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Complaint Investigation

Willow Valley Center For Nursing And Rehabilitatio

February 20, 2026 · Winston-salem, NC · 1900 W 1st Street
Citations 3
CMS Rating 1/5
Beds 230
Provider ID 345092
Healthcare Facility
Willow Valley Center For Nursing And Rehabilitatio
Winston-salem, NC  ·  View full profile →
Inspection Summary

Willow Valley Center for Nursing and Rehabilitatio in Winston-Salem, NC — inspection on February 20, 2026.

Found 3 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0602
Freedom from Abuse, Neglect, and Exploitation Deficiencies

investigated the missing Hydrocodone-Acetaminophen that began on 10/3/2025, but all the

regarding the missing Hydrocodone-Acetaminophen.

The DON revealed Nurse #1 arrived for her

suspended and needed to come into the facility in the morning to submit a statement.

The DON explained Nurse #1 did not come to the facility for several days to write a statement.

The DON indicated Nurse #1 was interviewed, and she had no recollection of what happened to the missing Hydrocodone-Acetaminophen or where she may have put the missing narcotic.

The DON said that Nurse #1 had her employment terminated due to a lack of stewardship of the narcotics.

The Administrator stated the situation did not appear to involve diversion and was unclear.

The Administrator recalled a hospice nurse stating the missing medication belonged to hospice and that hospice would conduct its own investigation and report to the proper authorities.

The DON stated that the facility was informed by a hospice nurse that Resident #2 was missing 30 tablets of Hydrocodone-Acetaminophen, and she thought it was connected to the missing Hydrocodone-Acetaminophen reported on 10/3/2025.

The DON confirmed she did not have any evidence of an investigation into Resident #2's missing Hydrocodone-Acetaminophen, but suspected Nurse #1 misplaced Resident #2's medication.An attempt was made to contact Nurse #1 on 2/17/2026 at 4:56 PM via the telephone; however, current contact information was not available, as her phone number was no longer active.

345092 02/20/2026

Willow Valley Center for Nursing and Rehabilitatio 1900 W 1st Street Winston-Salem, NC 27104

Based on this understanding, the Administrator believed the misappropriation was not reportable and assumed hospice would conduct its own investigation and reporting.

The Administrator noted that Nurse #1 had been employed at the facility for five months at the time of the incident and had previously struggled with recalling information in an unrelated circumstance.

She added that the facility was in the process of relocating offices, and documentation of the investigation into the missing Hydrocodone-Acetaminophen in October 2025 was lost.

Without documentation, the Administrator declined to speculate on what occurred or what further actions were taken by the facility.

345092 02/20/2026

Willow Valley Center for Nursing and Rehabilitatio 1900 W 1st Street Winston-Salem, NC 27104

According to the DON, Nurse #1 could not recall whether the medication had been administered or explain the discrepancies in the documentation.

The DON acknowledged that the documentation on the medication monitoring/control record should match the documentation on the MAR for a clear accounting of the narcotic medication.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Winston-Salem, NC, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Willow Valley Center for Nursing and Rehabilitatio or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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