Cycle 1
Health 2025-08-15 · Fire 2024-08-22
3 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Black Mountain, NC
Highland Farms
4-star overall rating with 3-star inspections with $4,271 in total fines with 3 recent health deficiencies
200 Tabernacle Road, Black Mountain, NC
(828) 669-6473
Overall
4 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
60
Certified beds
Average residents
48
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1971-11-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
1.25
Registered nurse staffing · state 0.59 · national 0.68
LPN hours / resident day
0.66
Licensed practical nurse staffing · state 0.87 · national 0.87
Aide hours / resident day
2.86
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
4.77
All reported nurse hours · state 3.78 · national 3.89
Licensed hours
1.91
RN + LPN hours · state 1.45 · national 1.54
Weekend hours
4.25
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.79
Weekend registered nurse coverage · state 0.38 · national 0.47
Physical therapist
0.08
Reported PT staffing · state 0.09 · national 0.07
Adjusted RN hours
1.47
CMS adjusted RN staffing hours
Adjusted total hours
5.62
CMS adjusted total nurse staffing hours
Case-mix index
1.16
Higher values indicate more complex resident acuity
RN turnover
25%
Annual RN turnover · state 48% · national 45%
Total nurse turnover
35%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
651
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
65.92
Composite VBP score used to determine payment impact.
Payment multiplier
1.0200
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
5.86
Performance 18.71% · Measure score 5.86 · Achievement 5.86 · This facility did not have sufficient data to calculate a baseline period measure result.
Healthcare-associated infections
5.20
Performance 6.28% · Measure score 5.20 · Achievement 5.20 · This facility did not have sufficient data to calculate a baseline period measure result.
Total nurse turnover
7.29
Baseline 72.58% · Performance 35.38% · Measure score 7.29 · Achievement 6.92 · Improvement 7.29
Adjusted total nurse staffing
8.01
Baseline 5.61 hours · Performance 5.36 hours · Measure score 8.01 · Achievement 8.01 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 8.51% |
10.72%
2.2 pts better
|
No Different than the National Rate · Eligible stays 147 · Observed rate 3.4% · Lower 95% interval 5.98% |
| Discharge to community | 50.49% |
50.57%
0.1 pts worse
|
No Different than the National Rate · Eligible stays 136 · Observed rate 52.21% · Lower 95% interval 44.42% |
| Medicare spending per beneficiary | 0.84 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 80.77% |
95.27%
14.5 pts worse
|
Numerator 63 · Denominator 78 |
| Falls with major injury | 1.28% |
0.77%
0.5 pts worse
|
Numerator 1 · Denominator 78 |
| Discharge self-care score | 67.14% |
53.69%
13.5 pts better
|
Numerator 47 · Denominator 70 |
| Discharge mobility score | 31.43% |
50.94%
19.5 pts worse
|
Numerator 22 · Denominator 70 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 77 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 6.28% |
7.12%
0.8 pts better
|
No Different than the National Rate · Eligible stays 70 · Observed rate 2.86% · Lower 95% interval 3.53% |
| Staff COVID-19 vaccination coverage | 1.94% |
8.2%
6.3 pts worse
|
Numerator 3 · Denominator 155 |
| Staff flu vaccination coverage | 49.44% |
42%
7.4 pts better
|
Numerator 44 · Denominator 89 |
| Discharge function score | 51.43% |
56.45%
5 pts worse
|
Numerator 36 · Denominator 70 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 6 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 95.83% |
96.28%
0.5 pts worse
|
Numerator 46 · Denominator 48 |
| Resident COVID-19 vaccinations up to date | 55% |
25.2%
29.8 pts better
|
Numerator 22 · Denominator 40 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.6 |
1.8
0.2 pts better
|
1.9
0.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.6 · Observed 1.3 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.9 |
1.8
0.9 pts better
|
1.8
0.9 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.9 · Observed 0.8 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 97.1% |
91.5%
5.6 pts better
|
93.4%
3.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 92.7% · Q2 97.8% · Q3 100.0% · Q4 97.5% · 4Q avg 97.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
94.1%
5.9 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 15.3% |
3.6%
11.7 pts worse
|
3.3%
12 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.6% · Q2 17.8% · Q3 15.9% · Q4 12.5% · 4Q avg 15.3% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 3.0% |
4.8%
1.8 pts better
|
11.4%
8.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.5% · Q2 2.3% · Q3 2.3% · Q4 5.4% · 4Q avg 3.0% |
| Percentage of long-stay residents who lose too much weight | 3.8% |
7.2%
3.4 pts better
|
5.4%
1.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.5% · Q2 0.0% · Q3 2.8% · Q4 6.5% · 4Q avg 3.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 4.3% |
21.6%
17.3 pts better
|
19.6%
15.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.9% · Q2 5.7% · Q3 2.7% · Q4 3.1% · 4Q avg 4.3% |
| Percentage of long-stay residents who received an antipsychotic medication | 2.8% |
15.0%
12.2 pts better
|
16.7%
13.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.7% · Q2 3.4% · Q3 0.0% · Q4 0.0% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 13.7% |
21.5%
7.8 pts better
|
16.3%
2.6 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 13.7% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 29.6% |
16.8%
12.8 pts worse
|
14.9%
14.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 32.4% · Q2 37.1% · Q3 22.9% · Q4 25.8% · 4Q avg 29.6% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.0% |
0.9%
0.1 pts worse
|
1.0%
About the same
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.1% · Q3 0.0% · Q4 2.0% · 4Q avg 1.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.9% |
2.6%
0.7 pts better
|
1.7%
0.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.4% · Q3 0.0% · Q4 5.1% · 4Q avg 1.9% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 32.4% |
21.2%
11.2 pts worse
|
19.8%
12.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 35.7% · Q2 30.1% · Q3 33.8% · Q4 29.9% · 4Q avg 32.4% |
| Percentage of long-stay residents with pressure ulcers | 6.0% |
6.0%
About the same
|
5.1%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.5% · Q2 4.9% · Q3 5.0% · Q4 8.7% · 4Q avg 6.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 90.6% |
79.9%
10.7 pts better
|
81.7%
8.9 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 78.2% · Q2 95.9% · Q3 98.4% · Q4 89.9% · 4Q avg 90.6% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 17.6% |
13.2%
4.4 pts worse
|
12.0%
5.6 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 17.6% · Observed 15.1% · Expected 9.5% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.5%
1.5 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 96.3% |
78.1%
18.2 pts better
|
79.7%
16.6 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 96.3% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 21.8% |
22.9%
1.1 pts better
|
23.9%
2.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 21.8% · Observed 15.1% · Expected 16.5% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-08-22 · Fire 2023-04-27
4 health deficiencies
Top issue: Infection Control (3 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-04-27 · Fire 2021-07-28
7 health deficiencies
Top issue: Pharmacy Service (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-08-15
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-09-12
D · Potential for more than minimal harm
2025-08-15
F559 · Resident Rights Deficiencies
Health
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Corrected 2025-09-12
D · Potential for more than minimal harm
2025-08-15
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-09-12
D · Potential for more than minimal harm
2024-08-22
F726 · Nursing and Physician Services Deficiencies
Health
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected 2024-09-20
D · Potential for more than minimal harm
2024-08-22
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-09-20
D · Potential for more than minimal harm
2024-08-22
F883 · Infection Control Deficiencies
Health
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2024-09-19
D · Potential for more than minimal harm
2024-08-22
F887 · Infection Control Deficiencies
Health
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected 2024-09-19
E · Potential for more than minimal harm
2023-04-27
F626 · Resident Rights Deficiencies
Health
Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.
Corrected 2023-05-19
E · Potential for more than minimal harm
2023-04-27
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-05-24
D · Potential for more than minimal harm
2023-04-27
F636 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Corrected 2023-05-19
D · Potential for more than minimal harm
2023-04-27
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2023-05-19
D · Potential for more than minimal harm
2023-04-27
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2023-05-19
D · Potential for more than minimal harm
2023-04-27
F867 · Administration Deficiencies
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2023-05-24
B · Minimal harm
2023-04-27
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2023-05-23
Penalties and ownership
What sits behind the stars
$4,271
2024-08-22
Fine
Fine · fine $4,271
Fine
Ownership
Givens Estates, Inc.
5% Or Greater Direct Ownership Interest · Organization
Givens Estates, Inc.
Operational/Managerial Control · Organization
Hoke, Kristine
Operational/Managerial Control · Individual
Hoke, Kristine
Corporate Director · Individual
Kerestes, David
Operational/Managerial Control · Individual
Kerestes, David
Corporate Director · Individual
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