Nursing homes › North Carolina › Cleveland Pines
1404 N Lafayette Street, Shelby, NC 28150 · 9804871500 · 120 certified beds
Per CMS filings, this facility is affiliated with Atrium Health, a group operating 6 facilities in 1 states. Group record: average rating 3.0/5, 0 abuse citation icons, 0 facilities on the Special Focus list, $21,991 in federal fines. This facility rates the same as its group average (3.0/5).
Total nurse staffing: 2.96 (North Carolina median: 3.53). RN hours: 0.31. Weekend total: 2.01. Nursing staff turnover: 43%.
All-time on record: 13 deficiency citations. Below: citations from 2023 onward (severity letters explained in methodology).
| Survey date | Deficiency | Sev. | Type | Status |
|---|---|---|---|---|
| 2025-11-18 | Provide appropriate foot care. | E | Health | corrected 2025-12-16 |
| 2025-11-18 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | E | Health | corrected 2025-12-16 |
| 2025-11-18 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Health | corrected 2025-12-16 |
| 2025-11-18 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Health | corrected 2025-12-16 |
| 2025-11-18 | Provide safe and appropriate respiratory care for a resident when needed. | D | Health | corrected 2025-12-16 |
| 2025-11-18 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Health | corrected 2025-12-16 |
| 2024-07-18 | Provide activities to meet all resident's needs. | E | Health | corrected 2024-08-30 |
| 2024-07-18 | 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. | D | Health | corrected 2024-08-15 |
| 2024-07-18 | 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. | D | Health | corrected 2024-08-15 |
| 2024-07-18 | Provide and implement an infection prevention and control program. | D | Health | corrected 2024-08-15 |
| 2023-03-23 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Health | corrected 2023-04-30 |
| 2023-03-23 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | Health | corrected 2023-04-30 |
| 2023-03-23 | Provide and implement an infection prevention and control program. | D | Health | corrected 2023-04-30 |
No federal fines or payment denials on record.
| Name | Role | Type | % | Since |
|---|---|---|---|---|
| BALL, RODNEY | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 08/30/2023 |
| HAYNES, KENNETH | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 06/21/2019 |
| RISSMILLER, SCOTT | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 06/21/2019 |
| BALL, RODNEY | Corporate Officer | Individual | NOT APPLICABLE | since 02/01/2023 |
| HAYNES, KENNETH | Corporate Officer | Individual | NOT APPLICABLE | since 12/20/2019 |
| ADVOCATE HEALTH INC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 12/02/2022 |
| ATRIUM HEALTH INC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 10/09/2020 |
| BROAD RIVER REHABILITATION | Operational/Managerial Control | Organization | NOT APPLICABLE | since 06/01/2023 |
| OPTIMED HOSPITALISTS | Operational/Managerial Control | Organization | NOT APPLICABLE | since 12/22/2017 |
| PRO DIVERSITY PARTNERS, LLC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 08/01/2021 |
| THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | Operational/Managerial Control | Organization | NOT APPLICABLE | since 02/01/2020 |
| DOTSON, KATHRYN | Operational/Managerial Control | Individual | NOT APPLICABLE | since 02/01/2020 |
| MURRAY, ROBERT | Operational/Managerial Control | Individual | NOT APPLICABLE | since 01/16/2024 |
Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 345282. Corrections: data@carerecords.org.