indian Hospital Authority, previously Eastern Band of Cherokee Indians.
- Ownership
- Non profit - Corporation
- Occupancy
- 77.9 residents on an average day (78% of 100 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 30 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.