Smoky Ridge Health and Rehabilitation
310 Pensacola Road, Burnsville, NC 28714Map
Medicare/Medicaid certified140 certified beds~101 residents/dayFor profit - Limited Liability company
Last standard health inspection: March 20, 2025
Smoky Ridge Health and Rehabilitation is a 140-bed for-profit, LLC-owned nursing home in Burnsville, Yancey County, North Carolina, serving an average of 101 residents per day. As of CMS data processed June 1, 2026, its overall rating is 2 of 5 stars.
CMS star ratings
CMS scores every nursing home 1–5 stars overall, built from three sub-ratings. moreless
Medicare inspects and measures every certified nursing home, then rolls the results into a 1–5 star overall rating. It combines three parts: health inspections, staffing, and quality measures. Five stars means much better than average — it does not mean perfect. One star means much worse than average — it does not mean every shift is bad. Stars are a screening tool, not a verdict. They can lag reality by months, and they can't see things like how kind the aides are or how the building smells at 7am.
What to do with this: use stars to build a shortlist, then visit in person. Nothing on this site replaces walking the halls.
Health-inspection stars are graded on a curve within each state — never compare stars across state lines. moreless
CMS sets health-inspection star cutoffs separately for each state: roughly the top 10% of homes in a state get 5 stars, the bottom 20% get 1 star, no matter how the state compares to others. That means a 4-star home in one state and a 4-star home in another state may have very different inspection records. The stars tell you how a home compares to its neighbors, not to the whole country. That's why this site shows your state's median next to each star rating — and never a national star comparison.
What to do with this: compare stars only between homes in the same state. To compare across states, use staffing hours — those are real numbers, not curves.
Not all three sub-ratings are equally hard to game: inspections are the most objective, quality measures the least. moreless
The three sub-ratings come from different sources. Health inspections are done on-site by trained state surveyors who show up mostly unannounced — the most objective signal. Staffing comes from payroll records that facilities must submit and CMS audits — quite reliable. Quality measures are partly self-reported by the facility from its own resident assessments — useful, but the facility grades some of its own homework.
What to do with this: when sub-ratings disagree, weigh the inspection star most and the quality-measure star least.
Staffing
Reported hours per resident per day, from payroll records. Hours, unlike stars, can be compared across states.
Hours per resident per day: total staff hours worked, divided by the number of residents. moreless
If a home reports 3.5 total nursing hours per resident per day, that's all nursing staff time across 24 hours — roughly one caregiver-hour every 7 hours per resident, spread across day, evening, and night shifts. On a real floor it decides whether call lights get answered in 5 minutes or 25, whether someone has time to help with dinner, and whether night shift is one aide for a hall or two. Unlike star ratings, hours are actual numbers, so they CAN be compared across state lines.
What to do with this: compare a home's hours to the state and national medians shown, and ask the facility how the hours split across day, evening, and night shifts.
RN (registered nurse) hours
LPN (licensed practical nurse) hours
Nurse aide hours
Total nursing hours
CMS also adjusts these numbers for how sick each home’s residents are — a home with sicker residents needs more staff for the same star. This home’s case-mix-adjusted total: 3.28 (US median, adjusted: 3.78).
CMS also adjusts staffing numbers for how sick each home's residents are. moreless
A home full of short-term rehab patients needs different staffing than a home caring for people with advanced dementia or ventilators. Case-mix adjustment estimates how many hours a home's particular residents need, then scales the reported hours so homes can be compared fairly. A home with sicker residents needs more staff for the same star. This page shows reported (raw payroll) numbers and compares them only to other reported numbers — like with like.
What to do with this: if a home's reported hours look low, check whether its residents may simply need less care — and ask the facility directly.
Staff turnover
Total nursing staff turnover: 48.1% · NC median: 49% · RN turnover: 18.8% (NC median: 45.5%)
The share of nursing staff who left within the year. Lower is steadier. moreless
Total nursing staff turnover is the percentage of the home's nurses and aides who stopped working there during the year. Around half of nursing-home staff leaving annually is sadly common in this industry. High turnover means residents are cared for by people who don't know them — which matters enormously for dementia care, pain management, and noticing the small changes that catch problems early. Low turnover usually means staff are treated well enough to stay.
What to do with this: when you visit, ask aides how long they've worked there. Long-tenured aides are the best sign a building has.
Inspections & deficiencies
The last 3 inspection cycles, from CMS’s federal health-survey file. State-only citations and fire-safety surveys are not included — an empty list means nothing federal is in this file, not that nothing ever happened.
Each deficiency gets a letter A–L: how severe it was × how widespread it was. moreless
Surveyors grade every deficiency on a grid. Severity runs from 'potential for minimal harm' up to 'immediate jeopardy to resident health or safety.' Scope runs from isolated (one or a few residents) to pattern to widespread. A and B are paperwork-level; D–F caused no actual harm but had the potential; G–I caused actual harm; J, K, and L mean immediate jeopardy — the most serious finding a surveyor can make. Most citations nationally are D–E.
What to do with this: scan for G or higher. One J/K/L tells you more than ten D's.
Standard surveys are routine; complaint surveys happen because someone reported a problem. moreless
A standard survey is the routine top-to-bottom inspection every home gets on a recurring cycle. A complaint survey happens because a resident, family member, or staff member reported something to the state — surveyors come specifically to investigate it. Infection-control surveys focus on practices like hand hygiene and isolation procedures. A deficiency found during a complaint survey means someone cared enough to report it and a surveyor confirmed enough to cite it.
What to do with this: note which deficiencies came from complaints — they show you what residents and families actually experienced.
The F-number on each deficiency is CMS's code for which federal requirement was violated. moreless
Every federal nursing-home requirement has a tag number. F0686, for example, is the pressure-ulcer requirement; F0600 is freedom from abuse. The tag tells you exactly which rule was broken, and the description next to it is CMS's own plain-language summary of that rule. The same tag appearing across multiple inspections is a pattern worth noticing.
What to do with this: if the same tag repeats across surveys, ask the facility what changed since the last citation.
This data shows federal health surveys only — state-only citations and fire-safety surveys aren't included. moreless
CMS's public deficiency file contains federal health-survey citations. It does not include citations issued under state-only rules, fire-safety (Life Safety Code) surveys, or anything older than three inspection cycles. A facility with no rows here may still have state citations or fire-safety findings. 'No deficiencies in this file' never means 'no violations ever.'
What to do with this: for the full picture, check your state health department's site and medicare.gov/care-compare, which shows fire-safety results separately.
22 deficiencies across the last 3 inspection cycles, in CMS’s federal health-survey file:
- Resident Assessment and Care Planning: 6
- Resident Rights: 4
- Quality of Life and Care: 3
- Nutrition and Dietary: 3
- Freedom from Abuse, Neglect, and Exploitation: 2
- Nursing and Physician Services: 1
- Pharmacy Service: 1
- Administration: 1
- Infection Control: 1
March 20, 2025Standard surveyTag F0578D — no actual harm, potential for more than minimal harm, isolated
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Deficient, Provider has date of correction · corrected April 14, 2025
March 20, 2025Standard + Complaint surveyTag F0602D — no actual harm, potential for more than minimal harm, isolated
Protect each resident from the wrongful use of the resident's belongings or money.
Past Non-Compliance · corrected December 12, 2024
March 20, 2025Standard surveyTag F0641D — no actual harm, potential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Deficient, Provider has date of correction · corrected April 14, 2025
March 20, 2025Standard surveyTag F0644D — no actual harm, potential for more than minimal harm, isolated
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Deficient, Provider has date of correction · corrected April 14, 2025
March 20, 2025Standard surveyTag F0646D — no actual harm, potential for more than minimal harm, isolated
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Deficient, Provider has date of correction · corrected April 14, 2025
March 20, 2024Complaint surveyTag F0600G — actual harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Deficient, Provider has date of correction · corrected April 5, 2024
December 1, 2023Standard + Complaint surveyTag F0583D — no actual harm, potential for more than minimal harm, isolated
Keep residents' personal and medical records private and confidential.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0584E — no actual harm, potential for more than minimal harm, pattern
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0641D — no actual harm, potential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0645E — no actual harm, potential for more than minimal harm, pattern
PASARR screening for Mental disorders or Intellectual Disabilities
Deficient, Provider has date of correction · corrected January 1, 2024
Show 12 more deficiencies
December 1, 2023Standard + Complaint surveyTag F0656D — no actual harm, potential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0684E — no actual harm, potential for more than minimal harm, pattern
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0689D — no actual harm, potential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0711E — no actual harm, potential for more than minimal harm, pattern
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0761E — no actual harm, potential for more than minimal harm, pattern
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0804B — no actual harm, potential for minimal harm, pattern
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0806E — no actual harm, potential for more than minimal harm, pattern
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0812F — no actual harm, potential for more than minimal harm, widespread
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0867F — no actual harm, potential for more than minimal harm, widespread
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Deficient, Provider has date of correction · corrected January 1, 2024
December 1, 2023Standard + Complaint surveyTag F0880F — no actual harm, potential for more than minimal harm, widespread
Provide and implement an infection prevention and control program.
Deficient, Provider has date of correction · corrected January 1, 2024
June 27, 2023Complaint surveyTag F0695D — no actual harm, potential for more than minimal harm, isolated
Provide safe and appropriate respiratory care for a resident when needed.
Deficient, Provider has date of correction · corrected June 30, 2023
June 8, 2022Standard surveyTag F0578D — no actual harm, potential for more than minimal harm, isolated
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Deficient, Provider has date of correction · corrected July 6, 2022
Fines & penalties
CMS can fine a home or stop paying for new admissions. Shown per CMS's current data window (~3 years) — not all-time. moreless
When deficiencies are serious or aren't fixed, CMS can impose a fine (a civil money penalty) or a payment denial — refusing to pay for new Medicare/Medicaid admissions until the home fixes the problem. Payment denials hit harder than most fines because they stop revenue. CMS's public dataset covers a rolling window of roughly the last three years, so the totals here are recent history, not an all-time record. Many facilities have no penalties in the window — that's common, not remarkable.
What to do with this: a recent large fine deserves a direct question on your visit — what happened, and what changed?
Fines: 1 totaling $59,631 — per CMS data (rolling ~3-year window).
| Date | Type | Amount / length |
|---|---|---|
| March 20, 2024 | Fine | $59,631 |
Ownership & chain
Who actually owns and controls the facility — individuals, companies, and their stakes. moreless
Nursing homes are often owned through layers: an operating company, a property company, management companies, and individual investors with percentage stakes. CMS publishes who holds 5%-or-greater interests and who has operational control. Ownership matters because it sets the budget: research has linked some ownership structures, especially certain chains and investment vehicles, to lower staffing. That's a pattern across the industry, not a verdict on any one building.
What to do with this: know who owns the home before you sign anything, and ask the administrator who actually sets the staffing budget.
Part of Brighton Healthcare (8 facilities). Chain average overall rating: 1.5★ — this facility: 2★.
Most US nursing homes belong to a chain. The chain's average rating is context for this home's rating. moreless
A chain is a group of facilities sharing an owner or operator. Chains share budgets, policies, and management practices, so a chain's average rating tells you something about the company behind the building. A home rating well above its chain's average may have an unusually strong local team; one below it may be the chain's neglected building. Either way, the chain sets the constraints the local staff work within.
What to do with this: if the chain average is low, ask the administrator what this building does differently.
| Owner / manager | Role | Stake | Since |
|---|---|---|---|
| Ctnc Holdings LLC (Organization) | 5% or greater direct ownership interest | 38% | 06/11/2025 |
| Fischer, David (Individual) | 5% or greater direct ownership interest | 29% | 06/11/2025 |
| Lefkowitz, Zev (Individual) | 5% or greater direct ownership interest | 29% | 06/11/2025 |
| Treff, Cynthia (Individual) | 5% or greater indirect ownership interest | 38% | 06/11/2025 |
| 310 Pensacola Rd LLC (Organization) | 5% or greater mortgage interest | NOT APPLICABLE | 03/04/2022 |
| 310 Pensacola Rd LLC (Organization) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Brighton Management LLC (Organization) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Ctnc Holdings LLC (Organization) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Fischer, David (Individual) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Lefkowitz, Zev (Individual) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Shade, Carla (Individual) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Treff, Cynthia (Individual) | Adp of the snf | NOT APPLICABLE | 03/04/2022 |
| Turbett, Timothy (Individual) | Adp of the snf | NOT APPLICABLE | 03/13/2023 |
| Etnc Holdings LLC (Organization) | Direct ownership interest | NOT APPLICABLE | 06/11/2025 |
| Treff, Esther (Individual) | Indirect ownership interest | NOT APPLICABLE | 06/11/2025 |
| Fischer, David (Individual) | Managing control - governing body | NOT APPLICABLE | 03/04/2022 |
| Fischer, David (Individual) | Operational/managerial control | NOT APPLICABLE | 03/04/2022 |
| Shade, Carla (Individual) | Operational/managerial control | NOT APPLICABLE | 03/04/2022 |
Visiting? Go in with questions.
Built from this facility’s own CMS data — bring them on the tour.
- CMS data shows 1 fine totaling $59,631 in its current data window — ask what the citations were for and what changed afterward.
- Their weekend total nurse staffing (3.01/resident/day) is lower than their overall figure (3.29) — ask who covers weekends and how shifts are filled when someone calls out.
- Their last standard health inspection was March 20, 2025 — ask what's improved since then.
- CMS records that this facility has a resident council — ask to speak with a council member before deciding.
- They have 140 certified beds and serve an average of 101 residents per day — ask which unit your person would be on and who staffs it overnight.
- They report 3.29 total nursing hours per resident per day (NC median: 3.51) — ask how those hours split across day, evening, and night shifts.
- CMS lists this facility as part of BRIGHTON HEALTHCARE (8 facilities) — ask what the chain decides centrally and what this building's team controls.
Data: Centers for Medicare & Medicaid Services (data.cms.gov), processing date June 1, 2026. This site is not affiliated with CMS or any government agency.