CCN 345511
Autumn Care of Statesville
2001 Vanhaven Drive, Statesville, NC 28625 · Iredell County
- Ownership
- For profit - Limited Liability company
- Certified beds
- 103
- Residents per day
- 97.4
- Health citations
- 8
- Penalties
- 0
- Fines
- 0 · $0
Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Staffing hours
Reported hours per resident per day come from the Payroll-Based Journal figures in the Provider Information file. Case-mix and adjusted hours account for how much care CMS expects given the residents’ needs. State and U.S. figures are averages from the same release.
- Measure
- This home
- State
- U.S.
- Nurse aide
- 2.27
- 2.34
- 2.32
- LPN/LVN
- 0.90
- 0.89
- 0.86
- Registered nurse
- 0.37
- 0.62
- 0.69
- Total nurse staff
- 3.54
- 3.85
- 3.86
- Weekend total
- 3.03
- 3.42
- 3.42
- Weekend RN
- 0.24
- 0.42
- 0.48
Adjusted total nurse hours: 3.56. Adjusted RN hours: 0.37. Case-mix total: 3.81. Case-mix index: 1.393.
Total nursing staff turnover: 55.2%. RN turnover: 27.3%. Administrators who left: 1.
How to read staffing hours
Payroll-Based Journal figures in Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Fines and penalties
CMS reports 0 fines totaling $0, and 0 payment denials.
The Penalties file has no individual penalty rows for this CCN.
Cycle 1 standard survey: July 1, 2026. Health deficiencies counted in cycle 1: 2. Cycle 1 total health score: 8.
Cycle 2 standard survey: April 16, 2025. Cycle 2/3 health deficiencies: 3. Total weighted health survey score: 9.
Penalties file and Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Health inspection citations
The Health Deficiencies file lists 8 citations for this home, including 0 at immediate jeopardy and 0 at actual harm. CMS may display some citations here that are not used in the health inspection rating, including citations under dispute.
July 1, 2026
2 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F602 | Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Complaint survey · Standard survey · Cycle 1 | D: isolated, no actual harm, with potential for more than minimal harm | Past Non-Compliance · April 2, 2026 |
| F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Standard survey · Cycle 1 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · July 21, 2026 |
April 16, 2025
3 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F554 | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · Standard survey · Cycle 2 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · May 9, 2025 |
| F578 | 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. Resident Rights Deficiencies · Standard survey · Cycle 2 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · May 9, 2025 |
| F880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Standard survey · Cycle 2 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · May 9, 2025 |
February 8, 2024
3 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F695 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Standard survey · Cycle 3 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · February 27, 2024 |
| F867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Administration Deficiencies · Standard survey · Cycle 3 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · February 27, 2024 |
| F880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Standard survey · Cycle 3 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · February 27, 2024 |
Health Deficiencies. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections