Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Highland Farms during CMS and state inspections, most recent first.
Failure to obtain psychotropic medication consent before initiation or continuation of ordered meds affected three residents. One resident with anxiety and depression received buspirone and escitalopram, another resident with anxiety/depression received mirtazapine, and a third resident with major depression received sertraline; in each case, the MAR showed the meds were given as ordered, but the record lacked documentation that the resident or representative was informed in advance of the risks and benefits. The DON, Psychiatric NP, Medical Director, and Administrator stated consent was required for psychotropic meds, including when residents were admitted on them or when doses were increased.
Incomplete Abuse Investigation and Reporting: A cognitively intact resident reported that a nurse aide grabbed her and yanked off her gown, leaving bruising on her arms. The DON and nursing staff documented the allegation and substantiated abuse, but the investigation was limited to one hall and did not include a resident statement, a statement from the accused aide, or broader interviews and skin checks. The facility notified DHSR and law enforcement, but APS/DSS notification was not documented.
Failure to complete a comprehensive trauma screening assessment on admission for a resident with anxiety disorder and insomnia. The resident and RP reported a history of domestic violence, but the chart had no trauma screening or trauma-informed care plan. The DON said the trauma history was unknown because the assessment was never completed, and the Medical Director and former SW stated that trauma screening was not being done for new admissions.
Surveyors found that kitchen staff failed to label and date leftover food in the walk-in cooler and freezer, and did not discard expired food items in the dry goods storage room. Unlabeled cooked chicken fillets, sliced potatoes, expired angel food cake, cornflakes, and poultry gravy powder were all available for use, contrary to food safety standards.
A resident with moderate cognitive impairment was moved to a different room without advance written notice to the responsible party or clear documentation of the reason for the change. The responsible party was notified only after the move had occurred, and staff interviews revealed inconsistent understanding of notification requirements.
A deficiency was cited due to the facility's failure to keep an area free from accident hazards and to provide adequate supervision to prevent accidents. Surveyors observed that the environment did not meet safety standards and lacked proper oversight.
The facility failed to provide competent nursing staff regarding glucometer disinfection. A nurse was observed not disinfecting a glucometer after use, and both she and a medication aide lacked documented training on the procedure. The DON confirmed the absence of training records and attributed the oversight to turnover in the SDC position.
A nurse failed to disinfect a glucometer after performing a blood glucose test on a resident, contrary to the facility's infection control policy. The nurse was unaware of the requirement to disinfect the device after each use, and the Director of Nursing confirmed that the glucometer should be cleaned per manufacturer instructions, which conflicted with the facility's policy. The Administrator stated that an EPA-approved disinfectant should be used to prevent the transmission of blood-borne pathogens.
A resident who consented to receive a pneumococcal vaccine did not receive it due to a lapse in the facility's immunization process. The resident's consent was documented, but the vaccine was not administered, and there was no record of past immunization. The DON expected timely administration, but the IP's lack of communication and process changes led to the oversight.
A resident with moderate cognitive impairment was not offered a COVID-19 vaccine upon admission to the facility, despite having not received one for over a year. The DON acknowledged the oversight, attributing it to the IP's lack of communication and changes in the immunization process. The resident expressed a desire to receive the vaccine, which was not documented or offered.
Failure to Obtain Psychotropic Medication Consent
Penalty
Summary
The facility failed to obtain consent and inform residents or their resident representatives in advance of the risks and benefits of psychotropic medications before those medications were started or continued for three residents reviewed for unnecessary medications. Resident #43 had diagnoses including generalized anxiety disorder and major depressive disorder and was receiving buspirone and escitalopram; the record showed these medications were administered as ordered, but there was no information indicating the resident was informed in advance of the risks and benefits when admitted to the facility. The admission MDS indicated the resident was cognitively intact and had received an anti-anxiety medication and an antidepressant during the look-back period. Resident #4 had diagnoses including adjustment disorder with mixed anxiety and depressed mood and generalized anxiety disorder and was ordered mirtazapine for depression. The medical record contained no signed consent showing the resident was informed in advance of the risks and benefits of mirtazapine when admitted. The MAR showed the medication was administered as ordered, and the admission MDS indicated the resident was cognitively intact and received an antidepressant during the look-back period. Resident #16 had major depressive disorder and was ordered sertraline for depression. The record contained no information indicating the resident was informed in advance of the risks and benefits of sertraline. The MAR showed sertraline was administered as ordered, and the admission MDS indicated the resident was moderately cognitively impaired and received antidepressant medication during the look-back period. Staff, the Psychiatric NP, the Medical Director, the DON, and the Administrator all stated that psychotropic medication consent was required before initiation or dose increases, including for residents admitted on psychotropic medications, and the DON and Administrator stated the consent form had not been completed because the electronic form was not set up to automatically be completed on admission and was overlooked.
Incomplete Abuse Investigation and Reporting
Penalty
Summary
The facility failed to implement its abuse policy for investigation and reporting after an allegation of staff-to-resident abuse involving a cognitively intact resident admitted with anxiety disorder and insomnia. The resident reported that a nurse aide grabbed her and yanked her gown off, causing bruising to her arms. Bruising in various stages of healing was documented on both arms and the right hand, and the facility substantiated the allegation of abuse. The investigation was limited and did not include a written or signed statement from the resident or a written statement from the accused nurse aide. The nurse aide denied the allegation during a later telephone interview and stated he was never asked to complete a statement or interviewed by the facility, his agency, or law enforcement. The investigation also did not include documented interviews from other cognitively intact residents the nurse aide had worked with or skin assessments for all moderately and severely cognitively impaired residents in the facility; instead, the DON instructed staff to limit interviews and assessments to one hall. Reporting was also incomplete. The facility submitted the initial report to DHSR and notified law enforcement, but there was no documentation of notification to APS/DSS on the initial report. During interview, the DON stated she did not realize APS was supposed to be notified within 24 hours and acknowledged that a more thorough investigation could have been completed. The Administrator stated she would expect the DON to follow reporting regulations and complete a thorough investigation before substantiating the allegation.
Failure to Complete Trauma Screening on Admission
Penalty
Summary
The facility failed to complete a comprehensive trauma screening assessment for a newly admitted resident who had diagnoses including anxiety disorder and insomnia. Resident #58 was admitted with a cognitively intact MDS assessment, but the medical record contained no comprehensive trauma screening and no trauma-informed care plan. The resident’s Responsible Party stated that the resident had a history of domestic violence, and the resident also stated that she had a history of domestic violence and could not recall being asked questions about that history or any other evaluation for past trauma. The DON stated that a comprehensive trauma assessment should have been completed on all residents by the Social Worker upon admission and quarterly, and that any trauma history would have been care planned. The DON said Resident #58’s history of domestic violence was unknown because the assessment was never completed, and that the resident would have been care planned for no male caregivers had the history been known. The Medical Director stated that the Provider did not conduct any form of trauma screening on new admissions, and the previous facility Social Worker stated that she had not completed trauma screenings on newly admitted residents or as part of ongoing assessments. The Administrator stated that a comprehensive trauma assessment should have been completed by the Social Worker or designee on each resident to evaluate for trauma history and possible triggers.
Failure to Properly Label, Date, and Discard Food Items
Penalty
Summary
Surveyors observed multiple deficiencies in food storage and labeling practices within the facility's kitchen. In the walk-in cooler, there was an open and unlabeled ripped plastic bag of cooked chicken fillets and an opened, unlabeled plastic-wrapped bag of thin sliced potatoes, both available for use. In the walk-in freezer, a tray of frozen angel food cake was found wrapped in plastic and labeled with a use-by date that had already passed. Additionally, in the dry goods storage room, two plastic bags of cornflakes and a plastic bin of poultry gravy powder were found with use-by dates that had expired, yet these items remained available for use. Interviews with the Dietary Manager and Food Service Director confirmed that the items were not stored or labeled according to facility policy and professional standards. The Dietary Manager acknowledged the improper storage and labeling, and the Food Service Director stated that staff had previously received education on proper procedures. The Administrator also confirmed that kitchen staff are expected to follow food safety standards and policies. These findings indicate that the facility failed to consistently label, date, and discard expired or improperly stored food items, as required.
Failure to Provide Advance Written Notice of Room Change
Penalty
Summary
The facility failed to notify the responsible party (RP) in advance of a room change for a resident who was moderately cognitively impaired. Documentation showed that the Social Service Director left a voicemail and sent an email to the RP on the same day the room change occurred, but there was no evidence that the RP or the resident was notified prior to the move or provided with the reason for the change in advance. The resident was moved to a different room on the same day as the notification, and the RP reported being informed only after the move had already taken place. The resident had been in her previous room for over a year and had refused to move, but this refusal was not documented or communicated among staff. Interviews with facility staff, including the interim Social Service Director, MDS Coordinator, DON, and Administrator, revealed inconsistent practices and understanding regarding notification requirements for room changes. The MDS Coordinator stated that the facility did not need permission to change a resident's room, and the Administrator believed that simply notifying the RP by email was sufficient. There was no documentation of the resident's refusal to move or of any discussion with the resident about the room change prior to it occurring.
Failure to Maintain Accident-Free Environment and Adequate Supervision
Penalty
Summary
A deficiency was identified in the facility's failure to ensure that an area was free from accident hazards and that adequate supervision was provided to prevent accidents. The report notes that the environment did not meet safety standards, which could contribute to accidents occurring. Specific actions or inactions leading to this deficiency include the lack of proper oversight and the presence of hazards in the area, as directly observed by surveyors.
Deficiency in Glucometer Disinfection Training
Penalty
Summary
The facility failed to ensure that nursing staff had the appropriate competencies regarding the disinfection of glucometers, as evidenced by observations and staff interviews. Nurse #1, who had been employed at the facility for about three months, was observed performing a blood glucose check and returning the glucometer to the medication cart without disinfecting it. During an interview, Nurse #1 admitted to not being aware of the need to disinfect the glucometer and confirmed that she had not received any training on this procedure. A review of her employee file corroborated the absence of any documented education on glucometer disinfection. Similarly, Medication Aide #1, who had been with the facility for a year and a half, reported that she was instructed during her orientation to clean glucometers after each use, using either a disinfectant wipe or an alcohol wipe. However, she admitted to using an alcohol prep pad for convenience. Her employee file also lacked documentation of education on glucometer disinfection. The Director of Nursing confirmed the absence of training records for both staff members and acknowledged that education on glucometer disinfection was not currently part of the new hire orientation, attributing this oversight to turnover in the Staff Development Coordinator position.
Failure to Disinfect Glucometer After Use
Penalty
Summary
The facility failed to implement its policy and procedures for glucometer disinfection, resulting in a deficiency in infection prevention and control. During an observation, Nurse #1 was seen performing a blood glucose test for a resident without disinfecting the glucometer afterward. The glucometer, labeled for individual use, was returned to its storage bag without being cleaned, despite the presence of disinfectant wipes in the medication cart. Nurse #1 stated she had not been informed of the need to disinfect the glucometer after each use and had not received any education on the facility's disinfection procedures. Interviews with the Director of Nursing (DON) and the Administrator revealed that the facility's policy required glucometers to be disinfected after each use, regardless of individual use, to prevent the transmission of blood-borne pathogens. The DON acknowledged that the glucometer in use was intended for home use and should be cleaned according to manufacturer instructions, which conflicted with the facility's policy. The Administrator confirmed that an EPA-approved disinfectant should be used to disinfect glucometers after each use.
Failure to Administer Pneumococcal Vaccine
Penalty
Summary
The facility failed to administer a pneumococcal vaccine to a resident who had consented to receive it. The resident, who was cognitively intact, had consented to the vaccine during a video conference with her family, as documented on the Resident Vaccine Consent Form. Despite the consent being recorded, there was no documentation in the resident's medical record indicating that the vaccine had been administered. The resident expressed her desire to receive the newest pneumococcal vaccine and was waiting for the facility to provide it. The Director of Nursing (DON) acknowledged the absence of any record of the vaccine being administered and noted that the facility lacked any past immunization history for the resident. The DON expected the vaccine to be offered upon admission and administered promptly after consent was obtained. However, the Infection Preventionist (IP), who was responsible for managing immunizations, had not communicated effectively and had made changes to the immunization process without discussing them with the DON. As a result, the administration of the pneumococcal vaccine to the resident was overlooked. The Administrator confirmed that the vaccine should have been offered and administered to the resident as per her consent.
Failure to Offer COVID-19 Vaccine to Resident
Penalty
Summary
The facility failed to offer and provide a COVID-19 vaccine to a resident, identified as Resident #42, who was reviewed for COVID-19 immunizations. Resident #42 was admitted to the facility with moderate cognitive impairment and had last received a COVID-19 vaccine prior to admission. There was no documentation in the medical record indicating that the COVID-19 vaccine had been offered to him since his admission. During an interview, Resident #42 confirmed that the facility had not discussed or offered the COVID-19 vaccine to him, and he expressed a desire to receive the newest recommended vaccine. The Director of Nursing (DON) acknowledged the absence of a record offering the COVID-19 vaccine to Resident #42 and explained that the Infection Preventionist (IP) was responsible for obtaining immunization history and offering vaccines to residents. The DON noted that the IP had been overwhelmed with other responsibilities and had not communicated changes to the immunization process effectively, resulting in the oversight. The Administrator also confirmed that the COVID-19 vaccine should have been offered to residents upon admission, and if Resident #42 had wanted the vaccine, it should have been administered.
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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 Black Mountain
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Nc State Veterans Home - Black Mountain | 1.2 mi | ★★★★★ | 2 | 0 |
| Mountain Ridge Rehabilitation And Healthcare Cente | 2.2 mi | ★★★★★ | 5 | 0 |
| Black Mountain Neuro-medical Treatment Center | 2.2 mi | ★★★★★ | 0 | 0 |
| Swannanoa Valley Health And Rehabilitation | 5.2 mi | ★★★★★ | 0 | 0 |
| The Laurels Of Summit Ridge | 7.7 mi | ★★★★★ | 2 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release October 2026) and official state health department websites.