01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-08 | 3 | 2024-10-10 | 2 |
| Cycle 2 | 2024-10-10 | 6 | 2023-05-11 | 4 |
| Cycle 3 | 2023-05-11 | 6 | 2022-02-10 | 0 |
CMS CCN 3453812026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Village Care Of King
440 Ingram Road · King, NC 27021 · Stokes County
Certified beds96CMS provider file
Recent citation rows21current 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
21 rows in the current release
4 rows carry G–L scope/severity codes; 3 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-08 · 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 · 2026-02-052026-01-08 · 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 · 2026-02-052026-01-08 · HEALTHF0865Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
Correction field: Deficient, Provider has date of correction · 2026-02-052025-07-11 · FIREE0006Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Correction field: Past Non-Compliance · complaint2025-07-11 · 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: Past Non-Compliance · complaint2025-07-11 · 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: Past Non-Compliance · complaint2025-07-11 · 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 · complaint2025-01-17 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Past Non-Compliance · 2024-10-29 · complaint2025-01-17 · 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 · 2025-02-07 · complaint2025-01-17 · 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 · 2025-02-07 · complaint2024-10-10 · 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 · 2024-11-262024-10-10 · 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 · 2024-11-262024-03-23 · HEALTHF0579Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide information about how to apply for and use Medicare and Medicaid benefits.
Correction field: Deficient, Provider has date of correction · 2024-04-09 · complaint2024-03-23 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2024-04-09 · complaint2024-03-23 · HEALTHF0660Severity J · isolated immediate jeopardy
Resident Assessment and Care Planning Deficiencies
Plan the resident's discharge to meet the resident's goals and needs.
Correction field: Deficient, Provider has date of correction · 2024-04-09 · complaint2024-03-23 · 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 · 2024-04-09 · complaint2024-01-19 · 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 · 2023-12-18 · complaint2023-05-11 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2023-06-052023-05-11 · 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 · 2023-07-212023-05-11 · FIREK0914Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2023-07-212023-05-11 · 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 · 2023-07-2103 / 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 |
|---|---|---|---|
| 2025-01-17 | Fine | $44,117 | 0 |
| 2024-03-23 | Fine | $49,544 | 0 |
| 2024-01-19 | Fine | $16,452 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- WWBV HOLDINGS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 09/30/2019
- MUSICK, AMYIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 10/25/2021
- VOLPE, BENJAMINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2019
- WEISBERG, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2019
- NICOLUZAKIS, GREGORYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- VOLPE, BENJAMINIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- WEISBERG, WILLIAMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2019
- SABER GOVERNANCE LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2019
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 hours3.58per resident day
RN hours0.38per resident day
Weekend nurse hours3.18per resident day
Staff turnover77.8%CMS reported field
06 / LOCAL RECORDS
Open the King ledger →