Below average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Accura Healthcare Of Franklin during CMS and state inspections, most recent first.
Food Temperatures Not Checked Before Meal Service: Dietary staff failed to check and record food temperatures before service, and some items were served below the required hot-holding temperature. A cook prepared multiple menu items, placed them in the steam table, and plated meals without verifying all items in the steam table; a test meal showed cauliflower at 127.0 F and pork chop at 129.2 F. On another meal service, a cook checked some items but not others, and a resident reported the chicken strip was not hot and was tough.
Incomplete Medicare Non-Coverage Notices: The facility failed to provide complete ABN/NOMNC information to 4 residents discharged from Medicare Part A. Records showed the notices were signed, but key fields such as the service/item, estimated costs, and payment-related details were left blank. The SSD stated they were unaware of the details needed on the SNF ABN forms, including per diem costs, and confirmed the required information had not been provided.
Failure to implement care-planned fall prevention interventions for a resident with repeated falls. The resident had poor balance, an unsteady gait, and psychotropic med use, and the care plan included bedside Dycem, non-slip footwear, a walker within reach, and staff cueing for transfers and toileting. Surveyors observed the resident barefoot at the bedside with no Dycem in place, and staff interviews confirmed the intervention was not implemented as care planned.
LPN lacked documented competency for PICC IV medication administration and gave an IV antibiotic through a PICC without checking for blood return before starting the infusion. The resident had an order for Meropenem IV, and the DON confirmed no competency or skills test had been completed for the LPN, despite facility policy requiring IV education and competency before providing IV services.
Infection Control Failure With Respiratory Equipment: A resident receiving O2 via nasal cannula had tubing stored in a mesh bag on the concentrator during repeated observations, and the tubing was marked with tape dated 6/8. The facility policy required weekly cleaning and replacement of O2 equipment, but the resident’s order summary did not include the weekly cleaning/change order, and the DON agreed this likely explained why the concentrator was not cleaned and the nasal cannula was not changed per policy.
Failure to Provide Consented Influenza and Pneumococcal Vaccines: A resident was admitted and later signed consent indicating receipt of the VIS and education for both the influenza vaccine and the pneumococcal vaccine, and requested both immunizations. However, record review found no evidence that either vaccine was given, and the IP confirmed the resident had not received them and was unsure why they were missed.
Failure to Provide Consented COVID-19 Vaccine: A resident signed a VIS acknowledgment and vaccination consent indicating they received education and wanted the COVID-19 vaccine, but the vaccine was not given. The IP confirmed the resident had not received the vaccine and was unsure why it had not occurred.
The facility did not ensure its low temp dish machine reached the required 120°F wash temperature, with logs showing only 65°F and staff observations confirming substandard temperatures. Sanitizer levels were recorded at 200 PPM and checked only once daily, contrary to policy. The Dietary Manager misunderstood required standards and confirmed improper monitoring, potentially affecting all residents.
Nursing assistants and a medication aide were assigned to care for residents with dementia without having completed the required dementia care training. Personnel and training records showed no evidence of completed training, yet these staff members worked independently with residents diagnosed with dementia. The facility's Business Office Manager confirmed that dementia care training was not provided before staff cared for these residents.
Multiple infection control lapses were observed, including improper hand hygiene and glove use during wound care and blood glucose testing, as well as failure to clean and properly store nebulizer kits, oxygen concentrator filters, and nasal cannulas for several residents. Staff and administration confirmed these practices did not meet facility policy or standard infection prevention protocols.
A resident with diabetes who was cognitively intact received insulin injections over a seven-day period, but the MDS did not reflect these injections. The DON confirmed the discrepancy between the MDS and the medication administration record, indicating a failure to ensure accurate assessment documentation.
A resident with a history of skin picking developed multiple open areas and scabs on their arms and legs, which were not documented in weekly skin assessments or progress notes. Staff were aware of the resident's skin issues, but no formal treatment was provided and the provider was not notified, contrary to facility policy and the resident's care plan.
Food Temperatures Not Checked Before Meal Service
Penalty
Summary
The facility failed to ensure that food item temperatures were checked prior to food service so that foods were served at a safe and appetizing temperature. The facility policy required temperatures of all food items to be taken and properly recorded prior to service of each meal, with hot foods held and served at at least 135 F and cold foods at or below 41 F. The census was 30, and the deficiency affected all residents served from the kitchen and dining room. On 7/23/26, Dietary Cook-A prepared pork chops, cornbread stuffing, cauliflower, grilled cheese sandwiches, and chicken strips. DC-A checked the final cooking temperatures of the pork chops and cauliflower after cooking, but did not record any of those temperatures. DC-A then placed the foods into the steam table and did not check the temperatures of the food items in the steam table before meal service. When a room tray test meal was observed, the cauliflower measured 127.0 F and the pork chop measured 129.2 F, both below 135 F, while the cornbread stuffing measured 146.1 F. DC-A confirmed that temperatures were obtained only after cooking and that food item temperatures in the steam table were not checked prior to meal service. On 7/27/26, Dietary Cook-C prepared nacho chicken, corn, refried beans, a hamburger patty, chicken strips, mashed potatoes, brown gravy, and vegetable beef soup. DC-C checked temperatures of some items in the steam table, including nacho chicken, corn, refried beans, hamburger patty, and ground nacho chicken, but did not check the chicken strips, mashed potatoes, brown gravy, or vegetable beef soup. DC-C plated and served meals to residents in the dining room and room trays, including a meal for Resident 25 with mashed potatoes, gravy, and a chicken strip whose service temperatures had not been checked, and a meal for Resident 14 that included vegetable beef soup whose service temperature had not been checked. Resident 25 stated the chicken strip was not hot and was tough. The Facility Administrator confirmed that foods are required to be checked and recorded prior to food service to ensure they are held at a safe and appetizing temperature.
Incomplete Medicare Non-Coverage Notices
Penalty
Summary
The facility failed to inform residents of services available in the facility and the charges for services not covered by the facility’s per diem rate. This deficiency affected 4 residents sampled: Residents 1, 5, 36, and 37. The surveyor reviewed an Entrance Conference Worksheet that identified these residents as having been discharged from a Medicare-covered Part A stay with benefit days remaining in the past 6 months. For Resident 1, the record showed discharge from Medicare A services with a note that the resident could pick up Medicare B to continue activity tolerance. The SNF Beneficiary Notification Review showed Medicare Part A services began on 3/4/26 and the last covered day was listed as 5/16/26, with discharge from services due to a plateau in progress. The facility had provided both a SNF ABN and a NOMNC, and the resident’s representative signed both forms over the phone. However, the ABN contained blank sections where the service or item subject to noncoverage, the estimated costs, and related payment information should have been completed. For Resident 5, the record showed discharge from Medicare A services with a note that the resident could pick up Medicare B for continued services. The resident signed both the NOMNC and ABN in person, but the ABN again contained blank sections for the service or item, estimated costs, and payment-related information. Similar omissions were found for Resident 36, whose NOMNC and ABN were signed in person and dated, but the ABN had blank sections for the service or item, estimated costs, and reason Medicare may not pay. Resident 37’s record showed discharge from Medicare A services after meeting all goals and discharge home with spouse and home care; the resident’s representative signed the NOMNC and ABN in person, but the ABN also had blank sections for the service or item, estimated costs, and reason Medicare may not pay. During interview on 7/23/26, the Social Service Director stated they were unaware of the details needed to be added on the SNF ABN forms, including the per diem costs. The Social Service Director stated they were not familiar with the process or how to obtain the missing information needed for residents and representatives to make informed decisions, and confirmed this information had not been provided to Residents 1, 5, 36, and 37 as required.
Failure to Implement Care-Planned Fall Prevention Interventions
Penalty
Summary
The facility failed to implement fall-prevention interventions for a resident who had a documented history of repeated falls and required assistance with some transfers and footwear. The resident’s MDS showed dependence on staff for putting on and taking off socks, shoes, and other footwear, supervision for standing from a sitting position and toilet transfers, and two falls since the prior assessment. The facility’s incident log documented four falls over several months, including unwitnessed and witnessed events, and the care plan identified fall risk related to unsteady gait, poor balance, and psychotropic medication use. After the resident’s falls, the care plan listed interventions such as keeping the resident’s phone within reach, placing Dycem on the floor beside the bed because the resident refused socks, using non-slip footwear when sitting on the edge of the bed, keeping the walker within reach, encouraging use of the call light, encouraging use of grab bars, and using the walker with ambulation. However, the record showed that the resident fell again after sliding off the bed, and the care plan did not contain a new intervention following that later fall. The progress notes and risk management review documented that the resident slipped off the bed because the resident did not want to wear footwear and that staff would encourage gripper socks, with Dycem available if the resident was not compliant. Survey observations and staff interviews showed that the planned bedside Dycem was not in place. The resident was observed sitting on the edge of the bed barefoot, and later again sitting on the bed with bare feet, with no Dycem on the floor beside the bed. Staff interviews confirmed that the resident did not like shoes, would not use gripper socks, and that the Dycem intervention was not in place as care planned. One aide stated there were no fall-prevention interventions, and the facility administrator confirmed that the facility was required to determine the cause of each fall and implement an intervention to prevent additional falls, with the intervention to be on the care plan and implemented.
LPN Lacked PICC Line IV Competency
Penalty
Summary
The facility failed to ensure nursing staff were competent to administer IV medications through a PICC line for one resident. The resident had an order for Meropenem 500 mg in sodium chloride 50 mL IV to infuse over 30 minutes. During observation of the medication administration, an LPN cleansed the PICC site, flushed the line with 10 mL of saline, prepared the medication and tubing, attached the tubing to the resident, set the infusion pump, and documented the medication administration in the eMAR. However, the LPN did not check for blood return before starting the infusion, and later confirmed that this was the first time giving the IV antibiotic to the resident since the resident returned from the hospital. Record review showed the facility policy required LPNs to complete IV education and competency with an RN before providing peripheral IV services and on an annual basis, and the nursing procedure reference stated that blood return and catheter patency must be confirmed before initiating infusion through a PICC line. The DON stated there were no competencies completed when the LPN was hired and that no competency skills day had been completed for staff yet that year. The DON also confirmed there was no competency or skills test completed for the LPN in the file, and the MDS Coordinator stated that IV orders were rare and that review with LPNs each time IV medications were ordered would be best.
Infection Control Failure With Respiratory Equipment
Penalty
Summary
The facility failed to use appropriate infection control practices when providing respiratory care services for one resident who was receiving 1-4 liters of oxygen via nasal cannula to keep oxygen saturations above 88% three times a day. A policy titled Respiratory Equipment Cleaning Procedure stated that oxygen tubing and nasal cannula/mask were to be changed weekly, the condenser was to be wiped down with disinfectant as needed and after use, and the humidifier receptacle and concentrator filter were to be cleaned weekly. Observations in the resident’s room on three separate occasions showed an oxygen concentrator with a black mesh bag hanging from the machine and oxygen tubing inside the bag with a folded piece of tape written “6/8” on it. The tubing remained in the bag during each observation, and the record review showed the resident’s order summary did not list the order for changing the filter and nasal cannula and/or mask and cleaning the machine weekly. The DON stated that all residents using oxygen condensers and concentrators should have such an order and agreed the missing order was probably the reason the concentrator was not cleaned and the nasal cannula was not changed weekly per policy.
Failure to Provide Consented Influenza and Pneumococcal Vaccines
Penalty
Summary
The facility failed to provide influenza and pneumococcal immunizations when they were offered and consented to by a resident. Record review showed the facility had policies for influenza and pneumococcal vaccinations that required residents to be questioned on admission, educated, and offered the vaccines, with the influenza vaccine offered during flu season and the pneumococcal vaccine offered year round. The policies also identified circumstances when vaccination would be contraindicated, including prior immunization, allergy, physician order not to vaccinate, refusal, febrile illness, or terminal condition. Resident 4 was admitted on 10/29/25. A vaccine consent form signed on 2/25/26 showed the resident received the VIS and education for both influenza and pneumococcal vaccines and indicated a desire to receive both vaccines. However, record review found no evidence that either vaccine was administered. During interview, the Infection Preventionist confirmed that Resident 4 had not received the vaccinations and was unsure why they had not occurred.
Failure to Provide Consented COVID-19 Vaccine
Penalty
Summary
The facility failed to provide a COVID-19 immunization to a resident who had consented to receive it. A facility policy titled, COVID-19 Vaccination, stated that all residents would be offered the vaccine, educated about it, and that the DON would follow up with the physician's office when questions arose about prior vaccination history. The policy also stated that residents would be questioned during admission about their COVID-19 vaccine status and offered the vaccine if they had never received it. Resident 4 was admitted to the facility and later signed an Acknowledgement of Vaccine Information Statement (VIS) and Vaccination Consent form indicating they received education and wanted the COVID-19 vaccine. A review of the resident's record showed that no COVID-19 vaccine was provided after the consent was signed. During interview, the Infection Preventionist confirmed that Resident 4 had not received the vaccine and was unsure why it had not occurred.
Failure to Maintain Required Dish Machine Temperatures and Sanitizer Monitoring
Penalty
Summary
The facility failed to ensure that its low temperature dish machine reached the required minimum wash temperature of 120 degrees Fahrenheit, as specified in facility policy and manufacturer guidelines. Record reviews for February and March 2025 showed that all recorded wash temperatures were only 65 degrees Fahrenheit, and rinse temperatures were 125 degrees Fahrenheit. Additionally, sanitizer concentration levels were recorded at 200 PPM, exceeding the required 50 PPM, and were only checked once per day instead of once per shift as required. Observations confirmed that the dish machine did not reach the required wash temperature during use, with maximum observed wash temperatures of 90 and 106 degrees Fahrenheit. Staff did not monitor the dish machine thermometer during cycles or test the sanitizer level during the rinse cycle. Interviews with the Dietary Manager revealed a misunderstanding of the required temperature standards, as the manager believed the wash temperature should be 60 degrees Fahrenheit and the rinse temperature 140 degrees Fahrenheit, based on information from the machine and chemical company representatives. The Dietary Manager also confirmed that the dish machine was not reaching the required wash temperature on initial loads and that chlorine levels were not being tested every shift as required. These failures had the potential to affect all residents in the facility, with a census of 30 at the time.
Failure to Ensure Dementia Care Training for Nursing Staff
Penalty
Summary
The facility failed to ensure that nursing staff, specifically nursing assistants and a medication aide, completed dementia care training prior to independently caring for residents diagnosed with dementia. A review of the facility's Human Resources policy indicated that all employees should receive initial orientation, including Alzheimer's and dementia care training. However, personnel and training records for several nursing assistants and a medication aide showed no evidence that this required dementia care training had been completed. Despite this, these staff members were assigned to work independently and provided care to residents with dementia-related diagnoses. Further review of daily shift assignments confirmed that these untrained staff members worked alone on multiple occasions, directly caring for residents with dementia. The facility's own listing identified six residents with a dementia-related diagnosis. During an interview, the Business Office Manager confirmed that dementia care training was not being completed upon hire or before staff were assigned to care for residents with dementia, and acknowledged that untrained staff had provided care to these residents.
Infection Control Failures in Wound Care, Glucose Testing, and Respiratory Equipment
Penalty
Summary
The facility failed to implement and maintain effective infection prevention and control practices in several instances involving multiple residents. For one resident with a stage 4 pressure ulcer and a history of sepsis, the Infection Preventionist (IP) did not perform hand hygiene or change gloves after removing a soiled dressing and before applying a new one, contrary to facility policy and standard practice. Additionally, the IP placed a wet brief over a clean dressing, which was confirmed by both the IP and a corporate nurse as not being standard or acceptable practice. Another deficiency was observed during blood glucose testing for a resident with diabetes mellitus. The IP performed an accucheck without wearing gloves or performing hand hygiene, despite facility policy requiring glove use and hand hygiene when in contact with blood or bodily fluids. The IP acknowledged forgetting to wear gloves during the procedure. Further deficiencies were identified in the cleaning and storage of respiratory equipment. Multiple observations revealed that nebulizer kits used by two residents were not cleaned after use, with residual medication and visible facial oils and debris present on the masks. Staff interviews confirmed that the kits had not been cleaned as required by facility policy. Additionally, one resident's oxygen concentrator filter was found to be coated with a gray fuzzy substance, indicating it had not been cleaned as ordered. The same resident's oxygen nasal cannula was repeatedly observed stored in a manner that allowed it to come into contact with potentially contaminated surfaces, such as the seat of a wheelchair and a stained incontinence pad, rather than being properly stored in a designated bag. These failures were confirmed by staff and the facility administrator.
Failure to Accurately Document Insulin Injections on MDS
Penalty
Summary
The facility failed to ensure that the Minimum Data Set (MDS) accurately reflected the administration of insulin injections for a resident diagnosed with Diabetes Mellitus. Record review showed that the resident was admitted with a diagnosis of diabetes and had a care plan in place that included diabetes medication as ordered. The resident was cognitively intact, as indicated by a BIMS score of 15. However, the most recent Quarterly MDS did not indicate that the resident had received any injections in the previous seven days. Further review of the Medication Administration Record for the same period revealed that the resident had, in fact, received insulin injections seven times. This discrepancy was confirmed by the Director of Nursing (DON), who acknowledged that the MDS should have reflected the seven injections administered. The DON also confirmed that the facility uses the RAI manual to ensure MDS accuracy, but in this instance, the MDS was not completed accurately.
Failure to Assess and Treat Resident's Skin Impairments
Penalty
Summary
A deficiency occurred when the facility failed to assess and provide treatment for a resident's impaired skin condition. Observation revealed that the resident had multiple open areas and scabs on their arms and legs, which were not documented in weekly skin assessments or progress notes over several weeks. The resident reported itching and scratching, and staff interviews confirmed awareness of the resident's skin picking behavior and the presence of open areas. However, there was no evidence that these skin issues were assessed, documented, or communicated to the provider, and no treatments were initiated. The resident's care plan indicated a history of skin picking and required weekly skin assessments, but these assessments did not reflect the actual condition of the resident's skin. Staff, including a nursing assistant and medication aide, acknowledged the resident's ongoing skin issues and that lotion was sometimes applied, but there was no formal treatment or provider notification. The Director of Nursing confirmed the lack of documentation and treatment, despite the facility's policy requiring weekly skin checks for all residents.
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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) |
|---|---|---|---|---|
| Good Samaritan Society - Colonial Villa | 21.3 mi | ★★★★★ | 0 | 0 |
| Heritage Of Webster County | 23.5 mi | ★★★★★ | 0 | 0 |
| Sunporch Of Smith County | 24.2 mi | ★★★★★ | 0 | 0 |
| Bethany Home, Inc | 27.5 mi | ★★★★★ | 0 | 0 |
| Phillips County Retirement Center | 30 mi | ★★★★★ | 11 | 0 |
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