Smoky Mountain Health and Rehabilitation Center

1349 Crabtree Road · Waynesville, NC · 28785 · 8284549260

50 certified beds For profit - Corporation Chain: Principle Long Term Care

  • No federal fines or payment denials in CMS’s 3-year window.
  • Inspection results have improved across recent cycles.

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Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.

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Red flags

69% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 73
Serious harm & abuse 20% 100
Staffing 20% 65
Federal penalties 15% 100
Trend 10% 78
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 4 of 5 Inspections: 3 of 5 Staffing: 4 of 5 Quality measures: 5 of 5

Total nurse hours / resident-day3.523.48 min · 4.1 strong
RN hours / resident-day0.800.55–0.75
Weekend hours / resident-day3.08≈ weekday level
Nursing turnover / year69%median 45%
Fines (3-yr window)none

Inspection citations (10 in the current record)

  • Potential for harm · D March 19, 2026

    Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

    Corrected April 11, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · E March 19, 2026

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected April 11, 2026 · Nutrition and Dietary

  • Potential for harm · D March 19, 2026

    Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.

    Corrected April 11, 2026 · Administration

  • Potential for harm · D February 5, 2025 · found via complaint

    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

    Corrected March 5, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D February 5, 2025 · found via complaint

    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

    Corrected March 5, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D February 5, 2025 · found via complaint

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected March 5, 2025 · Quality of Life and Care

  • Potential for harm · D February 5, 2025 · found via complaint

    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.

    Corrected March 5, 2025 · Pharmacy Service

  • Potential for harm · D September 28, 2023 · found via complaint

    Keep residents' personal and medical records private and confidential.

    Corrected October 22, 2023 · Resident Rights

  • Potential for harm · D September 28, 2023 · found via complaint

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected October 22, 2023 · Quality of Life and Care

  • Potential for harm · E September 28, 2023 · found via complaint

    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

    Corrected October 22, 2023 · Nutrition and Dietary

Family & resident reviews — a separate signal, never mixed into the score

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 345396 · certified since August 26, 1991. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.