01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-07-25 | 5 | 2024-08-29 | 3 |
| Cycle 2 | 2024-08-29 | 6 | 2023-07-27 | 1 |
| Cycle 3 | 2023-07-27 | 14 | 2022-03-03 | 0 |
CMS CCN 3452942026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Autumn Care Of Shallotte
237 Mulberry Street · Shallotte, NC 28459 · Brunswick County
Certified beds100CMS provider file
Recent citation rows29current CMS citation release
Penalty rows2current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
29 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-14 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2026-06-02 · complaint2026-05-14 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-06-02 · complaint2025-07-25 · HEALTHF0756Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-08-182025-07-25 · HEALTHF0760Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-08-18 · complaint2025-07-25 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-08-182024-08-29 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Past Non-Compliance · 2024-06-142024-08-29 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2024-09-20 · complaint2024-08-29 · HEALTHF0759Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-09-202024-08-29 · HEALTHF0760Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-09-202024-08-29 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-09-20 · complaint2024-08-29 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-09-202024-08-29 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-12-202024-08-29 · FIREK0521Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2024-12-202024-08-29 · FIREK0916Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have a battery powered remote alarm panel in a location accessible by operating personnel.
Correction field: Deficient, Provider has date of correction · 2024-12-202024-01-05 · HEALTHF0689Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Past Non-Compliance · 2023-12-01 · complaint2024-01-05 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2024-01-25 · complaint2023-10-26 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2023-11-09 · complaint2023-10-12 · HEALTHF0693Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Correction field: Deficient, Provider has date of correction · 2023-10-26 · complaint2023-07-27 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2023-08-212023-07-27 · HEALTHF0600Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2023-08-212023-07-27 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2023-08-212023-07-27 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-08-212023-07-27 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2023-08-212023-07-27 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2023-08-2103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-01-05 | Fine | $16,452 | 0 |
| 2023-10-12 | Fine | $9,143 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SHG AUTUMN, LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 03/01/2016
- WWBV HOLDINGS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 09/30/2019
- OHI ASSET (NC) SHALLOTTE, LPOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 03/01/2016
- VOLPE, BENJAMINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2019
- WEISBERG, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2019
- NICOLUZAKIS, GREGORYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- VOLPE, BENJAMINIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- WEISBERG, WILLIAMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- SHG MANAGEMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2019
- SULLIVAN, MELISSAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/17/2023
- VINER DAVIS, BETHANYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/08/2021
- CIBC BANK USAOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/31/2021
- CITRIN COOPERMAN ADVISORS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/01/2026
- OHI ASSET (NC) SHALLOTTE, LPOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/01/2016
- SABER GOVERNANCE LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/01/2019
- SABER HEALTHCARE GROUP LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/01/2026
- SHG AUTUMN, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/19/2026
- SHG MANAGEMENT LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/01/2019
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.50per resident day
RN hours0.98per resident day
Weekend nurse hours2.99per resident day
Staff turnover54.7%CMS reported field
06 / LOCAL RECORDS
Open the North Carolina ledger →Other published facilities nearby
No second facility in the same city met the directory rule.