Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 Maggie Valley Health And Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to provide residents with access to their personal trust funds for more than two months during a transition to new bank accounts after a change in ownership. A cognitively intact resident who relied on staff to shop for toiletries using his trust account reported that staff had stopped making purchases, and his family had been supplying his personal items instead. Another resident with moderate cognitive impairment, who typically received monthly cash from her trust account to buy phone minutes, did not receive her usual payments for over two months and only received a partial amount later. Facility leadership and business office staff confirmed that there was no cash box, no cash available, and that residents and responsible parties had been unable to access any trust account funds during this period, affecting all residents with such accounts.
The facility failed to request Level II PASRR evaluations for two residents after new serious mental illness conditions were identified. One resident with a prior Level I PASRR later developed nighttime hallucinations requiring antipsychotic therapy, yet no PASRR reevaluation was submitted in NC MUST. Another resident with a Level I PASRR was subsequently diagnosed with PTSD and depression and started on prazosin and sertraline, with these diagnoses reflected on the MDS, but no Level II PASRR request was made. The SW reported being responsible for Level II PASRR submissions but stated she was not always informed of new mental health diagnoses and acknowledged these omissions as oversights, which the administrator confirmed as residents being overlooked during PASRR reviews.
A resident admitted with non-Alzheimer’s dementia, anxiety disorder, major depressive disorder, and bipolar disorder, and treated with antianxiety, antidepressant, and anticonvulsant medications, had only a Level I PASRR on file. The existing PASRR did not include the resident’s mental health diagnoses, and no Level II PASRR request was submitted through NC MUST. The regional social worker/discharge planning consultant and the SW both acknowledged that the presence of mental health disorders with only a Level I PASRR should have triggered a Level II request, and the SW, who was responsible for these submissions, stated the omission was an oversight. The Administrator confirmed the SW’s responsibility for Level II PASRR requests and indicated this resident’s PASRR was overlooked during auditing.
Staff failed to follow the facility’s special droplet contact precautions for a Covid-19 positive resident. Policy and posted signage required hand hygiene before room entry and use of gown, N95, eye protection, and gloves. Instead, two NAs entered the resident’s room wearing only surgical masks, did not perform hand hygiene before entry, and provided direct physical assistance with positioning and meal setup. On another occasion, a third NA entered wearing a gown, gloves, eye protection, and a surgical mask instead of an N95 while repositioning the resident. Staff later acknowledged they had not read or followed the posted precautions or had been in a hurry and used the wrong mask.
Two residents, both cognitively intact and with significant medical conditions, experienced physical abuse from visiting family members during separate incidents. In both cases, the family members pinched and caused bruising to the residents' arms or shoulders during arguments, resulting in pain and distress. Staff intervened and reported the incidents, but the facility's existing policies did not prevent the abuse, which was attributed to inadequate background screening of visitors.
A resident with osteoporosis and hypertension, who was cognitively intact, experienced physical abuse by a family member resulting in pain and bruising. The facility did not report the abuse allegation to DHSR and APS within the required 2-hour timeframe, as staff misunderstood the reporting requirements and failed to complete the necessary notifications.
During a COVID-19 outbreak, the facility failed to follow CDC guidance by delaying broad-based testing and not providing N95 masks for staff caring for COVID-19 positive residents. Staff did not consistently wear required PPE, and the facility allowed COVID-19 positive staff to return to work prematurely. The facility's policies were outdated, and there was a lack of understanding of CDC recommendations among the Infection Preventionist and Director of Nursing.
The facility failed to manage medications properly, with undated and expired medications found on multiple carts. An undated Insulin Glargine pen was discovered, and an expired Geri-Lanta bottle was overlooked. Additionally, Latanoprost eye drops were improperly stored outside refrigeration. Nurses were unaware of proper protocols, and the DON acknowledged the need for better oversight.
A resident with aphasia and gastrostomy status did not receive privacy during tube feeding administration. The nurse left the door open and did not use the privacy curtain, exposing the resident's abdomen. This allowed another resident and staff to observe the procedure. The nurse admitted to not considering privacy measures when the resident's roommate was absent, and the DON confirmed that privacy should have been ensured.
The facility failed to remove expired nutritional supplements and ready-to-eat personal resident food from two nourishment rooms, potentially affecting residents. An expired supplement was found in the North nourishment room, and expired resident food was found in the South nourishment room. The Dietary Manager and Dietary Aide acknowledged the oversight, and the Administrator confirmed the items should have been discarded.
Failure to Provide Resident Access to Personal Trust Funds During Bank Transition
Penalty
Summary
The facility failed to honor residents' rights to manage their financial affairs by not providing access to personal trust accounts for more than two months. One resident, cognitively intact per a quarterly MDS assessment, reported that he maintained a trust account and routinely used his funds to purchase toiletries and personal items. He stated that facility staff had previously gone to the store monthly on his behalf and debited his account, but this practice had stopped for the past couple of months without explanation, and his family had been supplying his toiletries and other items during this time. Another resident, who was moderately cognitively impaired per a quarterly MDS assessment, reported that she had routinely received $70 in cash from her trust account at the beginning of each month but had not received any money for over two months until she was given $138 in cash by staff. She stated she used her money to buy phone minutes for herself and her son and indicated she was still owed additional funds. The Business Office Manager, Regional Business Office Manager, and Administrator each confirmed that, following a change in facility ownership and the transition to new bank accounts beginning in December, the facility had no cash box, no cash available, and residents and responsible parties had been unable to access trust account funds since January, affecting all residents with trust accounts and halting staff shopping for residents.
Failure to Request Level II PASRR Evaluations After New Mental Health Diagnoses
Penalty
Summary
The deficiency involves the facility’s failure to request Level II Preadmission Screening and Resident Review (PASRR) evaluations after new serious mental illness conditions were identified in residents who previously had Level I PASRR determinations. For one resident with a Level I PASRR dated 05/06/13, the admission MDS showed no serious mental illness per the state Level II PASRR process, although active diagnoses included major depressive disorder and anxiety disorder, and the resident was receiving antidepressant medication. On 11/19/25, a NP documented that the resident was experiencing nighttime hallucinations, with staff reporting the resident was screaming and terrified at night, and Seroquel 50 mg at bedtime was initiated. A psychiatric note on 02/27/26 documented follow-up after Seroquel was increased to 100 mg, with decreased hallucinations and mood disturbance. Despite these developments, an NC MUST inquiry on 03/17/26 showed no PASRR reevaluation requests had been submitted after 11/19/25. A second resident had a Level I PASRR dated 09/19/24, with no further screening required unless a significant change suggested a mental illness diagnosis or change in treatment needs. A psychiatric progress note dated 02/06/25 documented that on 01/30/25 the resident was started on prazosin 1 mg at bedtime and sertraline 50 mg daily for nightmares and PTSD symptoms, with diagnoses of PTSD and depression. The annual MDS later reflected active diagnoses of depression (other than bipolar) and PTSD, and antidepressant use, while still indicating the resident was not considered by the state Level II PASRR process to have a serious mental illness or intellectual disability. An NC MUST inquiry on 03/17/26 confirmed no PASRR reevaluation requests had been submitted after 01/30/25. In interviews, the social worker stated she was responsible for submitting Level II PASRR requests but was not always notified of new mental illness diagnoses and acknowledged not submitting requests for these two residents as an oversight. The administrator confirmed the social worker’s responsibility for Level II PASRR requests and stated these residents were overlooked during PASRR reviews and audits.
Failure to Request Level II PASRR for Resident With Serious Mental Health Disorders
Penalty
Summary
The deficiency involves the facility’s failure to submit a required Level II PASRR evaluation request for a resident admitted with serious mental health disorders. A PASRR Determination Notification dated 12/05/25 showed the resident had a Level I PASRR with no expiration date. The resident was admitted with diagnoses including non-Alzheimer’s dementia, anxiety disorder, major depressive disorder, and bipolar disorder. A physician’s progress note dated 12/12/25 documented dementia and anxiety with depression, treated with escitalopram 10 mg daily, buspirone 15 mg three times daily, and divalproex sodium 125 mg every morning and 250 mg nightly. The admission MDS indicated the resident was not considered by the state Level II PASRR process to have a serious mental illness or intellectual disability, but listed active psychiatric/mood disorder diagnoses of anxiety disorder, depression (other than bipolar), and bipolar disorder, and documented the use of antianxiety, antidepressant, and anticonvulsant medications during the assessment period. A NC MUST inquiry on 03/17/26 confirmed the resident only had a Level I PASRR effective 12/05/25 with no subsequent PASRR requests submitted. During interviews, the Regional Social Worker/Discharge Planning Consultant explained that when a resident is admitted with mental health disorders not reflected on the existing PASRR, the social worker should submit a Level II PASRR request, and acknowledged that this was not done for this resident. The Social Worker confirmed she was responsible for submitting Level II PASRR requests, verified the resident had mental health diagnoses and a Level I PASRR on admission, and stated that failing to submit the Level II request was an oversight. The Administrator also stated that the Social Worker was responsible for Level II PASRR submissions per regulatory guidelines and indicated that this resident’s PASRR was overlooked during review and auditing.
Failure to Follow Special Droplet Contact Precautions for Covid-19 Positive Resident
Penalty
Summary
Surveyors identified a deficiency in the facility’s infection prevention and control program related to failure to follow special droplet contact precautions for a resident with confirmed Covid-19. Facility policy dated 10/24/24 required implementation of special droplet contact precautions for newly identified Covid-19 cases, and the resident’s positive Covid-19 test on 3/14/26 resulted in placement on these precautions with signage posted outside the room. The posted signage dated 11/22 instructed staff to perform hand hygiene before entering and to wear a gown, N95 mask, eye protection, and gloves upon entry. Despite this, on 3/16/26 at 12:52 PM, two nursing assistants entered the resident’s room wearing only surgical masks, without performing hand hygiene before entry and without donning a gown, gloves, eye protection, or an N95 mask, while physically assisting the resident to sit on the side of the bed and setting up the lunch tray. They washed their hands with soap and water only after exiting the room and later acknowledged they should have worn the required PPE but did not and could not explain why. On 3/17/26 at 8:55 AM, another nursing assistant was observed inside the same resident’s room wearing a gown, gloves, eye protection, and a surgical mask instead of the required N95 mask while physically repositioning the resident in bed. This staff member removed PPE and washed hands with soap and water after exiting the room but reported she had been in a hurry and did not put on an N95 mask. The DON stated that the first two nursing assistants reported they had not read the special droplet contact precaution signage posted at the resident’s door, and that the third nursing assistant had received education on special droplet contact precautions but still did not follow protocol, stating she put on the wrong mask outside the room. The Administrator confirmed staff should have followed the posted special droplet contact precaution signage and could not explain why they did not.
Failure to Protect Residents from Abuse by Visitors
Penalty
Summary
The facility failed to protect residents from abuse by visitors, resulting in two separate incidents involving physical abuse by family members during visits. In the first incident, a resident with heart failure and anxiety disorder, who was cognitively intact and required moderate assistance for transfers, was subjected to physical abuse by her spouse, who has dementia. The spouse was observed by multiple staff members pinching, twisting, and shoving the resident while she was in her wheelchair, causing pain, bruising, and distress. The incident occurred after a verbal argument and was witnessed by several staff, who intervened to separate the resident from the family member. The resident reported pain and bruising to her right shoulder and forearm, and was evaluated for anxiety following the event. In the second incident, another cognitively intact resident with osteoporosis and impaired upper extremity mobility was physically abused by a visiting family member during a disagreement over a phone passcode. The family member grabbed and pinched the resident's right arm, resulting in pain and a circular bruise near the inner elbow. The incident was reported by a nurse who responded to yelling and found the resident upset and injured. The resident confirmed the abuse and stated it was the first occurrence of such behavior from the family member. The nurse did not witness the physical act but observed the aftermath and reported the incident to the DON. In both cases, the facility identified the root cause as inadequate background screening of visiting family members. The incidents were considered unusual as they involved visitors rather than staff. Both residents were asked during admission about any history of trauma or abuse from family members and had denied such history. The facility's policies and procedures for abuse were in place, but the events occurred despite these measures, and the facility had limited authority to screen visitors prior to entry.
Failure to Timely Report Abuse Allegation to State Agency and APS
Penalty
Summary
The facility failed to implement its abuse policy and procedure regarding timely reporting of an abuse allegation involving a resident with osteoporosis and high blood pressure, who was cognitively intact and had adequate hearing and vision. The incident involved a family member visiting the resident, yelling at her, and physically grabbing and twisting her arm, resulting in pain and visible bruising. The abuse allegation was reported to the DON and Administrator, but the required notifications to the State Agency (DHSR) and Adult Protective Services (APS) were not made within the specified 2-hour timeframe as outlined in the facility's policy. The initial report to DHSR was submitted over 20 hours after the facility became aware of the incident, and there was no documentation to support that APS had been notified. Interviews revealed that the Social Service Director (SSD) attempted to report the incident to APS by phone but did not complete the process due to distractions and did not follow up. The SSD also misunderstood the reporting timeframe, believing she had 24 hours to report to DHSR instead of the required 2 hours. The DON, upon returning to the facility, discovered the delay and submitted the report to DHSR but did not complete the APS notification. The Administrator confirmed that staff are expected to follow the abuse reporting policy and procedures, which were not adhered to in this case.
Failure to Implement CDC Guidance During COVID-19 Outbreak
Penalty
Summary
The facility failed to operationalize updated infection control policies and procedures in accordance with current CDC guidance during a COVID-19 outbreak. On 12/26/24, a staff member and residents on two different halls tested positive for COVID-19, but the facility did not implement broad-based COVID-19 testing for staff and residents until 1/8/24, after surveyor intervention. This delay resulted in additional staff and residents testing positive for COVID-19. The facility also failed to implement staff source control measures to prevent transmission during the outbreak. The facility did not provide staff with N95 masks for the care of COVID-19 positive residents, as per CDC guidance. Observations revealed that facility staff did not wear all required personal protective equipment (PPE) when entering rooms under transmission-based precautions for COVID-19. Additionally, the facility allowed staff to return to work after testing positive for COVID-19, contrary to CDC guidance. The facility's COVID-19 policies and procedures were not updated to align with current CDC guidance for testing, PPE requirements, and work restriction guidance for healthcare personnel. Interviews with the Infection Preventionist (IP) and Director of Nursing (DON) revealed a lack of understanding and implementation of CDC recommendations for COVID-19 testing and outbreak management. The IP and DON believed that testing was only necessary for symptomatic individuals, and the facility did not conduct contact tracing or broad-based testing until prompted by surveyors. The facility also failed to notify the local Health Department of the outbreak, which could have provided guidance and recommendations to mitigate the outbreak.
Medication Management Deficiencies in Facility
Penalty
Summary
The facility failed to properly manage and store medications across multiple medication carts, leading to deficiencies in medication labeling and storage. On the 400 hall medication cart, an undated Insulin Glargine pen was found, with the nurse unable to confirm if it was opened or not. The manufacturer's instructions specify that Insulin Glargine expires 28 days after opening and should be dated when removed from refrigeration. The nurse admitted to not noticing the pen due to its administration schedule and acknowledged that all nurses should check for undated and expired medications. On the 500 hall medication cart, an expired bottle of Geri-Lanta was found, which the nurse had overlooked during a quick check. Additionally, on the 200 hall medication cart, an unopened and undated bottle of Latanoprost eye drops was discovered, which should have been refrigerated until opened. The nurse was unaware of the storage requirements and the need to date the bottle upon removal from refrigeration. The Director of Nursing confirmed the need for proper dating and disposal of expired medications, indicating a lack of consistent oversight and adherence to medication management protocols.
Failure to Provide Privacy During Tube Feeding
Penalty
Summary
The facility failed to provide privacy during the administration of tube feeding for a resident diagnosed with aphasia following a stroke and gastrostomy status. The resident, who was rarely/never understood and had severely impaired cognitive skills, was observed receiving tube feeding in his room with the door wide open. Although there was a privacy curtain available, it was not used by Nurse #1, who exposed the resident's abdomen while administering the feeding. This lack of privacy allowed another resident and several staff members to observe the care being provided. Nurse #1 admitted during an interview that she typically used the privacy curtain when the resident's roommate was present but did not consider closing the door or using the curtain when the roommate was absent. The Director of Nursing confirmed that Nurse #1 should have ensured privacy by closing the door and using the curtain during the procedure. This oversight resulted in a breach of the resident's right to privacy during medical care.
Expired Food and Supplements Found in Nourishment Rooms
Penalty
Summary
The facility failed to remove expired nutritional supplements and ready-to-eat personal resident food from two nourishment rooms, which could potentially affect residents. During an observation of the North nourishment room, an expired unopened nutritional supplement was found stored in a cabinet. The Dietary Manager (DM) acknowledged that the supplement, stocked by kitchen staff, should have been discarded upon expiration. In the South nourishment room, expired resident food was found in the refrigerator, including three unopened individually packaged ready-to-eat containers. The DM stated that the nourishment rooms were checked twice daily, but the expired items were overlooked. The Dietary Aide responsible for checking the rooms confirmed that she did not notice the expired items during her morning check. The Administrator acknowledged that the expired items should have been removed and disposed of when expired.
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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 Maggie Valley
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Autumn Care Of Waynesville | 6.3 mi | ★★★★★ | 1 | 0 |
| Skyland Terrace And Rehabilitation | 6.8 mi | ★★★★★ | 3 | 0 |
| Smoky Mountain Health And Rehabilitation Center | 8.2 mi | ★★★★★ | 3 | 0 |
| Vero Health & Rehab Of Sylva | 11.5 mi | ★★★★★ | 7 | 0 |
| Skyland Care Center | 11.6 mi | ★★★★★ | 0 | 0 |
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