Above average — CMS composite of the measures below.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Bland County Nursing & Rehab Center during CMS and state inspections, most recent first.
Failure to Administer Ordered Gabapentin: Staff did not follow a provider order for Gabapentin for a resident with severe cognitive impairment, quadriplegia, ventilator dependence, and chronic pain syndrome. The MAR showed two missed doses, while nursing notes stated the medication was on hold until the prescription came in; however, the Omnicell inventory listed Gabapentin as available, and the DON stated staff should have pulled it from the emergency supply.
A resident with severe cognitive impairment, quadriplegia, ventilator dependence, and pneumonia with CRP-positive sputum culture did not receive all ordered doses of Cefepime. The MAR showed missed doses, and the DON stated the pharmacy sent only a partial supply, additional doses were taken from the Omnicell, and no more were available. A pharmacy non-covered medication notice in the record showed the refill was canceled pending facility authorization, but the authorization section was left blank.
Failure to Obtain Ordered Urinalysis: Facility staff did not obtain a urinalysis ordered by the medical provider for a resident with severe cognitive impairment, chronic respiratory failure with hypoxia, quadriplegia, ventilator dependence, and chronic pain syndrome. The resident had an elevated temp and hypotension, the provider was notified, and a UA with reflex was ordered, but the clinical record contained no results or evidence that it was completed; the DON stated it was not obtained and did not know why.
Incomplete Documentation of Provider Notification for Unobtained X-ray: A resident with severe cognitive impairment, ventilator dependence, quadriplegia, and Stage IV wounds had an order for a bilateral scapula x-ray due to concern for osteomyelitis. The x-ray company could not obtain the study because of the resident’s anatomy, and although the DON said the medical provider was notified, that notification was not documented in the clinical record.
Failure to Follow Contact Precautions for a Resident with CRPA: An RN entered a resident’s room wearing gloves only and exposed the resident’s enteral feeding tube site despite contact isolation orders and a posted sign requiring a gown and gloves. The resident had severe cognitive impairment, chronic respiratory failure with hypoxia, quadriplegia, ventilator dependence, and a respiratory culture positive for CRPA; the care plan and facility policy both required contact precautions.
A resident with bilateral hearing loss and intact cognition did not have a comprehensive care plan addressing hearing-related communication needs. Staff observations showed he could not hear most conversations even when spoken to loudly in his preferred ear, became frustrated and yelled that he could not hear, and had difficulty understanding medication instructions. The care plan focused on behaviors such as refusing care and yelling at staff, but did not address hearing loss or its impact on communication.
Activity Care Plans Not Reviewed or Documented for Three Residents: The facility failed to review, revise, and reassess the effectiveness of activity care plan interventions for three residents. One resident was cognitively intact with MS and pain, one had severe cognitive impairment with trach/PEG and respiratory failure, and one was in a persistent vegetative state with multiple serious diagnoses. The records showed activity care plans with initial and revised dates, but no activity progress notes or documented quarterly activity assessments/reviews. The AD stated care plans were only changed for resident-stated changes or new interests and that progress was not being documented because there was little change in activities.
Failure to Administer Ordered Gabapentin
Penalty
Summary
Facility staff failed to follow a medical provider order for Gabapentin for Resident #3, who was admitted on 4/08/26 with a history that included chronic respiratory failure with hypoxia, quadriplegia, central cord syndrome at C5, ventilator dependence, and chronic pain syndrome. The admission MDS dated 4/14/26 showed a BIMS score of 0 out of 15, indicating severe cognitive impairment. The resident’s comprehensive care plan identified pain related to pressure injuries, muscle spasms, neuropathy, C5 fracture, and contractures, with an intervention to administer pain medication as ordered. A provider order dated 4/08/26 directed Gabapentin 100 mg via PEG tube three times daily for neuropathy. The April 2026 MAR showed the medication was not administered on 4/09/26 at 2:00 PM and 10:00 PM. Nursing progress notes documented that Gabapentin was on hold until the prescription came in and later was on hold. The facility’s Omnicell inventory list showed Gabapentin 100 mg capsules were available, and the DON stated staff should have pulled the medication from the Omnicell to administer it. The facility policy on medication shortage/unavailable medications stated that if a medication is unavailable after normal pharmacy hours, a nurse should obtain the ordered medication from the emergency medication supply.
Ordered antibiotic was unavailable for administration
Penalty
Summary
The facility failed to ensure that a provider-ordered antibiotic was available for administration for one resident. Resident #3, who was admitted with chronic respiratory failure with hypoxia, quadriplegia, central cord syndrome at C5, dependence on a ventilator, chronic pain syndrome, and a BIMS score of 0 indicating severe cognitive impairment, was seen by the medical provider for pneumonia with a sputum culture positive for CRP (carbapenem-resistant Pseudomonas). The provider ordered Cefepime 1 gram IM twice daily for seven days, and the resident’s care plan included an intervention for medications as ordered for pneumonia infection. A review of the MAR showed Cefepime was not administered on three scheduled doses, including two doses on one day and one dose the next day. The DON stated the resident had received nine doses total, that the pharmacy sent only a partial supply of six doses, and that three additional doses were pulled from the Omnicell, after which no more doses were available. The DON also stated the resident’s Medicaid coverage was pending and that this often created problems when the pharmacy tried to bill for medication. The resident’s record contained a pharmacy non-covered medication notification form dated 5/03/26 showing the Cefepime refill was canceled because facility authorization was required for the fill and the pharmacy had initiated an insurance prior authorization; the authorization section was left blank and the form was scanned into the record.
Failure to Obtain Ordered Urinalysis
Penalty
Summary
Facility staff failed to provide laboratory services to meet the needs of 1 of 3 residents in the survey sample when a urinalysis ordered by the medical provider was not obtained for Resident #3. The resident was admitted on 4/08/26 and had a medical history that included chronic respiratory failure with hypoxia, quadriplegia, central cord syndrome at C5 level of the cervical spinal cord, dependence on ventilator, and chronic pain syndrome. An admission MDS with an ARD of 4/14/26 indicated a BIMS score of 0 out of 15, showing the resident was severely cognitively impaired. On 4/22/26, a nursing progress note documented an elevated temperature of 103.0 and hypotension, and the medical provider was notified and issued new orders, including a urinalysis with reflex. Although the order was present in the clinical record, there were no results or other evidence that the urinalysis was obtained. During interview, the DON stated the urinalysis was not obtained and did not know the reason, while noting the resident was being treated for pneumonia.
Incomplete Documentation of Provider Notification for Unobtained X-ray
Penalty
Summary
The facility failed to maintain a complete and accurate clinical record for a resident with severe cognitive impairment and significant medical complexity. Resident #3 was admitted with chronic respiratory failure with hypoxia, quadriplegia, central cord syndrome at C5, dependence on a ventilator, and chronic pain syndrome. The resident’s admission MDS showed a BIMS score of 0 out of 15, indicating severe cognitive impairment. The resident was seen by the medical provider for an elevated inflammatory panel with concern for osteomyelitis related to Stage IV wounds with bone exposure to the sacrum, iliac crests, and bilateral scapula, and an order was placed for an x-ray of the bilateral scapula. Although the clinical record included the order to obtain the bilateral scapula x-ray, there were no results documented in the record. During interview, the DON stated the x-ray company would not obtain the x-ray because of limitations caused by the resident’s anatomy, and the DON stated she notified the medical provider but failed to document that notification in the resident’s clinical record. The Administrator, DON, and Regional Corporate Representative were informed of the concern regarding the lack of documentation, and no further information was presented before the exit conference.
Failure to Follow Contact Precautions for Resident with CRPA
Penalty
Summary
The facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary environment and prevent the transmission of communicable diseases and infections by not following transmission-based precautions for one resident. Resident #3 was admitted with a history that included chronic respiratory failure with hypoxia, quadriplegia, central cord syndrome at C5, dependence on a ventilator, and chronic pain syndrome, and the admission MDS indicated a BIMS score of 0 out of 15, showing severe cognitive impairment. The resident’s clinical record included a lower respiratory culture dated 4/29/26 that was positive for carbapenem-resistant Pseudomonas aeruginosa (CRPA), and the provider ordered contact isolation on 4/30/26. The care plan also identified the need for isolation related to CRP in the sputum with an intervention to maintain isolation precautions per infection control policy. On 5/05/26, an RN entered the resident’s room wearing gloves only and pulled up the resident’s gown to expose the enteral feeding tube site. The RN stated the resident was on enhanced barrier precautions and that a gown was not needed because she was not working with the tubes. However, the facility’s Infection Preventionist stated that a gown and gloves were required to enter the room because the resident was on contact precautions, and a contact isolation sign posted at the door instructed staff to put on a gown before room entry. The facility policy on Transmission-Based (Isolation) Precautions stated that healthcare personnel caring for residents on Contact Precautions wear a gown and gloves for all interactions that may involve contact with the resident or potentially contaminated areas in the resident’s environment.
Incomplete care plan for resident with hearing loss and communication difficulty
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident with bilateral hearing loss and communication difficulty. The resident was admitted with diagnoses including bilateral hearing loss, and the MDS quarterly assessment documented minimal hearing difficulty in some environments, no hearing devices used, and a BIMS score of 13 indicating cognitive intactness. Review of the baseline care plan noted the resident was very hard of hearing and needed hearing aids, but the revised care plan addressed behaviors such as refusing medications, refusing care, yelling at staff, and refusing to have the bedside table cleaned off without addressing hearing loss or communication difficulty as a contributing factor. Observations and interviews showed the resident could not hear most of the interaction even when staff spoke very loudly into the resident's left ear, which was identified as the preferred ear. The resident became upset and dismissive during an interview, yelled that he could not hear, and ended the visit due to agitation. During medication administration, an LPN had to lean down and speak very loudly for the resident to understand, and another observation showed the resident still could not hear questions being asked. Staff interviews confirmed communication problems, with one LPN stating the resident became upset and apologized for an outburst, and another stating the resident needed staff to stand in front of him and speak loudly on his left side. The DON later updated the care plan to include hearing-related communication limitations.
Activity Care Plans Not Reviewed or Documented for Three Residents
Penalty
Summary
The facility failed to review, revise, and/or reassess the effectiveness of the interventions in the comprehensive person-centered activity care plans for 3 residents. For Resident #7, the record showed diagnoses including pain in the right hip, chronic kidney disease stage 3, unsteadiness on feet, and multiple sclerosis. The most recent MDS showed the resident was cognitively intact with a BIMS score of 15 out of 15. The activity care plan had an initiated date of 2/13/23 with later revisions to the focus and goal, but the interventions remained dated only to the original initiation date. The clinical record did not contain activity progress notes, and the admission Activity Evaluation was dated 3/10/25. For Resident #9, the record showed diagnoses including chronic respiratory failure with hypoxia, tracheostomy, gastrostomy, dependence on respirator, peripheral vascular disease, altered mental status, anxiety, intracerebral hemorrhage, anoxic brain damage, and cognitive communication deficit. The most recent MDS showed severe cognitive impairment, with the resident rarely or never understood and never or rarely making decisions. The activity care plan included an initiated focus date of 9/25/25, a revised goal date of 10/8/25, and interventions dated 9/26/25 and 10/16/25, but the clinical record did not contain activity progress notes. The admission Activity Evaluation was dated 9/18/25. For Resident #35, the record showed diagnoses including chronic respiratory failure with hypoxia, anoxic brain damage, heart failure, type 2 diabetes mellitus, persistent vegetative state, seizures, tracheostomy, gastrostomy, and osteomyelitis. The most recent MDS was not coded for Section C because the resident was in a persistent vegetative state. The activity care plan showed an initiated focus and goal date of 4/30/25, with interventions dated 4/30/25 and one intervention revised on 7/15/25. The clinical record did not contain activity progress notes, although it did include a Comprehensive Activity Evaluation dated 4/9/25 and an admission Activity Evaluation dated 10/1/25. The administrator and activity director stated quarterly activity progress notes had not been completed, and the activity director stated the care plan was not changed unless the resident voiced a change or had a new interest, and that progress was not being documented because there was not a lot of change with resident activities.
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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 Bastian
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mercer Healthcare Center | 6.6 mi | ★★★★★ | 10 | 0 |
| Bluestone Health And Rehabilitation | 7 mi | ★★★★★ | 35 | 1 |
| Westwood Center | 7 mi | ★★★★★ | 0 | 0 |
| Glenwood Healthcare Center | 11 mi | ★★★★★ | 0 | 0 |
| Princeton Health Care Center | 12.2 mi | ★★★★★ | 10 | 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 August 2026) and official state health department websites.