01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-27 | 1 | 2026-01-27 | 2 |
| Cycle 2 | 2024-10-14 | 13 | 2024-10-14 | 2 |
| Cycle 3 | 2023-06-08 | 0 | 2023-06-08 | 2 |
CMS CCN 3453542026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Piney Grove Nursing And Rehabilitation Center
728 Piney Grove Road · Kernersville, NC 27284 · Forsyth County
Certified beds92CMS provider file
Recent citation rows20current CMS citation release
Penalty rows3current 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
20 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-27 · HEALTHF0584Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has no plan of correction2026-01-27 · FIREK0161Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2026-04-012026-01-27 · FIREK0351Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2026-04-012024-10-14 · HEALTHF0561Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0565Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0602Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0623Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · HEALTHF0660Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Plan the resident's discharge to meet the resident's goals and needs.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · HEALTHF0697Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2024-11-19 · complaint2024-10-14 · HEALTHF0842Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-11-192024-10-14 · 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 · 2024-11-192024-10-14 · 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 · 2024-12-102024-10-14 · FIREK0911Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Correction field: Deficient, Provider has date of correction · 2024-12-102023-06-08 · FIREK0712Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2023-08-052023-06-08 · 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 · 2023-08-0503 / 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 |
|---|---|---|---|
| 2024-10-14 | Fine | $5,349 | 0 |
| 2024-10-14 | Fine | $5,350 | 0 |
| 2024-10-14 | Payment Denial | $0 | 6 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BOICE, GALEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/05/2018
- JOHNSON, DIANNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2011
- PRINCIPLE LONG TERM CARE, INC.Organization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2011
- STIMPSON, JAREDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/05/2024
- BOICE, GALEIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/05/2018
- HILL, RAYMONDIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- HILL, ROBERTIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- HILL, STEPHENIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- PIERCE, ASHLEYIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/03/2024
- STIMPSON, JAREDIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/03/2025
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 hours3.81per resident day
RN hours0.61per resident day
Weekend nurse hours3.63per resident day
Staff turnover66.1%CMS reported field
06 / LOCAL RECORDS
Open the Kernersville ledger →