01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-04 | 2 | 2024-09-05 | 2 |
| Cycle 2 | 2024-09-05 | 9 | 2023-05-12 | 2 |
| Cycle 3 | 2023-05-12 | 2 | 2021-11-12 | 0 |
CMS CCN 3455582026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Nc State Veterans Home - Black Mountain
62 Lake Eden Road · Black Mountain, NC 28711 · Buncombe County
Certified beds100CMS provider file
Recent citation rows17current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
17 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-12-04 · HEALTHF0645Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2025-12-302025-12-04 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-12-302025-02-19 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2025-03-17 · complaint2024-09-05 · HEALTHF0565Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2024-10-012024-09-05 · HEALTHF0572Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Give residents a notice of rights, rules, services and charges.
Correction field: Deficient, Provider has plan of correction · 2024-10-012024-09-05 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-10-012024-09-05 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2024-10-01 · complaint2024-09-05 · HEALTHF0600Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Past Non-Compliance · 2023-11-30 · complaint2024-09-05 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-10-012024-09-05 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2024-10-012024-09-05 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-10-012024-09-05 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2024-12-062024-09-05 · FIREK0372Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2024-12-062023-05-12 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2023-08-102023-05-12 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2023-08-102023-05-12 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2023-06-202023-05-12 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2023-06-2003 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-09-05 | Fine | $12,759 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- NC DEPT OF MILTARY AND VETERANS AFFAIRS NC DIVISION OF VETERAN AFFOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 10/01/2012
- BANKS, KATHLEENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/24/2025
- NC DEPT OF MILTARY AND VETERANS AFFAIRS NC DIVISION OF VETERAN AFFOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2012
- BANKS, KATHLEENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/05/2012
- JONES, BRANDEEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/14/2025
- STEPHENS, NICOLEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/05/2012
- BANKS, KATHLEENIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/24/2025
- JONES, BRANDEEIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/30/2025
- KUTOB, RABIIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/30/2025
- STEPHENS, NICOLEIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/05/2012
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.43per resident day
RN hours1.46per resident day
Weekend nurse hours4.33per resident day
Staff turnover45.3%CMS reported field
06 / LOCAL RECORDS
Open the Black Mountain ledger →