Graham Healthcare and Rehabilitation Center
811 Snowbird Road, Robbinsville, NC 28771 · Graham County · 80 certified beds · avg 57 residents/day · certified since Feb 5, 1991
Abuse citation flag (CMS)
Part of chain: PRINCIPLE LONG TERM CARE (40 facilities, chain avg rating 3.0★)
The abuse flag means inspectors cited this facility for abuse that caused harm to a resident within the past year, or potential for harm in each of the last two years. Source: CMS.
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · May 28, 2026 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: May 7, 2026 (Past Non-Compliance)
All citations in the current public record (16)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| May 28, 2026 | ▲ G · Actual harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| May 28, 2026 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint |
| Mar 5, 2026 | E · Potential for harm, repeated | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Mar 5, 2026 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Mar 5, 2026 | D · Potential for harm, one-off | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. |
| Mar 5, 2026 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Dec 19, 2024 | E · Potential for harm, repeated | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. |
| Dec 19, 2024 | E · Potential for harm, repeated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Dec 19, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Dec 19, 2024 | D · Potential for harm, one-off | The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. |
| Jul 18, 2024 | D · Potential for harm, one-off | The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint |
| Jul 20, 2023 | D · Potential for harm, one-off | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. |
| Jul 20, 2023 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Jul 20, 2023 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 20, 2023 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jul 20, 2023 | D · Potential for harm, one-off | The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (4 → 4).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 5 | 0 | D |
| 2024 | 5 | 0 | E |
| 2026 | 6 | 1 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | North Carolina avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.44 | 4.01 | 3.95 | top 20% in North Carolina; top 25% in the U.S. |
| Registered Nurse hours | 0.74 | 0.64 | 0.69 | top 24% in North Carolina; top 33% in the U.S. |
| Weekend total nurse staffing | 4.03 | 3.56 | 3.50 | top 17% in North Carolina; top 22% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.60 | 0.41 | 0.48 | top 15% in North Carolina; top 23% in the U.S. |
| Total nursing staff turnover (%) | 70.0 | 49.0 | 45.8 | bottom 9% in North Carolina; bottom 6% in the U.S. |
| RN turnover (%) | 60.0 | 45.7 | 42.9 | bottom 30% in North Carolina; bottom 22% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.67, RN 0.61, weekend 3.33. Staffing rating: 3/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: 3/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Boice, Gale | Individual | Corporate Officer | NOT APPLICABLE | 03/05/2018 |
| Boice, Gale | Individual | ADP of the SNF | NOT APPLICABLE | 03/05/2018 |
| Hill, Raymond | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2011 |
| Hill, Robert | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2011 |
| Hill, Stephen | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2011 |
| Johnson, Dianne | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2011 |
| Principle Long Term Care, INC. | Organization | Operational/Managerial Control | NOT APPLICABLE | 06/01/2016 |
| Stephens, Donna | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/04/2025 |
| Stephens, Donna | Individual | ADP of the SNF | NOT APPLICABLE | 10/07/2025 |
| Stover, Lani | Individual | ADP of the SNF | NOT APPLICABLE | 08/01/2021 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What specific steps do you take to prevent abuse and neglect, and how are staff trained on them?"
- "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
- "How do you record and honor each resident's treatment wishes and advance directives, and how do staff know about them?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "Does a pharmacist review every resident's medications and chart monthly, and how are their concerns acted on?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Valley View Care and Rehabilitation | 8.1 mi | Andrews, NC | ★★☆☆☆ | 2/5 | |
| Clay County Health and Rehabilitation | 18.6 mi | Hayesville, NC | ★★☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 345355.