Trinity Elms — nursing home in Clemmons, NC

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid · part of a continuing care retirement community (CCRC)
Certified beds: 100 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 92.4 CMS, MDS-derived
CMS Certification Number: 345565
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Nov 13, 2014
Ownership type: Non profit - Church related
Operator (legal business name): Lutheran Home - Forsyth County, Inc
CMS chain: Lutheran Services Carolinas 9 facilities
Phone: (336) 747-1153
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

9

latest Aug 18, 2026

Citations

25

16 health · 9 fire

Harm or worse

4

2 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J2	K·	L·
Actual harm	G2	H·	I·
Potential harm	D18	E·	F1
Minimal	A·	B1	C1

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

2

$15,646

Payment denials

0

Latest

Aug 20, 2024

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 345565
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 100
First approved: Nov 13, 2014
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for North Carolina.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Aug 18, 2026	Health	Health Complaint	2	Actual harm	—	Open →
Mar 19, 2026	Fire safety	Fire Safety Standard	2	Potential harm	—	Open →
Mar 19, 2026	Health	Health Complaint, Health Standard	5	Potential harm	—	Open →
Apr 30, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Jan 17, 2025	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Jan 17, 2025	Health	Health Standard	4	Potential harm	—	Open →
Aug 20, 2024	Health	Health Complaint	2	Immediate jeopardy	—	Open →
Aug 30, 2023	Fire safety	Fire Safety Standard	3	Potential harm	—	Open →
Aug 30, 2023	Health	Health Standard	2	Potential harm	1	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

Date	Type	Amount	Payment denial	Record
Aug 20, 2024	Civil money penalty (fine)	$7,823	—	345565\|Fine\|42497
Aug 20, 2024	Civil money penalty (fine)	$7,823	—	345565\|Fine\|42576

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J2	K·	L·
Actual harm	G2	H·	I·
Potential harm	D18	E·	F1
Minimal	A·	B1	C1

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Aug 18, 2026	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	G · Actual harm Isolated	Past non-compliance May 28, 2026	Complaint
Aug 18, 2026	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care	G · Actual harm Isolated	Past non-compliance May 28, 2026	Complaint
Mar 19, 2026	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 · Environment & life safety	D · Potential harm Isolated	Corrected Jun 27, 2026
Mar 19, 2026	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jun 27, 2026
Mar 19, 2026	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Past non-compliance Feb 4, 2026	Complaint
Mar 19, 2026	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 31, 2026
Mar 19, 2026	F-0655	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 31, 2026
Mar 19, 2026	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 31, 2026
Mar 19, 2026	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Past non-compliance Feb 4, 2026	Complaint
Apr 30, 2025	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Apr 30, 2025	Complaint
Jan 17, 2025	K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 2, 2025
Jan 17, 2025	K-0281	Install proper backup exit lighting. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 2, 2025
Jan 17, 2025	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 2, 2025
Jan 17, 2025	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 2, 2025
Jan 17, 2025	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 · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Feb 6, 2025
Jan 17, 2025	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Feb 6, 2025
Jan 17, 2025	F-0761	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. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jan 20, 2025
Jan 17, 2025	F-0851	Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. Administration Deficiencies · Administration & records	F · Potential harm Widespread	Past non-compliance Nov 15, 2024
Aug 20, 2024	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	J · Immediate jeopardy Isolated	Past non-compliance Aug 1, 2024	Complaint
Aug 20, 2024	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care	J · Immediate jeopardy Isolated	Past non-compliance Jul 24, 2024	Complaint
Aug 30, 2023	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Nov 11, 2023
Aug 30, 2023	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Nov 11, 2023
Aug 30, 2023	F-0759	Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Sep 18, 2023
Aug 30, 2023	K-0363	Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Nov 11, 2023
Aug 30, 2023	F-0609	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	B · Minimal Pattern	Plan of correction, not yet verified Sep 18, 2023

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 3

Health inspectionsstate 2.9

Staffingstate 2.7

Quality measuresstate 3.5

Long-stay QM

Short-stay QM

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing4.77

State avg 3.87US avg 3.90

Registered nurse (RN)0.65

State avg 0.62US avg 0.69

Licensed practical nurse0.70

State avg 0.88US avg 0.86

Nurse aide3.42

State avg 2.37US avg 2.35

Weekend total nurse4.41

State avg 3.40US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 5.07 (case-mix index 1.32).

Staff turnover

Total nursing staff turnover48.7%

State avg 48.7%US avg 45.3%

Registered nurse turnover64.7%

State avg 45.7%US avg 42.5%

Administrators who left1

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Mar 19, 2026
Cycle 1 health score: 60
Total weighted score: 63

Operating entity

Lutheran Home - Forsyth County, Inc

CMS legal business name of the certified provider. Operates this facility only.

VerifiedLinked by exact legal name

CMS chain

Lutheran Services Carolinas

9 facilities in 1 states. CMS chain ID 327.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 3.6

Ownership disclosures

Disclosures

22

Organizations

3

Individuals

17

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Ted Goins	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Oct 1, 2004
Richard Herman	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Jun 1, 2022
Douglas Nelson	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Sep 1, 2022
Lsa Management, Inc	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Aug 28, 2008
Lutheran Services for the Aging, Inc	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Aug 28, 2008
Ted Goins	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2004
Cynthia Mccoy	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jun 26, 2023
Dawn Owens-Watterson	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	May 3, 2023
Kesha Smith	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2012
Kesha Smith	Individual	Corporate officer / director	CORPORATE DIRECTOR	not provided	Sep 8, 2003
Karen Maddry	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Jan 1, 2014
Kirby Nickerson	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Oct 1, 2012
Lutheran Services for the Aging, Inc	Organization	Trustee	TRUSTEE OF THE SNF	not provided	Aug 28, 2008
Ted Goins	Individual	Trustee	TRUSTEE OF THE SNF	not provided	Oct 1, 2004
Douglas Nelson	Individual	Trustee	TRUSTEE OF THE SNF	not provided	Sep 1, 2022
Lsa Elms Property, Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Mar 16, 2025
Lsa Management, Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Mar 16, 2025
Ted Goins	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2004
Cynthia Mccoy	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Jun 26, 2003
Kirby Nickerson	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2012
Dawn Owens-Watterson	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 3, 2023
Kesha Smith	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2012

Same chain in North Carolina

All 8 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Trinity Glen 849 Waterworks Road, Winston-Salem, NC 27101 CCN 345088	117	Apr 2, 2026	6	—
Trinity Ridge 2140 Medical Park Drive, Hickory, NC 28602 CCN 345106	120	Jun 18, 2026	112 open	—
Trinity Place 24724 South Business 52, Albemarle, NC 28001 CCN 345109	76	Nov 20, 2025	121 harm1 open	$8,788
Trinity Village 1265 21 Street NE, Hickory, NC 28601 CCN 345152	104	Mar 11, 2026	121 harm	$8,512
Trinity Oaks 820 Klumac Road, Salisbury, NC 28144 CCN 345153	115	Apr 2, 2026	24	—
Glenflora 5701 N. Fayetteville Road, Lumberton, NC 28360 CCN 345194	52	May 28, 2026	131 IJ1 harm1 open	$30k
Aston Park Health Care Center 380 Brevard Road, Asheville, NC 28806 CCN 345198	120	Apr 16, 2026	279 open	—
Trinity Grove 631 Junction Creek Drive, Wilmington, NC 28412 CCN 345554Abuse icon	100	Sep 18, 2025	232 IJ2 harm	$103k

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 7449 Fair Oaks Drive, Clemmons, NC 27012
ZIP: 27012
County: Forsyth County FIPS 37067
State: North Carolina
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Cedar Hills Center for Nursing and Rehabilitation 3905 Clemmons Road, Clemmons, NC 27012 CCN 345131SFF Candidate	1.4 km	94	Jun 26, 2026	891 harm2 open	$73k
Bermuda Village Retirement Center 142 Bermuda Village Drive, Bermuda Run, NC 27006 CCN 345416	3.8 km	36	Jun 11, 2026	282 open	$7,976
Bermuda Commons Nursing and Rehabilitation Center 316 Nc Highway 801 South, Advance, NC 27006 CCN 345543	4 km	117	Apr 29, 2026	451 harm2 open	$13k
Homestead Hills 2101 Homestead Hills Drive, Winston-Salem, NC 27103 CCN 345559	9.9 km	40	Jul 1, 2026	171 IJ2 open	$27k
Silas Creek Rehabilitation Center 3350 Silas Creek Parkway, Winston Salem, NC 27103 CCN 345003	11.1 km	90	Jun 12, 2026	14	—
The Oaks 901 Bethesda Road, Winston-Salem, NC 27103 CCN 345284	11.7 km	131	Aug 5, 2026	32	—
Salemtowne 1550 Babcock Drive, Winston-Salem, NC 27106 CCN 345479	15.8 km	100	Mar 26, 2026	8	—
Brookridge Retirement Community 1199 Hayes Forest Drive, Winston-Salem, NC 27106 CCN 345209	17.1 km	77	Aug 1, 2025	131 open	—

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	345565	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	345565	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 345565

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction