Home / North Carolina / Black Mountain
Highland Farms
200 Tabernacle Road, Black Mountain, NC 28711 · Buncombe County · (828) 669-6473
60 certified beds, about 48 residents a day · Non profit - Corporation · Medicare and Medicaid since 1971
CMS Care Compare ratings, data as of September 1, 2026 · CCN 345078 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 31, 2026, inspectors cited 3 health deficiencies (the North Carolina average is 4.7, the national average 9.2).
None of its 10 health citations since August 2024 was rated as actual harm or immediate jeopardy.
CMS lists 1 fine totaling $4,271 in the last three years; the largest was $4,271, and the latest is dated August 22, 2024.
Nurses and nurse aides worked 4.92 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 1.33 of those hours.
28.1% of nursing staff left within the year CMS measured (North Carolina average 49.0%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 10 health citations on file.
July 31, 2026Standard inspection, Complaint inspection · 3 citations
- D Ensure that residents are fully informed and understand their health status, care and treatments.
Inspectors wroteBased on record review, staff, Psychiatric Nurse Practitioner and Medical Director interviews, the facility failed to obtain consent and inform the resident or Resident Representative in advance of the risks and benefits of psychotropic medications prior to the initiation of medication for 3 of 5 residents reviewed for unnecessary medications (Resident #43, Resident #4, Resident #16).
- D Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on record review and staff interviews, the facility failed to implement their abuse policy in the areas of investigation and reporting after an allegation of staff-to-resident abuse for 1 of 3 residents reviewed for abuse (Resident #58).
- D Provide care or services that was trauma informed and/or culturally competent.
Inspectors wroteBased on record review, Resident, Responsible Party, and staff interviews, the facility failed to complete a comprehensive trauma screening assessment on a newly admitted resident. Failure to identify a history of trauma leaves residents vulnerable to re-traumatization from unknown triggers. This affected 1 of 3 residents reviewed for abuse (Resident #58).
August 15, 2025Standard inspection · 3 citations
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations and staff interviews the facility failed to label and date leftover food stored for use in 1 of 1 walk in cooler and 1 of 1 walk-in freezer and failed to discard expired food items in 1 of 1 dry goods storage room. These practices had the potential to affect food served to residents.
- D Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Inspectors wroteBased on record review, and responsible party (RP) and staff interviews, the facility failed to notify the Responsible Party in advance of a room change for 1 of 1 resident reviewed for transfer to a new room in the facility (Resident #4).
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observations, record review, Security Officer interview, Independent Living (IL) Resident interview, and staff interviews, the facility failed to supervise a severely cognitively impaired resident who was known to wander and used a wander guard so staff could monitor whereabouts. On 5/25/2025, Nurse #3 disarmed the service hallway exit doors and overrode the wander guard system. Resident #3 exited the healthcare center and entered a service hallway to the old assembly room area in the independent living area of the continuing care retirement community without staff supervision. Resident #3 was returned to the healthcare center by an IL Resident and the Lead [NAME] without injury. This deficient practice affected 1 of 5 residents reviewed for accidents (Resident #3).
August 22, 2024Standard inspection · 4 citations
- D 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.
Inspectors wroteBased on observations, record review, and staff interviews the facility failed to provide competent nursing staff when 2 of 4 nursing staff (Nurse #1 and Medication Aide #1) were not educated on the facility's glucometer disinfection policy and procedures.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observations, record review, and staff interviews the facility failed to implement their policy and procedures for glucometer disinfection when Nurse #1 failed to disinfect a resident (Resident #201) glucometer after performing a capillary blood glucose test. This deficient practice occurred for 1 of 1 resident (Resident #201) reviewed for infection prevention and control.
- D Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on record review, resident and staff interviews the facility failed to administer a pneumococcal vaccine to a resident who had consented for the vaccine to be administered. This deficient practice occurred for 1 of 5 residents reviewed for Pneumococcal Immunizations (Resident #18).
- D 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.
Inspectors wroteBased on record review, resident and staff interviews the facility failed to offer and provide a COVID-19 vaccine to 1 of 5 residents reviewed for COVID-19 immunizations (Resident #42).
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| August 22, 2024 | Fine | $4,271 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | North Carolina | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 4.92 | 3.85 | 3.86 |
| Registered nurses | 1.33 | 0.62 | 0.69 |
| All nursing staff on weekends | 4.33 | 3.42 | 3.42 |
| Nurse aides | 2.86 | ||
| Licensed practical nurses | 0.73 | ||
| Nursing staff turnover (share who left in a year) | 28.1% | 49.0% | 45.8% |
| Registered nurse turnover | 15.4% | 45.6% | 42.9% |
| Administrators who left | not reported |
CMS expects 3.10 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 5.16 on weekdays and 4.33 on weekends, 16% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.2% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.68 in April to June 2025 to 4.92 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 4.92 | 1.33 | 5.16 | 4.33 | 0.2% | 0 of 90 | 48 |
| Oct to Dec 2025 | 4.86 | 1.15 | 5.13 | 4.18 | 1.9% | 0 of 92 | 51 |
| Jul to Sep 2025 | 4.77 | 1.25 | 4.98 | 4.25 | 5.1% | 0 of 92 | 48 |
| Apr to Jun 2025 | 4.68 | 1.10 | 4.88 | 4.17 | 3.1% | 0 of 91 | 48 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| North Carolina, Jan to Mar 2026 | 3.65 | 0.53 | 3.82 | 3.25 | 8.0% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | North Carolina | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 25.8 | 15.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.0 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 3.9 | 2.3 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 11.1 | 3.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.8 | 18.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.5 | 5.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 2.1 | 14.0 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 13.7 | 22.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 10.5 | 12.9 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.6 | 1.8 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.5 | 1.8 | 1.8 |
Owners and operators
Legal business name: GIVENS HIGHLAND FARMS LLC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Givens Estates, Inc. | Direct ownership interest | Organization | 12/01/2012 | |
| Hoke, Kristine | Corporate director | Individual | 08/08/2022 | |
| Kerestes, David | Corporate director | Individual | 12/18/2014 | |
| Givens Estates, Inc. | Operational/managerial control | Organization | 12/01/2012 | |
| Hoke, Kristine | Operational/managerial control | Individual | 08/08/2022 | |
| Kerestes, David | Operational/managerial control | Individual | 12/18/2014 | |
| Givens Estates, Inc. | Adp of the SNF | Organization | 06/04/2025 | |
| Hoke, Kristine | Adp of the SNF | Individual | 08/08/2022 | |
| Kerestes, David | Adp of the SNF | Individual | 12/08/2014 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 3 problems in this area, most recently on August 22, 2024: "Provide and implement an infection prevention and control program."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on July 31, 2026: "Ensure that residents are fully informed and understand their health status, care and treatments."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on July 31, 2026: "Provide care or services that was trauma informed and/or culturally competent."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 1 problem in this area, most recently on July 31, 2026: "Develop and implement policies and procedures to prevent abuse, neglect, and theft."
Other nursing homes nearby
- Nc State Veterans Home - Black Mountain Black Mountain, 1.2 mi · 5 of 5 stars · 13 citations
- Mountain Ridge Rehabilitation and Healthcare Cente Black Mountain, 2.2 mi · 1 of 5 stars · 13 citations
- Black Mountain Neuro-Medical Treatment Center Black Mountain, 2.2 mi · 5 of 5 stars · 5 citations
- Swannanoa Valley Health and Rehabilitation Swannanoa, 5.2 mi · 3 of 5 stars · 12 citations
- The Laurels of Summit Ridge Asheville, 7.7 mi · 4 of 5 stars · 17 citations
- Fleshers Fairview Health Care Fairview, 8.2 mi · 2 of 5 stars · 38 citations
- Bear Mountain Health and Rehabilitation Asheville, 10.2 mi · 3 of 5 stars · 16 citations
- The Laurels of Greentree Ridge Asheville, 10.7 mi · 5 of 5 stars · 15 citations
North Carolina contacts for a concern about a nursing home
These are the official offices in North Carolina. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: NC Division of Health Service Regulation, Nursing Home Licensure and Certification Section, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: North Carolina Long-Term Care Ombudsman Program. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: NC DHSR Regulated Facilities search (Statements of Deficiencies), where North Carolina publishes its own records on licensed homes.
Common questions
- What is Highland Farms's Medicare star rating?
- CMS rates Highland Farms 5 out of 5 stars overall, with 4 for health inspections, 5 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Highland Farms get at its last inspection?
- 3 health deficiencies at the standard inspection on July 31, 2026. The North Carolina average is 4.7.
- Has Highland Farms been fined?
- Yes. CMS lists 1 fine totaling $4,271 in the last three years.
- Does Highland Farms accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Highland Farms?
- CMS lists 9 owners and managers. Legal business name: GIVENS HIGHLAND FARMS LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.