Home / North Carolina / Lillington
54 Red Mulberry Way, Lillington, NC 27546 · Harnett County · (910) 814-8030
96 certified beds, about 92 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1978
CMS Care Compare ratings, data as of September 1, 2026 · CCN 345173 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on July 24, 2025, inspectors cited 5 health deficiencies (the North Carolina average is 4.7, the national average 9.2).
None of its 20 health citations since January 2023 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.26 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 0.50 of those hours.
44.4% of nursing staff left within the year CMS measured (North Carolina average 49.0%).
CMS links it to Saber Healthcare Group, an affiliated group of 126 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 20 health citations on file.
Inspectors wroteBased on record review, and interviews with resident, staff, and Physician, the facility failed to communicate with the physician and obtain further instructions 1) regarding steps to take when a rehabilitation resident was refusing to cooperate with safety recommendations while experiencing difficulty and pain while transferring in the manner she was attempting and which was not recommended by therapy and 2) when the resident screamed during the transfer, reported pain following the transfer, and requested to go to the hospital. This was for 1 of 3 residents reviewed for accidents (Resident # 1).
Inspectors wroteBased on observations, record review, and interviews with resident, staff, and Physician the facility failed to 1) assist a resident, who had been experiencing problems following surgery, in a transfer manner recommended by physical therapy and 2) failed to stop and communicate with the physician and the Director of Nursing for further directions when a resident was refusing a safe transfer technique before proceeding to attempt the transfer. This was for 1 of 3 residents reviewed for accidents (Resident #1).
Inspectors wroteBased on observations, records reviews, and staff interviews, the facility failed to follow the approved menu related to portion size. Seven (7) of 7 residents with physician-ordered large or double portions were served a single portion (Residents #21, #26, #36, #37, #6, #47, and #52). Seven (7) of 7 residents ordered a pureed diet received 4 ounces (oz.) of chili instead of 6 oz as specified on the menu (Residents #22, #2, #11, #1, #74, #80, and #90). Twelve (12) residents with an order for a regular or mechanical soft, low concentrated sweets diet received a full slice of cake rather than a half slice of cake as indicated on the menu (Residents #29, #30, #41, #49, #65, #69, #70, #72, #75, #79, #84, and #93). This deficient practice affected 26 of 91 residents.
Inspectors wroteBased on observations, record review, and interviews with staff, the facility failed to ensure dishware and cookware were washed and sanitized according to the manufacturer's recommendations for 1 of 1 dishwashing machine and 1 of 1 three compartment sink. This practice had the potential to affect food served to residents.
Inspectors wroteBased on staff and Resident Representative interviews and record review, the facility failed to maintain accurate code status information throughout the medical record for 1 of 15 residents reviewed for advance directives (Resident #11).
Inspectors wroteBased on record review and staff interviews, the facility failed to accurately code the Minimum Data Set (MDS) assessment in the area of Swallowing/Nutritional Status for 1 of 24 residents reviewed for accuracy of the MDS (Resident #80).
Inspectors wroteBased on observations, record review, and interviews with staff and Medical Director, the facility failed to provide fortified foods as ordered by the physician for weight loss and wound healing for 2 of 2 residents reviewed for nutrition (Residents #80 and #25).
Inspectors wroteBased on record reviews and staff interviews, the facility failed to schedule a Registered Nurse (RN) for at least 8 consecutive hours per day, 7 days a week for 1 of 36 days reviewed for sufficient staffing (4/13/24).
Inspectors wroteBased on observation, record review, staff interview, pharmacy interview and Physician interview, the facility failed to have a medication error rate less than 5% as evidenced by 6 medication errors out of 29 opportunities, resulting in a medication error rate of 20.69% for 1 of 2 residents observed during the medication administration observations.
Inspectors wroteBased on observations and staff interviews, the facility failed to maintain kitchen equipment in a clean and sanitary condition to prevent cross contamination by failing to clean under the shelf of 1 of 1 steam table observed. This practice had the potential to affect food served to the residents in the facility.
Inspectors wroteBased on record review, North Carolina Board of Nursing (NCBON) verification registry and staff interviews, the facility failed to verify a staff member working as a nurse (Nurse Aide #7) had an active professional nursing license with the NCBON for 1 of 4 nursing staff reviewed. NA #7 was in nursing school, did not have a professional nursing license and performed the job responsibilities of a nurse.
Inspectors wroteBased on record review, resident interview, staff interviews and Physician #1 interview the facility failed to complete an accurate medical record in documenting blood glucose (sugar) levels and sliding scale insulin coverage of blood glucose levels (Resident #66), the administration of enteral feedings (Resident #76), and the administration of medications (Resident #66, Resident #76 and Resident #245) for 3 of 10 residents whose medication regimen was reviewed.
Inspectors wroteBased on record reviews, residents and staff interviews, the facility failed to allow a resident to participate in the development of their care plan for 1 of 6 residents reviewed for care plan participation (Resident # 66).
Inspectors wroteBased on record review, resident interview and staff interviews, the facility failed to provide incontinence care to a resident that was incontinent for 1 of 4 residents dependent on staff for activities of daily living (ADL) care (Resident #244).
Inspectors wroteBased on record review, observation, and family, staff and physician interviews, the facility failed to implement interventions to reduce the risk for further falls for a resident at high risk for falls for 1 of 4 residents reviewed for accidents (Resident #82).
Inspectors wroteBased on record review, and staff and Medical Director (MD) interviews, the facility failed to ensure a resident did not receive anticoagulant medication (blood thinner) that had been discontinued for a resident with a subdural hematoma (brain bleed) and at risk for falls for 1 of 3 residents reviewed for unnecessary medications (Resident #82).
Inspectors wroteBased on observations and staff interviews, the facility failed to ensure the area surrounding the one dumpster on the campus was free of debris and the dumpster door was closed for 2 or 2 observations.
Inspectors wroteBased on observations, resident interviews and staff interviews, the facility failed to display survey results in a location accessible to residents during observations of the facility. This failure affected all residents in the facility.
Inspectors wroteBased on record review, resident interview and staff interviews, the facility failed to ensure staff spoke to a resident in a respectful and dignified manner for 1 of 1 resident (Resident #44) reviewed for dignity.
Inspectors wroteBased on observations and staff interviews, the facility failed to discard an expired medication and store Gabapentin liquid, a seizure medication, in the refrigerator as indicated on the pharmacy label and bottle of medication for 1 of 2 medications carts observed (Front 300-Hall Medication Cart).
10 fire safety citations on file: 5 on May 28, 2024, 5 on January 6, 2023.
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
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) | 3.26 | 3.85 | 3.86 |
| Registered nurses | 0.50 | 0.62 | 0.69 |
| All nursing staff on weekends | 2.79 | 3.42 | 3.42 |
| Nurse aides | 1.93 | ||
| Licensed practical nurses | 0.84 | ||
| Nursing staff turnover (share who left in a year) | 44.4% | 49.0% | 45.8% |
| Registered nurse turnover | 50.0% | 45.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.08 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 3.45 on weekdays and 2.79 on weekends, 19% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 3.1% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.36 in April to June 2025 to 3.26 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 | 3.26 | 0.50 | 3.45 | 2.79 | 3.1% | 0 of 90 | 92 |
| Oct to Dec 2025 | 3.27 | 0.34 | 3.47 | 2.78 | 4.5% | 0 of 92 | 91 |
| Jul to Sep 2025 | 3.30 | 0.39 | 3.52 | 2.74 | 3.3% | 0 of 92 | 90 |
| Apr to Jun 2025 | 3.36 | 0.41 | 3.58 | 2.81 | 4.4% | 0 of 91 | 90 |
| 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 | 3.3 | 15.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 2.3 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.0 | 3.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.5 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 6.0 | 18.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.0 | 5.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 12.4 | 14.0 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 27.3 | 22.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 11.5 | 12.9 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Emerald Health & Rehab Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it better than the national rate (61.5% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
61.5% this home
Better than 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. 187 eligible stays.
10.8% 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. 188 eligible stays.
6.3% 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. 131 eligible stays.
32.5% 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. 80 residents counted.
0.9% 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. 113 residents counted.
0.0% 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. 113 residents counted.
85.7% 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. 35 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: HARNETT HEALTHCARE GROUP, LLC. CMS links this home to Saber Healthcare Group, a group of 126 nursing homes averaging 2.9 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Bundle Tenant LLC | 5% or greater direct ownership interest | Organization | 07/09/2015 | |
| Saber Governance LLC | 5% or greater direct ownership interest | Organization | 01/01/2020 | |
| Shg Management LLC | 5% or greater direct ownership interest | Organization | 01/01/2020 | |
| Bundle Tenant LLC | 5% or greater indirect ownership interest | Organization | 01/01/2023 | |
| Saber Governance LLC | 5% or greater indirect ownership interest | Organization | 01/01/2023 | |
| Shg Management LLC | 5% or greater indirect ownership interest | Organization | 01/01/2023 | |
| Volpe, Benjamin | Corporate director | Individual | 03/01/2019 | |
| Weisberg, William | Corporate director | Individual | 03/01/2019 | |
| Nicoluzakis, Gregory | Corporate officer | Individual | 03/01/2019 | |
| Volpe, Benjamin | Corporate officer | Individual | 03/01/2019 | |
| Weisberg, William | Corporate officer | Individual | 03/01/2019 | |
| Saber Governance LLC | Operational/managerial control | Organization | 09/01/2019 | |
| Davis, Tim | Operational/managerial control | Individual | 07/02/2025 | |
| Joiner, Brian | Operational/managerial control | Individual | 12/17/2023 | |
| Bundle Tenant LLC | Adp of the SNF | Organization | 05/08/2026 | |
| Citrin Cooperman Advisors LLC | Adp of the SNF | Organization | 08/01/2012 | |
| Harnett Health Investors LP | Adp of the SNF | Organization | 08/01/2015 | |
| The Huntington National Bank | Adp of the SNF | Organization | 07/19/2019 | |
| Walker & Associates PC | Adp of the SNF | Organization | 12/18/2023 | |
| Joiner, Brian | Adp of the SNF | Individual | 12/17/2023 | |
| Pieper, Joel | Adp of the SNF | Individual | 01/09/2023 |
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.
These are the official offices in North Carolina. NursingHomeClear cannot take or act on complaints.