01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-07-01 | 5 | 2025-07-01 | 0 |
| Cycle 2 | 2024-05-22 | 5 | 2024-05-22 | 0 |
| Cycle 3 | 2023-01-05 | 1 | 2023-01-05 | 0 |
CMS CCN 2552932026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Diversicare Of Shelby
1108 Church Street · Shelby, MS 38774 · Bolivar County
Certified beds60CMS provider file
Recent citation rows11current 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
11 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-07-01 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2025-07-312025-07-01 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2025-07-312025-07-01 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-07-312025-07-01 · HEALTHF0851Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Correction field: Deficient, Provider has date of correction · 2025-07-312025-07-01 · 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 · 2025-07-312024-05-22 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2024-06-272024-05-22 · HEALTHF0641Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-06-272024-05-22 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-06-272024-05-22 · 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 · 2024-06-272024-05-22 · HEALTHF0851Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Correction field: Deficient, Provider has date of correction · 2024-06-272023-01-05 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2023-02-1003 / 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
- DAC OPCO MISSISSIPPI LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 04/01/2022
- DAC OPCO, LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST61% · since 01/27/2022
- CHRISTIAN, ZINAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 04/01/2022
- RATNER, ERANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2022
- BODIE, REBECCAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/01/2022
- KOHN, BRIANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/13/2024
- NEE, STEPHENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/20/2023
- RATNER, ERANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/13/2024
- WEISHAAR, MATTHEWIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/01/2022
- CHRISTIAN, ZINAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/06/2025
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 hours3.16per resident day
RN hours0.42per resident day
Weekend nurse hours2.90per resident day
Staff turnover41.7%CMS reported field
06 / LOCAL RECORDS
Open the Mississippi ledger →Other published facilities nearby
No second facility in the same city met the directory rule.