01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-14 | 3 | 2024-08-09 | 2 |
| Cycle 2 | 2024-08-09 | 1 | 2023-04-13 | 2 |
| Cycle 3 | 2023-04-13 | 3 | 2022-01-27 | 1 |
CMS CCN 3451292026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Davie Nursing And Rehabilitation Center
498 Madison Road · Mocksville, NC 27028 · Davie County
Certified beds96CMS provider file
Recent citation rows12current 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
12 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-11-14 · HEALTHF0695Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-11-252025-11-14 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-11-252025-11-14 · HEALTHF0812Severity F · widespread; 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 · 2025-11-252024-08-09 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-08-09 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-10-112024-08-09 · FIREK0923Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2024-10-112024-06-17 · HEALTHF0777Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
Correction field: Past Non-Compliance · 2024-06-11 · complaint2023-04-13 · 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 · 2023-05-022023-04-13 · 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 · 2023-05-022023-04-13 · FIREK0222Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2023-06-012023-04-13 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2023-06-012022-01-27 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2022-03-0903 / 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
- AUTUMN CORPORATIONOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/19/2019
- BENJAMIN N. VOLPE FAMILY DYNASTY TRUST (DATED DECEMBER 29, 2020)Organization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2023
- BNV DYNASTY LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2023
- DECANTED WILLIAM I. WEISBERG FAMILY DYNASTY TRUST (DATED SEPT 30, 2020Organization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2023
- SABER HEALTHCARE HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/19/2019
- SHG AUTUMN, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/19/2019
- WIW DYNASTY LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2023
- OHI ASSET (NC) MOCKSVILLE -1304 MADISON ROAD, 1.POrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 02/01/2019
- 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
- ASBILL, DARINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/19/2019
- WEISBERG, WILLIAMIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 12/26/2025
- CIBC BANK USAOrganization · ADP OF THE SNFNOT APPLICABLE · since 03/31/2021
- CITRIN COOPERMAN ADVISORS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/19/2019
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 hours3.30per resident day
RN hours0.36per resident day
Weekend nurse hours2.92per resident day
Staff turnover33.8%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.