Below average — CMS composite of the measures below.
The next survey window likely opens around February 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 Riverside Lifelong Health & Rehabilitation Salud during CMS and state inspections, most recent first.
Surveyors found multiple infection control failures involving droplet precautions for residents with suspected or confirmed influenza. A resident on isolation ate breakfast in the dining room with other residents while flu testing was pending and had not been educated on droplet precautions. Staff also used incorrect droplet signage for several rooms and entered isolation rooms without the PPE required by policy, including missing eye protection during a med pass and pour.
A resident with a colostomy, Parkinson’s disease, dementia, moderate cognitive impairment, and dependence for ADLs had EBP signage posted at the door and PPE available for high-contact care, but the care plan did not include EBP and only addressed colostomy care. An LPN stated the resident had EBP due to the colostomy and a recently developed pressure ulcer, and the DON and Administrator discussed that the care plan was missing EBP; the MDS Coordinator said she oversees care plans and that very few nurses update them.
A resident with dementia, CHF, and anxiety tested positive for the flu and was placed on droplet and contact precautions, with PPE and an isolation sign observed outside the room. Staff failed to review and revise the CCP to include the resident’s isolation status, and the Clinical Reimbursement Director confirmed the omission during interview.
Failure to Follow Side Rail Orders: Staff did not follow provider orders for side rails for two residents. One resident with gait, mobility, and fall-related diagnoses was observed with 1/4 side rails in place despite an order for 1/2 side rails every shift, and the care plan referenced 1/4 rails. Another resident with dementia and severe cognitive impairment was observed with only one side rail up even though the record included an order, bed rail assessment, and consent indicating bilateral 1/2 side rails. The DON acknowledged the discrepancy and stated the order would be changed.
Ordered meds were not available for two residents. One resident with cerebral palsy, epilepsy, GERD, and severe cognitive impairment had Parlodel and lansoprazole repeatedly documented as not given because they were waiting on pharmacy delivery or still not in, and the backup med bank did not include either drug. Another resident with severe cognitive impairment had pantoprazole documented as not in the pixis and on order, with no backup stock available.
Failure to promptly report lab results to the ordering practitioner. Two residents with significant cognitive impairment had ordered CBC/CMP and other labs drawn, but the results were not readily available in the record and were not reviewed by the provider in a timely manner. One resident had vascular dementia, DM, and hyperlipidemia; the other had CKD, anemia, vitamin deficiencies, HTN, and vascular dementia. The DON stated the facility used multiple labs and only one was linked to the EMR portal, and there was no single staff member responsible for ensuring timely receipt of results.
Missing and Unreported Laboratory Results: The facility failed to keep complete lab records for one resident with vascular dementia, diabetes, and hyperlipidemia, whose ordered CBC, CMP, A1C, vitamin studies, lipid panel, and magnesium results were not found in the chart. The facility also failed to ensure lab results for another resident with CKD, anemia, and severe cognitive impairment were reported to the provider; although CBC, CMP, vitamin D, and magnesium labs were ordered and documented as drawn, the results were not initially located in the record and the DON stated the facility used multiple labs with only one linked to the portal.
A resident with severe cognitive impairment, hospice services, and diagnoses including vascular dementia, CVA, HF, and HTN had an active DNR order, but the DDNR form in the chart was incomplete. The form was signed by the POA, yet the required boxes indicating the resident’s decision-making capacity and the applicable authorization section were left blank, leaving the medical record inaccurate and incomplete.
Failure to provide education for pneumococcal vaccine declination. A cognitively intact resident with multiple diagnoses had received PCV13, but the record showed no evidence that PCV20 or PCV21 was offered later while at the facility. The resident signed a vaccine consent/declination form declining the pneumococcal vaccine, yet the section confirming education and answered questions was left unchecked, despite facility policy stating education would be provided for those who decline vaccination.
Infection Control Failures With Droplet Precautions and PPE
Penalty
Summary
The facility failed to maintain an infection prevention and control program to provide a safe sanitary environment and to assist in the prevention, development, and transmission of communicable disease and infection. Surveyors observed multiple breakdowns in droplet precautions for residents identified with influenza-related respiratory symptoms and pending or positive flu testing, including incorrect signage, inconsistent use of PPE, and a resident leaving isolation to eat in a common dining area with other residents. Resident #2 had diagnoses including schizophrenia, bipolar disorder, and schizoaffective disorder, and the most recent MDS indicated a BIMS score of 15 out of 15. The resident developed respiratory symptoms and was placed on combined droplet and contact precautions while flu testing was pending. Despite this, the resident was observed sitting alone at a table in the dining room with four other residents nearby, and staff confirmed the resident ate breakfast in the dining room that morning. Staff also stated the resident was ambulatory and that they would have stopped the resident if they had seen the resident enter the dining room. The resident’s record showed a provider order for combined droplet and contact precautions and that all services, including meals, were to be brought to the room, yet the resident was not kept in the room and was not provided droplet precaution education before the event. Surveyors also found that droplet precaution signage and PPE use were inconsistent for multiple residents. Resident #16 and Resident #22 were observed with staff entering rooms without the PPE required by the facility’s droplet precaution policy, and Resident #32 had an incorrect droplet precaution sign posted outside the room. For Resident #48, during a medication pass and pour, an LPN and a CNA entered the room wearing masks, gowns, and gloves but no eye protection, despite a droplet precaution sign outside the room stating that eye protection was required. The facility’s policy stated that staff must wear a mask, eye protection, gown, and gloves upon room entry for droplet precautions, including influenza.
Failure to Include Enhanced Barrier Precautions in Care Plan
Penalty
Summary
Facility staff failed to develop a comprehensive care plan for a resident with diagnoses including colostomy, Parkinson’s disease, and dementia. The resident’s most recent MDS showed a BIMS score of 12 out of 15, indicating moderate cognitive impairment, and Section GG identified the resident as non-ambulatory, wheelchair-bound, incontinent, and requiring assistance with ADLs. Observation revealed an enhanced barrier precautions (EBP) sign posted near the resident’s door with gloves and gowns available for high-contact care, but the revised care plan dated 1/9/2026 did not include EBP; it only addressed colostomy care. During interview, an LPN stated the resident had EBP because of the colostomy and a recently developed pressure ulcer and that she followed facility policies and procedures for prevention and treatment of skin breakdown. At the end-of-day meeting, the Administrator and DON discussed that the resident’s care plan did not include EBP. The MDS Coordinator stated she oversees care plans, that all nursing staff can update them, and that very few nurses do so; she also said she would recommend more training for staff, especially upon admission. The care plan was updated during the conversation to include EBP.
Care Plan Not Updated for Isolation Precautions
Penalty
Summary
The facility staff failed to review and revise the comprehensive care plan for Resident #48 when the resident was placed on droplet precautions. Resident #48 had diagnoses including dementia, chronic diastolic congestive heart failure, and anxiety, and a significant change in status MDS with an ARD of 12/22/25 coded the resident as having problems with long- and short-term memory and being severely impaired in cognitive skills for daily decision making. During the initial tour, staff identified the resident as positive for the flu, and a droplet precaution sign and PPE were observed outside the resident’s room. The clinical record included a nursing progress note dated 02/25/26 stating the resident had tested positive for the flu and isolation precautions were in place. On 02/25/26, the provider ordered combined droplet and contact precautions with an end date of 03/07/26. Review of the comprehensive care plan showed that the facility had not reviewed and revised it to include droplet precautions. During an interview on 03/03/2026, the Clinical Reimbursement Director confirmed the resident’s isolation status was not on the care plan, and the issue was reviewed later that day with the Administrator and DON. The facility then provided its policy titled, Comprehensive Care Planning, which stated that each resident will have a person-centered comprehensive care plan developed and implemented to meet preferences and goals and address medical, physical, mental, and psychosocial needs.
Failure to Follow Side Rail Orders
Penalty
Summary
Facility staff failed to follow provider orders for side rails for two residents. One resident had diagnoses including muscle spasm, psychotic disorder with delusions, insomnia, abnormalities of gait and mobility, abnormal posture, extrapyramidal and movement disorder, difficulty walking, and repeated falls, and was cognitively intact with a BIMS score of 14/15. On observation, the resident’s bed had 1/4 bilateral side rails in place, while the record included a provider order for 1/2 side rails every shift for bed mobility, positioning, and safety. The care plan also referenced bilateral 1/4 side rails for safety during care provision and bed mobility. For the second resident, diagnoses included vascular dementia, dizziness and giddiness, macular degeneration, anxiety disorder, and major depressive disorder, and the resident had severe cognitive impairment with a BIMS score of 01/15. The resident was observed in bed with only one side rail up on the right side, and later the left side rail was still not up. The clinical record included a physician order for 1/2 side rails x 2 as tolerated every shift for bed mobility and positioning, a bed rail assessment indicating bilateral side rails should be up, and a side rail consent form stating 1/2 side rails should be up bilaterally. The care plan for this resident also referenced bilateral 1/4 side rails for safety during care provision and bed mobility. During interview, the DON stated the resident had 1/4 rails on the bed and that the care plan was correct, but acknowledged uncertainty about why one side was down and stated the order would be changed. The facility policy required a specific order identifying how many bed rails, which side of the bed, and when they are to be in place.
Unavailable Ordered Medications for Two Residents
Penalty
Summary
Pharmaceutical services were not provided to meet the needs of each resident when facility staff failed to ensure ordered medications were available for administration for two residents. For one resident with spastic quadriplegic cerebral palsy, epilepsy, gastroesophageal reflux disease, and severe cognitive impairment, provider orders were in place for Parlodel via J-tube twice daily and lansoprazole oral suspension via J-tube daily. The MAR showed repeated documentation of a code indicating the medications were not given, with nursing notes stating the medications were waiting on delivery from the pharmacy, not in, reordered, or still not in from the pharmacy. The facility med bank list did not include either medication as backup stock, and the surveyor could not locate documentation showing the lansoprazole dose was administered on one date when the MAR indicated it had been given. For a second resident with severe cognitive impairment, the MAR and progress note showed pantoprazole sodium delayed-release tablet 20 mg was not in the pixis and was on order, and the dose was coded with a 9 rather than a check mark. The med bank list did not include pantoprazole as an available backup medication. The survey team reviewed these concerns with the Administrator and DON, and the facility provided a diagram describing the process for unavailable medications, but no additional information was presented before the exit conference.
Failure to Promptly Report Lab Results to Ordering Practitioner
Penalty
Summary
Laboratory results were not promptly reported to the ordering practitioner for two residents. For Resident #6, who had vascular dementia, diabetes, and hyperlipidemia and a BIMS score of 5 indicating severe cognitive impairment, provider orders were entered for a CBC, CMP, hemoglobin A1C, vitamin B12, lipid panel, vitamin D, and magnesium. The same tests were ordered again shortly afterward, but the surveyor could not locate the results in the clinical record during review. Copies of lab results collected on 01/29/26 and 02/06/26 were later provided, and staff stated the provider did not review them until 03/05/26. For Resident #31, who had chronic kidney disease, vitamin D deficiency, B vitamin deficiency, hypertension, vascular dementia, and a BIMS score of 1 out of 15 indicating severe cognitive impairment, an NP ordered CBC, CMP, vitamin D, and magnesium testing for chronic anemia management. Nursing documentation showed the labs were drawn, but the results were not found in the record when reviewed by surveyors. The DON stated the facility used three different labs depending on insurance, only one was connected to the medical record portal, and she had to call the lab to obtain the results; she also stated the provider had not reviewed them yet and there was no single staff member responsible for ensuring labs were completed and results received timely.
Missing and Unreported Laboratory Results
Penalty
Summary
The facility failed to keep complete, dated laboratory records in the resident record for Resident #6 and failed to ensure provider-ordered laboratory results were filed in the clinical record. Resident #6 had diagnoses including vascular dementia, diabetes, and hyperlipidemia, and a quarterly MDS assessment showed a BIMS score of 5, indicating severe impairment in cognitive skills for daily decision making. Provider orders were entered for a CBC, CMP, hemoglobin A1C, vitamin B12, lipid panel, vitamin D, and magnesium, and the same laboratory tests were ordered again shortly afterward. During record review, the surveyor could not locate the results in the clinical record, and the Nurse Officer Assistant later provided copies of laboratory results obtained on 01/29/26 and 02/06/26. The Director of Education stated the laboratory results should have been included in the clinical record. The facility also failed to report laboratory results obtained for Resident #31 to the provider. Resident #31 had diagnoses including chronic kidney disease, vitamin D deficiency, deficiency of other B group vitamins, hypertension, and vascular dementia, and an MDS assessment showed a BIMS score of 01 out of 15, indicating severe cognitive impairment. An NP note documented chronic anemia managed with ferrous sulfate and folic acid, and ordered CBC, CMP, vitamin D, and magnesium labs. A nursing note documented that the labs were drawn, but later NP notes stated the blood was not drawn and would be followed up. The January physician order summary showed the labs were ordered for one time only, and the results were not initially located in the clinical record. The DON stated the facility used three different labs based on insurance, only one was connected to the medical record portal, and there was no single staff member responsible for ensuring labs were completed and results received timely.
Incomplete DDNR Documentation in Resident Record
Penalty
Summary
The facility failed to ensure the clinical record was complete and accurate for 1 of 22 current residents, resident #10, because the Durable Do Not Resuscitate (DDNR) order in the medical record was incomplete. Resident #10 had diagnoses including vascular dementia, cerebral infarction, venous insufficiency, heart failure, and hypertension. The admission MDS with an assessment reference date of 2/20/26 indicated a brief interview for mental status score of 7/15, showing severe cognitive impairment, and also indicated the resident had a condition or chronic disease that may result in life expectancy of less than 6 months and was receiving hospice services. Review of the physician's orders showed an active do not resuscitate order. Under miscellaneous documents, the resident had a DDNR form signed by the POA listed on the face sheet and dated 2/13/26. The form stated that the undersigned had a physician/patient relationship and had certified in the medical record that the patient or an authorized person had directed that life-prolonging procedures be withheld or withdrawn in the event of cardiac or respiratory arrest. However, neither of the required boxes indicating whether the patient was capable or incapable of making an informed decision was checked, and the section that followed for the applicable authorization option was also left incomplete. On 3/3/26 at 4:20 PM, the survey team met with the Administrator and DON and discussed the concern, and no further information was provided before the exit conference.
Failure to Provide Education for Pneumococcal Vaccine Declination
Penalty
Summary
The facility failed to offer education for the declination of a pneumococcal vaccine for one of five residents reviewed for immunization status, Resident #57. Resident #57 had diagnoses including atherosclerosis of native arteries of the extremities with rest pain in the right leg, allergic rhinitis, polyneuropathy, and encounter for surgical aftercare following surgery on the circulatory system. The most recent MDS showed a BIMS score of 15 out of 15, indicating the resident was cognitively intact. The resident’s immunization record showed receipt of Prevnar 13 on 05/16/2022, but no evidence was found in the clinical record that the resident was offered PCV20 or PCV21 at least one year later while at the facility. On 3/5/26, the DON provided an Influenza, Pneumococcal, COVID-19 and RSV Vaccine Informed Consent and Declination form signed by Resident #57 and dated 2/27/26. The form showed the resident did not consent to a pneumococcal vaccine, but the section stating that the resident had been provided enough education to make an informed decision and had all questions answered was left unchecked. The facility policy titled Influenza and Pneumococcal Immunization for Residents stated that education would be provided for those who decline vaccination.
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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 Saluda
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Dockside Health & Rehab Center | 4.9 mi | ★★★★★ | 0 | 0 |
| Three Rivers Health & Rehab Center | 11.3 mi | ★★★★★ | 0 | 0 |
| Rappahannock Westminster Canterbury | 12 mi | ★★★★★ | 0 | 0 |
| Walter Reed Post Acute | 12.9 mi | ★★★★★ | 0 | 0 |
| Riverside Lifelong Health & Rehabilitation Sanders | 13.6 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 October 2026) and official state health department websites.