Above average — CMS composite of the measures below.
The next survey window likely opens around November 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 Nc State Veterans Home - Salisbury during CMS and state inspections, most recent first.
Staff failed to properly disinfect shared blood glucose meters before and after each use, using alcohol wipes instead of EPA-registered disinfectant wipes, and sometimes not disinfecting at all. This occurred during blood glucose checks for two residents with bloodborne pathogens, with staff demonstrating lack of knowledge about correct procedures despite prior training. The meters were not individually labeled or stored, leading to potential cross-contamination.
Two residents experienced a lack of dignity and respect for their rights when one was subjected to rough handling during bathing despite asking for it to stop, and another had their urine collection bag left uncovered and visible from the hallway after a medical procedure. Staff did not respond to resident requests or ensure privacy measures were maintained.
Two residents were administered antipsychotic and antidepressant medications without appropriate mental health diagnoses, and a PRN antipsychotic was ordered for longer than regulations allow. Staff, including the DON and Consultant Pharmacist, did not verify medication orders for compliance, relying instead on pharmacy review and assuming hospice orders were exempt from certain requirements.
A resident with dementia and chronic conditions reported being roughly handled by a nursing assistant during a shower, repeatedly asking for the care to stop. Despite the resident's complaints, neither the involved NA nor another NA who overheard the allegation reported it to administration or the charge nurse, allowing the accused NA to continue working. The incident was only reported days later by the resident's representative, resulting in delayed assessment and documentation, and a failure to follow the facility's abuse reporting policy.
A resident with chronic pain did not receive lidocaine patches as ordered by the physician, with nurses administering fewer patches than prescribed and failing to seek clarification or update the order. Both the DON and physician confirmed the order was not followed or clarified by staff.
A resident with an indwelling urinary catheter was observed on two occasions with their catheter collection bag lying on the floor, despite staff knowledge that the bag should be hung below the bladder and off the floor. Staff interviews confirmed awareness of proper catheter care, but the training materials did not specifically address bag placement. The deficiency was identified through direct observation and staff interviews.
Two residents received antipsychotic and antidepressant medications without appropriate diagnoses or correct PRN stop dates, and the Consultant Pharmacist failed to identify or report these drug regimen irregularities during monthly reviews. Facility staff were unaware of regulatory requirements for PRN antipsychotic duration and did not question physician orders, resulting in continued inappropriate medication use.
Nursing staff failed to accurately document and administer lidocaine patches as ordered for a resident with pain management needs. Nurses applied fewer patches than prescribed and signed the MAR as if the full dose was given, resulting in inaccurate medical records. The DON and ADON confirmed that the documentation did not reflect actual practice.
Two residents did not have proper documentation related to influenza vaccination: one did not have evidence of receiving vaccine education or a Vaccine Information Statement (VIS) prior to consenting, and another received the vaccine without a signed consent form, with only staff witness signatures indicating verbal consent. Facility staff acknowledged missing documentation and inconsistent practices, despite policy requirements for providing the VIS and documenting education and consent.
A resident with a history of tobacco use, stroke, and vascular dementia did not receive a required quarterly smoking safety screen, as mandated by facility policy. The resident, who required supervision while smoking, continued to participate in supervised smoking sessions. The DON confirmed that the assessment was not completed and that there was no system in place to ensure these evaluations were done on schedule.
The facility did not post a complete and current list of required state agency and advocacy group contact information, including the State Survey Agency, Adult Protective Services, Ombudsman Program, and others. Observations showed missing or outdated postings in key areas, and staff interviews revealed confusion about responsibility for maintaining these postings.
Two residents' representatives signed arbitration agreements without adequate explanation from facility staff. In one case, a representative was present with the Admissions Coordinator but was not given an explanation of the forms. In another, the representative received the paperwork electronically and had no verbal communication with staff, leading to confusion about the agreement's content.
Unlabeled items were found in nourishment rooms on both floors of the facility, including lactose-free milk, Gatorade, cherry coke, ice cream cones, and containers of ice cream. Dietary staff were unsure of ownership, and it was noted that nursing staff were responsible for labeling residents' items, while staff items were not allowed in these rooms.
A resident who was alert and independent expressed a preference to eat in the dining room during evening meals but was repeatedly denied this choice due to staff shortages. Staff interviews confirmed that residents were often unable to use the dining room for supper because staff were too busy assisting others. The DON and Administrator were unaware of the specific complaints, although the expectation was for residents to have dining choices.
A resident dependent on staff for personal hygiene due to a stroke and hemiplegia was not shaved as per their care plan. Despite the resident's preference for being shaved, staff did not fulfill this need due to time constraints and other priorities. Interviews with staff and administration confirmed the oversight in providing necessary personal hygiene care.
Failure to Properly Disinfect Shared Blood Glucose Meters
Penalty
Summary
Facility staff failed to properly clean and disinfect shared blood glucose meters before and after each use, as required by both facility policy and the manufacturer's instructions. Observations revealed that staff used alcohol wipes instead of EPA-registered disinfectant wipes, and in some cases, did not disinfect the meters at all prior to use. This practice was observed during blood glucose checks for two residents, both of whom were identified as having bloodborne pathogens, including hepatitis C. The blood glucose meters were not labeled for individual resident use and were stored in a manner that allowed for potential cross-contamination. Nursing staff, including a nurse and the Assistant Director of Nursing (ADON), demonstrated a lack of knowledge regarding the correct disinfection procedures. The nurse stated he was trained to use alcohol for cleaning, and the ADON admitted she was unaware that the meter needed to be cleaned both before and after each use. Both staff members had previously received training on blood glucose meter disinfection, but failed to follow the correct procedures during observed care. The facility's policy and the manufacturer's guidelines both specified the use of EPA-registered disinfectant wipes with a required contact time, which was not followed. The deficiency was identified during direct observation and interviews, which confirmed that the improper cleaning and disinfection of blood glucose meters occurred while caring for residents with known bloodborne pathogens. The facility's monitoring systems failed to detect or correct these lapses in infection control, and staff continued to use shared meters without proper disinfection, increasing the risk of cross-contamination and exposure to bloodborne infections among residents.
Removal Plan
- Removed and discarded prior blood glucose meters that were being utilized for multi-resident use.
- Placed individual blood glucose meters in a zipped plastic bag with resident's name identifier to prevent cross contamination.
- Blood glucose meters are removed from the zipped plastic bag prior to entering the resident room, then cleaned, disinfected, and air-dried per EPA-registered disinfectant wipe manufacturer's recommendation before and after use.
- Blood glucose meters are stored in each resident's respective medication cart.
- Applied residents' names to the individual blood glucose meters.
- Upon resident discharge, blood glucose meter is disinfected with EPA-registered disinfectant wipe and stored in medication room.
- All new admissions and residents with new blood glucose meter testing orders will be given a new blood glucose meter by the nurse receiving the order and/or admitting nurse.
- Nurse and/or admitting nurse will label the blood glucose meter and baggy with resident's name and place it in their respective medication cart.
- Education provided to all Licensed Nurses on the specific resident use of blood glucose meters, storage, cleaning, and disinfecting using proper EPA-disinfecting wipe.
- Licensed Nurses who have not received the education will be removed from the schedule until the education has been completed.
- Education related to cleaning, disinfecting, and storage of individual blood glucose meters will be added to the general orientation of newly hired Licensed Nurses.
- Administrator and/or Director of Health Services is responsible for ensuring all Licensed Nurses are educated.
- Licensed nurses who are scheduled to work will receive in-person education and complete return demonstration of cleaning and disinfecting blood glucose meters.
- Licensed Nurses who are not scheduled to work will receive over the phone education with return demonstration review by Director of Health Services prior to next scheduled shift.
- Administrator and/or Director of Health Services maintains the employee roster of those who have been educated and who require review.
- Facility contacted the local health department regarding the infection control breach.
- Medical Director was notified of the infection control breach.
Failure to Honor Resident Dignity and Rights
Penalty
Summary
The facility failed to honor a resident's right to dignity and self-determination in two separate incidents. In the first incident, a resident with chronic pain and dementia, who was moderately cognitively impaired and dependent on staff for bathing and toileting, requested that a nursing assistant stop a shower due to being handled roughly. Despite the resident's repeated requests to stop and expressions of discomfort, the nursing assistant continued with the shower and did not report the incident to supervisory staff. The resident later expressed fear of the nursing assistant and felt that his concerns were not being heard by staff. In the second incident, another resident with severe cognitive impairment and an indwelling catheter was observed multiple times with his urine collection bag visible from the hallway, lacking a privacy or dignity cover. The urine in the collection bag was visible to staff, visitors, and other residents passing by. Staff interviews confirmed that the privacy cover was not in place following the resident's return from a urology procedure, and that staff had not noticed or addressed the missing cover during their shifts. Both incidents demonstrate failures to maintain resident dignity and respect resident rights, as staff did not respond appropriately to resident requests or ensure privacy measures were in place. These deficiencies were identified through observations, record reviews, and interviews with residents, staff, and family members.
Failure to Ensure Proper Diagnosis and Regulatory Compliance for Psychotropic Medication Use
Penalty
Summary
The facility failed to ensure that two residents had appropriate diagnoses for the use of antipsychotic and antidepressant medications, and did not comply with regulations regarding the duration of PRN antipsychotic orders. For one resident with mild dementia, agitation, and brief psychotic disorder, a PRN order for Haldol was written for 60 days to manage agitation, without a proper diagnosis justifying its use for agitation and without adhering to the required 14-day stop date for PRN antipsychotics. The order was written by a Physician Assistant and hospice Physician, both of whom were unaware of the 14-day regulatory limit. The Consultant Pharmacist, who reviewed the order, did not question the extended duration or the diagnosis, assuming hospice orders were exempt, and the Director of Nursing stated that staff did not verify medication orders for accuracy or compliance with regulations. For another resident with unspecified dementia and no documented behavioral or psychotic disturbances, antipsychotic (olanzapine) and antidepressant (sertraline) medications were ordered and administered without a supporting mental health diagnosis. The resident's records and progress notes did not indicate behaviors or symptoms that would justify the use of these medications. The Physician Assistant and Assistant Director of Nursing confirmed that the medications were ordered for dementia without behaviors, and that no mental health diagnosis was present until after the deficiency was identified. The Director of Nursing acknowledged that the facility relied solely on pharmacy review for medication order accuracy and was unaware of the missing diagnoses until it was brought to their attention. These deficiencies were identified through record review and interviews with facility staff, the Consultant Pharmacist, and the prescribing clinicians. The facility's process lacked adequate checks to ensure that medication orders were supported by appropriate diagnoses and that regulatory requirements for PRN antipsychotic medications were followed.
Failure to Immediately Report and Protect Resident Following Allegation of Rough Handling
Penalty
Summary
The facility failed to follow and implement its abuse policy and procedures in the case of a resident with multiple diagnoses, including unspecified dementia, chronic obstructive pulmonary disease, and chronic pain. The resident reported that a nursing assistant (NA) was rough and manhandled him during a shower, and despite the resident's repeated requests for the NA to stop, the care continued. The resident expressed fear and distress, stating that staff did not listen when he tried to report the incident after returning to his room. Two nursing assistants were aware of the resident's allegations: one directly involved in the incident and another who overheard the resident's complaints. Neither assistant reported the incident to administration or the charge nurse as required by facility policy, allowing the NA in question to complete the shift and return to work the following day. The charge nurse on duty did not recall being informed of the incident, and the resident's representative did not immediately report the allegation to staff, only doing so during a subsequent visit after the resident repeated his account and appeared upset. The facility's policy required immediate reporting of any abuse allegations to the Administrator and safeguarding of the resident. However, the delay in reporting resulted in the accused NA continuing to work and potentially exposed other residents to risk. The initial assessment and documentation of the resident's condition were also delayed, with the skin and pain assessment not documented until days after the incident. Staff interviews revealed a lack of awareness or recall regarding the reporting of the incident, and the facility's investigation confirmed that the abuse allegation was not reported promptly as required by policy.
Failure to Administer Lidocaine Patches per Physician Order
Penalty
Summary
The facility failed to administer lidocaine 4% external pain patches according to the physician's order for one resident with diagnoses of right hip and low back pain. The physician's order specified that four lidocaine patches were to be applied daily to the resident's bilateral hips and bilateral lower back. However, review of the Medication Administration Record (MAR) and staff interviews revealed that nurses consistently failed to apply the prescribed number of patches. One nurse admitted to applying only two patches on the dates she worked, choosing either the hips or the lower back, and stated she did not seek clarification or a new order from the physician despite her belief that the resident no longer needed four patches. Another nurse reported only applying one patch on the dates she worked, acknowledging awareness of the order but unable to explain why she did not follow it, nor did she request clarification from the physician. The physician confirmed that the order was for four patches daily and stated that no staff had contacted him for clarification or to change the order. The Director of Nursing and Assistant Director of Nursing also confirmed that the nurses should have either followed the physician's order or sought clarification if there were questions. The failure to administer the medication as ordered was identified through observations, record reviews, and staff and physician interviews.
Catheter Collection Bag Found on Floor
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment and an indwelling urinary catheter was observed on two separate occasions with their urinary catheter collection bag lying on the floor, both in the dining area and in bed. The bag was covered for privacy, but its placement on the floor was directly observed by surveyors. Staff interviews revealed that nursing assistants and nurses were aware that catheter bags should not be on the floor and should be hung below the bladder, but none reported seeing the bag on the floor during their shifts. The Assistant Director of Nursing and the Physician Assistant both confirmed that it was unacceptable for the catheter bag to be on the floor due to the increased risk of infection. Record review indicated that the resident's care plan included a goal to prevent complications or injury related to catheter use. Training records showed that staff had received education on catheter care, but the provided training materials did not specifically address the proper placement of the catheter collection bag. Despite staff knowledge and training, the deficiency occurred due to the failure to ensure the catheter bag was consistently kept off the floor, as required for infection prevention.
Failure to Identify and Report Drug Regimen Irregularities During Monthly Pharmacist Reviews
Penalty
Summary
A deficiency occurred when the Consultant Pharmacist failed to identify and report drug regimen irregularities for two residents during monthly medication reviews. For one resident with mild dementia, brief psychotic disorder, and anxiety, a PRN order for Haldol (haloperidol) was written for 60 days for agitation, with the diagnosis listed as dementia with agitation. The Consultant Pharmacist did not document any recommendations or irregularities regarding the inappropriate duration of the PRN antipsychotic order, which should have been limited to 14 days, nor did she question the diagnosis or the order, assuming it was acceptable due to the resident's hospice status. Interviews with facility staff revealed a lack of awareness about the 14-day limit for PRN antipsychotic medications and a reluctance to question hospice physician orders, even when the diagnosis or duration was incorrect. For another resident with unspecified dementia without behavioral or psychotic disturbances, physician orders were in place for olanzapine (an antipsychotic) and sertraline (an antidepressant), both prescribed for dementia without behaviors. The Consultant Pharmacist's monthly reviews did not document any recommendations or irregularities regarding the lack of appropriate diagnoses for these medications. Although the Pharmacist stated that a message was sent to the physician to review the diagnosis for sertraline, there was no documentation of this notification, and the issue with olanzapine was not addressed in a timely manner. The Physician Assistant confirmed that there were no current diagnoses of depression or psychosis for this resident, and the Assistant Director of Nursing acknowledged that the medications were prescribed without a mental health diagnosis. Throughout the review period, the Consultant Pharmacist did not consistently identify or report medication irregularities related to the indicated use and scheduled stop dates of antipsychotic and antidepressant medications for the two residents. Facility staff, including the DON and ADON, confirmed that medication orders were only checked monthly by the Consultant Pharmacist and that no recommendations or notifications regarding these irregularities were received. This lack of identification and reporting of drug regimen irregularities resulted in the continuation of inappropriate medication orders for both residents.
Inaccurate Documentation of Medication Administration
Penalty
Summary
The facility failed to maintain accurate medical records and ensure proper documentation of medication administration for a resident with orders for lidocaine adhesive patches. The resident had a physician's order specifying the application of four 4% lidocaine patches daily to bilateral hips and lower back. However, observations and interviews revealed that nursing staff did not follow the order as written. One nurse consistently applied only two patches, either to the resident's low back or hips, and documented in the Medication Administration Record (MAR) as if all four patches were administered. Another nurse admitted to applying only one patch per administration, despite signing the MAR for four patches, and could not provide a reason for not following the order. Both nurses acknowledged that their documentation on the MAR was inaccurate, as it did not reflect the actual number of patches applied. The Director of Nursing and Assistant Director of Nursing confirmed that the nurses should have clarified the order if they were not administering the medication as prescribed, and agreed that the documentation was not accurate. The deficiency was identified through observations, record reviews, and staff interviews, which demonstrated a pattern of inaccurate documentation and failure to follow physician orders for medication administration.
Failure to Document Vaccine Education and Obtain Proper Consent for Influenza Vaccination
Penalty
Summary
The facility failed to properly document education regarding the influenza vaccine for one resident and failed to obtain a required signature on the influenza vaccine consent/refusal form for another resident. In the first instance, a resident who was cognitively intact consented to receive the influenza vaccine and signed the consent form, but there was no Vaccine Information Statement (VIS) attached, nor was there documentation in the electronic medical record (EMR) indicating that education about the vaccine was provided to the resident or their representative. The Infection Preventionist confirmed that she did not always bring a VIS form when discussing vaccination and that documentation of education was missing from the EMR. Both the Director of Nursing (DON) and the Administrator were unable to explain why the VIS was not provided or why education was not documented, despite facility policy requiring that the VIS be provided and education documented prior to vaccine administration. In the second case, another resident with moderate cognitive impairment had a consent form marked as consenting to the influenza vaccine, but neither the resident nor their representative had signed the form. The form was witnessed by two staff members, including the Infection Preventionist, who stated that she witnessed verbal consent but did not document this on the form. The vaccine was administered without a resident or representative signature, and the VIS form attached also lacked the required signature. The DON stated that the resident likely refused to sign but gave verbal consent, yet there was no documentation of verbal or telephone consent as required. Interviews with staff revealed inconsistent practices regarding the provision and documentation of vaccine education and consent. The Infection Preventionist, DON, and Administrator all acknowledged gaps in documentation and were unable to provide reasons for the missing information. Facility policy required that the VIS be provided and education documented prior to vaccine administration, but these steps were not consistently followed or recorded for the residents involved.
Failure to Complete Required Smoking Safety Screen for Resident
Penalty
Summary
The facility failed to complete a required quarterly smoking safety screen for a resident with a history of tobacco use, cerebral vascular accident, and vascular dementia. According to the facility's policy, staff are required to evaluate each resident's ability to safely use smoking materials and determine the level of supervision needed. The resident's previous assessment indicated the need for supervision while smoking, as the resident was unable to hold or extinguish cigarettes independently. However, the August 2025 Nursing Quarterly Assessment did not include the mandated smoking safety screen for this resident. Interviews with the resident confirmed ongoing participation in supervised smoking during designated times. The DON acknowledged that quarterly smoking safety screens are required and that staff nurses are responsible for completing these assessments. Upon review, the DON was unable to provide documentation of the August 2025 assessment and confirmed there was no system in place to ensure timely completion of these required evaluations.
Failure to Post Required State Agency and Advocacy Group Contact Information
Penalty
Summary
The facility failed to post a complete and up-to-date list of names, addresses (including mailing and email), and telephone numbers of all required state agencies and advocacy groups, such as the State Survey Agency, Adult Protective Services, State Long-Term Care Ombudsman Program, Resident Advocacy Network, Home and Community Based Service Programs, and the Medicaid Fraud Control Unit. Observations conducted over four days revealed that the front hallway bulletin board lacked this required signage. While Resident Rights posters with the local Ombudsman's contact information were present at the first-floor nurses station and the second-floor nurses station, the latter displayed outdated information. No other postings for the required agencies or advocacy groups were observed in the facility. Interviews with facility staff, including the Recreation Director, Social Worker, and Administrator, confirmed that the responsibility for maintaining these postings was unclear and that the required information had not been posted for over three years. The Recreation Director updated the Ombudsman's contact information when notified of changes but was not involved with other postings. The Social Worker was unaware of the status of the postings, and the Administrator believed the postings were current but later acknowledged the required information had not been posted during his tenure.
Failure to Explain Arbitration Agreement to Resident Representatives
Penalty
Summary
The facility failed to adequately inform resident representatives about the arbitration agreement prior to obtaining their signatures. For two residents reviewed, the representatives either did not have the agreement explained to them or were not given the opportunity for verbal communication regarding the content of the agreement. In one case, the representative sat with the Admissions Coordinator during the pre-admission meeting, but reported that the Coordinator did not explain any of the forms and only indicated where to sign. The arbitration agreement for this resident was signed without either the acceptance or declination box being checked. In another instance, the representative received the admission paperwork, including the arbitration agreement, via email and was instructed to sign without any verbal explanation or communication from the Admissions Coordinator. The representative had to interpret the paperwork independently and later expressed a lack of understanding about the agreement. Interviews with facility staff confirmed that forms were sent electronically with an offer to answer questions if contacted, but no proactive explanation was provided. The DON acknowledged that forms should be explained if not understood, but this was not done in these cases.
Unlabeled Items Found in Nourishment Rooms
Penalty
Summary
The facility failed to remove unlabeled items from nourishment rooms on both the first and second floors, as observed during a survey. On the second floor, a bottle of lactose-free milk, a bottle of orange Gatorade, and an opened bottle of cherry coke were found in the refrigerator without labels. Dietary staff were unsure if these items belonged to residents or nursing staff, but acknowledged that they should not have been in the refrigerator unlabeled. It was noted that nursing staff were responsible for labeling items belonging to residents, and staff items were not permitted in the nourishment rooms. On the first floor, two push-up ice cream cones and two open containers of ice cream were also found unlabeled. Dietary staff and a nurse indicated that these items belonged to a resident, but they could not recall which resident. The Director of Nursing and the Administrator confirmed that nursing staff had been educated to label residents' items and that dietary staff were expected to check nourishment rooms daily for unlabeled items. However, the Dietary Manager was unavailable for an interview during the survey.
Failure to Honor Resident Dining Preferences
Penalty
Summary
The facility failed to honor a resident's preference for dining in the dining room during evening meals. The resident, who was alert, oriented, and independent but required setup for eating, expressed a desire to eat in the dining room with friends. However, the resident was repeatedly told by staff that dining in the dining room was not possible due to staff shortages, particularly on weekends and sometimes during the week. Interviews with staff members confirmed that residents were often unable to use the dining room for supper because staff were too busy assisting residents who required help, leaving no time to accommodate those who wanted to dine in the dining room. The Director of Nursing acknowledged that there were instances when dining in the dining room was not allowed and stated that staff had been educated to permit residents to choose their dining preferences. However, the Director of Nursing and the Administrator were not aware of the specific complaints from the resident about being unable to eat in the dining room. The Administrator expected residents to have a choice in dining but was unaware that nursing staff were not following this expectation.
Failure to Provide Personal Hygiene Care
Penalty
Summary
The facility failed to provide adequate personal hygiene care for a resident who was dependent on staff assistance due to a stroke and hemiplegia. The resident was admitted with these conditions and required moderate assistance with personal hygiene, including shaving. Despite the care plan indicating the need for staff assistance with personal hygiene, the resident was observed with a full beard, approximately 1/2 inch long, and expressed a preference for being shaved, which was not fulfilled by the staff. The deficiency was further highlighted during interviews with staff members. Nurse Aide #2 admitted to not shaving the resident during a shower session due to time constraints and other residents needing showers. The Assistant Director of Nursing confirmed that shaving should be provided during shower times, and the Administrator acknowledged that while the resident sometimes refused shaving, staff should ensure it is done. This indicates a lapse in following the care plan and ensuring the resident's personal hygiene needs were met.
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Illustrative
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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 Salisbury
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Autumn Care Of Salisbury | 0.1 mi | ★★★★★ | 6 | 0 |
| Compass Healthcare And Rehab Rowan, Llc | 1.5 mi | ★★★★★ | 2 | 0 |
| Piedmont Health & Rehab Center | 1.8 mi | ★★★★★ | 6 | 1 |
| Trinity Oaks | 2.3 mi | ★★★★★ | 0 | 0 |
| Salisbury Rehabilitation And Nursing Center | 3.2 mi | ★★★★★ | 17 | 1 |
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