01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-07-24 | 0 | 2024-05-16 | 1 |
| Cycle 2 | 2024-05-16 | 0 | 2022-12-09 | 1 |
| Cycle 3 | 2022-12-09 | 2 | 2021-07-16 | 0 |
CMS CCN 3455742026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Bellarose Nursing And Rehab
200 Bellarose Lake Way · Garner, NC 27529 · Wake County
Certified beds100CMS provider file
Recent citation rows4current CMS citation release
Penalty rows0current 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
4 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-05-16 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-06-132022-12-09 · 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 · 2023-01-052022-12-09 · HEALTHF0585Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has plan of correction · 2023-01-052022-12-09 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2023-01-1603 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- EVANS, KISAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST13% · since 08/01/2011
- EVANS, TONIIndividual · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 08/01/2011
- MILLER, WILLIAMIndividual · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 08/01/2011
- SHERRILL, DEBBIEIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST25% · since 08/01/2011
- BURROUGHS, WILLIAMIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 02/24/2018
- DIXON, JUSTINIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 04/09/2018
- EVANS, KISAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/01/2011
- EVANS, ROBERTIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/01/2011
- RICHARDSON, SANDRAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 11/17/2017
- EVANS, KISAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2011
- EVANS, RILEYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2011
- EVANS, ROBERTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2011
- EVANS, TONIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2011
- BURROUGHS, WILLIAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/24/2018
- DIXON, JUSTINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/09/2018
- EVANS, KISAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2011
- EVANS, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2011
- RICHARDSON, SANDRAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/27/2017
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 hours4.46per resident day
RN hours0.44per resident day
Weekend nurse hours3.77per resident day
Staff turnover25.0%CMS reported field
06 / LOCAL RECORDS
Open the Garner ledger →