01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-19 | 5 | 2026-03-19 | 2 |
| Cycle 2 | 2025-01-10 | 10 | 2025-01-10 | 5 |
| Cycle 3 | 2023-10-27 | 5 | 2023-10-27 | 4 |
CMS CCN 3450392026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Summerstone Health And Rehabilitation Center
485 Veterans Way · Kernersville, NC 27284 · Forsyth County
Certified beds138CMS provider file
Recent citation rows31current 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
31 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-07 · 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: Deficient, Provider has date of correction · 2026-05-13 · complaint2026-03-19 · 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 · 2026-05-07 · complaint2026-03-19 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2026-05-072026-03-19 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2026-04-132026-03-19 · HEALTHF0791Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
Correction field: Deficient, Provider has date of correction · 2026-05-072026-03-19 · 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 · 2026-05-292026-03-19 · FIREK0911Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Correction field: Deficient, Provider has date of correction · 2026-05-292025-03-03 · HEALTHF0689Severity J · isolated immediate jeopardy
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: Past Non-Compliance · 2025-02-04 · complaint2025-01-10 · HEALTHF0622Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Correction field: Deficient, Provider has date of correction · 2025-02-04 · complaint2025-01-10 · HEALTHF0624Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Prepare residents for a safe transfer or discharge from the nursing home.
Correction field: Deficient, Provider has date of correction · 2025-02-04 · complaint2025-01-10 · HEALTHF0689Severity D · isolated; potential for more than minimal 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 plan of correction · 2025-02-04 · complaint2025-01-10 · 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 · 2025-02-042025-01-10 · 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 · 2025-02-042025-01-10 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-02-04 · complaint2025-01-10 · 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 · 2025-02-042025-01-10 · 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 · 2025-02-042025-01-10 · 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 · 2025-02-042025-01-10 · FIREK0100Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Meet other general requirements.
Correction field: Deficient, Provider has date of correction · 2025-04-062025-01-10 · 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 · 2025-04-062025-01-10 · 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 · 2025-04-062025-01-10 · 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 · 2025-04-062025-01-10 · 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 · 2025-04-062023-10-27 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2023-11-252023-10-27 · HEALTHF0600Severity D · isolated; potential for more than minimal 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: Deficient, Provider has date of correction · 2023-11-2503 / 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 |
|---|---|---|---|
| 2025-01-10 | Fine | $14,511 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- JOHN A MCNEILL JR 2012 IRRV TROrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 04/06/2025
- LIBERTY HEALTHCARE GROUP LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 04/06/2025
- LIBERTY HEALTHCARE PROPERTIES OF KERNERSVILLE LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 04/06/2025
- RONALD B. AND CYNTHIA J. MCNEILL 2013 IRREVOCABLE TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/24/2025
- MCNEILL, JOHNIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 04/06/2025
- MCNEILL, RONALDIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 04/06/2025
- MILLER, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/06/2025
- CALCUTT, JOSEPHIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/06/2025
- WILSON, JEFFREYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/06/2025
- LONG TERM CARE MANAGEMENT SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/24/2025
- BORK, MATTHEWIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/29/2007
- MCNEILL, JOHNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/06/2025
- MCNEILL, RONALDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/06/2025
- VANDERHOOF, RICHARDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/06/2025
- WRIGHT, ANNAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2025
- OLIVER, ANNAIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 04/06/2025
- PURVIS, JENNYIndividual · TRUSTEE OF THE SNFNOT APPLICABLE · since 04/06/2025
- JOHN A MCNEILL JR 2012 IRRV TROrganization · ADP OF THE SNFNOT APPLICABLE · since 05/31/2025
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 hours3.55per resident day
RN hours0.37per resident day
Weekend nurse hours3.25per resident day
Staff turnover70.3%CMS reported field
06 / LOCAL RECORDS
Open the Kernersville ledger →