Tsali Care Center: Staffing, Turnover, and Inspection Record
Tsali Care Center is a 100-bed nonprofit nursing home in Cherokee, North Carolina. In the CMS August 2026 release it reported 4.23 nurse aide hours per resident per day, 81% above the North Carolina average of 2.34, and 47.2% nursing staff turnover (North Carolina average 49.0%).
Tsali Care Center
267 Tsali Care WayCherokee, NC 28719
Swain County
CMS Care Compare, August 2026 release
Special Focus Facility candidate. CMS lists this home as a candidate for its Special Focus Facility program, which is for nursing homes with a history of serious quality issues.
How many staff hours residents get
CMS reports staffing as hours per resident per day, from the payroll records each home submits. At Tsali Care Center, nurse aides logged 4.23 hours per resident per day, 81% above the North Carolina average. With about 78 residents a day, that works out to roughly 329 aide hours a day, or about 41 eight-hour aide shifts across day, evening, and night. On weekends, total nursing hours per resident ran 10% below the all-days figure.
| Hours per resident per day | This home | North Carolina avg | US avg |
|---|---|---|---|
| Nurse aides (CNAs) | 4.23 | 2.34 | 2.32 |
| Licensed practical nurses | 0.61 | 0.89 | 0.86 |
| Registered nurses | 1.30 | 0.61 | 0.69 |
| All nursing staff | 6.14 | 3.83 | 3.86 |
| All nursing staff, weekends | 5.55 | 3.40 | 3.42 |
CMS Care Compare, August 2026 release: reported staffing hours from Payroll-Based Journal data, and CMS state and US averages.
Staff turnover
47.2% of nursing staff at Tsali Care Center left over the year CMS measured, against a North Carolina average of 49.0% and a US average of 45.8%. Registered nurse turnover was 31.3%. 1 administrator left over the same period.
Inspections and penalties
State inspectors last completed a standard health inspection on Aug 1, 2025. The most recent inspection cycle, which also counts complaint and infection-control inspections from the past 12 months, found 26 health deficiencies (North Carolina average 4.8). CMS lists 4 fines totaling $157,555 and 1 payment denial in the last three years.
| Inspection date | Penalty | Amount or length |
|---|---|---|
| Jul 31, 2025 | Fine | $11,047 |
| Apr 10, 2025 | Fine | $15,028 |
| Jul 31, 2024 | Fine | $12,542 |
| Jul 31, 2024 | Fine | $118,938 |
| Jul 31, 2024 | Payment Denial | 81 days from Aug 29, 2024 |
CMS Penalties file, August 2026 release. A payment denial stops Medicare and Medicaid payment for new admissions for the days shown.
CMS star ratings
CMS rates every nursing home from one to five stars overall and on health inspections, staffing, and quality measures. Tsali Care Center holds 2 of 5 overall; the North Carolina average is 2.9.
About Tsali Care Center
- Ownership: Non profit - Corporation
- Legal name: Cherokee Indian Hospital Authority
- Medicare and Medicaid certified since: Apr 18, 1996
- Councils: resident council
- Area: rural
Nursing homes near Tsali Care Center
The closest homes by distance, with the same CMS figures. Select a column to sort.
| Mountain View Manor Nursing Center Bryson City | 8.1 | 120 | 1.96 | 3.21 | — | 1 | $14,131 |
| Vero Health & Rehab of Sylva Sylva | 9.9 | 106 | 2.27 | 3.74 | — | 1 | $359,818 |
| Skyland Care Center Sylva | 9.9 | 94 | 2.20 | 3.51 | 46.0% | 4 | None |
| Maggie Valley Health and Rehabilitation Center Maggie Valley | 13.9 | 114 | 1.83 | 3.05 | 31.8% | 2 | $51,012 |
| Autumn Care of Waynesville Waynesville | 18.5 | 90 | 2.12 | 3.43 | 69.8% | 1 | $107,387 |
| Skyland Terrace and Rehabilitation Waynesville | 20.2 | 90 | 1.98 | 3.39 | 53.3% | 4 | $8,512 |
| Macon Valley Nursing and Rehabilitation Center Franklin · abuse citation | 21.9 | 200 | 2.62 | 3.78 | 76.5% | 2 | $5,689 |
| Smoky Mountain Health and Rehabilitation Center Waynesville | 22.1 | 50 | 2.21 | 3.93 | 60.8% | 3 | None |
Aide hrs and all nurse hrs are staff hours per resident per day. Fines are the CMS total for the last three years. Turnover is the share of nursing staff who left over a year. All figures from CMS Care Compare.
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Source: CMS Care Compare Provider Information, State and US Averages, and Penalties files, August 2026 release. Figures are as CMS publishes them; check Medicare Care Compare for the latest. Methodology.