Adams Farm Living & Rehabilitation
5100 Mackay Road
Jamestown, NC, 27282
3368555596
CCN: 345535
2
Overall2
Health2
Staffing2
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
ACTIVE LIVING CENTER, INC
1128a1
Excluded 1997-04-15
Ownership
| Name | Role | % |
|---|---|---|
| ADAMS FARM LIVING INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| NOAH K DUNCAN MRTL TR | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| GILLIAM, ROBERT | CORPORATE DIRECTOR | NOT APPLICABLE |
| BOYETTE, BARBARA | CORPORATE DIRECTOR | NOT APPLICABLE |
| GILLIAM, ROBERT | CORPORATE OFFICER | NOT APPLICABLE |
| SCHMIDLIN, JAMES | CORPORATE OFFICER | NOT APPLICABLE |
| CENTURY CARE MANAGEMENT, INC. | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| GILLIAM, ROBERT | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| NILES, MARIA | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Penalties (1)
| Date | Type | Amount |
|---|---|---|
| 2025-05-01 | Fine | $37K |
Health Deficiencies (8)
2025-12-05 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
2025-05-01 · Health
D
F842 · 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.
D
F756 · Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
G
F711 · Nursing and Physician Services Deficiencies
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
G
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
G
F580 · 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.
2024-08-21 · Health
E
F812 · 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
F761 · 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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.58
RN Hrs/Resident/Day0.54
0.40
LPN Hrs/Resident/Day0.81
0.89
CNA Hrs/Resident/Day2.33
2.29
PT Hrs/Resident/Day0.12
0.07
Data as of 2026-03-01