Map showing the location of Piedmont Hills Center for Nursing and Rehab in Greensboro, North Carolina
109 S Holden Road, Greensboro, NC, 27407

Overall Score

CMS Five-Star Quality Rating
1/5Much below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • North CarolinaLowest tier among peers417 rated homes · average 2.9★
  • Guilford CountyLowest tier among peers20 rated homes · average 3.2★
  • United StatesLowest tier among peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.9 vs NC avg
  • StaffingCan add or remove a star1★−1.7 vs NC avg
  • Quality measuresCan add or remove a star2★−1.2 vs NC avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

  • Special Focus Facility candidateThis facility is on the CMS candidate list for the Special Focus Facility program, meaning it is among the poorest-performing facilities in its state on recent inspections.
  • Abuse citation flagCMS shows an abuse icon: inspectors cited the facility for abuse that led to harm within the past year, or for abuse that could have led to harm in each of the last two years.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersNC avg2.9★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersNC avg2.7★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments2★Above only 8% of peersNC avg3.2★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.25hrsAbove only 19% of peersNC avg3.78Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.28hrsAbove only 7% of peersNC avg0.59Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better60%Above only 27% of peersNC avg50%RN turnover75%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$249,761Above only 3% of peersNC avg$45,050Fines · denials5 · 1
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
62citations
7inspection dates
2actual harm (G–I)
7immediate jeopardy (J–L)
Oct 23, 2025most recent

Citations by monthAug 2022 – Oct 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Oct 23, 20252 citationsCycle 1worst G · actual harm$77,700
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareG · isolatedCorrected Nov 24, 2025
  2. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Nov 24, 2025
Jun 11, 20251 citationCycle 1worst J · immediate jeopardy$26,685
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Apr 26, 2025
Feb 10, 20252 citationsCycle 1worst J · immediate jeopardy
  1. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Feb 21, 2025
  2. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Feb 21, 2025
Dec 5, 202411 citationsCycle 1worst E · no actual harm$18,086
  1. F584Honor 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.Resident RightsB · patternCorrected Dec 30, 2024
  2. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Feb 10, 2025
  3. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningE · patternCorrected Feb 10, 2025
  4. F656Develop 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 PlanningD · isolatedCorrected Feb 10, 2025
  5. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Feb 21, 2025
  6. F687Provide appropriate foot care.Quality of Life and CareD · isolatedCorrected Feb 10, 2025
  7. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Feb 10, 2025
  8. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Feb 10, 2025
  9. F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and DietaryD · isolatedCorrected Feb 10, 2025
  10. Assure that each resident’s assessment is updated at least once every 3 months.Resident Assessment and Care PlanningB · patternCorrected Dec 30, 2024
  11. F553Allow resident to participate in the development and implementation of his or her person-centered plan of care.Resident RightsD · isolatedCorrected Feb 10, 2025
Jul 17, 20244 citationsCycle 2worst K · immediate jeopardy$30,504
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Aug 1, 2024
  2. F761Ensure 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 ServiceE · patternCorrected Aug 1, 2024
  3. F880Provide and implement an infection prevention and control program.Infection ControlK · patternCorrected Aug 1, 2024
  4. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesK · patternCorrected Aug 1, 2024
Dec 4, 202332 citationsCycle 2worst J · immediate jeopardy$96,786, payment denial
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Jan 1, 2024
  2. Assure that each resident’s assessment is updated at least once every 3 months.Resident Assessment and Care PlanningB · patternCorrected Jan 1, 2024
  3. Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.AdministrationF · widespreadCorrected Jan 1, 2024
  4. F575Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.Resident RightsC · widespreadCorrected Jan 1, 2024
  5. F578Honor 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 RightsD · isolatedCorrected Jan 1, 2024
  6. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Jan 1, 2024
  7. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsD · isolatedCorrected Jan 1, 2024
  8. F602Protect each resident from the wrongful use of the resident's belongings or money.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jan 1, 2024
  9. F636Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.Resident Assessment and Care PlanningB · patternCorrected Jan 1, 2024
  10. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningE · patternCorrected Jan 1, 2024
  11. F642Ensure a qualified health professional conducts resident assessments.Resident Assessment and Care PlanningD · isolatedCorrected Jan 1, 2024
  12. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Jan 1, 2024
  13. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareJ · isolatedCorrected Jan 1, 2024
  14. F727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.Nursing and Physician ServicesE · patternCorrected Jan 1, 2024
  15. F732Post nurse staffing information every day.Nursing and Physician ServicesC · widespreadCorrected Jan 1, 2024
  16. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceE · patternCorrected Jan 1, 2024
  17. F761Ensure 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 ServiceE · patternCorrected Jan 1, 2024
  18. F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and DietaryD · isolatedCorrected Jan 1, 2024
  19. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Jan 4, 2024
  20. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsE · patternCorrected Jan 1, 2024
  21. F584Honor 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.Resident RightsD · isolatedCorrected Jan 1, 2024
  22. F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.Resident RightsE · patternCorrected Jan 1, 2024
  23. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jan 1, 2024
  24. F660Plan the resident's discharge to meet the resident's goals and needs.Resident Assessment and Care PlanningD · isolatedCorrected Jan 1, 2024
  25. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Jan 1, 2024
  26. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareG · isolatedCorrected Jan 1, 2024
  27. F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy ServiceD · isolatedCorrected Jan 1, 2024
  28. F791Provide or obtain dental services for each resident.Quality of Life and CareE · patternCorrected Jan 1, 2024
  29. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationF · widespreadCorrected Jan 1, 2024
  30. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlD · isolatedCorrected Jan 1, 2024
  31. F914Provide bedrooms that don't allow residents to see each other when privacy is needed.EnvironmentalD · isolatedCorrected Jan 1, 2024
  32. F947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.Nursing and Physician ServicesD · isolatedCorrected Jan 1, 2024
Aug 19, 202210 citationsCycle 3worst K · immediate jeopardy
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareK · patternCorrected Sep 14, 2022
  2. F727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.Nursing and Physician ServicesE · patternCorrected Sep 14, 2022
  3. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceK · patternCorrected Sep 14, 2022
  4. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Sep 14, 2022
  5. F814Dispose of garbage and refuse properly.Nutrition and DietaryF · widespreadCorrected Sep 14, 2022
  6. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationE · patternCorrected Sep 14, 2022
  7. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2022
  8. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2022
  9. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Sep 14, 2022
  10. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Sep 14, 2022

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.25hrsAbove only 19% of peers−0.53 vs NC avg
  • Registered nursesRN hours only0.28hrsAbove only 7% of peers−0.31 vs NC avg
  • Licensed practical nursesLPN hours0.54hrs
  • Nurse aidesCNA hours2.43hrs
  • Weekend nursingAll staff on Saturdays and Sundays2.98hrs
  • North Carolina average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better60%Above only 27% of peersNC avg 50%
  • RN turnoverRegistered nurses only75%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy126 certified beds · ~118 residents a day94%Above 83% of peersNC avg 83%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $249,761In fines
  • 5Fines
  • 1Payment denial
  • $45,050NC avg in fines
Above only 3% of peersFewer fines than 3% of rated homes in North Carolina

Actions on record

  1. Oct 23, 2025Civil money penalty$77,700
  2. Jun 11, 2025Civil money penalty$26,685
  3. Dec 5, 2024Civil money penalty$18,086
  4. Jul 17, 2024Civil money penalty$30,504
  5. Dec 4, 2023Civil money penalty$96,786
  6. Dec 4, 2023Denial of payment for new admissionsfrom Jan 2, 2024

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Alliance Health Group10 facilities in the chain1.5★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Alignment Holdco LLC
Indirect owners (5%+)
  • Yosef Emanuel
Operational or managerial control
  • Alliance Health Group LLC
  • Jennifer Reagan
Corporate officers
  • Yosef Emanuel

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 345116 · 109 S Holden Road, Greensboro, NC, 27407.
  • Percentiles compare this facility with every rated nursing home in North Carolina and Guilford County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

Own or manage a facility?

Claim your free listing to correct details, reply to reviews, and show your verified badge.

Claim your facility

Read our latest articles