Home / North Carolina / Rich Square
300 North Main Street, Rich Square, NC 27869 · Northampton County · (252) 539-4161
69 certified beds, about 66 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1991
CMS Care Compare ratings, data as of September 1, 2026 · CCN 345356 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on July 2, 2025, inspectors cited 10 health deficiencies (the North Carolina average is 4.7, the national average 9.2).
Of 27 health citations since February 2023, 7 were rated as actual harm or immediate jeopardy to residents (7 immediate jeopardy).
CMS lists 1 fine totaling $190,684 in the last three years; the largest was $190,684, and the latest is dated November 21, 2023.
Nurses and nurse aides worked 3.17 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 0.41 of those hours.
52.1% of nursing staff left within the year CMS measured (North Carolina average 49.0%).
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 27 health citations on file.
Inspectors wroteBased on staff interview and review of the Facility Assessment the facility failed to ensure the required parties were involved in the development the Facility Assessment, failed to: have an accurate facility assessment that recorded the current administrative staff and Medical Director, ensure the staffing plan considered specific staffing needs for each unit and shift as required, provide information regarding the skills and competencies that were required for licensed nursing staff and Certified Nurse Aides (CNAs), and have an accurate staff type and position list. This deficient practice had the potential to affect 54 of 54 residents.
Inspectors wroteBased on record reviews, and staff and Nurse Practitioner interviews, the facility failed to provide written information to the resident and/or resident representative pertaining to their right to accept or refuse medical/surgical treatment and the opportunity to formulate an Advance Directive for 1 of 7 sampled residents (Resident #1).
Inspectors wroteBased on record reviews and staff interviews, the facility failed to provide a Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) (form 10055) prior to discharge from Medicare Part A skilled services for 2 of 3 residents reviewed for beneficiary notification (Resident #19 and Resident #108).
Inspectors wroteBased on observations, record review, and resident and staff interviews, the facility failed to accurately code the Minimum Data Set (MDS) assessment in the areas of use of anticonvulsant medication (Resident #45), resident prescribed diet (Resident #6), and use of a hearing aid (Resident #25) for 3 of 21 residents whose MDS assessments were reviewed.
Inspectors wroteBased on observations, record review, and resident and staff interviews, the facility failed to develop a person-centered care plan in the areas of use of side rails for positioning (Resident #45), and hearing loss with use of a hearing aid (Resident #25) for 2 of 21 residents whose care plans were reviewed.
Inspectors wroteBased on observations, record review, and staff interviews, the facility failed to revise the care plan in the areas of pain management, hypertension management, and anticoagulant (blood thinner) medication use (Resident # 18) and the use of a wander/elopement alarm (Resident #45) for 2 of 21 residents whose care plans were reviewed.
Inspectors wroteBased on observations, record review, and staff, Pharmacy Consultant and Nurse Practitioner (NP) interviews, the facility failed to clarify the physician orders for lidocaine 4% external pain patches that resulted in the pain patches remaining on the resident's skin over the manufacturer's recommended duration of 12 hours. This deficient practice was for 1 of 3 residents observed for medication administration (Resident #15).
Inspectors wroteBased on record review, observations, and staff, Nurse Practitioner and Registered Dietitian (RD) interviews, the facility failed to provide nutritional supplements to prevent further weight loss as recommended by the RD and prescribed by physician (Resident #45) for 1 of 3 residents reviewed for nutrition.
Inspectors wroteBased on observations, record review, and staff interviews, the facility failed to implement their infection prevention program policies and procedures when Nurse #2 failed to perform hand hygiene between glove changes during the observation of medication administration for 1 of 4 staff observed for infection control practices (Nurse #2).
Inspectors wroteBased on record review and staff interviews, the facility failed to notify the Ombudsman in writing of a resident transfer to the hospital for 2 of 2 residents reviewed for hospitalization (Resident #25 and Resident #57).
Inspectors wroteBased on staff interviews and record review the facility failed to perform a Significant Change in Status Minimum Data Set (MDS) assessment for 1 of 1 resident reviewed for hospice care (Resident #38).
Inspectors wroteBased on record review, observations and staff interviews, the facility failed to obtain a physician order for the use of supplemental oxygen and apply signage indicating the use of oxygen outside the resident's room for 1 of 3 residents reviewed for oxygen use (Resident #152).
Inspectors wroteBased on record review and staff interviews, the facility failed to document providing education of the influenza vaccine (2023-2024 season) and pneumococcal vaccine and the resident's or resident representative's refusal to receive the influenza vaccine (2023-2024 season) and pneumococcal vaccine for 2 of 6 residents reviewed for immunizations (Resident #41 and Resident #152).
Inspectors wroteBased on record review and staff interviews, the facility failed to document providing education of the COVID (2023-2024 season) vaccine and the resident's or resident representative's refusal to receive the COVID (2023-2024 formula) vaccine for 2 of 6 residents reviewed for immunizations (Resident #41 and Resident #152).
Inspectors wroteBased on record review, resident interview and staff interviews, the facility failed to provide written notice of transfer/discharge to the resident and to the ombudsman for the resident who was transferred from the facility to the hospital for 1 of 2 residents reviewed for hospitalization (Resident #29).
Inspectors wroteBased on record review, resident interview and staff interviews, the facility failed to provide the bed hold policy in writing at the time of transfer to 1 of 2 residents reviewed for discharged to the hospital (Resident #29). This practice had the potential to impact other residents.
Inspectors wroteBased on record review and interviews with staff, Emergency Medical Services (EMS) personnel, pharmacist, and physician, the facility failed to identify the seriousness of seizure activity on 12/4/23 and the need for medical intervention for a resident with a history of seizures who had not been provided with his anti-seizure medication (Vimpat) since 11/25/23. Resident #3 had four incidents of seizure activity between 12/4/23 and 12/5/23. Following the fourth seizure (12/5/23) the physician ordered Ativan (an antianxiety medication commonly used as a rescue medication for seizures) via intramuscular (IM) injection and the facility staff were unable to access the emergency Ativan medication supply to treat the resident in the facility. [...]
Inspectors wroteBased on observation, record review, interviews with residents, staff, dialysis center nurse, and Emergency Medical Services staff, the facility failed to provide safe transportation in the facility's transportation van and to ensure wheelchairs were utilized during transportation in accordance with manufacturer's instructions for 2 of 4 residents reviewed for accidents (Resident #1 and Resident #2). On 11/1/23 Transportation Assistant #1 utilized a geriatric chair (a padded chair with a wheeled base) to transport Resident #1 and during transportation the resident slid out of the chair onto the floor of the van. Resident #1 was not injured. On 11/27/23 Transportation Assistant #1 did not buckle Resident #2's seatbelt and during transportation the resident fell out of the wheelchair and onto the floor of the van. Resident #2 reported pain in her right shoulder the following day. [...]
Inspectors wroteBased on observation, record reviews and interviews with residents, staff, dialysis center nurse, and Emergency Medical Services staff, the facility failed to ensure Transportation Assistant #1, who was also a facility Nurse Aide, was trained by staff who was aware of the facility's transportation van's manufacturer's instructions for safe securement when Nurse Aide #1 provided her with training. Nurse Aide #1 was not aware that transporting a resident in a geriatric chair (a padded chair with a wheeled based) was not in accordance with the transportation van's manufacturer's instructions. In addition, the facility failed to verify Transportation Assistant #1's competency to ensure resident safety during transportation for 1 of 1 staff who transported residents in the facility's transportation van. [...]
Inspectors wroteBased on record review and interviews with staff, pharmacist, and physician, the facility failed to obtain an anti-seizure medication for a resident with a history of seizures resulting in 22 missed doses of the medication and to have staff capable of accessing the emergency medication supply to treat a medical emergency. Resident #3 was ordered Vimpat two times a day for seizures and from 11/25/23 through 12/5/23 the resident did not receive the medication as it was not obtained from the pharmacy. Resident #3 had four incidents of seizure activity between 12/4/23 and 12/5/23. Following the fourth seizure (12/5/23) the physician ordered Ativan (an antianxiety medication commonly used as a rescue medication for seizures) via intramuscular (IM) injection and the facility staff were unable to access the emergency medication supply. [...]
Inspectors wroteBased on record review and interviews with staff, Emergency Medical Services (EMS) personnel, pharmacist, and physician interviews, the facility failed to administer an anticonvulsant medication to a resident for a period of 10 and half consecutive days and doses (11/25/23 through 12/5/23). Resident #3 had four incidents of seizure activity between 12/4/23 and 12/5/23. EMS was contacted on 12/5/23 and the resident was transported to the emergency room (ER) where Vimpat was administered. The resident had no further seizure activity after receiving Vimpat in the ER and was discharged back to the facility the same day. Upon return to the facility the resident was not administered one dose of the anticonvulsant on 12/6/23 for a total of 22 missed doses. This occurred for 1 of 3 residents (Resident #3) whose medications were reviewed. [...]
Inspectors wroteBased on observation, record review, interviews with residents, staff, dialysis center nurse, and Emergency Medical Services staff, pharmacist and physician, the facility failed to provide effective leadership and oversight to ensure systems and processes were in place as evidenced by numerous deficient practices in multiple regulatory groupings resulting in immediate jeopardy and substandard quality of care. These high severity deficiencies were in the areas of physician notification, management of change in condition, safe transportation of residents, competent nursing staff, routine and emergency medication availability, accessibility and administration. Residents #1 and #2 were not transported in the van safely using transport chairs and fastening seat belts. Resident #3 did not receive his seizure medication as ordered and experienced seizure activity. [...]
Inspectors wroteBased on record review and interviews with staff and physician, the facility failed to notify the physician of a medical emergency when Resident # 3 had seizure activity. Resident #3 had four incidents of seizure activity between 12/4/23 and 12/5/23. Emergency Medical Services (EMS) was contacted and the resident was transported to the emergency room (ER) where Vimpat (anti-seizure medication) was administered. The resident had no further seizure activity after receiving Vimpat and was discharged back to the facility the same day. This occurred for 1 of 3 residents (Resident #3) reviewed for notification of change. Immediate Jeopardy began on, 12/04/23, when the facility failed to notify the physician when Resident #3 had seizure activity. The immediate jeopardy was removed on 12/23/23 when the facility provided an acceptable credible allegation for immediate jeopardy removal. [...]
Inspectors wroteBased on record review and staff interview the facility's Quality Assessment and Assurance Committee failed to maintain implemented procedures and monitor interventions that the committee had previously put in place following the recertification and complaint investigation survey of 1/11/22. The deficiency is in the area of providing oversight and leadership to ensure and maintain effective systems and processes (F835). The continued failure during two federal surveys showed a pattern of the facility's inability to sustain an effective Quality Assurance Program.
Inspectors wroteBased on record review 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 10 of 63 days reviewed for sufficient staffing (4/30/23, 5/27/23, 6/03/23, 6/04/23, 6/10/23, 6/11/23, 6/17/23, 6/18/23, 6/24/23, and 6/25/23).
Inspectors wroteBased on observation, record review, Rehabilitation Director, and staff interviews, the facility failed to place hand splint to left hand for contracture management for 1 of 2 residents observed for range of motion (Resident #10).
Inspectors wroteBased on observations and staff interviews, the facility failed to maintain a clean and sanitary homelike environment by failing to clean tube feeding poles, and floor near tube feed poles for 2 of 2 residents reviewed for receiving tube feedings. (Resident #42, and #5).
8 fire safety citations on file: 1 on July 2, 2025, 3 on June 6, 2024, 2 on February 23, 2023, 2 on January 11, 2022.
| Date | Penalty | Amount or length |
|---|---|---|
| November 21, 2023 | Fine | $190,684 |
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) | 3.17 | 3.85 | 3.86 |
| Registered nurses | 0.41 | 0.62 | 0.69 |
| All nursing staff on weekends | 2.69 | 3.42 | 3.42 |
| Nurse aides | 1.91 | ||
| Licensed practical nurses | 0.85 | ||
| Nursing staff turnover (share who left in a year) | 52.1% | 49.0% | 45.8% |
| Registered nurse turnover | 62.5% | 45.6% | 42.9% |
| Administrators who left | 2 |
CMS expects 3.80 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 3.36 on weekdays and 2.69 on weekends, 20% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 1.7% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.65 in April to June 2025 to 3.17 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 | 3.17 | 0.41 | 3.36 | 2.69 | 1.7% | 0 of 90 | 66 |
| Oct to Dec 2025 | 1.33 | 0.10 | 1.44 | 1.06 | 0.4% | 59 of 92 | 60 |
| Jul to Sep 2025 | 3.55 | 0.32 | 3.77 | 3.00 | 5.2% | 0 of 92 | 53 |
| Apr to Jun 2025 | 3.65 | 0.49 | 3.89 | 3.05 | 11.7% | 0 of 91 | 54 |
| 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 | 7.3 | 15.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.4 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.6 | 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 | 1.8 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 9.3 | 18.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 7.8 | 5.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 14.2 | 14.0 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 26.1 | 22.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 13.9 | 12.9 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.3 | 1.8 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.9 | 1.8 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Rich Square Health & Rehabilitation Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (50.7% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
50.7% 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. 81 eligible stays.
9.3% 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. 94 eligible stays.
8.8% 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. 53 eligible stays.
40.5% 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. 37 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. 53 residents counted.
4.9% 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. 53 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
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. 18 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: Legal Business Name Not Available.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Ownership data not available |
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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