CCN 015187 · Hale County, Alabama
Moundville Health and Rehabilitation, LLC
Third Avenue, Moundville, AL 35474
Moundville Health and Rehabilitation, LLC is a 68-bed for-profit nursing home in Moundville, Alabama, first certified for Medicare or Medicaid in 1977. CMS rates it 4 out of 5 stars overall in its September 2026 data, and it averaged 64.9 residents a day, about 95% of its certified beds. It has an active FHA-insured Section 232 loan: $3.6 million originally, at 3.31%, with $3.4 million outstanding as of September 30, 2026 and maturity in June 2057.
Facility facts
- Certified beds
- 68
- Average residents per day
- 64.9 (95.4% of beds)
- Ownership type
- For profit - Corporation
- Certification
- Medicare and Medicaid
- Legal business name
- Moundville Health and Rehabilitation LLC
- Certified since
- Oct 1, 1977
- Chain or affiliated group
- Nhs Management (43 facilities, chain average 2.9 stars)
- Location
- Urban
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | Alabama median | US median |
|---|---|---|---|
| Overall rating | 4 of 5 | State spread: 42 at 1, 45 at 2, 50 at 3, 41 at 4, 45 at 5 | |
| Health inspections | 4 of 5 | ||
| Quality measures | 4 of 5 | ||
| Staffing | 4 of 5 | ||
| Total nurse hours per resident per day | 3.98 | 3.88 | 3.68 |
| RN hours per resident per day | 0.62 | 0.64 | 0.58 |
| Weekend nurse hours per resident per day | 3.45 | ||
| Nursing staff turnover | 44.0% | 46.7% | 44.9% |
| Occupancy (residents / beds) | 95.4% | 88.2% | 85.7% |
| Fines reported by CMS | None | ||
| Health deficiencies, latest standard survey | 0 (Oct 7, 2021) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Moundville Health and Rehabilitation, LLC meets that part today: 4 stars overall, 4 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| Nhs Operations LLCOrganization | Direct Ownership Interest | 100% | 11/08/2002 |
| James Norman Estes Jr TrOrganization | Indirect Ownership Interest | 5% | 11/08/2002 |
| Jennifer Lee Estes Tr 031093Organization | Indirect Ownership Interest | 5% | 11/08/2002 |
| Estes, JamesIndividual | Indirect Ownership Interest | 89% | 11/08/2002 |
| Moundville Health Realty, LLCOrganization | Security Interest | n/a | 09/12/2008 |
| Nhs Facilities Group LLCOrganization | Security Interest | n/a | 05/01/2022 |
| Regions BankOrganization | Security Interest | n/a | 08/27/2012 |
| Servisfirst BankOrganization | Security Interest | n/a | 05/01/2022 |
| Boyd, CaseyIndividual | Operational / Managerial Control | n/a | 04/28/2023 |
| Duffy, MarciaIndividual | Operational / Managerial Control | n/a | 12/12/2003 |
| Milligan, BrettIndividual | Operational / Managerial Control | n/a | 02/24/2023 |
| Rasco, LynnIndividual | Operational / Managerial Control | n/a | 07/01/2022 |
Changes of ownership
No change of ownership for this facility appears in the CMS change-of-ownership file, which starts in January 2016.
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| May 18, 2022 | 223(f) refinance or purchaseHUD project name: Moundville Health and Rehabilitation, LLC, 68 beds. Lender at endorsement: Regions Bank | $3,600,000 | Active: 3.31%, $3,350,935 balanceMatures Jun 1, 2057. Servicer: Regions Bank | 06222108 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.