CREATE TABLE #t
(
	Acct int NOT NULL
	,Note nvarchar(MAX) NOT NULL
);
INSERT INTO #t
VALUES (1, 'Blanket Lien Filed, account returned to Provider. Blah Blah will continue to follow and pursue lien payment. Called Pt Blahat xxx-xxx-xxxx. Left voice mail. Voicemail greeting did not state a name. Called Pt at xxx-xxx-xxxx. Left voice mail.
Voicemail greeting did not state a name.');

WITH RowNotes
AS
(
	SELECT Acct
		,1 AS NoteRow
		,LEFT(Note, SplitIndex) AS Note
		, SUBSTRING(Note, SplitIndex + 1, 1000000) AS RestNote
	FROM
	(
		SELECT Acct, Note
			,CASE
				WHEN NoteLen < 250 THEN NoteLen
				ELSE NoteLen + 1 - PATINDEX('%[^0-9,A-Z,a-z,-]%', REVERSE(LEFT(Note, 250)))
			END AS SplitIndex
		FROM
		(
			SELECT Acct, Note
				,LEN(LEFT(Note, 250)) AS NoteLen
			FROM #t
		) D1
	) D

	UNION ALL

	SELECT Acct
		,NoteRow
		,LEFT(Note, SplitIndex) AS Note
		, SUBSTRING(Note, SplitIndex + 1, 1000000) AS RestNote
	FROM
	(
		SELECT Acct, Note, NoteRow
			,CASE
				WHEN NoteLen < 250 THEN NoteLen
				ELSE NoteLen + 1 - PATINDEX('%[^0-9,A-Z,a-z,-]%', REVERSE(LEFT(Note, 250)))
			END AS SplitIndex
		FROM
		(
			SELECT Acct, RestNote As Note
				,NoteRow + 1 AS NoteRow
				,LEN(LEFT(RestNote, 250)) AS NoteLen
			FROM RowNotes
			WHERE LEN(RestNote) > 0
		) D1
	) D
)
SELECT Acct, NoteRow, Note
FROM RowNotes
ORDER BY Acct, NoteRow;