Madison Health and Rehabilitation
345 Manor Road, Mars Hill, NC 28754 · Madison County · 100 certified beds · avg 85 residents/day · certified since May 25, 1981
Abuse citation flag (CMS)
Part of chain: SANSTONE HEALTH & REHABILITATION (18 facilities, chain avg rating 4.2★)
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: 3/5
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 · Aug 27, 2025 · 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.
All citations in the current public record (5)
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 |
|---|---|---|
| Feb 11, 2026 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Aug 27, 2025 | ▲ 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 |
| Nov 15, 2024 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Aug 30, 2023 | D · Potential for harm, one-off | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Aug 30, 2023 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (1 → 1).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 2 | 0 | D |
| 2024 | 1 | 0 | E |
| 2025 | 1 | 1 | G ▲ |
| 2026 | 1 | 0 | E |
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)
1 fine totaling $9,110.
| Date | Type | Amount / length |
|---|---|---|
| Aug 27, 2025 | Fine | $9,110 |
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) | 3.71 | 4.01 | 3.95 | top 47% in North Carolina; bottom 47% in the U.S. |
| Registered Nurse hours | 0.69 | 0.64 | 0.69 | top 27% in North Carolina; top 37% in the U.S. |
| Weekend total nurse staffing | 3.10 | 3.56 | 3.50 | bottom 37% in North Carolina; bottom 36% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.40 | 0.41 | 0.48 | top 35% in North Carolina; top 48% in the U.S. |
| Total nursing staff turnover (%) | 37.9 | 49.0 | 45.8 | top 24% in North Carolina; top 31% in the U.S. |
| RN turnover (%) | 29.4 | 45.7 | 42.9 | top 23% in North Carolina; top 28% 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 3.60, RN 0.67, weekend 3.02. Staffing rating: 4/5.
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: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Sprenger, Christopher | Individual | 5% or Greater Direct Ownership Interest | — | 12/14/2010 |
| Ardent Health and Rehabilitation Co | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/14/2010 |
| Madison Healthcare Properties, LLC | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 10/22/2013 |
| Niebes, Haley | Individual | W-2 Managing Employee | NOT APPLICABLE | 06/01/2019 |
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 did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "If my family member is able to manage their own medications, would you allow it, and how is that decided?"
- "How do you decide when a feeding tube is truly needed, and how do staff care for residents who have one?"
- "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 |
|---|---|---|---|---|---|
| Elderberry Health Care | 7.2 mi | Marshall, NC | ★★☆☆☆ | 3/5 | |
| The Greens at Weaverville | 9.2 mi | Weaverville, NC | ★★★★☆ | 4/5 | |
| Bear Mountain Health and Rehabilitation | 13.2 mi | Asheville, NC | ★★★☆☆ | 3/5 | |
| Emerald Ridge Health and Rehabilitation | 13.2 mi | Asheville, NC | ★☆☆☆☆ | 1/5 | |
| Smoky Ridge Health and Rehabilitation | 14.3 mi | Burnsville, NC | ★★☆☆☆ | 2/5 | |
| River Bend Health and Rehabilitation | 15.5 mi | Asheville, NC | ★☆☆☆☆ | 1/5 | abuse |
| The Laurels of Summit Ridge | 16.9 mi | Asheville, NC | ★★★★☆ | 3/5 | |
| NC State Veterans Home - Black Mountain | 17.3 mi | Black Mountain, NC | ★★★★★ | 3/5 | |
| Swannanoa Valley Health and Rehabilitation | 17.4 mi | Swannanoa, NC | ★★★☆☆ | 3/5 | |
| Elevate Health and Rehabilitation | 17.7 mi | Asheville, NC | ★☆☆☆☆ | 1/5 | |
| Highland Farms | 18.2 mi | Black Mountain, NC | ★★★★★ | 4/5 | |
| Stonecreek Health and Rehabilitation | 18.5 mi | Asheville, NC | ★★★☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 345206.