Below average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Alpine Skilled Nursing And Rehabilitation during CMS and state inspections, most recent first.
Surveyors identified that the facility did not consistently provide the minimum required nursing staffing hours on certain weekends, based on review of PBJ staffing data and weekend staffing pattern forms for a fiscal quarter. On two separate weekend days, the total nursing hours actually provided fell below the calculated minimum required hours. In a subsequent interview, the administrator confirmed that the facility failed to meet the minimum staffing requirements on those days.
Nursing staff failed to follow medication administration and documentation requirements for two residents. For one resident with intact cognition and multiple medical conditions, an LPN left a cup containing four oral medications unattended at the bedside and did not remain with the resident to ensure the medications were taken, contrary to facility policy. For another resident with rhabdomyolysis, acute pulmonary edema, CKD, heart failure, and atrial flutter, physician orders for IV Lasix twice daily over several days were not documented as administered on multiple ordered times, and the DON and corporate nurse confirmed the absence of documentation. These issues reflect a lack of required competencies and adherence to medication administration procedures by licensed nursing staff.
Surveyors found that staff failed to follow Enhanced Barrier Precautions and infection control practices during catheter care and bathing for a dependent resident with an indwelling urinary catheter, PEG tube, and pressure ulcer, including not wearing gowns and reusing the same washcloth on genital, perineal, and leg areas, including over an open blister. In addition, a resident with respiratory and neurologic conditions had a nebulizer mask and Yankauer suction device left uncovered instead of stored in bags as required by facility policy, and another resident with chronic pulmonary disease had oxygen tubing left on the floor and not bagged when oxygen was not in use.
Food safety standards were not followed during meal service and food storage. A dietary staff member used the same gloved hand to touch multiple breakfast items and scoop handles, while undated salads, sandwiches, soups, meats, and vegetables were found in the refrigerator and freezer. A bag of drink mix was stored on the floor, cleaner was kept above a food prep table, and lunch items were served at improper temperatures without reheating. The dietary staff member also continued touching scoop handles and then placing rolls on resident trays.
A resident with multiple chronic conditions and a cognitively intact BIMS score was self-administering a prescribed nasal spray that was kept on a dresser in the room, rather than secured as required by facility policy. The resident stated that staff provided new bottles as needed and that she administered the medication herself. Review of records and staff interviews showed there was no provider order for self-administration and no completed self-administration assessment or consent, despite facility policy requiring an interdisciplinary evaluation, documentation, and secure storage before allowing self-administration of medications.
A resident with CVA, dysphasia, malnutrition, and a PEG tube had a continuous Isosource 1.5 feeding running at 55 ml/hr with water boluses, but the feeding bag was not labeled with the resident’s identifying information, formula type, or the date and time it was started. An LPN confirmed the bag was not labeled as required.
A resident with a pressure ulcer did not receive a timely wound assessment by an RN upon discovery of skin breakdown. The resident, who was alert and oriented, reported a sacrum wound, but the initial assessment was conducted by an LPN/Wound Care Nurse. The first RN assessment occurred days later, leading to a deficiency in accurate assessment procedures.
The facility failed to display 'Oxygen in Use' signage outside the rooms of three residents receiving continuous oxygen therapy, as required by their policy. This deficiency was confirmed by the DON during observations.
The facility failed to assess entrapment risks before installing side rails for several residents, including those with severe cognitive impairments and mobility issues. Observations revealed side rails in use without prior assessments or physician orders, and interviews confirmed the absence of necessary documentation.
The facility did not conduct Quality Assessment and Assurance (QAA) meetings at least quarterly, as required. Records showed meetings on specific dates, but there was no meeting between two of these dates, indicating a lapse. An interview with the administrator confirmed the absence of a meeting during this period.
A pharmacist failed to identify and report a medication irregularity for a resident prescribed Quetiapine Fumarate without an appropriate diagnosis. The facility's policy requires communication of medication issues to prescribers and leadership, but the pharmacist did not document or notify the necessary parties about the irregularity, as confirmed by the DON.
A facility failed to ensure a resident's drug regimen was free from unnecessary psychotropic medications. The resident, with multiple diagnoses including adjustment disorder with depressed mood and vascular dementia, was prescribed Quetiapine Fumarate without an appropriate diagnosis. The DON confirmed the lack of a suitable diagnosis for this antipsychotic medication.
Failure to Meet Minimum Weekend Nursing Staffing Requirements
Penalty
Summary
The facility failed to ensure sufficient nursing staff on all days to meet residents’ needs and to provide at least the minimum required staffing hours on certain weekends. Review of the facility’s PBJ Staffing Data Report for Fiscal Year Quarter 4 2025 (July 1 to September 30) showed that excessively low weekend staffing was triggered. Further review of the Staffing Pattern Forms for weekends in that quarter revealed that on 07/06/2025 the facility provided 255.70 nursing hours when 260.85 hours were required, and on 08/24/2025 the facility provided 271.20 nursing hours when 282 hours were required. In an interview on 01/12/2026 at 3:45 p.m., the administrator confirmed the facility did not provide the minimum required staffing hours on those two dates. No specific resident medical histories or conditions were described in the report, and the deficiency was based on documented staffing hours and administrative confirmation of failure to meet minimum staffing requirements on the identified weekends.
Failure to Ensure Competent Medication Administration and Documentation
Penalty
Summary
The deficiency involves failures in nursing staff competency related to medication administration for two residents. Facility policy for administering oral medications, revised April 2019, requires staff to remain with the resident until all medications have been taken. For one resident, admitted on 06/03/2022 with diagnoses including hemiplegia, muscle wasting, obesity, muscle weakness, pain, debility, and hypokalemia, a quarterly MDS showed intact cognition for daily decision making. On 01/11/2026 at 10:25 a.m., this resident was observed lying in bed with a medication cup containing four pills left unattended on the over-bed table; the resident stated these were his morning medications that he had not taken. At 10:30 a.m., the medications were still at the bedside when observed with the LPN responsible, who acknowledged the medications should not have been left at the bedside and that she should have stayed with the resident until the medications were swallowed. The DON later confirmed the nurse should not have left the medications unattended and should have remained until they were taken. For a second resident, admitted on 12/19/2025 with diagnoses of rhabdomyolysis, acute pulmonary edema, chronic kidney disease, heart failure, and atrial flutter, a physician order dated 12/31/2025 directed Lasix 10 mg/ml, 4 ml IV twice daily for edema for three days, with one dose to be given that day and then twice daily for three days. Review of the January 2026 MAR showed no documented evidence that Lasix was administered as ordered on 01/01/2026 at 8:00 p.m., 01/02/2026 at 8:00 a.m., and 01/03/2026 at 8:00 p.m. In an interview on 01/13/2026 at 4:45 p.m., the DON and Corporate Nurse confirmed there was no documentation of Lasix administration for those ordered times. These findings demonstrate failures to ensure licensed nurses had and applied the necessary competencies and skills to administer and document medications according to physician orders and facility policy.
Failure to Follow Enhanced Barrier Precautions and Sanitary Storage of Respiratory Equipment
Penalty
Summary
The deficiency involves the facility’s failure to implement its infection prevention and control program, including Enhanced Barrier Precautions (EBP), during urinary catheter care and bathing. One resident with metabolic encephalopathy, mild protein calorie malnutrition, a stage 3 sacral pressure ulcer, dementia, chronic kidney disease, benign prostatic hyperplasia with urinary retention, and an indwelling urinary catheter and PEG tube had an EBP sign posted on the room door. During observation of a bed bath and catheter care, two CNAs entered the room and provided care without donning gowns, despite facility guidance that gowns and gloves are to be used for high-contact care activities such as bathing and device care for residents with indwelling devices and wounds. One CNA performed catheter care and a bed bath without a gown, and the other washed the resident’s face without a gown. During the same bathing episode, the CNA providing catheter care used improper bathing technique that did not follow infection control practices. After placing soap into a washbasin, the CNA cleaned the resident’s penis with a washcloth and then placed the washcloth back into the soapy water. The CNA then retrieved the same washcloth and used it to wipe the resident’s buttocks, legs, and over an open blister on the leg, repeatedly returning the washcloth to the same basin of soapy water. The CNA continued to wash the resident’s lower legs with the same washcloth that had already been used on the genital and perineal areas and over the open blister. In a subsequent interview, the CNA acknowledged not using a gown and confirmed using the same washcloth after cleaning the resident’s penis. The facility also failed to store respiratory equipment in a sanitary manner for two additional residents. For one resident with a history including cerebrovascular accident, dysphagia, acute respiratory failure, protein calorie malnutrition, hypertension, and muscle wasting, a nebulizer mask was observed lying uncovered on a bedside table, and a Yankauer oral suction instrument was observed sitting uncovered on the suction machine, contrary to facility policy requiring such items to be stored in bags. For another resident with interstitial pulmonary disease, pulmonary fibrosis, chronic pulmonary edema, and mild intermittent asthma, an oxygen concentrator with humidifying water was present in the room, and the oxygen tubing attached to the concentrator was observed not stored in a bag and lying on the floor on multiple observations when the resident was not using oxygen. The DON later confirmed that the oxygen tubing should have been stored in a bag and was not stored correctly.
Food Safety and Serving Practices Deficiency
Penalty
Summary
Food was not stored, prepared, distributed, and served in accordance with professional food safety standards. During the kitchen observation, a dietary staff member was seen serving breakfast with the same gloved hand touching bacon, fried eggs, toast, biscuits, pancakes, and the scoop handle for scrambled eggs. The staff member confirmed this practice during interview. In the refrigerator, three salads, 22 sandwiches, and two bowls of soup were undated, and the cook confirmed they were not dated. A bag of pink lemonade for the drink dispenser was sitting directly on the floor, and an open package of cleaner was stored on an upper shelf above the food preparation table. In the walk-in freezer, there was an undated bag of fish and two undated bags of chicken, and in the walk-in refrigerator there were undated pans of diced tomatoes, diced tomatoes with the lid open, diced green pepper, and a bag of salad fixings. The cook confirmed these issues during interview. During lunch service, steam table temperatures showed pureed au gratin potatoes at 116 degrees Fahrenheit and chopped pork loin at 127 degrees Fahrenheit, and the cook did not reheat either item before serving. The pureed potatoes were served to multiple residents, and the chopped pork loin was served to multiple residents. During the meal, the dietary staff member continued using a gloved hand to touch serving scoop handles and then pick up rolls for resident trays. The dietary manager later agreed with the issues identified in the kitchen.
Failure to Assess and Authorize Resident Self-Administration of Medication
Penalty
Summary
The deficiency involves the facility’s failure to follow its own policy requiring assessment and authorization before allowing residents to self-administer medications. The facility’s Self-Administration of Medications policy states that residents have the right to self-administer medications only if the interdisciplinary team determines it is clinically appropriate and safe, based on an assessment of the resident’s mental and physical abilities, including understanding of labels, purpose, dosage, timing, administration, and recognition of risks. The policy further requires completion of a Self Administration of Medications assessment form and a signed consent form, and specifies that medications for self-administration must be stored in a locked cabinet in the resident’s room, not accessible to other residents, with the resident responsible for reporting each dose used to nursing staff. Resident #1 was admitted with diagnoses including encephalopathy (unspecified), Parkinsonism (unspecified), essential tremor, COPD (unspecified), and shortness of breath, and had a BIMS score of 12 indicating cognitive intactness. Physician’s orders included Flonase (fluticasone propionate nasal spray) to be administered as one inhalation in both nostrils twice daily. On multiple observations over two days, surveyors noted a bottle of fluticasone on top of a dresser at the foot of the resident’s bed, rather than secured in a locked cabinet. The resident reported that she self-administered the fluticasone and that staff brought her a new bottle when needed. The DON confirmed the presence of the fluticasone bottle in the room, and the corporate RN confirmed that there was no physician order for self-administration and no completed self-administration assessment for this resident, despite the resident self-administering the medication and keeping it at bedside.
Unlabeled Tube Feeding Bag
Penalty
Summary
The facility failed to ensure that a resident's tube feeding bag was labeled with the resident's identifying information, the type of formula, and the date and time it was started. Resident #61 had an admit date of 10/31/2025 and diagnoses including cerebral vascular accident, dysphasia, malnutrition, and PEG tube placement. The physician's orders included nothing by mouth and Isosource 1.5 tube feeding at 55 ml/hour. During observation on 01/11/2026 at 3:30 p.m., the tube feeding bag infusing at 55 cc/hr with 150 cc water bolus every 4 hours was not labeled with the resident's identifying information, the formula being infused, or the date and time it was started. At 4:00 p.m., an interview with S4LPN confirmed the bag was not labeled as required and should have been.
Failure to Conduct Timely RN Wound Assessment
Penalty
Summary
The facility failed to ensure an accurate assessment was completed for a resident with a pressure ulcer. The deficiency was identified when a resident, who was alert and oriented, reported having a wound on the sacrum area. The resident was admitted with several diagnoses, including idiopathic pulmonary fibrosis and mild protein malnutrition. Despite the presence of a wound, a body assessment completed earlier did not record any skin issues. A nurse's note indicated that skin breakdown was reported and assessed by an LPN/Wound Care Nurse, who obtained new physician orders for preventive measures. However, the initial wound assessment was not completed by a registered nurse when the skin breakdown was first identified. The first wound assessment by an RN was conducted several days later, as confirmed by the Director of Nurses. This delay in assessment by a registered nurse upon the initial discovery of the skin breakdown constitutes the deficiency noted in the report.
Failure to Display Oxygen Use Signage
Penalty
Summary
The facility failed to provide appropriate respiratory care by not displaying signage indicating oxygen use outside the rooms of three residents. The facility's Oxygen Administration policy, revised in October 2010, requires an 'Oxygen in Use' sign to be placed outside the resident's room. However, observations revealed that residents who were receiving continuous oxygen therapy did not have the required signage on their doors. This deficiency was noted for three residents, each with various medical conditions requiring oxygen therapy. Resident #29, with severe cognitive impairment and multiple diagnoses including heart failure and dementia, was observed receiving oxygen therapy without the necessary signage. Similarly, resident #316, who was alert and oriented, was also receiving oxygen therapy without the required sign. Resident #104, with a history of hypertension and atrial fibrillation, was observed on multiple occasions with oxygen in use but without the appropriate signage. The Director of Nursing confirmed the absence of the required signage for these residents.
Failure to Assess Entrapment Risks Before Side Rail Installation
Penalty
Summary
The facility failed to ensure that residents were assessed for the risk of entrapment from side rails before their installation. This deficiency was observed in five residents who were reviewed for side rail use. The facility did not complete the required Side Rail Utilization Assessment and obtain consent for side rails prior to their implementation for these residents. Resident #40, who had severe cognitive impairment and required extensive assistance with daily activities, was observed with side rails in the raised position without a prior assessment for entrapment risks. Similarly, resident #55, who had no cognitive impairment but required assistance with mobility, also had side rails installed without an entrapment risk assessment. Both residents' medical records lacked physician orders for side rails, and interviews with the Director of Nursing confirmed the absence of necessary assessments. Resident #50, who was severely cognitively impaired and dependent on staff for all activities, had side rails installed without an entrapment risk assessment, despite having a care plan that included side rails for mobility. Resident #22, with severe cognitive impairment, had side rails installed without prior assessment or consent, which was only completed after the fact. Resident #104, also severely cognitively impaired, had side rails installed without an entrapment risk assessment. Interviews confirmed the lack of documentation for assessing entrapment risks before side rail installation for these residents.
Failure to Conduct Quarterly QAA Meetings
Penalty
Summary
The facility failed to conduct Quality Assessment and Assurance (QAA) meetings at least quarterly, as required. A review of records showed that the QAA meetings were held on 10/18/2023, 04/09/2024, 07/10/2024, and 10/30/2024. However, there was no record of a meeting between 10/18/2023 and 04/09/2024, indicating a lapse in the quarterly meeting schedule. An interview with the administrator on 12/04/2024 confirmed the absence of a quarterly meeting in January 2024, further substantiating the failure to adhere to the required meeting frequency.
Pharmacist Fails to Report Medication Irregularity
Penalty
Summary
The pharmacist at the facility failed to identify and report medication irregularities for a resident who was prescribed Quetiapine Fumarate without an appropriate diagnosis. The facility's policy requires the consultant pharmacist to communicate potential or actual problems related to medications to prescribers and facility leadership. However, during the monthly drug regimen review, the pharmacist did not document any irregularity regarding the use of Quetiapine Fumarate for the resident, who had multiple diagnoses including type 2 diabetes mellitus, spinal stenosis, and vascular dementia. An interview with the Director of Nursing confirmed that the pharmacist did not notify the facility, the DON, or the attending physician about the lack of an appropriate diagnosis for the antipsychotic medication prescribed to the resident. This oversight was identified during a review of the resident's electronic health records, which showed an order for Quetiapine Fumarate for mood related to adjustment disorder with depressed mood, but no corresponding diagnosis to justify its use.
Inappropriate Use of Psychotropic Medication
Penalty
Summary
The facility failed to ensure that a resident's drug regimen was free from unnecessary psychotropic medications. Specifically, the facility did not have an appropriate diagnosis documented in the medical record for the use of Quetiapine Fumarate, an antipsychotic medication, for a resident. The resident, who was admitted with multiple diagnoses including type 2 diabetes mellitus with diabetic neuropathy, adjustment disorder with depressed mood, vascular dementia, and major depressive disorder, had an order for Quetiapine Fumarate to be administered twice daily for mood related to adjustment disorder with depressed mood. During an interview, the Director of Nursing confirmed that the resident did not have an appropriate diagnosis for the use of this antipsychotic medication.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Ruston
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Princeton Place-ruston | 10.9 mi | ★★★★★ | 6 | 0 |
| Leslie Lakes Retirement Center | 13 mi | ★★★★★ | 10 | 0 |
| Forest Haven Nursing & Rehab Ctr, Llc | 13.1 mi | ★★★★★ | 0 | 0 |
| Willow Ridge Nursing And Rehabilitation Center,llc | 13.4 mi | ★★★★★ | 3 | 0 |
| Ruston Nursing And Rehabilitation Center, Llc | 14.9 mi | ★★★★★ | 1 | 0 |
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