Average — CMS composite of the measures below.
A standard survey is most likely before around December 2026
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 Franklin Nursing Home during CMS and state inspections, most recent first.
Several residents with cognitive and physical impairments were found to have non-functioning or inaccessible call lights, including one with a history of falls whose call light did not work and others whose call lights were out of reach or not checked by staff. Staff and leadership interviews confirmed that call lights were not always tested or monitored as required by facility policy.
A resident with COPD, cognitive communication deficit, and paranoid schizophrenia had a bathroom cabinet that was not cleaned by housekeeping. The resident reported roaches in the bathroom, and surveyors observed a dry black substance on the inside of the cabinet and wall that the resident identified as roach excrement. Housekeeping staff and leadership stated the bathroom should be cleaned daily, but the cabinet interior had not been cleaned and pest control records documented live American cockroaches in the resident’s room.
Care plans were not revised for two residents after changes in activity needs were identified. Both residents had severely impaired cognition, and their MDS assessments showed important activity preferences such as music, fresh air, pets, reading, and favorite activities. Although both were placed on an in-room activities list for 2 to 3 times per week, their care plans were not updated to reflect those current needs, and staff confirmed the revisions were not made.
Inadequate Nail Care for Two Residents Needing ADL Assistance: Two residents with severe cognitive impairment and significant ADL needs were observed with blackish/brownish substance under fingernails and uneven nail edges. One resident was blind and said he wished someone would clean and cut his nails. Staff stated CNAs were responsible for nail care for most residents, but both residents were not found to have received the needed nail cleaning and trimming described in their care plans.
Failure to Provide Planned In-Room Activities: Two residents with severe cognitive impairment and individualized activity preferences were not provided the in-room activities documented in their care plans. One resident with depression, anxiety, and dementia and another resident with dementia, legal blindness, and cataracts were both scheduled for in-room programming, but the Activity Director stated she forgot to visit them. Observations showed one resident lying in bed staring at the wall and the other seated in his room stating he preferred music and in-room activities.
A resident with seizures and severe cognitive impairment had a seizure in the lobby, vomited, and developed worsening respiratory status with SpO2 dropping to 52. Staff sent him to the hospital by EMS, but the LVN later stated he likely used a nasal cannula instead of a NRB mask, and an observed NRB demonstration showed the mask set at 4 LPM with the bag not inflated. Interviews with the DON, ADON, RNC, and NP confirmed that a NRB at 10 to 15 LPM with the bag inflated was the expected device for respiratory distress, and the facility had no specific seizure or emergency care policy beyond notifying the physician of a change in status.
A resident's prescription antifungal shampoo was left unsecured in an unlocked shower room instead of being stored in a locked treatment cart as required. Staff interviews confirmed that the expected protocol was not followed, and the DON acknowledged that all prescribed medications should be locked when not in use. The resident had moderate cognitive impairment and required assistance with personal care, highlighting the importance of proper medication storage.
Three residents in the facility experienced inadequate nail care, leading to poor hygiene and potential health risks. A resident with severe cognitive impairment had jagged nails with a fecal odor, affecting his ability to eat and causing scratches. Another resident with intact cognition but impaired vision had long, rough nails with a blackish substance, leading to skin scratches. A third resident with Parkinson's and diabetes had long nails with a fecal odor, expressing fear of infection due to past experiences. Despite requests for assistance, their nail care needs were not met.
A resident with Down syndrome and anxiety was not treated with dignity during a feeding session. An LVN stood partially behind the resident, failing to introduce herself or face the resident, causing the resident to struggle to see who was feeding her. The facility's policy requires staff to sit and face residents during feeding to ensure dignity.
The facility failed to secure medication carts, leaving them unlocked and unattended, which could allow unauthorized access to medications. LVN H admitted to forgetting to lock the carts after dispensing medications, and CNA J was uncomfortable with locking the carts as only nurses were authorized to do so. The Director of Nurses and the Administrator acknowledged the expectation for carts to be locked, but there was a lack of adherence to the facility's policy.
The facility failed to comply with food safety standards when the Administrator and Maintenance Supervisor entered the kitchen without wearing required hair and beard nets. They were observed standing over uncooked chicken, risking contamination. The Dietary Manager confirmed the expectation for all staff to wear hair restraints, as per the facility's infection control policy.
A facility failed to ensure proper hand hygiene during resident care, as a CNA did not sanitize or wash her hands after touching contaminated surfaces before feeding a resident. The resident, with multiple health conditions and requiring assistance with eating, was at risk due to this lapse. Staff interviews confirmed awareness of hygiene protocols, but the incident highlighted a failure to adhere to the facility's hand hygiene policy.
Failure to Ensure Functional and Accessible Call Light System
Penalty
Summary
The facility failed to ensure that the call light system was functional and accessible for several residents, as observed through direct observation, interviews, and record review. One resident with dementia, muscle weakness, and a history of falls was found to have a non-functioning call light at her bedside, and she was unaware that it was not working. Her care plan specifically required a working and reachable call light due to her fall risk. Another resident with Down Syndrome and dementia was observed with her call light out of reach, placed under her pillow, contrary to her care plan instructions that it should be within reach and staff should encourage its use. Additional observations revealed that a resident with Alzheimer's disease and heart conditions had her call light more than three feet away while she was sleeping in an easy chair, making it inaccessible. A fourth resident with dementia, diabetes, and dysphagia could not reach his call light because it was hanging off the side of the bed, and he was unsure how often staff checked on him. Staff interviews confirmed that they were unaware of the non-functioning or inaccessible call lights, and in one case, a CNA replaced a non-working call light after it was discovered during the survey. Facility leadership, including the Maintenance Supervisor, DON, ADON, and Administrator, acknowledged that call lights are required to be within reach and functional at all times. The facility's policy also mandates that call lights be accessible, demonstrated to residents, and checked for functionality. However, staff interviews revealed that call lights were not routinely tested during daily rounds, and there was a lack of consistent monitoring to ensure compliance with these requirements.
Unclean Bathroom Cabinet With Pest Residue
Penalty
Summary
The facility failed to ensure housekeeping services maintained a sanitary and comfortable interior for one resident’s bathroom cabinet. Resident #22 was a [AGE]-year-old female with diagnoses including COPD, cognitive communication deficit, and paranoid schizophrenia. Her quarterly MDS reflected a BIMS score of 9, indicating moderate cognitive impairment. Her care plan noted an ADL self-care performance deficit related to schizophrenia, depression, and dementia, and also stated she was independent and continent for toileting. During an observation and interview, Resident #22 reported there were roaches in her bathroom and said the facility had treated for them. The bathroom itself was observed to be clean, but the inside of the bathroom cabinet contained a collection of dry black substance scattered on the cabinet interior and wall. The resident identified the substance as roach excrement. A later observation of the same cabinet showed the same dry black substance still present, with no observable change from the prior day. Housekeeping staff and leadership acknowledged the cabinet had not been cleaned. Housekeeper B stated he mostly cleaned floors and had not cleaned the bathroom in a long time, and he was unsure why the cabinet had not been cleaned. The Housekeeping Director stated she was not aware the cabinet interior was not being cleaned and said housekeeping was responsible for cleaning and sanitation of the facility. The DON stated bathrooms should be cleaned daily, including the bathroom cabinet, and the ADMIN stated the bathroom should be cleaned daily by housekeeping. A pest control service report from earlier in the month documented three live American cockroaches in the resident’s closet and bathroom, with bait and monitors applied.
Care plans not revised for changed activity needs
Penalty
Summary
The comprehensive care plan was not reviewed and revised by the interdisciplinary team after changes in activity needs were identified for two residents. Resident #9 had diagnoses including major depressive disorder, anxiety disorder, other lack of coordination, and unspecified dementia, and his annual MDS assessment showed a BIMS score of 5, indicating severely impaired cognition. The assessment also reflected that going outside for fresh air was very important to him, and that reading, being around pets, listening to music, keeping up with the news, and doing favorite activities were somewhat important. Resident #9's comprehensive care plan, dated 07/20/2025, did not reflect revisions for activity preferences and needs identified in August 2025. The record showed he was identified in the first week of August as needing in-room activities 2 to 3 times per week because he had declined attending group activities. An Activity in Room Resident List dated 09/09/2025 included his name for in-room activities 2 to 3 times per week. During observation on 09/09/2025 at 10:50 AM, he was lying in bed staring at the wall, his television was off, and he was not interviewable. Resident #37 had diagnoses including unspecified dementia, legal blindness, bilateral cataracts, and osteoarthritis of both shoulders. His annual MDS assessment showed a BIMS score of 5, and his quarterly MDS assessment showed a BIMS score of 3, both indicating severely impaired cognition. The assessments reflected that listening to music was very important to him, and being around pets, keeping up with the news, and doing favorite activities were somewhat important. His comprehensive care plan, initiated on 05/13/2024, stated he had little or no activity involvement related to resident wishes not to participate and that he would participate in activities of choice 2 to 3 times per week, but it was not revised in August 2025 to reflect his need for in-room activities. An Activity in Room Resident List dated 09/09/2025 included his name for in-room activities 2 to 3 times per week. Interviews with the MDS Coordinator, Activity Director, and Assistant Director of Nurses confirmed that the care plans were expected to be revised when activity needs or preferences changed, and that Resident #9's and Resident #37's care plans were not revised to reflect their current activity needs.
Inadequate Nail Care for Two Residents Needing ADL Assistance
Penalty
Summary
The facility failed to ensure two residents who were unable to perform activities of daily living received needed nail care to maintain cleanliness and grooming. Resident #9 had diagnoses including major depressive disorder, anxiety disorder, other lack of coordination, and unspecified dementia, and his MDS showed severely impaired cognition with assistance needed for personal hygiene, dressing, and oral hygiene. His care plan directed staff to check nail length and trim and clean nails on bath day and as needed, but during observation he was found lying in bed with blackish/brownish substance under the middle and ring fingernails of his right hand, and the middle fingernail was uneven around the edges. Resident #37 had diagnoses including unspecified dementia, legal blindness, bilateral cataracts, and osteoarthritis of both shoulders, and his MDS showed severely impaired cognition with assistance needed for personal hygiene, dressing, showers, and oral hygiene. His care plan also directed staff to check nail length and trim and clean nails on bath day and as needed, but during observation he was sitting in his wheelchair with blackish/brownish substance under the middle, ring, and fore fingernails of his right hand, and the ring and middle fingernails were uneven around the edges. He stated he could not see his fingernails, said he was blind, and stated he wished someone would cut and clean them for him. Staff interviews showed the CNA staff were responsible for cleaning, trimming, and filing nails for residents without diabetes, while nurses handled nail care for residents with diabetes. Multiple staff members stated they had provided care to both residents and were not aware that either resident refused nail care. The LVN, CNA, treatment nurse, and ADON all stated that blackish/brownish material under the nails could be bacteria and could cause illness if ingested, and that uneven nails could cause injury. The facility policy stated nail management includes cleansing, trimming, smoothing, and cuticle care and is usually done during the bath.
Failure to Provide Planned In-Room Activities
Penalty
Summary
The facility failed to provide an ongoing program of activities based on the comprehensive assessment, care plan, and preferences of two residents who were identified as needing in-room activities. Resident #9 had diagnoses including major depressive disorder, anxiety disorder, other lack of coordination, and unspecified dementia, and his MDS assessment showed a BIMS score of 5, indicating severely impaired cognition. His assessment indicated that going outside for fresh air was very important to him, and that reading, being around pets, listening to music, keeping up with the news, and doing favorite activities were somewhat important. His care plan directed staff to engage him in simple, structured activities, provide activities that accommodated his abilities and communication needs, and encourage out-of-room social, spiritual, stimulus, and mental stimulation activities. Resident #37 had diagnoses including unspecified dementia, legal blindness, bilateral cataracts, and osteoarthritis of both shoulders. His MDS assessments showed BIMS scores of 5 and later 3, indicating severely impaired cognition. His assessment indicated that listening to music was very important to him, and being around pets, keeping up with the news, and doing favorite activities were somewhat important. His care plan stated that he had little or no activity involvement related to his wishes not to participate, that he would participate in activities of choice 2 to 3 times per week, and that staff should explain the importance of social interaction and leisure activity time and encourage participation. The Participation Record for August 2025 reflected that both residents did not receive in-room activities from 08/11/2025 through 08/25/2025. During interview, the Activity Director stated Resident #9 had been changed to receive in-room activities 3 times per week and that the plan was to begin on 08/11/2025, but she had no excuse for why he did not receive in-room visits. She also stated Resident #37 had been added to the in-room activity program 2 to 3 times per week, but she did not have an explanation for why he did not receive in-room activities during that time frame. The Activity Director later stated she forgot to visit both residents during August after adding them to the in-room activity program. Observations showed Resident #9 lying in bed staring at the wall with his television off, and Resident #37 sitting in his wheelchair in his room, looking downward, stating that he enjoyed music and would enjoy having music in his room, and that he did not want group activities and preferred activities in his room.
Respiratory Distress Care Not Provided Correctly During Seizure Event
Penalty
Summary
The facility failed to ensure safe and appropriate respiratory care for a resident who needed emergency respiratory support during a seizure episode. The resident was a male with Down Syndrome, seizures, and cognitive communication deficit, and his BIMS score reflected severe cognitive impairment. His physician orders included Full Code status, but there were no current orders for oxygen equipment or specialized respiratory care. His care plan addressed Full Code status and seizure precautions, but the record did not show a specific respiratory care plan for the event that occurred. During the incident, the resident was in the lobby when he began having tremors, then vomited and had seizure activity lasting 3 to 4 minutes. The progress note stated that his lung sounds worsened and his SpO2 dropped to 52 during the seizure activity. He was sent to the hospital by EMS while still having tremors, and his oxygen saturation was documented as up to 72 on 5 L O2 at the time of transfer. The LVN later stated that the resident was breathing but had low oxygen levels, that a crash cart was brought out, and that EMS was called right away. Interviews and observation showed that staff did not consistently use the correct oxygen equipment or settings for respiratory distress. The LVN later stated he must have used a nasal cannula rather than a non-rebreather mask, and that a nasal cannula was not ideal for the situation. The DON, ADON, RNC, and NP all stated that a non-rebreather mask should be used for a resident in respiratory distress, with oxygen flow set around 10 to 15 LPM, and that the bag should be inflated before placement. An observation of staff demonstration showed the non-rebreather mask being set to 4 LPM with the bag not inflated. The facility did not have a specific seizure care or emergency care policy beyond a policy for notifying the physician of a change in status.
Failure to Secure Prescription Medication in Locked Storage
Penalty
Summary
A deficiency occurred when a resident's prescription ketoconazole shampoo, which was ordered for topical use three times a week, was not stored in accordance with state and federal regulations. Instead of being kept in a locked treatment nurse cart as required, the prescription shampoo was found on a shelf in an unlocked shower room. Observations confirmed that the shower room door was left unlocked, and the shampoo was accessible, contrary to facility policy and professional standards for medication storage. Interviews with staff revealed that the expected protocol was for the treatment nurse to provide the prescribed shampoo to the shower aide at the time of the resident's shower, after which the shampoo was to be returned to the treatment nurse and locked in the treatment cart. However, on the day in question, the treatment nurse failed to retrieve the shampoo after it was used, and the shower aide did not return it. Both the treatment nurse and the shower aide acknowledged the expectation for secure storage but admitted to lapses in following the protocol. The Director of Nursing also confirmed that all prescribed medications, including shampoos, were to be locked when not in use and that leaving them in the shower room was not acceptable. The resident involved had moderate cognitive impairment and required assistance with personal care, including showers. The facility's own policy stated that only authorized personnel should have access to medications and that all medication storage areas must be locked. Despite this, the prescribed shampoo was left unsecured in an area accessible to staff and potentially to residents, as the shower room was not locked. There was no evidence of residents wandering in the area at the time, but the failure to secure the medication was a clear violation of storage requirements.
Inadequate Nail Care for Residents
Penalty
Summary
The facility failed to provide adequate nail care for three residents, leading to poor hygiene and potential health risks. Resident #17, a male with severe cognitive impairment and multiple health issues, was observed with jagged nails and a blackish substance under his nails, which emitted an odor of feces. Despite requesting assistance, his nails were not cleaned, affecting his ability to eat and causing scratches on his arm. Resident #31, who has intact cognition but impaired vision due to cataracts, also experienced inadequate nail care. His nails were long and rough, with a blackish substance underneath. He reported scratching his leg, which bled slightly, and despite asking for assistance, his nails were not attended to, leaving him concerned about potential skin damage. Resident #46, with intact cognition but requiring assistance due to Parkinson's disease and diabetes, had long nails with a blackish substance and an odor of feces. He expressed fear of infection due to his diabetic condition and past experiences with nail infections. Despite requesting nail care, he was informed it would be done the following week, leaving him at risk of infection and further health complications.
Failure to Maintain Resident Dignity During Feeding
Penalty
Summary
The facility failed to treat a resident with respect and dignity during a feeding session. The incident involved a resident with Down syndrome, anxiety disorder, cognitive communication deficit, and impaired visual function, who required assistance with personal care. During an observation, a Licensed Vocational Nurse (LVN) was seen standing partially behind and beside the resident while feeding her, without facing her or introducing herself. The resident attempted multiple times to turn her head to see the person feeding her, indicating difficulty in recognizing the caregiver and the food being offered. The LVN admitted to not following the proper protocol of sitting and facing the resident while feeding, acknowledging that this was a dignity issue. The Director of Nurses confirmed that staff were expected to sit when feeding residents, as standing could compromise the resident's dignity. The facility's policy on resident rights emphasized treating each resident with respect and dignity, promoting their quality of life, and recognizing their individuality.
Medication Cart Security Lapse
Penalty
Summary
The facility failed to ensure that all drugs and biologicals were stored in locked compartments, making them inaccessible to unauthorized staff, visitors, and residents. During an observation, it was noted that three medication carts were left unattended and unlocked near the nurse's desk. Specifically, Medication Cart #1 and Medication Cart #2 were found unlocked near the nurse's desk, and Medication Cart #3 was unlocked approximately 15 feet away from the nurse's desk. This lapse in security was observed between 1:30 AM and 1:43 AM, allowing potential unsupervised access to medications. Interviews with staff revealed that LVN H was aware that the medication carts were unlocked but failed to ensure they were secured after dispensing medications. LVN H admitted to forgetting to lock the carts after administering medications to a resident approximately 40 minutes before the surveyor's arrival. CNA J, who was asked by LVN H to lock one of the carts, expressed discomfort with the task, as only nurses were authorized to lock and unlock the medication carts. The Director of Nurses and the Administrator acknowledged the expectation for medication carts to be locked when not in use, but there was a lack of clarity and adherence to the facility's medication cart policy. The facility's Medication Cart Policy, dated 2003, mandates that medication carts be locked when not in use or under the direct supervision of a designated nurse. Despite this policy, the Director of Nurses was unaware of the specific protocol and did not provide further clarification to the surveyor. The Administrator recognized the potential risks of residents accessing unlocked medication carts, including the possibility of allergic reactions or physical harm if medications were ingested. However, there was no indication that the facility had a clear plan to address these deficiencies at the time of the survey.
Failure to Adhere to Food Safety Standards in Kitchen
Penalty
Summary
The facility failed to adhere to professional standards for food service safety in the kitchen, as observed during a survey. On the specified date, the Administrator and the Maintenance Supervisor entered the kitchen without wearing the required hair and beard nets. They were observed standing over a large bowl of approximately 15 uncooked chicken breasts being defrosted in the sink. The Maintenance Supervisor had significant facial hair and long hair, while the Administrator also had long hair, both of which were not covered as per the facility's policy. This oversight was acknowledged by both individuals during interviews, where they admitted the potential risk of hair contamination in the food. The Dietary Manager confirmed that all staff, including non-dietary personnel, were expected to wear hair and beard nets when entering the kitchen. The facility's policy on infection control, dated 2012, required clean hair to be covered with an effective hair restraint, and facial hair to be closely trimmed and covered. Despite being in-serviced on these requirements, the Maintenance Supervisor and Administrator failed to comply, potentially exposing residents to health risks from contaminated food.
Infection Control Deficiency Due to Improper Hand Hygiene
Penalty
Summary
The facility failed to maintain an effective Infection Control Program, specifically in ensuring proper hand hygiene procedures were followed by staff during the direct care of a resident. On the observed date, a Certified Nursing Assistant (CNA) did not sanitize or wash her hands after touching contaminated surfaces, such as the floor and a chair, before handling the resident's food and feeding the resident. This lapse in protocol was observed during a meal service, where the CNA's fingers came into contact with the floor and subsequently touched the resident's plate and food without any hand hygiene measures being taken. The resident involved was an elderly male with multiple medical conditions, including transient cerebral ischemic attack, unspecified dementia, legal blindness, and muscle weakness. He required maximal assistance with daily activities, including eating, due to his severely impaired cognition and other health issues. The resident's care plan highlighted the need for consistent routines and assistance with eating, emphasizing the importance of maintaining a hygienic environment to prevent potential health risks. Interviews with staff, including the CNA involved, Licensed Vocational Nurses (LVNs), and the Director of Nurses, revealed a general understanding of the hand hygiene expectations. However, there was a lack of recall regarding the specific dates of in-service training on hand hygiene. The staff acknowledged the potential for cross-contamination and the risk of illness from improper hand hygiene, yet the incident demonstrated a failure to adhere to the facility's hand hygiene policy, which required hand sanitization before and after assisting residents with meals.
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Illustrative
What surveyors actually found near you
We read the 13 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
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 Franklin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Crossroads Nursing & Rehabilitation | 12.7 mi | ★★★★★ | 10 | 0 |
| Bremond Nursing And Rehabilitation Center | 14.5 mi | ★★★★★ | 3 | 0 |
| Lampstand Nursing And Rehabilitation | 26.7 mi | ★★★★★ | 22 | 0 |
| Avir At Bryan | 26.8 mi | ★★★★★ | 19 | 0 |
| Crestview Retirement Community | 26.8 mi | ★★★★★ | 2 | 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 October 2026) and official state health department websites.