01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-06-24 | 1 | 2025-04-16 | 3 |
| Cycle 2 | 2025-04-16 | 7 | 2024-01-24 | 3 |
| Cycle 3 | 2024-01-24 | 3 | 2022-09-02 | 1 |
CMS CCN 3454492026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
King Health And Rehabilitation Center
115 White Road · King, NC 27021 · Stokes County
Certified beds96CMS provider file
Recent citation rows18current 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
18 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.
2026-06-24 · 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 · 2026-07-20 · complaint2025-04-16 · 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 · 2025-05-122025-04-16 · 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 · 2025-05-122025-04-16 · 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 · 2025-05-12 · complaint2025-04-16 · 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 · 2025-05-122025-04-16 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-05-122025-04-16 · HEALTHF0761Severity D · isolated; 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 · 2025-05-122025-04-16 · 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 · 2025-05-122025-04-16 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-07-292025-04-16 · FIREK0345Severity E · pattern; 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 · 2025-07-292025-04-16 · 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 · 2025-07-292024-02-29 · HEALTHF0602Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Past Non-Compliance · 2024-02-06 · complaint2024-01-24 · HEALTHF0761Severity D · isolated; 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 · 2024-02-142024-01-24 · 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 · 2024-02-142024-01-24 · FIREK0341Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Correction field: Deficient, Provider has date of correction · 2024-05-012024-01-24 · FIREK0521Severity E · pattern; 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 · 2024-05-012024-01-24 · 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 · 2024-05-012022-09-02 · 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 · 2022-10-1003 / 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
- KING HOLDINGS I LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- BRIDGEWATER NC HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- HL FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- HSHC 2024 FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- IB MIMI 2022 FAMILY GRANTOR TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- IB MIMI 2022 FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- JK 2022 GRANTOR FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- MILANO FAMILY HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- ML MILANO 2022 FAMILY GRANTOR TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- ML MILANO 2022 FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- TJ FAMILY TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- TOL OPCO INVESTCO LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- UH CAROLINA SNF OPERATIONS HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- UNIVERSAL OPERATIONS HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- WILL FAMILY 2016 TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/01/2024
- HORNE, JERRYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2024
- SHAW, VERAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2024
- SHAYO, JULIUSIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2024
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 hours2.98per resident day
RN hours0.37per resident day
Weekend nurse hours2.74per resident day
Staff turnover59.8%CMS reported field
06 / LOCAL RECORDS
Open the King ledger →