Skilled nursing facility · CMS certification number 345565
Trinity Elms
Clemmons, North Carolina · Medicare and Medicaid
Certified beds, as filed in Care Compare: 100
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: 2 · Fines: 2 · Fines, total amount: $15,646.00 · Payment denials: 0. The most recent penalty on file: August 20, 2024, Fine, $7,823. 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 October 1, 2023 to September 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on March 21, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $21,287,350 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $8,761,910 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,525,440 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,306,333 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $219,107 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $680,789 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $899,896 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $899,896 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 36,600 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 3,197 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 13,773 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 15,848 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 32,818 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 95 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 42 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 285 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 422 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.65 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 327.93 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 77.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1405665, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended September 30, 2023
Cost report for October 1, 2022 to September 30, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 13, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,982,900 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,376,322 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,606,578 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,988,766 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $617,812 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $217,064 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $834,876 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $834,876 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,835 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 264 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 432.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 113.01 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1374890, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended September 30, 2022
Cost report for October 1, 2021 to September 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 20, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,470,217 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,190,253 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,279,964 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,717,454 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $562,510 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,083,828 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,646,338 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,646,338 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,004 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 226 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.3 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 644.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 132.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1344610, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended September 30, 2021
Cost report for October 1, 2020 to September 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 2, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,293,803 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $283,939 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,009,864 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,151,327 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $858,537 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $784,511 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,643,048 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,643,048 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,182 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 215 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.42 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 561.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 140.38 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1311145, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended September 30, 2020
Cost report for October 1, 2019 to September 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 18, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,598,432 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,815,723 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,782,709 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,948,114 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$165,405 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $334,201 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $168,796 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $168,796 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,415 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 279 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 114.06 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 116.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1280336, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended September 30, 2019
Cost report for October 1, 2018 to September 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 16, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,897,687 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,315,198 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,582,489 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,649,638 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$67,149 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $255,042 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $187,893 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $187,893 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,369 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 334 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 112.62 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 99.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1298807, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended September 30, 2018
Cost report for October 1, 2017 to September 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 19, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,499,195 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,118,442 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,380,753 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,512,806 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$132,053 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $209,556 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $77,503 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $77,503 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,517 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 317 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.49 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 371.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 105.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1221457, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended September 30, 2017
Cost report for October 1, 2016 to September 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 28, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,322,353 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,370,961 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,951,392 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,428,323 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$476,931 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $178,372 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$298,559 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$298,559 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,118 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 313 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 95.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 109 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1184353, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended September 30, 2016
Cost report for October 1, 2015 to September 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 21, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,867,540 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,865,218 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,002,322 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,703,232 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $299,090 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $177,282 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $476,372 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $476,372 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,895 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 319 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 477.96 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 106.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1209146, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended September 30, 2015
Cost report for November 13, 2014 to September 30, 2015 — a reporting period of 321 days, on form CMS-2540-10, settled, processed by CMS on July 31, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,637,073 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $615,097 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,021,976 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,646,651 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$624,675 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $79,345 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$545,330 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$545,330 (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 | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,996 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 263 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 94.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 68.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1203857, read from the public cost report file SNF10FY2015.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 |
|---|---|---|---|---|
| GOINS, TED | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2004 |
| LSA ELMS PROPERTY, INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/16/2025 |
| LSA MANAGEMENT, INC. | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/16/2025 |
| MCCOY, CYNTHIA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/26/2003 |
| NICKERSON, KIRBY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2012 |
| OWENS-WATTERSON, DAWN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/03/2023 |
| SMITH, KESHA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2012 |
| SMITH, KESHA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/08/2003 |
| MADDRY, KAREN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2014 |
| NICKERSON, KIRBY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2012 |
| GOINS, TED | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 10/01/2004 |
| HERMAN, RICHARD | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 06/01/2022 |
| NELSON, DOUGLAS | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 09/01/2022 |
| GOINS, TED | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2004 |
| LSA MANAGEMENT, INC. | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 08/28/2008 |
| LUTHERAN SERVICES FOR THE AGING, INC. | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 08/28/2008 |
| MCCOY, CYNTHIA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/26/2023 |
| OWENS-WATTERSON, DAWN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/03/2023 |
| SMITH, KESHA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2012 |
| GOINS, TED | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2004 |
| LUTHERAN SERVICES FOR THE AGING, INC. | TRUSTEE OF THE SNF | Organization | NOT APPLICABLE | since 08/28/2008 |
| NELSON, DOUGLAS | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2022 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of LUTHERAN HOME - FORSYTH COUNTY, INC. (enrollment ID O20140521001291).
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 |
|---|---|---|---|---|---|
| CYNTHIA D MCCOY | Individual | ADP OF THE SNF | Not stated in the filing | 6/26/2003 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAWN P OWENS-WATTERSON | Individual | ADP OF THE SNF | Not stated in the filing | 5/3/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KESHA L SMITH | Individual | ADP OF THE SNF | Not stated in the filing | 10/1/2012 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KIRBY NICKERSON | Individual | ADP OF THE SNF | Not stated in the filing | 10/1/2012 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LSA ELMS PROPERTY, INC | Organization | ADP OF THE SNF | Not stated in the filing | 3/16/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| LSA MANAGEMENT, INC. | Organization | ADP OF THE SNF | Not stated in the filing | 3/16/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| TED W GOINS | Individual | ADP OF THE SNF | Not stated in the filing | 10/1/2004 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KESHA L SMITH | Individual | CORPORATE DIRECTOR | 0 | 9/8/2003 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KAREN MADDRY | Individual | CORPORATE OFFICER | Not stated in the filing | 1/1/2014 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KIRBY NICKERSON | Individual | CORPORATE OFFICER | 0 | 10/1/2012 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DOUGLAS E NELSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 9/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RICHARD HERMAN | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TED W GOINS | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 10/1/2004 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CYNTHIA D MCCOY | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/26/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAWN P OWENS-WATTERSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 5/3/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KESHA L SMITH | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/1/2012 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LSA MANAGEMENT, INC. | Organization | OPERATIONAL/MANAGERIAL CONTROL | 100 | 8/28/2008 | Private equity company: No Real estate investment trust: No Holding company: No |
| LUTHERAN SERVICES FOR THE AGING, INC. | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/28/2008 | Private equity company: No Real estate investment trust: No Holding company: No |
| TED W GOINS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/1/2004 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DOUGLAS E NELSON | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 9/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LUTHERAN SERVICES FOR THE AGING, INC. | Organization | TRUSTEE OF THE SNF | Not stated in the filing | 8/28/2008 | Private equity company: No Real estate investment trust: No Holding company: No |
| TED W GOINS | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 10/1/2004 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARY M FINKLEA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: GEORGE E BRAMLEY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LSA MANAGEMENT, INC. (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KIRBY NICKERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KIRBY NICKERSON (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since August 28, 2008. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since August 28, 2008. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DOUGLAS E NELSON (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DOUGLAS E NELSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DAWN P OWENS-WATTERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 3, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DAWN P OWENS-WATTERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 3, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: RICHARD HERMAN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LSA ELMS PROPERTY, INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 8, 2003. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: CYNTHIA D MCCOY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 26, 2003. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: CYNTHIA D MCCOY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 26, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
Recent changes on this record
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARY M FINKLEA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: GEORGE E BRAMLEY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LSA MANAGEMENT, INC. (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KIRBY NICKERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KIRBY NICKERSON (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since August 28, 2008. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LUTHERAN SERVICES FOR THE AGING, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since August 28, 2008. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DOUGLAS E NELSON (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DOUGLAS E NELSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DAWN P OWENS-WATTERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 3, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DAWN P OWENS-WATTERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 3, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: TED W GOINS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: RICHARD HERMAN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: LSA ELMS PROPERTY, INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 1, 2012. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KESHA L SMITH (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 8, 2003. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: CYNTHIA D MCCOY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 26, 2003. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: CYNTHIA D MCCOY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 26, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- March 21, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- March 13, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- March 20, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- March 2, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- September 16, 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- February 18, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- March 19, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- August 21, 2018: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- July 31, 2018: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- February 28, 2018: 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 | March 19, 2026 | March 19, 2026 | 5 | 2 |
| 2 | January 17, 2025 | January 17, 2025 | 5 | 4 |
| 3 | August 30, 2023 | August 30, 2023 | 4 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
14 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| March 19, 2026 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Yes | Past Non-Compliance | February 4, 2026 |
| March 19, 2026 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | March 31, 2026 |
| March 19, 2026 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | No | Deficient, Provider has date of correction | March 31, 2026 |
| March 19, 2026 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | March 31, 2026 |
| March 19, 2026 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Past Non-Compliance | February 4, 2026 |
| April 30, 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | Yes | Deficient, Provider has date of correction | April 30, 2025 |
| January 17, 2025 | Health | F 0578 | Resident Rights Deficiencies | 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. | D | No | Deficient, Provider has date of correction | February 6, 2025 |
| January 17, 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | February 6, 2025 |
| January 17, 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 | No | Deficient, Provider has date of correction | January 20, 2025 |
| January 17, 2025 | Health | F 0851 | Administration Deficiencies | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | No | Past Non-Compliance | November 15, 2024 |
| August 20, 2024 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | J | Yes | Past Non-Compliance | August 1, 2024 |
| August 20, 2024 | 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. | J | Yes | Past Non-Compliance | July 24, 2024 |
| August 30, 2023 | 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. | B | No | Deficient, Provider has plan of correction | September 18, 2023 |
| August 30, 2023 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | September 18, 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 |
|---|---|---|---|---|---|
| August 20, 2024 | Fine | $7,823 | 42497 | ||
| August 20, 2024 | Fine | $7,823 | 42576 |
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 | Non profit - Church related |
| Legal Business Name | LUTHERAN HOME - FORSYTH COUNTY, INC. |
| Date First Approved to Provide Medicare and Medicaid Services | 2014-11-13 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | Y |
| County/Parish | Forsyth |
| Telephone Number | 3367471153 |
| Chain Name | LUTHERAN SERVICES CAROLINAS |
| Chain ID | 327 |
| 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 | 100 |
| Average Number of Residents per Day | 90.8 |
| Overall Rating | 2 |
| Health Inspection Rating | 3 |
| QM Rating | 1 |
| Long-Stay QM Rating | 1 |
| Short-Stay QM Rating | 1 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on Trinity Elms: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On March 21, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
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The citable document for Trinity Elms
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 North Carolina 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 345565.