Below average — CMS composite of the measures below.
A standard survey is most likely before around September 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Macon Valley Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with chronic pain did not receive scheduled oxycodone as ordered due to a nurse's lack of awareness about the emergency medication kit and failure to seek assistance or contact the pharmacy or provider. The resident experienced severe pain, which was observed and reported by staff, while documentation showed missed doses and lack of follow-up.
A resident's controlled pain medication (Oxycodone) was misappropriated when one card of tablets and its count sheet went missing despite correct shift-to-shift counts and required signatures. Staff interviews revealed that nurses did not always physically verify the placement of controlled substances on the correct medication cart, and medication cards were sometimes used out of order. The discrepancy was discovered during a narcotic audit, leading to an internal investigation and the removal of a nurse from staffing.
A resident admitted with a history of blood clots, pulmonary embolism, and chronic pain was not provided with a baseline care plan addressing anticoagulant therapy or pain medication within 48 hours of admission. The care plan was delayed due to the absence of the usual staff responsible for its completion and lack of awareness by the weekend supervisor, resulting in the omission of critical interventions for the resident's prescribed therapies.
A resident's controlled substances were misappropriated due to improper shift transition protocols. Nurse #1 left the facility without counting the medications with another nurse, and Nurse #2 started her shift without verifying the count. The discrepancy was discovered the next morning, and the missing medications were replaced by the facility.
The facility failed to maintain accurate controlled substance counts and did not conduct proper counts during shift transitions, leading to a missing blister card of oxycodone for a resident. The issue arose when a nurse left the facility due to a family emergency without updating the count sheet or conducting a proper count, and the incoming nurse did not verify the count, resulting in the misappropriation of the medication.
The facility's QAA Committee failed to maintain procedures and monitor interventions, resulting in a repeat deficiency in the misappropriation of controlled substances. Despite monthly QAA meetings and corrective actions, the facility continued to exhibit issues with nursing staff not following policies for counting and verifying controlled substances during shift transitions.
Failure to Administer Scheduled Pain Medication as Ordered
Penalty
Summary
A deficiency occurred when a resident with a complex medical history, including chronic pain and chronic opiate therapy, did not receive scheduled pain medication as ordered. The resident was admitted with orders for scheduled and as-needed oxycodone and tramadol. On the day following admission, the scheduled oxycodone doses were not administered because the nurse on duty, who was new to the facility, was unaware that the medication was available in the emergency controlled medication kit. The nurse did not contact the pharmacy, provider, or other staff to resolve the issue and did not document administration of as-needed tramadol, which she later stated she had given. The resident reported severe pain, stating her pain level exceeded 10 and caused her to cry and almost scream. Nursing staff and a nursing assistant confirmed the resident was in pain and that her medication had not arrived from the pharmacy. Documentation showed that scheduled oxycodone doses were marked as unavailable due to waiting on pharmacy delivery, despite the medication being present in the emergency kit. The nurse did not follow up with the on-call provider or pharmacy and did not seek assistance from other nurses or the DON regarding the missing medication. Interviews with facility leadership and other clinical staff revealed that the emergency controlled medication kit was fully stocked and contained the ordered medication. The DON and Administrator stated that nurses were expected to utilize the emergency kit and seek help if medications were missing. The failure to administer the scheduled pain medication as ordered resulted in unmanaged pain for the resident, as directly observed and reported by staff and the resident herself.
Failure to Protect Resident from Misappropriation of Controlled Medication
Penalty
Summary
A deficiency occurred when the facility failed to protect a resident's right to be free from misappropriation of controlled medications. The incident involved a resident who had an active order for Oxycodone HCL 5 mg, with 120 tablets delivered to the facility. The medication was signed in by two nurses and the pharmacy courier, but a subsequent audit revealed that one card of 30 tablets and its corresponding declining count sheet were missing from the medication cart and narcotic records. Multiple shift-to-shift controlled substance counts were documented as correct, but the discrepancy was discovered during a narcotic audit by the Assistant Director of Nursing (ADON), who noted inconsistencies between the electronic Medication Administration Record (eMAR) and the physical count sheets. Staff interviews and written statements indicated that the process for receiving and storing controlled substances involved two nurses and the pharmacy courier counting and signing for the medications. However, it was revealed that the nurses did not always physically verify the placement of the medications on the correct cart. The missing medication card and count sheet were not immediately detected, as shift-to-shift counts appeared correct, and the medication cards were sometimes used out of order. The ADON's investigation found that the number of narcotic cards and count sheets matched, but one card and its sheet could not be located after a thorough search. Further investigation led to the removal of a nurse from staffing after she refused to provide a statement or submit to a drug screen. The Director of Nursing (DON) and other staff conducted a full audit and investigation, confirming that no other residents' medications were missing and that all other counts were correct. The incident was reported to the facility administrator, and the nurse involved was reported to the Board of Nursing. The deficiency was substantiated by the inability to account for the missing controlled medication and the associated documentation.
Failure to Develop Timely Baseline Care Plan for Anticoagulant and Pain Management
Penalty
Summary
The facility failed to develop a baseline care plan that addressed a resident's anticoagulant therapy and pain medication within 48 hours of admission. The resident was admitted with a history of deep vein thrombosis, pulmonary embolism, avascular necrosis of the lower extremities, and was on chronic opiate therapy for pain. Admission orders included Xarelto for anticoagulation and both scheduled and PRN narcotic and non-narcotic pain medications. Despite these orders, the baseline care plan did not include goals or interventions for either anticoagulant therapy or pain management. Interviews with nursing staff and administration revealed that the baseline care plan was typically completed by the Unit Manager, who was not present on weekends. As a result, if a resident was admitted on a Friday evening, the baseline care plan would not be completed until the following Monday, unless the Unit Manager was available. In this case, the baseline care plan was not completed within the required timeframe due to the Unit Manager's absence and the facility's ongoing annual survey. The new weekend supervisor was not aware of the requirement to complete baseline care plans on weekends, contributing to the deficiency.
Failure to Protect Resident's Controlled Substances
Penalty
Summary
The facility failed to protect a resident's right to be free from misappropriation of controlled substances. Resident #1, who was admitted with diagnoses including osteoporosis and hip fractures, had an order to receive oxycodone for pain management. A discrepancy was noted in the controlled substance count sheet during a shift transition, revealing that a blister card of 30 tablets of oxycodone was missing from the medication cart. The incident was reported to the Director of Nursing (DON) and an investigation was initiated immediately. The investigation revealed that Nurse #1 had a family emergency and left the facility without counting the controlled substances with another nurse. She handed the medication cart keys to Nurse Aide (NA) #1 in the parking lot, who then passed them to Nurse #2. Nurse #2 started her shift without verifying the controlled substances count with any nursing staff. The discrepancy was discovered the following morning when Nurse #3 took over the shift and found that a blister card of oxycodone was missing. Both Nurse #1 and Nurse #2 were drug screened with negative results, and the allegation of misappropriation was unsubstantiated. Interviews with the involved staff confirmed that proper protocols for counting controlled substances during shift transitions were not followed. Nurse #1 admitted to not updating the controlled substance count sheet and leaving the facility without a proper handover. Nurse #2 acknowledged starting her shift without verifying the controlled substances count. The DON and the Medical Director were notified of the incident, and the missing medications were replaced by the facility. Resident #1 was assessed for pain and reported no issues in receiving pain medication timely.
Failure to Maintain Accurate Controlled Substance Counts
Penalty
Summary
The facility failed to maintain an accurate accounting of controlled medications and did not conduct proper controlled substance counts during shift transitions. Specifically, a blister card containing 30 tablets of oxycodone 5 mg was found missing from a medication cart. The discrepancy was discovered during a shift transition when Nurse #3 and Nurse #2 counted the controlled substances and found that the count sheet indicated 49 cards, but only 48 cards were present in the cart. This missing card belonged to a resident who had an order for oxycodone for pain management due to osteoporosis and hip fractures. The issue began when Nurse #1 took over the medication cart from Nurse #4 and failed to update the controlled substance count sheet to reflect the correct number of 50 cards, instead leaving it at 48 cards. Later, Nurse #1 had a family emergency and left the facility without conducting a proper count with another nurse. She handed the medication cart keys to NA #1 in the parking lot, who then passed them to Nurse #2. Nurse #2 started her shift without verifying the controlled substances in the cart with another nurse, assuming the count was accurate based on Nurse #1's assurance. Interviews with the involved staff revealed that the facility's protocol for counting controlled substances during shift transitions was not followed. Nurse #1 admitted to not updating the count sheet and not conducting a proper count before leaving. Nurse #2 also acknowledged starting her shift without verifying the controlled substances with another nurse. The DON and the Administrator both emphasized the expectation for nursing staff to follow the facility's protocol to prevent such incidents. The failure to adhere to these protocols led to the misappropriation of the resident's controlled medication.
Repeat Deficiency in Misappropriation of Controlled Substances
Penalty
Summary
The facility's Quality Assessment and Assurance (QAA) Committee failed to maintain implemented procedures and monitor interventions following the recertification and complaint survey conducted on 02/16/24 and the complaint investigation survey conducted on 04/02/24. This resulted in a repeat deficiency in the area of misappropriation/exploitation of residents' property. Specifically, the facility failed to protect residents' rights to be free from misappropriation of controlled substances. During the recertification and complaint survey on 02/16/24, the facility failed to protect residents' rights to be free from misappropriation of controlled medications for four residents reviewed for misappropriation of property. This issue persisted and was again identified during the complaint investigation survey on 04/02/24 for one resident reviewed for the same issue. During an interview conducted with the Administrator on 04/02/24, it was revealed that the facility conducted QAA meetings at least once monthly to discuss areas of concern, including deficiencies from surveys. The Administrator attributed the failure to the nursing staff's inability to follow policies and procedures related to counting, verifying, and confirming the quantity of controlled substances in the medication cart during shift transitions. Despite the implementation and monitoring of corrective actions since the last survey, the facility continued to exhibit deficiencies in this area, indicating an ongoing issue with the effectiveness of the QAA program.
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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 Franklin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Eckerd Living Center | 15.1 mi | ★★★★★ | 4 | 0 |
| Mountain View Manor Nursing Center | 17.5 mi | ★★★★★ | 0 | 0 |
| Skyland Care Center | 19.1 mi | ★★★★★ | 0 | 0 |
| Vero Health & Rehab Of Sylva | 19.2 mi | ★★★★★ | 7 | 0 |
| Mountain View Health Care | 20 mi | ★★★★★ | 0 | 0 |
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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 July 2026) and official state health department websites.