Federal inspection record · CMS data as of October 1, 2026
Clayton Rehabilitation and Healthcare Center
204 Dairy Road, Clayton, NC · (919) 553-8232
- Certified beds
- 90
- Residents per day
- 84
- Ownership
- For-Profit
- Chain
- Simcha Hyman & Naftali Zanziper
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- April 16, 1990
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in North Carolina.
-
Staffing
★★★★★no change (already 1)
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among North Carolina homes
Clayton Rehabilitation and Healthcare Center carries 169.25 inspection points. That is fewer than 5% of North Carolina's 415 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in North Carolina: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–4 pts
- 4★ 4–15 pts
- 3★ 15–35 pts
- 2★ 35–73.5 pts
- 1★ over 73.5 pts
Bars show every rated home in North Carolina by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
38 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
-
J
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
-
G
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Everything else, by area of care
Pharmacy Service9F
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D
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.
- F
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure that residents are free from significant medication errors.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure that residents are free from significant medication errors.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Resident Assessment and Care Planning7E
- D
Ensure each resident receives an accurate assessment.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure each resident receives an accurate assessment.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Plan the resident's discharge to meet the resident's goals and needs.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Nutrition and Dietary5E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Quality of Life and Care5E
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Environmental4E
- D
Keep all essential equipment working safely.
- D
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- D
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Resident Rights2D
- D
Keep residents' personal and medical records private and confidential.
- D
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.
Administration2D
- D
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
- D
Provide timely, quality laboratory services/tests to meet the needs of residents.
Nursing and Physician Services1E
- E
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Infection Control1D
- D
Provide and implement an infection prevention and control program.
Inspection history
2026-02-13
19 health deficiencies · 9 fire-safety deficiencies
Top issue: Nutrition and Dietary (4 deficiencies)
2024-11-27
16 health deficiencies · 4 fire-safety deficiencies
Top issue: Pharmacy Service (4 deficiencies)
2023-10-26
3 health deficiencies · 0 fire-safety deficiencies
Top issue: Environmental (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h 11 min of nursing staff time a day, 24 min of it from a registered nurse.
This home
3 h 11 min
North Carolina average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 75% of nursing staff and 82% of registered nurses left in the past year, along with 4 administrators.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$166,075 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-10-30 | Fine | $166,075 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.4 pts worse | 2.1 | 1.7 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident daysAbout the same | 1.7 | 1.7 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine4.6 pts better | 97.0% | 92.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine5.8 pts worse | 88.9% | 94.7% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.7 pts better | 0.7% | 3.4% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms3.8 pts worse | 10.6% | 6.8% | 13.5% |
| Percentage of long-stay residents who lose too much weight5 pts worse | 12.1% | 7.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication9.4 pts better | 11.7% | 21.1% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication0.2 pts worse | 14.1% | 13.9% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened1.5 pts worse | 18.1% | 16.6% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.8 pts better | 14.2% | 15.0% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladderAbout the same | 0.6% | 0.6% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.3 pts worse | 3.4% | 2.1% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8.7 pts worse | 28.6% | 19.9% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.9 pts worse | 7.3% | 5.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine10 pts better | 91.5% | 81.5% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit6.2 pts better | 6.5% | 12.7% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.7 pts better | 0.7% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine10.2 pts better | 91.3% | 81.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission4.9 pts better | 17.3% | 22.2% | 23.4% |
·
Who owns and runs it
4 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Nc East Holding LLC | 5% Or Greater Direct Ownership Interest · Organization | 100% | 9 facilities |
| Alter, Tzvi | 5% Or Greater Indirect Ownership Interest · Individual | 80% | 23 facilities |
| Alter, Tzvi | Corporate Director · Individual | 0% | 23 facilities |
| Davis, Jennifer | W-2 Managing Employee · Individual | 0% | 4 facilities |
·
Fire safety
13 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7D
- D
Provide properly protected cooking facilities.
- D
Install an approved automatic sprinkler system.
- D
Properly install and monitor supervisory attachments on automatic sprinkler systems.
- D
Inspect, test, and maintain automatic sprinkler systems.
- D
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- D
Install an approved automatic sprinkler system.
- D
Install corridor and hallway doors that block smoke.
Services3F
- F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- E
Have properly installed electrical wiring and gas equipment.
- D
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Gas, Vacuum, and Electrical Systems2D
- D
Have generator or other power source capable of supplying service within 10 seconds.
- D
Have generator or other power source capable of supplying service within 10 seconds.
Egress1D
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
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Other homes nearby
-
Springbrook Nursing and Rehabilitation Center
Clayton, NC · Principle Long Term Care
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 51 min
- Fines
- $25,625
-
Bellarose Nursing And Rehab
Garner, NC
★★★★★- Worst citation, 3 yrs
- none
- Nursing / resident / day
- 4 h 25 min
- Fines
- $0
-
Barbour Court Nursing and Rehabilitation Center
Smithfield, NC · Principle Long Term Care
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 11 min
- Fines
- $0