Skilled nursing facility · CMS certification number 345282
Cleveland Pines
Shelby, North Carolina · Medicare and Medicaid
Certified beds, as filed in Care Compare: 120
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 27 March 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,055,121 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,388,161 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,666,960 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,147,537 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,480,577 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $80,286 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,400,291 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,400,291 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 43,920 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,857 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 24,030 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 9,974 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 35,861 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 62 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 47 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 187 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 296 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 511.28 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 121.15 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1448833, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 31 December 2023
Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,960,844 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $170,104 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,790,740 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,605,406 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,814,666 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $64,712 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,749,954 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,749,954 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,761 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 210 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 323.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 156 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1434936, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 October 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,450,349 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$497,077 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,947,426 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,117,207 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$5,169,781 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $89,142 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$5,080,639 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$5,080,639 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,116 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 165 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 54.35 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 340.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 176.46 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1396936, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 July 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,968,259 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$788,644 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,756,903 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,740,914 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,984,011 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $500,483 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,483,528 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,483,528 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,380 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 188 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.04 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 463.93 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 161.6 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1359493, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 31 December 2020
Cost report for 1 February 2020 to 31 December 2020 — a reporting period of 334 days, on form CMS-2540-10, settled, processed by CMS on 25 January 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,355,782 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$584,759 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,940,541 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,744,478 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,803,937 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $344,594 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,459,343 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,459,343 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,174 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 227 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 228.02 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 137.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1340933, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 February 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,115,006 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,430,362 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,684,644 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,084,806 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,400,162 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,990 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,392,172 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,392,172 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,176 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 379 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.77 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 455.77 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 106.01 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1310708, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 December 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,678,551 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,620,762 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,057,789 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,801,938 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,744,149 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $35,813 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,708,336 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,708,336 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,788 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 436 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 324.9 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 93.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1277313, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 31 December 2017
Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 June 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,721,102 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,630,026 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,091,076 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,268,279 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,177,203 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $24,367 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,152,836 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,152,836 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 38,101 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 364 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 443.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 104.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1258017, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 19 December 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,657,843 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,702,410 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,955,433 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,108,507 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,153,074 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $28,661 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,124,413 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,124,413 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,393 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 315 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 488.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 128.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1216475, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,625,683 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,760,134 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,865,549 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,343,933 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$478,384 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $35,814 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$442,570 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$442,570 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 41,081 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 342 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.99 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 527.98 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 120.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1189093, read from the public cost report file SNF10FY2015.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated 1 August 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| ADVOCATE HEALTH INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/29/2025 |
| ATRIUM HEALTH INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/29/2025 |
| BROAD RIVER REHABILITATION | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/29/2025 |
| DOTSON, KATHRYN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2020 |
| MURRAY, ROBERT | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/16/2024 |
| OPTIMED HOSPITALISTS | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/29/2025 |
| PRO DIVERSITY PARTNERS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/29/2025 |
| BALL, RODNEY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2023 |
| HAYNES, KENNETH | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 12/20/2019 |
| 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 |
| 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 |
| DOTSON, KATHRYN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2020 |
| MURRAY, ROBERT | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/16/2024 |
| 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 |
| BALL, RODNEY | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 08/30/2023 |
| HAYNES, KENNETH | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 06/21/2019 |
| RISSMILLER, SCOTT | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 06/21/2019 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of AHSNF, INC. (enrollment ID O20200328000172).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| ADVOCATE HEALTH INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| ATRIUM HEALTH INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| BROAD RIVER REHABILITATION | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| KATHRYN G DOTSON | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2020 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| OPTIMED HOSPITALISTS | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| PRO DIVERSITY PARTNERS, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| ROBERT JAMES MURRAY | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/16/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RODNEY E BALL | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KENNETH D HAYNES | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/21/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RODNEY E BALL | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/30/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SCOTT C RISSMILLER | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/21/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KENNETH HAYNES | Individual | OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/20/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| ADVOCATE HEALTH INC | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/2/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ATRIUM HEALTH INC | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/9/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| BROAD RIVER REHABILITATION | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| KATHRYN G DOTSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2020 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| OPTIMED HOSPITALISTS | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/22/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| PRO DIVERSITY PARTNERS, LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| ROBERT JAMES MURRAY | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/16/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| KENNETH D HAYNES | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/21/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RODNEY E BALL | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/30/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SCOTT C RISSMILLER | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/21/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: SCOTT C RISSMILLER no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 March 2026: ROBERT JAMES MURRAY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: OPTIMED HOSPITALISTS, PLLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: OPTIMED HOSPITALISTS, PLLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADVOCATE HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADVOCATE HEALTH INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ATRIUM HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ATRIUM HEALTH INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ROBERT JAMES MURRAY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ROBERT JAMES MURRAY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BROAD RIVER REHABILITATION appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BROAD RIVER REHABILITATION appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: PRO DIVERSITY PARTNERS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: PRO DIVERSITY PARTNERS, LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 3 June 2024: ROBERT JAMES MURRAY appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 1 November 2023: ANTHONY DEFURIO no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANTHONY DEFURIO no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: RODNEY E BALL appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 15 May 2023: RODNEY E BALL no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
- 15 May 2023: EUGENE A WOODS no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
- 15 May 2023: RODNEY E BALL appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
Recent changes on this record
- 1 July 2026: SCOTT C RISSMILLER no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: SCOTT C RISSMILLER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 27 March 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 March 2026: ROBERT JAMES MURRAY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: OPTIMED HOSPITALISTS, PLLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: OPTIMED HOSPITALISTS, PLLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADVOCATE HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADVOCATE HEALTH INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ATRIUM HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ATRIUM HEALTH INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ROBERT JAMES MURRAY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ROBERT JAMES MURRAY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KENNETH D HAYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: KATHRYN G DOTSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BROAD RIVER REHABILITATION appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BROAD RIVER REHABILITATION appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RODNEY E BALL appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: PRO DIVERSITY PARTNERS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: PRO DIVERSITY PARTNERS, LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SCOTT C RISSMILLER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 28 August 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 16 October 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 3 June 2024: ROBERT JAMES MURRAY appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 1 November 2023: ANTHONY DEFURIO no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANTHONY DEFURIO no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: RODNEY E BALL appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 21 July 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 15 May 2023: RODNEY E BALL no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
- 15 May 2023: EUGENE A WOODS no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
- 15 May 2023: RODNEY E BALL appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 18 November 2025 | 18 July 2024 | 6 | 3 |
| 2 | 18 July 2024 | 23 March 2023 | 4 | 1 |
| 3 | 23 March 2023 | 10 June 2021 | 3 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
13 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 18 November 2025 | Health | F 0607 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 November 2025 | Health | F 0644 | Resident Assessment and Care Planning Deficiencies | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 November 2025 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | E | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 November 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 November 2025 | Health | F 0700 | Quality of Life and Care Deficiencies | 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 | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 November 2025 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | No | Deficient, Provider has date of correction | 16 December 2025 |
| 18 July 2024 | Health | F 0578 | 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. | D | No | Deficient, Provider has date of correction | 15 August 2024 |
| 18 July 2024 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | E | No | Deficient, Provider has date of correction | 30 August 2024 |
| 18 July 2024 | Health | F 0688 | 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. | D | No | Deficient, Provider has date of correction | 15 August 2024 |
| 18 July 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 15 August 2024 |
| 23 March 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | 30 April 2023 |
| 23 March 2023 | Health | F 0867 | Administration Deficiencies | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | No | Deficient, Provider has date of correction | 30 April 2023 |
| 23 March 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 30 April 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | AHSNF, INC. |
| Date First Approved to Provide Medicare and Medicaid Services | 1988-06-30 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Cleveland |
| Telephone Number | 9804871500 |
| Chain Name | ATRIUM HEALTH |
| Chain ID | 55 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 120 |
| Average Number of Residents per Day | 102.4 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 4 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 2 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on Cleveland Pines: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 July 2026: SCOTT C RISSMILLER no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for Cleveland Pines
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in North Carolina at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 345282.