Jacob's Creek Nursing and Rehabilitation Center — nursing home in Madison, NC

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 170 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 151.1 CMS, MDS-derived
CMS Certification Number: 345050
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): May 8, 1968
Ownership type: For profit - Limited Liability company
Operator (legal business name): Granite Falls Ltc, LLC
CMS chain: Principle Long Term Care 37 facilities
Phone: (336) 548-9658
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

6

latest Dec 18, 2025

Citations

18

8 health · 10 fire

Harm or worse

1

1 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J1	K·	L·
Actual harm	G·	H·	I·
Potential harm	D13	E3	F1
Minimal	A·	B·	C·

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

2

$16,801

Payment denials

1

Latest

Sep 18, 2024

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 345050
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 170
First approved: May 8, 1968
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for North Carolina.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Dec 18, 2025	Fire safety	Fire Safety Standard	2	Potential harm	—	Open →
Dec 18, 2025	Health	Health Standard	0	No citations	—	Open →
Sep 18, 2024	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Sep 18, 2024	Health	Health Complaint, Health Standard	4	Immediate jeopardy	—	Open →
Apr 27, 2023	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Apr 27, 2023	Health	Health Standard	4	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

Date	Type	Amount	Payment denial	Record
Sep 18, 2024	Denial of payment for new admissions	—	Oct 9, 2024 · 2 days	345050\|Payment Denial\|2024-10-09
Sep 18, 2024	Civil money penalty (fine)	$12,784	—	345050\|Fine\|42519
Sep 18, 2024	Civil money penalty (fine)	$4,017	—	345050\|Fine\|42529

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J1	K·	L·
Actual harm	G·	H·	I·
Potential harm	D13	E3	F1
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Dec 18, 2025	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Feb 27, 2026
Dec 18, 2025	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Feb 27, 2026
Sep 18, 2024	F-0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	J · Immediate jeopardy Isolated	Past non-compliance Aug 5, 2024	Complaint
Sep 18, 2024	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Jan 20, 2025
Sep 18, 2024	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jan 20, 2025
Sep 18, 2024	K-0363	Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 20, 2025
Sep 18, 2024	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jan 20, 2025
Sep 18, 2024	F-0687	Provide appropriate foot care. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Oct 11, 2024
Sep 18, 2024	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Oct 11, 2024
Sep 18, 2024	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	E · Potential harm Pattern	Corrected Oct 11, 2024
Apr 27, 2023	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jul 5, 2023
Apr 27, 2023	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jul 5, 2023
Apr 27, 2023	K-0341	Install a fire alarm system that can be heard throughout the facility. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jul 5, 2023
Apr 27, 2023	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jul 5, 2023
Apr 27, 2023	F-0550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected May 25, 2023
Apr 27, 2023	F-0609	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected May 25, 2023
Apr 27, 2023	F-0626	Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected May 25, 2023
Apr 27, 2023	F-0867	Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Administration Deficiencies · Administration & records	D · Potential harm Isolated	Corrected May 25, 2023

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 3

Health inspectionsstate 2.9

Staffingstate 2.7

Quality measuresstate 3.5

Long-stay QM

Short-stay QMNot rated

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing3.62

State avg 3.87US avg 3.90

Registered nurse (RN)0.34

State avg 0.62US avg 0.69

Licensed practical nurse0.82

State avg 0.88US avg 0.86

Nurse aide2.46

State avg 2.37US avg 2.35

Weekend total nurse3.28

State avg 3.40US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 4.28 (case-mix index 1.18).

Staff turnover

Total nursing staff turnover39.3%

State avg 48.7%US avg 45.3%

Registered nurse turnover33.3%

State avg 45.7%US avg 42.5%

Administrators who left3

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Dec 18, 2025
Cycle 1 health score: 0
Total weighted score: 10

Operating entity

Granite Falls Ltc, LLC

CMS legal business name of the certified provider. Operates 5 facilities.

VerifiedLinked by exact legal name

CMS chain

Principle Long Term Care

37 facilities in 2 states. CMS chain ID 423.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 2.9

Ownership disclosures

Disclosures

8

Organizations

1

Individuals

6

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
James Goforth	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Jan 1, 2025
Principle Long Term Care, Inc	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jan 1, 2011
Kathleen Wilson	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jan 1, 2025
Gale Boice	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Mar 5, 2018
Dianne Johnson	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Jan 1, 2011
Principle Long Term Care, Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Apr 14, 2025
James Goforth	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 12, 2025
Kathleen Wilson	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 12, 2025

Other facilities operated by Granite Falls Ltc, LLC

All 4 →

Facility	Beds	Last inspection	Citations (window)	Fines
University Place Nursing and Rehabilitation Center 9200 Glenwater Drive, Charlotte, NC 28262 CCN 345142	207	Jul 24, 2025	492 harm1 open	$276k
Magnolia Lane Nursing and Rehabilitation Center 107 Magnolia Drive, Morganton, NC 28655 CCN 345219	121	Dec 19, 2025	351 harm2 open	—
Macon Valley Nursing and Rehabilitation Center 3195 Old Murphy Road, Franklin, NC 28734 CCN 345263	200	Aug 13, 2026	221 harm	$5,689
Graham Healthcare and Rehabilitation Center 811 Snowbird Road, Robbinsville, NC 28771 CCN 345355Abuse icon	80	May 28, 2026	221 harm	$14k

Same chain in North Carolina

All 36 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Carolina Rivers Nursing and Rehabilitation Center 1839 Onslow Drive Extension, Jacksonville, NC 28540 CCN 345072	120	Dec 12, 2025	151 open	$4,271
Willow Creek Nursing and Rehabilitation Center 2401 Wayne Memorial Drive, Goldsboro, NC 27534 CCN 345113	200	Jun 11, 2026	252 harm	$16k
Northchase Nursing and Rehabilitation Center 3015 Enterprise Drive, Wilmington, NC 28405 CCN 345119	140	Jun 23, 2025	361 harm	$7,901
Greenhaven Health and Rehabilitation Center 801 Greenhaven Drive, Greensboro, NC 27406 CCN 345132Abuse icon	120	Sep 4, 2025	402 IJ3 harm1 open	$123k
University Place Nursing and Rehabilitation Center 9200 Glenwater Drive, Charlotte, NC 28262 CCN 345142	207	Jul 24, 2025	492 harm1 open	$276k
Pine Ridge Health and Rehabilitation Center 706 Pineywood Road, Thomasville, NC 27360 CCN 345144	140	Aug 6, 2026	316 open	—
Bethany Woods Nursing and Rehabilitation Center 33426 Old Salisbury Road, Albemarle, NC 28002 CCN 345146	180	Apr 2, 2026	313 open	—
Harmony Hall Nursing and Rehabilitation Center 312 Warren Avenue, Kinston, NC 28501 CCN 345156	175	Feb 27, 2026	362 harm2 open	—

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 1721 Bald Hill Loop, Madison, NC 27025
ZIP: 27025
County: Rockingham County FIPS 37157
State: North Carolina
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	CMS overall	Last inspection	Citations (window)	Fines
Countryside 7700 US Highway 158, Stokesdale, NC 27357 CCN 345390	15.1 km	60		Jun 25, 2026	102 open	—
Unc Rockingham Rehab & Nursing Care Center 205 East Kings Highway, Eden, NC 27288 CCN 345249	20.9 km	121		Aug 6, 2026	181 open	—

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	345050	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	345050	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 345050

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction