Blue Ridge Care Center LLC

Inspectors wroteBased on observations, staff interviews, and review of the facility policy titled, Food Storage, the facility dietary staff failed to label and date opened food items and failed to properly discard expired milk. The facility census was 163 and 162 residents were receiving an oral diet.

Inspectors wroteBased on observations, staff interviews, and review of the facility policy titled, Dishwasher Temperature, the facility failed to demonstrate a properly functioning dish machine to sanitize dishware to prevent food borne illness. The facility census was 163 and 162 residents were receiving an oral diet.

Inspectors wroteBased on observations, family and staff interviews, record review, and review of the facility's policy titled, Promoting/Maintaining Residents Dignity, the facility failed to protect the privacy of health information for one of three residents (R) (R19) reviewed for privacy. Specifically, the facility posted instructions on R19's wall that disclosed birthday, gender, medical identification, and picture. The deficient practice had the potential to place R19 at risk of a diminished quality of life in an environment that promotes the maintenance or enhancement of each resident's dignity.

Inspectors wroteBased on staff interviews, record review, and review of a policy titled, Use of Psychotropic Medication(s), the facility failed to ensure as needed psychotropic medication were ordered and limited to 14 days for one of five residents (R) (R 123) reviewed for un-necessary medications, The deficient practice had the potential to place the resident at risk for medical complications, unmet needs, and a diminished quality of life.

Inspectors wroteBased on observation, record review, staff interviews, and review of the facility policy's titled, Comprehensive Care Plans, Oxygen Administration, and Use of Psychotropic Medications, the facility failed to develop a person-centered comprehensive care plan for four of 48 sampled residents (R) (R71, R90, R21, and R123) out of 48 sampled residents. Specifically, the facility failed to develop a care plan for R71 related to an indwelling urinary catheter, failed to develop a care plan for R21 and R90 related to oxygen, and failed to develop a care plan for R123 related to psychotropic medication. The deficient practice had the potential to cause R71, R90, R21, and R123 not to receive necessary care and services.

Inspectors wroteBased on observations, staff and resident family interviews, record review and review of the facility policy titled, Nutritional and Dietary Supplements, the facility failed to provide one of 48 sampled residents (R) (R15) a nutrition supplement as ordered.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility's policy titled Oxygen Administration, the facility failed to ensure oxygen was administered as ordered by the physician for two of 14 residents (R) (R90 and R21) receiving oxygen. This deficient practice had the potential to place R90 and R21 at increased risk of respiratory complications.

Inspectors wroteBased on observations, staff and family interviews, and review of the facility menu, the facility failed to serve the lunch meal as written on the menu for one of 48 sampled residents (R) (R15).

Inspectors wroteBased on observations, staff interview, record review, and review of the facility policy titled, Catheter Care, the facility failed to follow proper infection control practices related to hand washing during catheter care for one of seven residents (R) (R71) with indwelling urinary catheters. The deficient practice had the potential to cause R71 increased risk for urinary tract infections.

Inspectors wroteBased on interview and record review, the facility failed to revise their CLIA (Clinical Laboratory Improvement Amendments) certificate within 30 days after new ownership. The facility does not have a current CLIA certificate appropriate for the level of testing it conducts after approximately seven months of ownership.

Inspectors wroteBased on record review, observations, and resident and staff interviews, the facility failed to provide bath linen in good condition on seven of nine hallways (C hall, 600 hall, 200 hall, 400 hall, 500 hall, 800 hall and 900 hall).

Inspectors wroteBased on observations, staff interviews, and review of the facility policy titled, Food Storage, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety. The facility had expired food in storage areas reserved for resident snacks. This practice affected two of three units (Middle Unit and the Nursing Unit) observed in the facility for resident food storage.

Inspectors wroteBased on observations, staff interviews, and review of the facility policy titled, Hand Hygiene, the facility failed to ensure proper hand hygiene during the lunch meal in the Nursing Unit Main Dining Room for three of 14 residents (R) (R4, R5, and R6). The deficient practice had the potential to cause foodborne illnesses for residents eating in the Nursing Unit Main Dining room.

Inspectors wroteBased on observations and resident and staff interviews, the facility failed to promote dignity for one of 14 residents (R) (R 6) who ate in the main dining room. Specifically, R6 was seated at a table with inappropriate height. Findings Include:1. Observation on 7/7/2025 at 12:43 pm, at the second table, two of six residents had meal trays and were eating. R6 was seated at that table, but R6 was upset about not having food and Certified Nursing Assistant (CNA) AA moved R6 to the third empty table that was also upper lip height. Observation on 7/7/2025 at 12:59 pm, R6 was observed sitting in a lowered seat wheelchair eating independently with her upper lip at table height. Observation on 7/7/2025 at 1:18 pm, R6 was seated at a single table at eye level. R6 introduced herself. Interview on 7/7/2025 at 1:33 pm, CNA AA said R6 eats all her food, but her upper lip is almost at table height. [...]

Inspectors wroteBased on observations, staff interviews, record review, and review of the policy titled, Oxygen (O2) Administration, the facility failed to maintain a clean O2 concentrator filter consistent with professional standards of practice for two of 23 residents (R) (R56 and R119) who use O2. The deficient practice had the potential to cause respiratory distress for R56 and R119.

Inspectors wroteBased on observation, staff interview, and review of facility documents titled Food Storage and Distribution and Department Policy and Procedure, the facility failed to ensure that the piping under one of one hood and over the stove was without rust and failed to ensure cleanliness of this area underneath the hood over the stove in the kitchen.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to individualize and/or implement a resident-centered care plan for six of 41 sampled residents (R) (R#97, R#45, R#70, R#117, R#20, and R#486) related to: activities for R#97; Activities of Daily Living (ADL) for R#45; and related to the restorative services for (R#70) (R#117) (R#20) and (R#486).

Inspectors wroteBased on observation, record review and staff interviews, the facility failed to ensure that activities of daily living (ADL) were provided for two of 41 sampled residents (R) (R#45 and R#68) related to nail and hair care.

Inspectors wroteBased on observation, record review and staff interview, the facility failed to provide an ongoing program of activities for one resident (R) (R #97), who needed extensive to total assistance by staff for provision of all care. The sample size was 42 residents.

Inspectors wroteBased on observation, interviews, record review and review of the policy titled Restorative Nursing, the facility failed to follow Occupational Therapy (OT) and Physical Therapy (PT) Restorative Nursing Treatment Plan recommendations for range of motion (ROM) and orthotic application for four residents (R), (R#20), (R#70), (R#117) and (R#486) reviewed for ROM and mobility. The sample size was 41. Review of the policy titled Restorative Nursing revised 9/29/22 revealed: Purpose: To establish uniform guidelines concerning restorative care. Definition: General rehabilitative/restorative nursing care is that which does not require the use of a qualified professional therapist to render such care. Policy: Rehabilitative nursing is provided for each resident admitted . Philosophy: [...]

Inspectors wroteBased on observations, resident interviews, staff interviews, record review and review of policies titled Control of Medications and Medication Self Administration, the facility failed to provide an environment that was free from potential accidents and hazards for two of 41 sampled residents (R) (R#47 and R#437) related to properly storing medications which were located on the bedside tables in residents rooms.

Inspectors wroteBased on observations, staff interviews, record reviews and review of policy titled Oxygen Administration, the facility failed to obtain a physician order to administer oxygen to one of 41 sampled residents (R) (R#437) that required oxygen.