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Autumn Care of Statesville
2001 Vanhaven Drive, Statesville, NC 28625 · CMS Certification Number (CCN) 345511
At a glance
- CMS overall rating
- ★★★★☆ 4 of 5
- Health inspection citations
- 8 in the last 3 inspection cycles (0 immediate jeopardy, 0 actual harm, 1 from complaints)
- Fire safety citations
- 7
- Fines (last 3 years)
- 0 fines, total $0
- Payment denials
- 0
- Most recent standard inspection
- July 1, 2026
- Official record
- Medicare Care Compare page for this facility
Source: CMS Nursing Home Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
CMS star ratings
CMS rates every Medicare- and Medicaid-certified nursing home from 1 to 5 stars. Health inspection stars are relative to other homes in the same state: the top 10% get 5 stars and the bottom 20% get 1 star. CMS says to use the ratings together with other information, including a visit. Technical Users’ Guide
| Rating | This facility | North Carolina average | U.S. average |
|---|---|---|---|
| Overall | ★★★★☆ 4 of 5 | 2.9 | 3 |
| Health inspections | ★★★★☆ 4 of 5 | 2.9 | 2.8 |
| Staffing | ★★☆☆☆ 2 of 5 | 2.7 | 2.9 |
| Quality measures | ★★★★☆ 4 of 5 | 3.3 | 3.6 |
| Long-stay quality | ★★★★★ 5 of 5 | Not published | Not published |
| Short-stay quality | ★★☆☆☆ 2 of 5 | Not published | Not published |
Averages: CMS State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Health inspections
| Inspection cycle | Standard survey date | Health citations | From standard survey | From complaints |
|---|---|---|---|---|
| Cycle 1 (most recent) | July 1, 2026 | 2 | 2 | 1 |
| Cycle 2 | April 16, 2025 | 3 | 3 | 0 |
CMS weighted health inspection score: 9 (lower is better; it counts citation severity, complaints and repeat revisits). Citations from infection control inspections: Not published. How to read these citations
8 health citations across 3 inspection dates, newest first. The letter is CMS’s scope/severity code: A–C means potential for minimal harm, D–F potential for more than minimal harm, G–I actual harm, and J–L immediate jeopardy.
July 1, 2026: 2 citations (Standard + Complaint)
| Severity | Tag | What was cited | Type | Status |
|---|---|---|---|---|
| D | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies | Standard | Deficient, Provider has date of correction Corrected 07/21/2026 |
| D | F-0602 | Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies | Standard + Complaint | Past Non-Compliance Corrected 04/02/2026 |
April 16, 2025: 3 citations (Standard)
| Severity | Tag | What was cited | Type | Status |
|---|---|---|---|---|
| D | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies | Standard | Deficient, Provider has date of correction Corrected 05/09/2025 |
| D | F-0578 | 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 | Deficient, Provider has date of correction Corrected 05/09/2025 |
| D | F-0554 | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies | Standard | Deficient, Provider has date of correction Corrected 05/09/2025 |
February 8, 2024: 3 citations (Standard)
| Severity | Tag | What was cited | Type | Status |
|---|---|---|---|---|
| D | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies | Standard | Deficient, Provider has date of correction Corrected 02/27/2024 |
| D | F-0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Administration Deficiencies | Standard | Deficient, Provider has date of correction Corrected 02/27/2024 |
| D | F-0695 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies | Standard | Deficient, Provider has date of correction Corrected 02/27/2024 |
Source: CMS Health Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Fire safety inspections
7 fire safety citations across 3 inspection dates
| Date | Severity | Tag | What was cited | Status |
|---|---|---|---|---|
| 04/16/2025 | D | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies | Deficient, Provider has date of correction Corrected 05/30/2025 |
| 04/16/2025 | D | K-0911 | Meet requirements for the installation and maintenance of electrical systems. Gas, Vacuum, and Electrical Systems Deficiencies | Deficient, Provider has date of correction Corrected 05/30/2025 |
| 04/16/2025 | D | K-0741 | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies | Deficient, Provider has date of correction Corrected 05/30/2025 |
| 02/08/2024 | D | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies | Deficient, Provider has date of correction Corrected 03/18/2024 |
| 02/08/2024 | D | K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies | Deficient, Provider has date of correction Corrected 03/18/2024 |
| 02/08/2024 | D | K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. Egress Deficiencies | Deficient, Provider has date of correction Corrected 03/18/2024 |
| 08/25/2022 | D | K-0352 | Properly install and monitor supervisory attachments on automatic sprinkler systems. Smoke Deficiencies | Deficient, Provider has date of correction Corrected 10/08/2022 |
Automatic sprinklers in all required areas: Yes. CMS does not count fire safety citations in the health inspection star rating.
Source: CMS Fire Safety Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Penalties
No fines or payment denials published for this facility in the CMS Penalties file (last 3 years).
Source: CMS Penalties: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Staffing
| Measure | This facility | North Carolina average | U.S. average |
|---|---|---|---|
| Total nurse staff hours per resident per day | 3.54 | 3.85 | 3.86 |
| Registered nurse (RN) hours per resident per day | 0.37 | 0.62 | 0.69 |
| LPN/LVN hours per resident per day | 0.9 | Not published | Not published |
| Nurse aide hours per resident per day | 2.27 | Not published | Not published |
| Total nurse staff hours per resident per day, weekends | 3.03 | Not published | Not published |
| RN hours per resident per day, weekends | 0.24 | Not published | Not published |
| Total nursing staff turnover (%) | 55.2 | 49 | 45.8 |
| Registered nurse turnover (%) | 27.3 | Not published | Not published |
| Administrators who have left | 1 | Not published | Not published |
Reported hours come from the Payroll-Based Journal (PBJ) staffing data that facilities submit to CMS each quarter.
Source: CMS Provider Information; State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Facility details
- Legal business name
- Autumn Care of Statesville LLC
- Ownership type
- For profit - Limited Liability company
- Chain
- Saber Healthcare Group (126 facilities)
- Ownership changed in last 12 months
- No
- Certified beds
- 103
- Average residents per day
- 97.4
- Participates in
- Medicare and Medicaid
- Located inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- First approved for Medicare/Medicaid
- December 19, 2001
- County/parish
- Iredell
Source: CMS Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Owners and managers reported to CMS
28 ownership and management records
| Name | Role | Type | Ownership % | Since |
|---|---|---|---|---|
| WILLIAM I WEISBERG FAMILY DYNASTY TRUST (DATED JUNE 1, 2011) | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 67% | undefined undefined, NaN |
| VOLPE, BENJAMIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | undefined undefined, NaN |
| WEISBERG, WILLIAM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | undefined undefined, NaN |
| NICOLUZAKIS, GREGORY | CORPORATE OFFICER | Individual | NOT APPLICABLE | undefined undefined, NaN |
| VOLPE, BENJAMIN | CORPORATE OFFICER | Individual | NOT APPLICABLE | undefined undefined, NaN |
| WEISBERG, WILLIAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | undefined undefined, NaN |
| SABER GOVERNANCE LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | undefined undefined, NaN |
| SHG MANAGEMENT LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | undefined undefined, NaN |
| HOPPING, DARIN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | undefined undefined, NaN |
| RABUCK, TAMBRIA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | undefined undefined, NaN |
| WEISBERG, WILLIAM | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| BENJAMIN N. VOLPE FAMILY DYNASTY TRUST (DATED DECEMBER 29, 2020) | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| BNV DYNASTY LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| CITRIN COOPERMAN ADVISORS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| DECANTED WILLIAM I. WEISBERG FAMILY DYNASTY TRUST (DATED SEPT 30, 2020 | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| SABER GOVERNANCE LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| SABER HEALTHCARE GROUP LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| SHG 4 MT, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| SHG MANAGEMENT LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| STATESVILLE REAL ESTATE HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| WALKER & ASSOCIATES PC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| WIW DYNASTY LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | undefined undefined, NaN |
| AYOUBI, NASIB | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| HOPPING, DARIN | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| NICOLUZAKIS, GREGORY | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| RABUCK, TAMBRIA | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| VOLPE, BENJAMIN | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
| WEISBERG, WILLIAM | ADP OF THE SNF | Individual | NOT APPLICABLE | undefined undefined, NaN |
Source: CMS Ownership: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026
Check it yourself
- Medicare Care Compare: Autumn Care of Statesville. Full inspection reports, quality measures and staffing.
- DHSR Complaint Intake Unit: File a Complaint. The state agency also takes nursing home complaints.
- Ask the facility to show you its most recent inspection report and plan of correction.
Page built from CMS data files processed September 1, 2026 (CMS refreshes monthly). Last checked October 26, 2026. Not a ranking or endorsement.