01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-04-24 | 0 | 2025-04-24 | 3 |
| Cycle 2 | 2024-02-13 | 16 | 2024-02-13 | 3 |
| Cycle 3 | 2022-09-22 | 12 | 2022-09-22 | 2 |
CMS CCN 3455692026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Springbrook Nursing And Rehabilitation Center
195 Springbrook Avenue · Clayton, NC 27520 · Johnston County
Certified beds100CMS provider file
Recent citation rows36current CMS citation release
Penalty rows3current 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
36 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 9 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-04-24 · 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 · 2024-06-18 · complaint2025-04-24 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-06-192025-04-24 · 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 · 2025-06-192025-04-24 · FIREK0918Severity E · pattern; 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 · 2025-06-192024-08-30 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Past Non-Compliance · 2024-08-08 · complaint2024-06-05 · HEALTHF0600Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Past Non-Compliance · 2024-05-21 · complaint2024-02-13 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-03-11 · complaint2024-02-13 · HEALTHF0553Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Correction field: Deficient, Provider has date of correction · 2024-03-11 · complaint2024-02-13 · HEALTHF0584Severity B · pattern; potential for 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 plan of correction · 2024-03-112024-02-13 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2024-03-11 · complaint2024-02-13 · 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 · 2024-03-11 · complaint2024-02-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-03-11 · complaint2024-02-13 · 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 · 2024-03-11 · complaint2024-02-13 · 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 · 2024-03-112024-02-13 · 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 · 2024-03-11 · complaint2024-02-13 · HEALTHF0760Severity J · isolated immediate jeopardy
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Past Non-Compliance · 2024-01-18 · complaint2024-02-13 · 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 · 2024-03-112024-02-13 · HEALTHF0814Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2024-03-112024-02-13 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-03-112024-02-13 · HEALTHF0867Severity E · pattern; 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 · 2024-03-112024-02-13 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-04-242024-02-13 · 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 · 2024-04-242024-02-13 · 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 · 2024-04-242022-09-22 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2022-10-1803 / 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 |
|---|---|---|---|
| 2024-06-05 | Fine | $8,824 | 0 |
| 2024-02-13 | Fine | $16,801 | 0 |
| 2024-02-13 | Payment Denial | $0 | 9 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HILL, RAYMONDIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/02/2015
- HILL, ROBERTIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2011
- HILL, STEPHENIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/02/2015
- KENDALL, TAMIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 11/18/2020
- LUE, JOHNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/16/2017
- BOICE, GALEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/05/2018
- JOHNSON, DIANNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/02/2015
- PRINCIPLE LONG TERM CARE, INC.Organization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2015
- BOICE, GALEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/18/2018
- BOICE, GALEIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/05/2018
- HILL, RAYMONDIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/02/2015
- HILL, ROBERTIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- HILL, STEPHENIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/02/2015
- KENDALL, TAMIIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/19/2025
- LUE, JOHNIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/16/2017
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 hours3.95per resident day
RN hours0.72per resident day
Weekend nurse hours3.53per resident day
Staff turnover50.9%CMS reported field
06 / LOCAL RECORDS
Open the Clayton ledger →