Home / North Carolina / Clayton
204 Dairy Road, Clayton, NC 27520 · Johnston County · (919) 553-8232
90 certified beds, about 86 residents a day · For profit - Individual · Medicare and Medicaid since 1990
CMS Care Compare ratings, data as of September 1, 2026 · CCN 345317 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on February 13, 2026, inspectors cited 4 health deficiencies (the North Carolina average is 4.7, the national average 9.2).
Of 38 health citations since October 2023, 2 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $166,075 in the last three years; the largest was $166,075, and the latest is dated October 30, 2025.
Nurses and nurse aides worked 3.11 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 0.45 of those hours.
77.8% of nursing staff left within the year CMS measured (North Carolina average 49.0%).
CMS links it to Simcha Hyman & Naftali Zanziper, an affiliated group of 79 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 38 health citations on file.
Inspectors wroteBased on observations and staff interviews, the facility failed to clean 1 of 1 walk-in refrigerator in the main kitchen, failed to label and date opened non-perishable food items stored in the dry goods pantry in the main kitchen, and failed to label juice stored for use in 1 of 2 nourishment refrigerators (Nourishment room [ROOM NUMBER]). This practice had the potential to affect the food served to residents.
Inspectors wroteBased on record review and staff interviews, the facility failed to accurately code the Minimum Data Set Assessments (MDS) for 1 of 29 residents whose MDS assessments were reviewed for accuracy (Resident #6).
Inspectors wroteBased on record review, and Nurse Practitioner, Pharmacist and Medical Director interviews, the facility failed to ensure that identified medication regimen irregularities were acted upon for 1 of 6 residents reviewed for medication regimen review (Resident #5). Findings Included:Resident #5 was admitted to the facility on [DATE] with diagnoses including bipolar disorder, schizoaffective disorder, depression, end stage renal disease with dependence on dialysis, and orthostatic hypotension. A review of physician orders for Resident #5 dated 10/16/2025 and 10/17/2025 revealed:- Midodrine HCl 5 milligram tablets, give 15 milligrams by mouth four times daily, and the medication order listed the diagnosis of hypokalemia. This medication is used to treat low blood pressure. [...]
Inspectors wroteBased on observation, record review, and staff interviews, the facility failed to ensure medications requiring refrigeration were stored in accordance with United States Pharmacopeia standards for 1 of 2 medication refrigerators reviewed for medication storage (Medication room [ROOM NUMBER]'s refrigerator). On 2/10/2026 at 1:33 pm, during an observation with the Director of Nursing (DON) of the medication refrigerator in Medication room [ROOM NUMBER], the refrigerator temperature gauge read 66 degrees Fahrenheit (F). There was a total of 52 medications stored inside of the refrigerator at the time of this observation. Those medications were: [...]
Inspectors wroteBased on observation, record review, and interviews with staff, Physician, Paramedics, and Fire Department First Responders, the facility failed to ensure basic lifesaving support was provided effectively when residents lost signs of life on weekends. The facility failed to ensure emergency equipment was in a place which would not delay resuscitation efforts for Resident # 21. One facility nurse (Nurse # 1) reported a delay in finding an AMBU bag (Artificial Manual Breathing Unit) to ventilate Resident # 21 and another facility nurse (Nurse # 2) along with emergency medical responders reported an AMBU bag was never used by facility staff to ventilate Resident # 21. (An AMBU bag is used to ventilate a resident who has stopped breathing so that with each chest compression oxygenated blood will circulate while resuscitation efforts are being conducted). [...]
Inspectors wroteBased on observation, record review, and interviews with resident, staff, responsible party (RP), Physician, Physician Assistant, Nurse Practitioner, and Hospice Nurse the facility failed to, 1) ensure the Wound Physician's unclear plan of pressure sore treatment for a resident (Resident # 17) was clarified 2) ensure a dressing was changed when a resident's (Resident # 17's) dressing saturated through to the pillowcase and the resident voiced pain from the pressure sore 3) ensure treatment orders were obtained and initiated when residents (Resident # 1 and Resident # 18) were identified with pressure sores (4) ensure nurses knew they were responsible for pressure sore care for residents (Resident # 1 and Resident # 26) and that care was completed and 4) ensure a nurse could access the treatment cart and supplies to change a pressure sore dressing (Resident # 26). [...]
Inspectors wroteBased on record review, staff interviews, and a pharmacy consultant interview, the facility failed to have effective systems in place for the return of controlled medications to the pharmacy for 4 of 4 medication carts (100-hall, 200-hall, 300-hall, 400-hall).
Inspectors wroteBased on observation, record review, and interviews with staff and Physician the facility failed to 1) ensure the plan of care for wounds following cancer surgery was clarified when two different providers were involved in overseeing the wounds (Resident # 8) and 2) Nurses who were responsible for wound care could access the Wound Physician's plan of care (Resident # 8) and therefore implement and follow it 3) that residents received wound care for skin cancer wounds (Resident # 8) and diabetic ulcer wounds (Resident # 1). This was for 2 of 3 sampled residents who had wounds which were not pressure related (Resident #8 and Resident #1).
Inspectors wroteBased on observation, record review, and interviews with staff the facility failed to ensure a working system to evaluate nurses' competency in skills, facility procedures, and knowledge. This was for 3 of 3 nurses reviewed for competency validation (Nurses # 2, # 6, and # 5).
Inspectors wroteBased on record review, observation and interviews with residents and staff, the facility failed to deliver meal trays at regular consistent, scheduled times while experiencing a problem with a broken oven. This issue affected 2 of 3 halls two halls reviewed for mealtime deliveries (200 hall and 400 hall). This deficient practice had the potential to affect multiple residents for meal delivery.
Inspectors wroteBased on record review and staff interview the facility failed to ensure the medical record was accurate and complete regarding the application of dressing changes for Residents # 8, # 17, and # 26. This was for 3 of 6 sampled residents with wounds which required dressings.
Inspectors wroteBased on observation, record review, and staff interviews the facility failed to ensure staff were knowledgeable that they should protect the privacy of a resident's medical information by not texting over a nonsecure personal phone to the Nurse Practitioner a resident's name and medical information. This was for 1 of 1 sampled resident reviewed for privacy of health care information (Resident #1).
Inspectors wroteBased on record review and interviews with staff, Nurse Practitioner, and Pharmacist, the facility failed to ensure a nurse knew he was responsible for a newly admitted resident in order that the nurse reconcile what medications had been given to the resident at the hospital, then validate with the facility provider what medications were needed on day of admission to the facility, and administer those medications (Resident # 1). Additionally, the facility failed to ensure nurses were knowledgeable about a newly admitted resident's medical history and could access the medical history when they were assigned to that resident (Resident # 1) and that a resident (Resident # 19) did not miss a dose of a medication ordered four times per day. This was for 2 or 10 residents reviewed for professional standards of practice (Resident #1 and Resident #19).
Inspectors wroteBased on record review and interviews with staff, the facility failed to ensure a diabetic resident who received all of his nutrition by way of enteral feeding (an enteral feeding is a method of providing nutrition for individuals who are unable to eat by mouth and involves using a feeding tube to deliver nutrients and fluids directly into the stomach or small intestine) received enteral feedings as ordered during two consecutive days. This was for 1 of 2 sampled residents who received enteral feedings (Resident #1).
Inspectors wroteBased on observation, record review, facility Wound Physician and staff interviews, the facility failed to administer four doses of an antibiotic as ordered by the physician for a resident's wound infection. This was for 1 of 7 residents whose medications were reviewed (Resident # 26).
Inspectors wroteBased on observation and interview with resident and staff the facility failed to provide palatable food to a resident when a burnt, blackened piece of toast was served to a resident. This was for 1 of 5 residents reviewed for dietary services provided to residents (Resident # 27).
Inspectors wroteBased on observation, record review, Responsible Party interview, and staff interview the facility failed to ensure the dietary electronic system worked in a manner that allowed for a resident to be served her preferences when the preferences were offered on the menu as an option and when the resident had impairment of her communication skills and could not verbally voice preferences when meals were served. This was for 1 of 5 sampled residents reviewed for dietary services (Resident # 4).
Inspectors wroteBased on observation, record review, and interviews with staff, Nurse Practitioner, Wound Physician, and hospice staff, the facility failed to ensure effective communication and coordination of care occurred with the hospice provider. On 10/17/25 Resident #26 was identified with a wound infection and facility nursing staff attempted to reach the hospice provider's on-call services on 10/17/25 and 10/18/25 to evaluate the resident and determine if an order was needed for an as needed (PRN) pain medication stronger than the resident's active PRN order for acetaminophen to have available to treat potential increased pain resulting from the wound infection. This deficient practice affected 1 of 2 sampled residents reviewed for coordination of hospice services (Resident #26).
Inspectors wroteBased on record review and staff interview the facility failed to maintain a kitchen oven in working condition which in turn affected meal delivery times. This was for 1 of 2 kitchen ovens (Oven # 1).
Inspectors wroteBased on interviews with resident, staff and the facility's pest control technician, the facility failed to communicate effectively amongst themselves and with their pest control technician regarding locations, extent, and times of live roach sightings in order that a plan be developed to treat and control the roaches. This was for rooms on 3 of 4 of four facility residential hallways (the 200, 300, and 400 hallways) and the service hallway.
Inspectors wroteBased on observation, record review, and interviews with resident, staff, Physician, Nurse Practitioner, and Pharmacist, the facility failed to provide services to ensure the accurate acquiring, dispensing, and administration of medications for three (Residents # 2, # 5, and #9) of five sampled residents whose medications were reviewed. For Residents # 5 and # 9 the facility failed to acquire and administer medications to newly admitted residents. For Resident # 2 the facility failed to ensure an effective system was in place for the accounting of a medication the resident supplied from home in order that unused medication be returned to the resident and that she not receive another resident's medication at discharge.
Inspectors wroteBased on record review and interviews with staff, Nurse Practitioner, and Pharmacist the facility failed to prevent significant medication errors for two (Residents # 5 and #9) of five sampled residents whose medications were reviewed. For Resident # 5 the facility failed to ensure her Insulin, anticoagulant, and neuropathy medications were administered on the evening of her admission. Following the missed neuropathy medication on Resident # 5's admission date, the facility failed to administer the neuropathy medication on seven more occasions during consecutive days for Resident # 5. The facility failed to obtain and administer an antibiotic to Resident # 9.
Inspectors wroteBased on record review, and interviews with resident and staff, the facility failed to have a system in place to ensure clean linens were available for two (Resident 7 and Resident #8) of eight sampled residents who were interviewed and which resulted in Resident # 8 having no linens to bathe before leaving for an outside appointment.
Inspectors wroteBased on observation, record review, and interviews with resident, staff, and the facility's pest control company technician, the facility failed 1) to make sure holes to the exterior were repaired and sealed to prevent pests from entering in her room and 2) ensure multiple doors in common areas in the facility had weather stripping to seal gaps for one (Resident # 12) of one sampled resident who reported unresolved and repetitive pests issues in her room.
Inspectors wroteBased on observations and staff interviews the facility failed to label and date leftover food items stored in the walk-in refrigerator for one of one walk in refrigerators observed for food storage. This practice had the potential to affect food served to residents.
Inspectors wroteBased on record review and staff interviews the facility failed to accurately code the Minimum Data Set (MDS) assessment in the area of medication for 2 of 20 residents (Resident #2 and Resident #17)whose MDS was reviewed.
Inspectors wroteBased on record review, staff, resident, and family interviews, the facility failed to invite residents to care plan meetings (Resident #40, Resident #16, and Resident #79) for 3 of 3 residents reviewed for care planning.
Inspectors wroteBased on observation, record review, and staff interviews, the facility failed to maintain a medication administration error rate of less than 5% when a nurse failed to prime an insulin pen and failed to administer Tylenol as ordered by the physician. This resulted in an error rate of 8% for 2 of 25 opportunities observed during medication pass. (Resident #95)
Inspectors wroteBased on observations, record review, and staff interviews the facility failed to implement their infection control policy when Nurse Aide (NA) #1 did not perform hand hygiene during meal delivery and set-up after knocking on the room door, handling the bed control, moving the overbed table and handling bed linens for 1 of 2 NAs observed passing meal trays on 1 of 4 halls. This had the potential to result in the cross contamination of microorganisms (germs) between residents.
Inspectors wroteBased on record review, and interviews with resident and staff the facility failed to provide discharge planning for a cognitively intact resident who was admitted to the facility for short term rehabilitation with the goal to discharge home to her previous residence in the community. Soon after admission, Resident #9 decided she was unhappy at the facility and preferred to receive rehabilitation at home rather than the facility and she voiced her desire to return home to staff. Discharge planning had not been addressed with the resident resulting in the resident leaving the facility with transportation provided by her friend. This was for one of four sampled residents discharged during the week or following the week of the facility's social worker's absence due to illness.
Inspectors wroteBased on record review and interviews with staff, family, and physicians, and laboratory employees the facility failed to 1) ensure they identified when a resident initially developed arterial wounds to his feet to ensure the resident received treatment and services at onset of the wounds and 2) recognize a critical hemoglobin level reported to them needed follow up and the lab needed redrawn as ordered by the physician so a determination could be made if the hemoglobin was continuing to drop (Resident # 2). This was for two (Resident # 1 and # 2) of three residents reviewed for medical services being provided per professional standards of care.
Inspectors wroteBased on record review and interviews with resident and staff, the facility failed to identify a resident, for whom they were accountable, was missing from the facility. The resident left the facility and returned home without anyone realizing she was missing until the day following her departure. This was for one (Resident #9) of one resident reviewed for supervision.
Inspectors wroteBased on record review and interviews with staff, pharmacist and physician the facility failed to ensure a resident's medications were available for administration for one (Resident # 9) of one sampled resident reviewed for medication administration.
Inspectors wroteBased on record review and interviews with staff and the facility's lab company employees, the facility failed to ensure there was effective communication between facility staff and the lab company to avoid a lapse of multiple days between a failed lab draws and the next attempt to obtain a successful lab result for a physician ordered lab. This was for one (Resident # 2) of three residents whose labs were reviewed.
Inspectors wroteBased on record review, staff interview, and resident interview the facility failed to ensure a resident's record accurately reflected a resident's signature on a form indicating the resident left the facility against medical advice. This was for one (Resident # 9) of one sampled resident who had documentation the resident left against medical advice.
Inspectors wroteBased on observation, record review, and interviews with residents, staff, dialysis staff, transport company staff, and the facility's pest control provider's service technician, the facility failed to ensure a system was in place on three of four halls to ensure ants did not climb into residents' beds or on residents while the pest control company was baiting underground ant colonies while trying to eradicate them.
Inspectors wroteBased on observation, record review, staff interview, physicians' interview, and interviews with dermatology office staff, the facility failed to follow through in referring a resident to a dermatologist for treatment after the resident was identified to have basal cell carcinoma. This was for one (Resident # 12) of four residents reviewed for professional standards in the provision of medical care.
Inspectors wroteBased on record review, staff interviews, and pharmacist interview the facility failed to ensure accurate accounting for the dispensing and receipt of 15 tablets of Oxycodone. This was for one (Resident # 5) of one sampled resident whose Oxycodone was reported by the pharmacy as delivered but reported by the facility as not definitively received.
13 fire safety citations on file: 9 on February 13, 2026, 4 on November 27, 2024.
| Date | Penalty | Amount or length |
|---|---|---|
| October 30, 2025 | Fine | $166,075 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | North Carolina | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.11 | 3.85 | 3.86 |
| Registered nurses | 0.45 | 0.62 | 0.69 |
| All nursing staff on weekends | 2.66 | 3.42 | 3.42 |
| Nurse aides | 1.69 | ||
| Licensed practical nurses | 0.97 | ||
| Nursing staff turnover (share who left in a year) | 77.8% | 49.0% | 45.8% |
| Registered nurse turnover | 75.0% | 45.6% | 42.9% |
| Administrators who left | 2 |
CMS expects 3.54 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.29 on weekdays and 2.66 on weekends, 19% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 19.2% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.17 in April to June 2025 to 3.11 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.11 | 0.45 | 3.29 | 2.66 | 19.2% | 0 of 90 | 86 |
| Oct to Dec 2025 | 3.48 | 0.51 | 3.66 | 3.02 | 20.4% | 2 of 92 | 79 |
| Jul to Sep 2025 | 3.28 | 0.43 | 3.44 | 2.88 | 11.5% | 2 of 92 | 82 |
| Apr to Jun 2025 | 3.17 | 0.31 | 3.38 | 2.64 | 14.9% | 1 of 91 | 83 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| North Carolina, Jan to Mar 2026 | 3.65 | 0.53 | 3.82 | 3.25 | 8.0% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| North Carolina, all employers | |||
| CNAs (nursing assistants) | $18.49 | $17.28 to $21.08 | 64,010 |
| LPNs and LVNs | $30.42 | $28.50 to $33.51 | 18,010 |
| Registered nurses | $40.56 | $37.87 to $49.06 | 111,120 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | North Carolina | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 15.3 | 15.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.7 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 3.9 | 2.3 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.1 | 3.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.8 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 15.8 | 18.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 8.8 | 5.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 12.3 | 14.0 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 22.8 | 22.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 11.1 | 12.9 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.6 | 1.8 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.3 | 1.8 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Clayton Rehabilitation and Healthcare Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (49.8% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
49.8% this home
No different from the national rate
US median of homes 51.5% · North Carolina: 93 better, 25 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 160 eligible stays.
12.8% this home
No different from the national rate
US median of homes 10.7% · North Carolina: 1 better, 4 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 167 eligible stays.
9.4% this home
No different from the national rate
US median of homes 7.1% · North Carolina: 1 better, 3 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 94 eligible stays.
71.7% this home
Median of homes: North Carolina54.0% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 53 residents counted.
0.0% this home
Median of homes: North Carolina0.6% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 82 residents counted.
13.7% this home
Median of homes: North Carolina2.5% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 82 residents counted.
97.6% this home
Median of homes: North Carolina97.5% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 41 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: CLT OPCO LLC. CMS links this home to Simcha Hyman & Naftali Zanziper, a group of 79 nursing homes averaging 2.7 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Nc East Holding LLC | 5% or greater direct ownership interest | Organization | 100% | 07/01/2022 |
| Alter, Tzvi | 5% or greater indirect ownership interest | Individual | 80% | 07/01/2022 |
| Davis, Jennifer | W-2 managing employee | Individual | 07/01/2022 | |
| Alter, Tzvi | Corporate director | Individual | 07/01/2022 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
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