Southern Manor Rest Home, INC.

Southern Manor Rest Home, INC. was paid $2.05M by Medicaid between Jan 2018 and Jul 2024, across 1 billing code. Its largest line is 99509, Home visit for assistance with activities of daily living and personal care — 100% of everything it billed.

33Billing provider infoSOUTHERN MANOR REST HOME, INC.
RUTHERFORDTON, NC 28139

33aNPI1417087990assigned 03/06/2007

33bProvider typeAssisted Living Facility

28Total paid$2.05M

24GClaims41,154

24DCodes billed1

24AFirst – last monthJan 2018 – Jul 2024

Compared with peers

Next to other Assisted Living Facility providers in North Carolina

Rank by total paid#157 of 291

Median peer was paid$2.32M

This provider vs. median0.9×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration100% of spending on code 99509 with only 1 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	6,588	$253K
2019	7,784	$278K
2020	7,401	$322K
2021	6,255	$379K
2022	4,972	$307K
2023	5,262	$335K
2024incomplete	2,892	$179K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99509	Home visit for assistance with activities of daily living and personal care	100%	41,154	1,345	$2.05M

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialCHAI, SEUNG KWAN (PRESIDENT/ADMINISTRATOR)