Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Smoky Ridge Health And Rehabilitation during CMS and state inspections, most recent first.
A facility failed to maintain consistent advance directive information for a resident with chronic obstructive pulmonary disease, leading to a discrepancy between electronic and paper records. The resident's paper records indicated a preference for CPR, while the electronic records incorrectly showed a DNR order. Staff interviews confirmed the error, with the Unit Manager admitting to the mistake and the Administrator and DON acknowledging the need for consistency.
The facility inaccurately coded MDS assessments for three residents, leading to deficiencies in pressure ulcer care, fall injury, and discharge status. A resident with multiple pressure ulcers was incorrectly coded as not receiving care, another resident's fall with a subdural hematoma was not coded as a major injury, and a third resident's discharge to home was mistakenly recorded as a hospital discharge. The MDS Coordinator and DON acknowledged these errors.
A facility failed to complete a PASRR level II for a resident diagnosed with schizoaffective disorder after admission. Staff interviews revealed that the PASRR level II should have been completed upon the new diagnosis, but it was overlooked, indicating a lapse in the facility's assessment coordination process.
A facility failed to request a PASRR re-evaluation for a resident with intellectual disabilities after a significant change in condition. The resident had a Level II PASRR determination, but no re-evaluation was requested following a noted change in their MDS assessment. Staff interviews revealed a lack of clarity in managing PASRR requests during a transition period when the previous SW left.
A resident's hydrocodone-acetaminophen medication was misappropriated by a nurse who failed to follow proper procedures for wasting controlled substances. The nurse signed out two doses at midnight, with one marked as 'popped in error' without a second signature. The nurse tested positive for oxycodone and was unable to provide prescription documentation, leading to her suspension and termination after an investigation.
Discrepancy in Advance Directive Records
Penalty
Summary
The facility failed to maintain accurate advance directive information for a resident, leading to a discrepancy between the electronic and paper medical records. The resident, who was admitted with chronic obstructive pulmonary disease and a history of pulmonary embolism, had intact cognition and had signed a Medical Scope of Treatment (MOST) form indicating a preference for cardiopulmonary resuscitation (CPR) in the event of no pulse and not breathing. However, the electronic medical record contained a physician's order for Do Not Resuscitate (DNR), which was incorrectly entered by the Unit Manager. Interviews with staff revealed that the assigned nurse relied on the paper medical records in emergencies, which showed the resident's preference for CPR. The Social Worker confirmed that the resident wanted to receive CPR and remain a full code, as indicated in the MOST form. The Unit Manager admitted to the mistake in the electronic records, acknowledging that the resident's code status should have been entered as full code to match the paper records. The Administrator and Director of Nursing agreed that the advance directive information should be consistent across both electronic and paper records.
Inaccurate MDS Coding for Pressure Ulcer, Fall, and Discharge
Penalty
Summary
The facility failed to accurately code Minimum Data Set (MDS) assessments for three residents, leading to deficiencies in the areas of pressure ulcer care, fall injury, and discharge status. Resident #96, admitted with multiple unstageable pressure ulcers, was inaccurately coded as not receiving pressure ulcer care, despite records showing she received care as ordered. This oversight was acknowledged by the MDS Coordinator during an interview. Resident #35, who had a fall resulting in a subdural hematoma and a shoulder dislocation, was not coded for a major injury on the discharge MDS assessment. The MDS Coordinator and Director of Nursing admitted they were unaware of the subdural hematoma at the time of coding, as they had not thoroughly reviewed the hospital discharge summary. Resident #94 was discharged home, but the MDS assessment incorrectly indicated a discharge to an acute hospital. The MDS Coordinator confirmed this was a coding error and should have reflected a discharge to the community. In all cases, the Administrator and Director of Nursing expressed an expectation for MDS assessments to be completed accurately, highlighting the facility's failure to ensure accurate documentation and assessment of residents' conditions and care.
Failure to Complete PASRR Level II for New Mental Health Diagnosis
Penalty
Summary
The facility failed to ensure a Preadmission Screening and Resident Review (PASRR) level II was completed for a resident who received a new mental health diagnosis. The resident was admitted to the facility with a PASRR level I completed, but after being diagnosed with schizoaffective disorder, a PASRR level II was not conducted. This oversight was identified during a review of the resident's medical record and confirmed through staff interviews. Interviews with the Social Worker, MDS Coordinator, and Administrator revealed that a PASRR level II should be completed upon admission for residents with a mental health diagnosis and when there is a change in condition or a new mental health diagnosis. The staff acknowledged that the PASRR level II for the resident with the new diagnosis of schizoaffective disorder was overlooked, indicating a lapse in the facility's process for coordinating assessments with the PASRR program.
Failure to Request PASRR Re-evaluation After Significant Change
Penalty
Summary
The facility failed to request a Preadmission Screening and Resident Review (PASRR) re-evaluation for a resident with moderate intellectual disabilities and anxiety disorder after a significant change in their physical or mental status. The resident, who was admitted with a Level II PASRR determination, experienced a significant change in condition as noted in their Minimum Data Set (MDS) assessment. Despite this change, no request for a PASRR re-evaluation was made after the initial determination dated 12/31/18. Interviews with facility staff revealed that the responsibility for submitting PASRR re-evaluation requests was not clearly managed during a transition period when the previous Social Worker (SW) left in December 2024. The MDS Coordinator, who temporarily took over the PASRR process, was unaware that a referral was needed for a physical decline in condition. The facility's Administrator confirmed that requests for PASRR Level II re-evaluations should be made when a resident experiences a significant change in condition, as per regulatory guidelines.
Misappropriation of Resident's Narcotic Medication
Penalty
Summary
The facility failed to protect a resident's right to be free from misappropriation of a controlled narcotic pain medication. This incident involved a resident who was prescribed hydrocodone-acetaminophen for pain management. The medication was scheduled to be administered four times a day. On a specific date, discrepancies were noted in the medication administration records, where Nurse #8 signed out two doses of the medication at midnight, with one dose marked as 'popped in error' without a second nurse's signature to verify the waste. Nurse #8 was assigned to administer medications on the hall where the resident resided. Despite being scheduled to work until 11:00 PM, Nurse #8 claimed to have administered the midnight dose of the medication, which was outside her scheduled shift. Nurse #8's actions were not corroborated by Nurse #4, who was on duty at the time and administered the midnight dose to the resident, as the resident reported not receiving it earlier. Nurse #8's drug test returned positive for oxycodone, and she failed to provide documentation for any prescriptions or allergies. The facility's investigation revealed that Nurse #8 did not follow the protocol for wasting controlled medications, which requires a second nurse's signature. The discrepancies in the medication records and the positive drug test led to the conclusion that there was a misappropriation of the resident's medication. The facility took immediate action by suspending Nurse #8 and conducting a thorough investigation, which included notifying relevant authorities.
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Illustrative
What surveyors actually found near you
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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.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Burnsville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Greens At Spruce Pines | 11.4 mi | ★★★★★ | 0 | 0 |
| Madison Health And Rehabilitation | 14.3 mi | ★★★★★ | 2 | 0 |
| Erwin Health Care Center | 16.7 mi | ★★★★★ | 0 | 0 |
| Center On Aging And Health | 16.8 mi | ★★★★★ | 10 | 0 |
| Christian Care Center Of Unicoi County | 16.8 mi | ★★★★★ | 4 | 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.