Below average — CMS composite of the measures below.
The next survey window likely opens around April 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 Towne Square Care Of Puryear during CMS and state inspections, most recent first.
Food items in the kitchen were found stored without required labels, use-by dates, expiration dates, or stock dates. Surveyors observed unlabeled and undated items in the walk-in refrigerator, freezer, and dry storage, including scrambled egg mixture, watermelon halves, chicken breast, spinach, tater tots, chicken nuggets, fish strips, pork loins, rice, flour, ravioli, soup, and other items. The CDM confirmed several items lacked proper dating and acknowledged some dates were incorrect or missing.
Expired medications were found on two medication carts, with an LPN confirming outdated clonidine, morphine sulfate, duloxetine, and hyoscyamine sulfate remained stored on the carts. The facility policy stated expired medications should not be available for use and should be removed from medication carts at or before expiration. Residents involved had diagnoses including HTN, kidney disease, dementia, Alzheimer’s disease, CHF, diabetes, depression, GERD, and osteoarthritis.
Inaccurate PBJ RN Staffing Submission: The facility failed to accurately report direct care staffing data to CMS for PBJ Quarter 1 2026. The PBJ report showed no 8-hour RN coverage on multiple days, but review of time punches, schedules, daily postings, and licensing checklist sheets showed RN coverage was present. The ADM stated the issue may have been due to incorrect transcription from the timeclock and acknowledged the report did not reflect the actual hours worked.
The facility was found to have unsanitary conditions in the kitchen and medication room, with a dark slimy buildup in the ice machine and a yellow sticky substance in the nourishment refrigerator. The Certified Dietary Manager and a Registered Nurse confirmed that these conditions should not be present, indicating a failure to adhere to the facility's sanitization policy.
A facility failed to develop an elopement risk care plan for a resident with moderate cognitive impairment and multiple diagnoses. Despite a policy requiring care plans to be updated based on residents' needs, the resident's care plan lacked interventions for elopement risk. An incident occurred when the resident was found outside in the parking lot, attempting to go home. The DON confirmed the resident was an elopement risk and should have had a care plan to address this.
The facility failed to document communication with a hospice provider for a resident, as required by policy, and did not follow physician orders for routine lab tests for another resident. The DON confirmed the absence of a hospice documentation process and acknowledged that required labs were not conducted, highlighting lapses in communication and adherence to medical directives.
Two residents in the facility had unsecured hazardous items, such as nail polish and lotions labeled 'keep out of reach of children,' in their rooms. Both residents were cognitively intact and required supervision. An LPN was unsure about the policy for these items, and the DON confirmed they should be secured. Another LPN confirmed that nail polish and remover should be stored in a locked medication cart or room.
The facility failed to post complete daily staff information, including the total number of staff and actual hours worked by licensed staff responsible for resident care, for 20 out of 24 sampled days. The facility's policy requires daily posting of this information to ensure proper staffing according to regulations. The DON confirmed the missing documentation and inaccuracies in the forms.
A facility failed to maintain a medication error rate below 5%, with two errors observed. One resident received Omeprazole at an incorrect time, and another received an incorrect dosage of Folic Acid. RN A did not follow the prescribed orders, leading to these errors.
The facility failed to secure medications properly, as a medication cart was left unlocked and unattended, and a resident's room contained unsecured cough drops. An LPN confirmed that the cart should be locked and that no residents were assessed to self-administer medications.
The facility failed to follow infection control practices during medication administration. An LPN used contaminated gloves to clean a glucometer, and an RN did not disinfect a blood pressure cuff between residents. Additionally, the RN administered a dropped medication tablet to a resident without replacing it.
The facility failed to maintain sanitary conditions in the kitchen, with observations of dirty equipment, carbon build-up on pans and grills, and disrepair in kitchen cabinets. The Dietary Manager and Administrator acknowledged the issues, which could potentially affect all 25 residents receiving meal trays from the kitchen.
The facility failed to report allegations of abuse to APS, the Ombudsman, and local law enforcement for three residents. One resident reported inappropriate touching by another resident, and another reported being hit by a staff member. The facility did not complete required 5-day follow-up reports to the state agency.
A resident with severe cognitive impairment and a history of falls experienced an unwitnessed fall resulting in a head injury. Despite the facility's policy requiring neuro checks for 72 hours post-incident, no neuro checks were conducted. The Director of Nursing confirmed the absence of these checks in the resident's medical record.
The facility failed to ensure there was an RN on duty for 8 consecutive hours a day, 7 days a week for 4 days reviewed. There was no RN scheduled or documented as having worked for 8 consecutive hours on these days, as confirmed by the DON.
The facility failed to maintain an adequate supply of over-the-counter medications, specifically Mucinex and Omeprazole, affecting a resident who did not receive these medications on multiple occasions. The RN and Administrator confirmed the lack of stock and issues with medication procurement.
Food Items Stored Without Required Labels and Dates
Penalty
Summary
Food was not stored, prepared, and served under sanitary conditions when multiple food items in the kitchen were found unlabeled, undated, or missing use-by, expiration, or stock dates. In the walk-in refrigerator, surveyors observed 4 clear plastic bags of unknown yellow liquid later confirmed by the Certified Dietary Manager (CDM) to be scrambled egg mixture, 2 plastic-wrapped watermelon halves, and 3 unopened packages of chicken breast, all without labels or dates. In the dry storage room, surveyors also found a round plastic container of rice and a round plastic container of flour with no legible use-by or expiration dates. During interview, the CDM confirmed the yellow liquid was scrambled egg mixture but stated the dates were unknown and that dates would need to be located to place on the items. The CDM also acknowledged that the watermelon halves and chicken breast had no use-by, expiration, or stock dates, and stated the items should have the date they were placed in the refrigerator or a use-by date. In the walk-in freezer, surveyors found 2 undated unopened bags of spinach, an undated clear plastic bag of tater tots, an opened undated bag of chicken nuggets, a bag of ground cooked meat dated only with a stock date of 3/3/2026 and no name, expiration date, or use-by date, an opened unlabeled bag of fish strips, and 4 unlabeled, undated whole pork loins. Additional observations showed other stored foods were also missing required dating information or were expired. The CDM confirmed that rice and flour containers had incorrect dates on their lids and stated those dates were not the stock dates. Surveyors also found unopened bags of spinach, unopened and opened bags of ravioli with only stock dates, a package of bologna with a manufacturer expiration date of 5/12/2025, a container of beef soup dated 3/11/2026 with no use-by or expiration date, and unopened bags of marshmallows with an expiration date of 2/17/2026. The CDM stated the soup was good for 2 months, and 60 days from the stored date had already passed.
Expired medications found on medication carts
Penalty
Summary
The facility failed to ensure medications were properly stored when expired and outdated drugs remained on two medication carts, Hall 1 and Hall 2. The facility policy titled Medication Storage stated that no discontinued, outdated, or deteriorated medications should be available for use and that expired medications are to be removed from medication carts prior to or at the time of expiration. During observation and interview, LPN A confirmed expired medications were present on both carts. On Hall 1, expired medications included 3 tablets of a resident’s clonidine 0.1 mg, which had expired on 4/30/2026, and 1 bottle of another resident’s morphine sulfate 15 mL, which had expired in 3/2026. On Hall 2, expired medications included 10 capsules of a resident’s duloxetine 20 mg, which had expired on 12/31/2025, and 30 tablets of another resident’s hyoscyamine sulfate 0.125 mg, which had expired on 4/30/2026. The residents involved had diagnoses including hypertension, kidney disease, dementia, Alzheimer’s disease, anxiety, congestive heart failure, diabetes, depression, gastro-esophageal reflux disease, heart failure, and osteoarthritis, and their records showed varying cognitive status from cognitively intact to moderately cognitively impaired.
Inaccurate PBJ RN Staffing Submission
Penalty
Summary
The facility failed to submit accurate direct care staffing information to CMS for PBJ Quarter 1 2026, based on payroll and other verifiable and auditable data. Review of the facility’s PBJ Staffing Data Report showed no daily RN coverage for 8 consecutive hours on multiple dates, including 10/25/2025, 10/26/2025, 11/08/2025, 11/09/2025, 11/22/2025, 11/23/2025, 11/30/2025, 12/06/2025, 12/07/2025, 12/20/2025, and 12/28/2025. The facility policy required all necessary staffing hours to be submitted to CMS, and the CMS PBJ Policy Manual stated that direct care staffing and census data must be collected quarterly and be timely and accurate. A review of time punches, the working schedule, staff daily postings, and Nursing Home Licensing Checklist sheets showed the PBJ Staffing Data Report was not accurately reported, because the facility did have daily RN coverage for 8 consecutive hours. During interview, the Administrator stated that the issue may have been due to incorrect transcription from the timeclock reading and that the Business Office Associate needed to compare findings with the DON’s daily staffing sheets before reporting. The Administrator later stated the report was not correct because it did not accurately reflect the actual hours worked and that staffing information should be reported accurately.
Unsanitary Conditions in Kitchen and Medication Room
Penalty
Summary
The facility failed to maintain a sanitary kitchen environment, as evidenced by observations of unsanitary conditions in the ice machine and nourishment refrigerator. During a kitchen inspection, a dark slimy buildup was found inside the ice machine. The Certified Dietary Manager confirmed that such a buildup should not be present. Additionally, in the medication room, the nourishment refrigerator was found to have a yellow sticky substance in both the freezer and on the second shelf of the refrigerator. A Registered Nurse confirmed that there should not be any yellow substance present in these areas. These observations indicate a failure to adhere to the facility's policy on sanitizing food storage areas and equipment, which requires that all equipment be cleaned and sanitized regularly.
Failure to Develop Elopement Risk Care Plan
Penalty
Summary
The facility failed to develop an elopement risk care plan for a resident who was identified as having moderate cognitive impairment and multiple diagnoses, including Impulse Disorder, Paranoid Schizophrenia, Dementia, and Anxiety. The facility's policy on care planning, dated February 1, 2017, mandates that care plans be developed, implemented, and updated based on residents' needs and any changes that occur during their stay. Despite this policy, the care plan for the resident, dated December 29, 2024, did not include any focus, problems, or interventions related to elopement risk. An incident occurred on February 2, 2025, when the resident was found outside the facility in the parking lot in her wheelchair, attempting to go home. This incident was documented in a nurse's note and an incident report, both dated February 2, 2025. During an interview on March 25, 2025, the Director of Nursing confirmed that the resident's exit from the building classified her as an elopement risk and acknowledged that a care plan should have been developed to address this risk and prevent future occurrences.
Deficiencies in Hospice Communication and Adherence to Physician Orders
Penalty
Summary
The facility failed to establish a documented communication process between the long-term care facility and the hospice provider, as required by their policy and the Nursing Facility Hospice Agreement. This deficiency was identified in the case of a resident who was admitted to hospice care. The Director of Nursing (DON) confirmed that there was no designated place for hospice to document their visits and notes, which is contrary to the facility's policy that mandates all communications between the hospice and the nursing facility to be documented in the resident's clinical record. This lack of documentation could potentially lead to unmet resident needs and preferences at the end of life. Additionally, the facility did not adhere to physician orders for another resident who was supposed to have routine lab tests conducted at specified intervals. Despite the orders for regular lab tests, the resident had not received any labs since admission, which was confirmed by the DON. The failure to conduct these labs as ordered indicates a lapse in following physician directives, which is essential for monitoring and managing the resident's health conditions, including diabetes, hypertension, and the use of various medications.
Unsecured Hazardous Items Found in Resident Rooms
Penalty
Summary
The facility failed to ensure a safe and secure environment for residents, as evidenced by the presence of hazardous items in the rooms of two residents. Resident #18, who was cognitively intact and required supervision with activities of daily living, had several unsecured items in their room, including nail polish and various lotions labeled 'keep out of reach of children.' These items were observed on the dresser and bedside table during medication administration. When questioned, an LPN was unsure about the policy regarding these items and deferred to the Director of Nursing, who later confirmed that such items should be secured and away from residents. Similarly, Resident #22, also cognitively intact and requiring supervision, had unsecured nail polish and nail polish remover on their bedside table. An LPN confirmed that these items should be stored in a locked medication cart or medication room, away from residents. The presence of these unsecured hazardous items in resident rooms indicates a failure to adhere to the facility's policy of maintaining a hazard-free environment.
Incomplete Daily Staff Postings
Penalty
Summary
The facility failed to comply with its policy on daily staff postings, as evidenced by the incomplete documentation of the total number of staff and actual hours worked by licensed staff responsible for resident care. This deficiency was observed in the facility's Daily Staff Posting forms for 20 out of 24 sampled days between March 1, 2025, and March 24, 2025. The facility's policy, dated February 1, 2017, mandates the daily posting of resident census and staffing information to ensure proper licensed nursing staff are provided according to regulations. During an interview on March 25, 2025, the Director of Nursing confirmed the missing documentation and acknowledged the inaccuracy of the forms.
Medication Administration Errors Observed
Penalty
Summary
The facility failed to ensure that medications were administered with a medication error rate of less than 5%, as evidenced by two observed errors out of 26 opportunities, resulting in a medication error rate of 7.69%. The first error involved a resident with diagnoses including Anxiety, Chronic Pain Syndrome, Hypertension, GERD, and Asthma. The resident was cognitively intact with a BIMS score of 15. A physician's order required Omeprazole 20mg to be administered before breakfast at 5 AM. However, RN A administered the medication at 8:46 AM, which was not in accordance with the prescribed time, constituting a medication error. The second error involved another resident with diagnoses including Dysphagia, Cognitive Communication Deficit, Depression, Drug Induced Myopathy, Hypertension, and Weakness. This resident was moderately cognitively impaired with a BIMS score of 11. The facility's order summary indicated that the resident was to receive 1mg of Folic Acid daily. During medication administration, RN A administered two 400 mcg tablets of Folic Acid, totaling 800 mcg, which was less than the prescribed 1mg. RN A acknowledged the error and admitted that she should have consulted the Director of Nursing or the physician for further instructions due to the unavailability of the correct dosage.
Medication Storage Deficiency
Penalty
Summary
The facility failed to ensure that medications were properly stored and secured, as evidenced by an unsecured and unattended medication cart and unsecured medications in a resident's room. The facility's policy on medication storage, dated February 1, 2017, mandates that medications and biologicals be stored in a safe and secure manner, with compartments locked when not in use. However, observations revealed that the Short Hall Medication Cart was left unlocked and unattended at the Nurses' Station, with no licensed nursing staff present. During an interview, an LPN confirmed that the medication cart should be locked at all times when not in use. Additionally, in the room of a resident with diagnoses including anxiety, chronic pain syndrome, hypertension, and asthma, a bag of cough drops was found unsecured and unattended on the bedside table. The resident was cognitively intact and required moderate assistance with activities of daily living. An LPN confirmed that the cough drops should have been locked on the medication cart or in the medication room, as no resident in the facility had been assessed to self-administer medications. These findings indicate a failure to adhere to the facility's medication storage policy, compromising the security of medications.
Infection Control Lapses During Medication Administration
Penalty
Summary
The facility failed to adhere to proper infection control practices during medication administration, as observed with two nurses. One nurse, identified as LPN C, was seen cleaning a glucometer machine with gloves that had been contaminated by reaching into a trash can to retrieve a cleaning cloth package. LPN C did not change gloves or re-clean the glucometer after this action, which is against the facility's hand hygiene policy that requires hand hygiene after handling potentially contaminated items. Another nurse, RN A, failed to clean reusable resident equipment between uses. RN A used a blood pressure cuff on one resident and then another without disinfecting it in between, contrary to the facility's policy on disinfecting resident equipment. Additionally, RN A dropped a medication tablet on a resident's chest, picked it up with bare hands, and administered it to the resident, acknowledging later that the tablet should have been discarded and replaced. These actions were confirmed by RN A during an interview, admitting to not following the required disinfection and medication administration protocols.
Unsanitary Conditions in Kitchen
Penalty
Summary
The facility failed to ensure food was stored, prepared, and served under sanitary conditions. Observations revealed multiple instances of unsanitary conditions in the kitchen, including a dirty trash can, carbon build-up on pans, dirty equipment, and a deep fryer with food particles and carbon build-up. Additionally, the flat grill had significant carbon build-up, and the kitchen cabinets were in disrepair with peeling Formica laminate and dark furry stains, possibly mold, under the sink. The cabinet under the sink also had an old stained cloth and a caved-in floor with a torn back wall. These observations were made over several days and confirmed through interviews with the Dietary Manager (DM) and the Administrator, who acknowledged the unsanitary conditions and the need for reeducation and replacement of certain items. The facility's policies and cleaning schedules were reviewed, revealing that the food service area should be maintained in a clean and sanitary manner, with specific cleaning tasks assigned weekly and monthly. However, the DM admitted that certain cleaning tasks, such as removing carbon build-up from pans and cleaning the deep fryer, had been overlooked. The DM also confirmed that the trash cans, ovens, and other equipment should not have the observed build-up and stains. The Administrator agreed that the kitchen cabinets needed replacement and that the mold-like stains and disrepair under the sink were unacceptable. The facility had a census of 25 residents, all of whom received meal trays from the kitchen, indicating that the unsanitary conditions could potentially affect all residents.
Failure to Report Allegations of Abuse
Penalty
Summary
The facility failed to report allegations of abuse to the appropriate authorities, including Adult Protection Service (APS), the Long-Term Care Ombudsman, and local law enforcement, for three residents. Resident #8, who was severely cognitively impaired, was involved in an incident where he allegedly touched Resident #17 inappropriately. Despite the investigation, which included assessments and interviews, the facility did not report the incident to the police and failed to complete a 5-day follow-up report to the state agency. The Director of Nursing and the Administrator confirmed these lapses during interviews. Resident #177, who was moderately cognitively impaired, reported being hit by a staff member. The Administrator conducted an investigation, including interviews and assessments, but did not report the allegation to the police, APS, or the Ombudsman. Additionally, the facility did not complete a 5-day follow-up report to the state agency. These failures to report and follow up on allegations of abuse were confirmed by the Administrator during an interview.
Failure to Conduct Neurological Checks After Unwitnessed Fall
Penalty
Summary
The facility failed to ensure neurological checks were obtained after an unwitnessed fall with a head injury for a resident. The facility's policy required neuro checks to be performed for a 72-hour period following such incidents. However, a review of the medical record revealed that no neuro checks were conducted for the resident after the fall on 3/27/2024, which resulted in a hematoma and bruising to the left side of her face. The Director of Nursing confirmed the absence of neuro checks in the resident's medical record during an interview on 4/3/2024. The resident, who was admitted with diagnoses including Dementia, Osteoarthritis, and a history of Malignant Neoplasm of the Uterus, was assessed as severely cognitively impaired and at risk for falls. The fall incident report indicated that the resident was found on the bathroom floor with a hematoma to her left outer brow and a skin tear on her left hand. Despite these injuries, the facility did not perform the required neuro checks, as confirmed by the Director of Nursing. Observations on subsequent days noted the resident still had significant bruising and discoloration on her face.
Failure to Ensure RN Coverage for 8 Consecutive Hours Daily
Penalty
Summary
The facility failed to ensure there was a Registered Nurse (RN) on duty for 8 consecutive hours a day, 7 days a week for 4 of 29 days reviewed. Specifically, on 10/8/2023, 11/5/2023, 11/11/2023, and 11/26/2023, there was no RN scheduled or documented as having worked for 8 consecutive hours. This was confirmed through a review of the facility's policy, nurse schedules, group hours report, and time sheets. The Director of Nurses (DON) also confirmed the lack of RN coverage on these dates during an interview on 4/3/2024.
Failure to Maintain Adequate Supply of Over-the-Counter Medications
Penalty
Summary
The facility failed to maintain an adequate supply of over-the-counter medications, specifically Mucinex and Omeprazole, for three medication carts. The facility's policy required supplies to be ordered from an approved medical vendor and maintained in the stock room, with orders placed at least monthly or more frequently if needed. Despite this policy, the facility was out of Mucinex and Omeprazole for at least a week, as confirmed by a Registered Nurse (RN) and the Administrator. The RN noted that the facility had been experiencing problems with medication procurement for the last month or two, and the Administrator admitted to not saving order sheets after placing orders, which contributed to the issue. Resident #7 was directly affected by this deficiency, as documented in the Electronic Medication Administration Record (EMAR) and Medication Administration Record (MAR). The resident did not receive Mucinex on multiple occasions over several months, and during an observation, the RN confirmed that the resident's medication cup did not contain Mucinex or Omeprazole due to the lack of stock. Interviews with the RN and the Administrator revealed that the facility had not taken alternative measures, such as purchasing the medications from a local retail store, to ensure the availability of these essential medications for the residents.
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Illustrative
What surveyors actually found near you
We read the 27 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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
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Illustrative
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Nursing homes near Puryear
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Henry County Health And Rehabilitation | 10.2 mi | ★★★★★ | 2 | 0 |
| Spring Creek Post-acute Rehabilitation Center | 10.2 mi | ★★★★★ | 1 | 0 |
| Patriot Health And Rehabilitation Center | 10.6 mi | ★★★★★ | 0 | 0 |
| Hillview Community Living Center | 22.5 mi | ★★★★★ | 9 | 0 |
| Ahc Mckenzie | 22.6 mi | ★★★★★ | 6 | 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.