Cleveland Pines

1404 N Lafayette Street
Shelby, NC, 28150
9804871500
CCN: 345282
3
Overall
3
Health
2
Staffing
4
Quality
ChainATRIUM HEALTH
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
DOTSON, KATHRYNCONTRACTED MANAGING EMPLOYEENOT APPLICABLE
MURRAY, ROBERTCONTRACTED MANAGING EMPLOYEENOT APPLICABLE
BALL, RODNEYCORPORATE DIRECTORNOT APPLICABLE
HAYNES, KENNETHCORPORATE DIRECTORNOT APPLICABLE
RISSMILLER, SCOTTCORPORATE DIRECTORNOT APPLICABLE
BALL, RODNEYCORPORATE OFFICERNOT APPLICABLE
HAYNES, KENNETHCORPORATE OFFICERNOT APPLICABLE
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (1)
DateTypeAmount
2023-03-23Fine$5K
Health Deficiencies (13)
2025-11-18 · Health
D
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F700 · 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.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
E
F687 · Quality of Life and Care Deficiencies
Provide appropriate foot care.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
2024-07-18 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F688 · 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.
E
F679 · Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
D
F578 · 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.
2023-03-23 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F867 · Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
3.28
3.68
RN Hrs/Resident/Day
0.43
0.54
LPN Hrs/Resident/Day
0.90
0.81
CNA Hrs/Resident/Day
1.94
2.33
PT Hrs/Resident/Day
0.04
0.12
Data as of 2026-03-01