01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-12 | 1 | 2026-03-12 | 1 |
| Cycle 2 | 2025-01-22 | 3 | 2025-01-22 | 0 |
| Cycle 3 | 2023-04-06 | 5 | 2023-04-06 | 0 |
CMS CCN 4253412026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Lake Moultrie Nursing Home
1038 Mcgill Lane · Saint Stephen, SC 29479 · Berkeley County
Certified beds88CMS provider file
Recent citation rows10current CMS citation release
Penalty rows1current 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
10 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-12 · HEALTHF0759Severity D · isolated; 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 · 2026-03-302026-03-12 · FIREK0712Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-03-232025-01-22 · HEALTHF0578Severity J · isolated immediate jeopardy
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2025-01-232025-01-22 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-02-102025-01-22 · HEALTHF0695Severity D · isolated; 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 · 2025-02-072023-04-06 · 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 · 2023-05-022023-04-06 · 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 · 2023-05-022023-04-06 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2023-05-022023-04-06 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2023-05-022023-04-06 · HEALTHF0689Severity G · isolated actual 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 · 2023-05-0203 / 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 |
|---|---|---|---|
| 2025-01-22 | Fine | $11,196 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- CLARENDON MEMORIAL HOSPITALOrganization · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 09/30/2005
- STANLEY, MATHEWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/06/2019
- BROWDER, CHRISTINAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/12/2016
- MATTHEWS, ROBINIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/12/2016
- MATTHEWS, ROBINIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/12/2016
- STANLEY, MATHEWIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/06/2019
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 hours3.59per resident day
RN hours0.71per resident day
Weekend nurse hours3.16per resident day
Staff turnover28.4%CMS reported field
06 / LOCAL RECORDS
Open the South Carolina ledger →Other published facilities nearby
No second facility in the same city met the directory rule.