Skilled nursing facility · CMS certification number 115727
Jeffersonville Care Center LLC
Jeffersonville, Georgia · Medicare and Medicaid
Certified beds, as filed in Care Compare: 131
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 1 · Fines: 1 · Fines, total amount: $4,119.00 · Payment denials: 0. The most recent penalty on file: April 9, 2026, Payment Denial. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, as submitted, processed by CMS on June 23, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,792,386 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$370,010 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,162,396 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,390,542 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$228,146 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,042 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$223,104 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$223,104 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 47,946 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 2,390 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 25,968 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,285 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 30,643 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 32 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 140 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 50 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 222 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 74.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 185.49 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 138.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1429803, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 11, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,785,474 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $865,600 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,919,874 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,438,147 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$518,273 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $100,161 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$418,112 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$418,112 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,857 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 429 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 67.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 95.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 81.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438736, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on June 12, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,658,994 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,122,069 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,536,925 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,155,441 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$618,516 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,579 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$579,937 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$579,937 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 38,425 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 380 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 60.85 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 116.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 101.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1382882, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 12, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,790,432 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $159,403 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,631,029 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,583,556 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $47,473 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,324,366 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,371,839 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,371,839 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,187 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 435 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 70.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 100.48 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1337981, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 1, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,877,374 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,080,155 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,797,219 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,294,412 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$497,193 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $722,812 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,619 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $225,619 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,095 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 437 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 82.96 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 91.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1328447, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 13, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,287,013 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $402,027 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,884,986 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,793,882 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $91,104 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$14,951 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $76,153 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $76,153 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,966 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 232 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 89.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 210.9 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 155.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1306948, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 8, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,578,179 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $507,364 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,070,815 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,910,002 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $160,813 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$10,296 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $150,517 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $150,517 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,358 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 453 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 94.01 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 73.64 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1275251, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for December 12, 2016 to December 31, 2017 — a reporting period of 384 days, on form CMS-2540-10, settled, processed by CMS on December 20, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,458,660 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $553,231 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,905,429 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,290,399 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$384,970 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$11,494 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$396,464 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$396,464 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,843 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 200 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 55.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 104.79 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 84.22 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1248424, read from the public cost report file SNF10FY2017.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| No owner named in the filing | Ownership Data Not Available | Not stated in the filing | Not stated in the filing | Not stated in the filing |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of JV JEFFERSONVILLE LLC (enrollment ID O20161229000744).
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| DAVID K LEMCKE | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 30 | 11/14/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KAREN D FORRISTER | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 70 | 11/14/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID K LEMCKE | Individual | CORPORATE OFFICER | Not stated in the filing | 2/16/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KAREN D FORRISTER | Individual | CORPORATE OFFICER | Not stated in the filing | 11/14/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KAREN D FORRISTER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/16/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PEACH HEALTH GROUP LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/17/2016 | Private equity company: No Real estate investment trust: No Holding company: No |
| LINTON HOLLEMAN | Individual | W-2 MANAGING EMPLOYEE | 100 | 7/16/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- June 15, 2023: CAROLYN E DISHER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: PEACH HEALTH GROUP LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since June 17, 2016. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: KAREN D FORRISTER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since February 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: LINTON HOLLEMAN (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since July 16, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: DAVID K LEMCKE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since February 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
Recent changes on this record
- April 9, 2026: A penalty was recorded: Payment Denial. NH_Penalties_Sep2026_2.csv
- September 11, 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- June 23, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- June 12, 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- June 15, 2023: CAROLYN E DISHER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: PEACH HEALTH GROUP LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since June 17, 2016. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: KAREN D FORRISTER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since February 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: LINTON HOLLEMAN (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since July 16, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: DAVID K LEMCKE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since February 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- December 12, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- August 1, 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- December 13, 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- December 8, 2020: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- December 20, 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | April 9, 2026 | April 9, 2026 | 6 | 16 |
| 2 | February 20, 2025 | February 20, 2025 | 5 | 13 |
| 3 | August 24, 2023 | August 24, 2023 | 7 | 10 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
18 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| April 9, 2026 | Health | F 0568 | Resident Rights Deficiencies | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | F | No | Deficient, Provider has date of correction | May 6, 2026 |
| April 9, 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | May 6, 2026 |
| April 9, 2026 | Health | F 0644 | Resident Assessment and Care Planning Deficiencies | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | E | No | Deficient, Provider has date of correction | May 6, 2026 |
| April 9, 2026 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | May 6, 2026 |
| April 9, 2026 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | May 6, 2026 |
| February 3, 2026 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | March 10, 2026 |
| February 20, 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Yes | Deficient, Provider has date of correction | April 2, 2025 |
| February 20, 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Yes | Deficient, Provider has date of correction | April 2, 2025 |
| February 20, 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | Yes | Deficient, Provider has date of correction | April 2, 2025 |
| February 20, 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Yes | Deficient, Provider has date of correction | April 2, 2025 |
| February 20, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | April 2, 2025 |
| August 24, 2023 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0626 | Resident Rights Deficiencies | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
| August 24, 2023 | Health | F 0919 | Environmental Deficiencies | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | No | Deficient, Provider has date of correction | October 5, 2023 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| April 9, 2026 | Payment Denial | May 8, 2026 | 39 | ||
| August 24, 2023 | Fine | $4,119 | 36922 |
From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | Legal Business Name Not Available |
| Date First Approved to Provide Medicare and Medicaid Services | 2016-12-12 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Twiggs |
| Telephone Number | 4782986700 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 131 |
| Average Number of Residents per Day | 96.3 |
| Overall Rating | 2 |
| Health Inspection Rating | 2 |
| QM Rating | 3 |
| Long-Stay QM Rating | 4 |
| Short-Stay QM Rating | 2 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on August 1, 2026.
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On April 9, 2026: A penalty was recorded: Payment Denial. That is one line of the alert.
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The citable document for Jeffersonville Care Center LLC
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Georgia at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 115727.