01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-05-01 | 11 | 2025-02-27 | 2 |
| Cycle 2 | 2025-02-27 | 3 | 2023-10-26 | 1 |
| Cycle 3 | 2023-10-26 | 3 | 2022-05-05 | 2 |
CMS CCN 3454332026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Clay County Health And Rehabilitation
86 Valley Hideaway Drive · Hayesville, NC 28904 · Clay County
Certified beds90CMS provider file
Recent citation rows22current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
22 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-01 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0711Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0712Severity B · pattern; potential for minimal harm
Nursing and Physician Services Deficiencies
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Correction field: Deficient, Provider has plan of correction · 2026-05-282026-05-01 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0760Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0882Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2026-05-282026-05-01 · HEALTHF0887Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Correction field: Deficient, Provider has date of correction · 2026-05-282025-02-27 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2025-03-252025-02-27 · HEALTHF0641Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-03-252025-02-27 · HEALTHF0700Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has date of correction · 2025-03-252025-02-27 · FIREK0222Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2025-05-242025-02-27 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-05-242023-10-26 · HEALTHF0756Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2023-11-212023-10-26 · HEALTHF0760Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2023-11-212023-10-26 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-11-212023-10-26 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2023-12-272022-05-05 · FIREK0345Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2022-07-222022-05-05 · FIREK0521Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2022-07-2203 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HAYESVILLE PARENTCO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- EVH HOLDCO LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- NCOP HOLDCO LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- NU C II IRREVOCABLE TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- NU C IRREVOCABLE TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- SNF CARE CENTERS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- ZENITH HOLDCO II LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- ZENITH HOLDCO LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2025
- HOBACK, TIFFANYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2025
- SEMONES, BRANDIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2025
- SNF MGR LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- CHANDROSS, MARKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- GARRETT, KATHIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- HOBACK, TIFFANYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- JONES, TEQUILLAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- SEMONES, BRANDIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- VARGAS, CARLOSIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- SNF MGR LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/14/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.17per resident day
RN hours0.39per resident day
Weekend nurse hours2.87per resident day
Staff turnover49.4%CMS reported field
06 / LOCAL RECORDS
Open the North Carolina ledger →Other published facilities nearby
No second facility in the same city met the directory rule.