Below average — CMS composite of the measures below.
The next survey window likely opens around October 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 Westwood Hills Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
Failure to Protect Resident from Resident-to-Resident Abuse: A cognitively impaired resident with a history of verbal and physical aggression struck another cognitively impaired resident at the nurse’s station after a verbal exchange. The struck resident fell to the floor, was initially assessed with only minor complaints, and later was found to have a hip fracture and an olecranon fracture requiring hospital transfer and surgery. Staff interviews confirmed the altercation and the resident’s prior aggressive behaviors.
Surveyors found expired nutritional supplement shakes in the facility's dry storage and on the service line, with three expired shakes prepared for resident service before being removed by surveyors. Dietary staff interviews revealed missed checks of expiration dates and a failure to remove expired items as required.
A resident with chronic pain received oxycodone as ordered, but 30 tablets and related documentation went missing after pharmacy delivery. Despite verification by two nurses and regular shift counts, the loss was not detected until the supply was nearly depleted. The DON and staff were unable to locate the missing medication or records, and the incident was reported to authorities. The resident did not miss any doses due to timely replacement, but the event revealed a breakdown in the facility's controlled substance tracking system.
The facility failed to implement broad-based testing during a COVID-19 outbreak, resulting in the virus spreading to two hallways and affecting multiple residents. Initially relying on contact tracing, the facility did not transition to broad-based testing despite ongoing positive cases and CDC guidelines recommending such an approach when contact tracing fails. Interviews revealed that the facility believed the outbreak was contained and did not consider broad-based testing necessary.
A facility failed to update a resident's code status in the medical record, resulting in a discrepancy between the care plan and a physician's DNR order. The resident, who was severely cognitively impaired, had a care plan indicating Full Code, while a later physician order indicated DNR. Staff interviews revealed that the oversight occurred due to the Unit Manager forgetting to update the care plan and the Director of Nursing acknowledging the lapse in the facility's process.
A resident with vascular dementia and frequent incontinence was prescribed Ciprofloxacin for a UTI, despite lab results showing resistance. The error was identified after the medication was administered, and the resident was switched to the correct antibiotic. The oversight occurred due to assumptions about lab report reviews and was acknowledged by the NP.
Failure to Protect Resident from Resident-to-Resident Abuse
Penalty
Summary
The facility failed to protect a resident from resident-to-resident abuse when one cognitively impaired resident struck another resident at the nurse’s station, causing the second resident to fall to the floor. The resident who was struck had diagnoses including dementia, alcohol abuse, and a right hip fracture history, and was documented as severely cognitively impaired, wandering, and behaviorally impaired. The resident who struck him had diagnoses including traumatic brain injury, paranoid schizophrenia, and dementia, and was also documented as severely cognitively impaired with wandering and behavioral issues. According to the incident investigation, the two residents were at the nurse’s station when the resident who was struck told the other resident to stop yelling at staff. The other resident then hit him in the face, knocking him down. The witness nurse reported seeing the resident punch the other resident in the left jaw and fall to the floor. The struck resident was assessed afterward and initially complained of burning in the right hip, but no obvious extremity abnormalities were noted at that time. He remained at the nurse’s station for a period after the incident and was later placed on 1:1 supervision because staff believed he was the aggressor. The resident’s injuries were not identified until the next morning, when he complained of pain in both hips and the left elbow. Assessment then revealed a swollen left elbow and the left leg rotated outward and shorter than the right. The NP was notified, the resident was sent to the ER, and hospital records showed a left olecranon fracture and a left hip fracture requiring surgical repair. Interviews with the nurse, DON, NP, Psychiatric Provider, and Administrator confirmed the resident-to-resident altercation and that the resident who initiated the physical aggression had a history of verbal and physical aggression toward residents and staff.
Expired Nutritional Shakes Found in Storage and on Service Line
Penalty
Summary
The facility failed to remove expired nutritional supplement shakes from their dry storage area, resulting in expired products being prepared for service to residents. During an observation of the dry storage area, surveyors found 48 mixed berry flavored nutritional shakes with an expiration date of 08/01/25 and 18 vanilla flavored shakes with an expiration date of 06/20/25 on the top shelf. A follow-up observation revealed that while the mixed berry shakes remained, only 15 vanilla shakes were left, indicating that some expired shakes had been removed from storage. Subsequently, three expired vanilla nutritional shakes were found on the service line, ready to be served to residents, and were only removed after surveyor intervention. Interviews with dietary staff revealed that the Assistant Dietary Manager believed she had checked the nutritional shakes earlier in the week but acknowledged missing some, and stated that expiration dates should have been checked when items were pulled for service. The Dietary Manager explained that expired food items were supposed to be checked and removed twice a week, typically when new stock arrived, and accepted responsibility for ensuring expired items were not present. The Administrator confirmed that there was no reason for expired nutritional shakes to remain in storage or reach the service line, regardless of the low usage rate among residents.
Failure to Safeguard and Account for Controlled Medication
Penalty
Summary
The facility failed to implement effective systems to safeguard a resident's controlled medication, resulting in the misappropriation of 30 tablets of oxycodone 15 mg for one resident. The resident, who was cognitively intact and had chronic pain syndrome, was admitted with an order for oxycodone 15 mg every six hours. The pharmacy delivered 120 tablets in four cards, and the medication was verified and signed in by two nurses. However, the medication was not started immediately due to leftover tablets from a previous order. When the supply was nearly exhausted, it was discovered that one card of 30 tablets and its corresponding declining count sheet were missing, as well as the shift change count sheet for the relevant period. Interviews with nursing staff revealed that the medication count was verified upon delivery, but the missing card and documentation were not noticed until the resident was nearly out of medication. The nurse who initiated the last card did not realize that the previous card was missing and simply used the remaining card in the cart. The Director of Nursing (DON) and other staff searched for the missing medication and documentation but were unable to locate them. The investigation included reviewing packing slips, count sheets, and interviewing staff, but the missing medication and documentation could not be accounted for. The facility reported the loss to the appropriate authorities, including the Drug Enforcement Administration and local police. Despite drug testing staff and conducting interviews, the investigation could not confirm whether the medication was diverted or accidentally discarded. The resident did not miss any doses, as additional medication was obtained before the supply was exhausted. The incident highlighted a failure in the facility's system for tracking and safeguarding controlled substances, as evidenced by the missing medication, declining count sheet, and shift change documentation.
Failure to Implement Broad-Based Testing During COVID-19 Outbreak
Penalty
Summary
The facility failed to implement broad-based testing during a COVID-19 outbreak, which resulted in the spread of the virus to two of five hallways, affecting 11 residents on the 100 hall and one resident on the 200 hall. The outbreak began when a newly hired activity employee tested positive for COVID-19, and the facility initially relied on contact tracing to manage the situation. Despite ongoing positive cases among residents and staff, the facility did not transition to broad-based testing, as recommended by CDC guidelines, when contact tracing failed to halt transmission. The facility's policy allowed for either contact tracing or broad-based testing during an outbreak, with a preference for contact tracing. However, the policy also stated that if additional cases were identified and transmission was uncontrolled, broad-based testing should be considered. The facility continued with contact tracing, testing individuals who had close contact with the initial positive case and adding symptomatic residents and staff to the testing list. Despite these efforts, the outbreak spread, and the facility did not implement broad-based testing, even after a resident on a different hall tested positive. Interviews with the Director of Nursing (DON), Infection Preventionist (IP), and representatives from SPICE and the local health department revealed that the facility did not consider broad-based testing because the outbreak seemed to be contained to one hall and was believed to be fizzling out. The local health department was informed of the outbreak but did not provide additional recommendations for broad-based testing. The facility continued to rely on contact tracing and mask-wearing protocols, but the outbreak eventually affected residents on multiple halls, indicating a failure to adequately control the spread of COVID-19.
Failure to Update Resident's Code Status in Medical Record
Penalty
Summary
The facility failed to ensure that a resident's code status election was accurately reflected throughout the medical record. Resident #92, who was severely cognitively impaired, had a care plan indicating a Full Code status, while a physician order dated later indicated a Do Not Resuscitate (DNR) status. This discrepancy was identified during a review of the resident's records and staff interviews. Nurse #1 explained that code status elections are discussed upon admission and during care plan meetings, and any changes are supposed to be updated in the care plan. However, the Unit Manager (UM) admitted to forgetting to update the care plan after taking the DNR order. The Director of Nursing (DON) acknowledged that the resident's change in code status was overlooked, despite the facility's process of reviewing new orders in daily meetings. This oversight resulted in the resident's care plan not being updated to reflect the DNR status.
Failure to Prescribe Effective Antibiotic for UTI
Penalty
Summary
The facility failed to prescribe an effective antibiotic for a resident with a urinary tract infection. The resident, who was admitted with vascular dementia and was frequently incontinent, had a urinalysis showing over 100,000 bacteria resistant to Ciprofloxacin. Despite this, a physician ordered Ciprofloxacin for the resident, which was administered over two days. The error was identified when the Nurse Practitioner, who had initially reviewed the urinalysis, acknowledged the mistake upon re-evaluation. The Unit Manager explained that lab reports were typically reviewed by medical providers, and she would only intervene if a provider was unavailable. The Director of Nursing confirmed the error was reported by the Nurse Practitioner, who had already switched the resident to the correct antibiotic. The infection preventionist, known for meticulous checks, would have likely caught the error within a couple of days, but the oversight had already occurred.
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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 Wilkesboro
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Ridge Valley Center For Nursing And Rehabilitation | 0.4 mi | ★★★★★ | 1 | 0 |
| Wilkesboro Health And Rehabilitation | 1.5 mi | ★★★★★ | 3 | 0 |
| Wilkes Regional Medical Ctr Sn | 1.6 mi | ★★★★★ | 0 | 0 |
| Valley Nursing And Rehabilitation Center | 18.4 mi | ★★★★★ | 6 | 0 |
| Pruitthealth-elkin | 20.5 mi | ★★★★★ | 0 | 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 July 2026) and official state health department websites.