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Complaint Investigation

Hibriten Mountain Nursing And Rehabilitation

February 26, 2026 · Lenoir, NC · 2030 Harper Avenue Nw
Citations 11
CMS Rating 1/5
Beds 100
Provider ID 345329
Healthcare Facility
Hibriten Mountain Nursing And Rehabilitation
Lenoir, NC  ·  View full profile →
Inspection Summary

Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC — inspection on February 26, 2026.

Found 11 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0554
Resident Rights Deficiencies
Potential for More Than Minimal Harm

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0554 during a standard health inspection conducted on 2026-02-26.

Category: Resident Rights Deficiencies

The facility was found deficient in the following area: Allow residents to self-administer drugs if determined clinically appropriate.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0578 during a standard health inspection conducted on 2026-02-26.

Category: Resident Rights Deficiencies

The facility was found deficient in the following area: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-24.

pills left on one card that was delivered on 09/04/25 and the pharmacy informed them they could not

be at least 30 pills of the opioid medication still available.

The Director of Nursing stated they

it.

The DON stated at that time, she reported the concern to the Former Administrator and the Regional Nurse Consultant.

She was directed to count all the cards on all the facility's medication carts which was completed and reportedly found no discrepancies.

The Director of Nursing also reported she reviewed 30 days of pharmacy deliveries with no discrepancies found.

The Director of Nursing reported she interviewed Nurse #3 who had signed for the delivery and was reportedly told that Nurse #3 did not count or verify the medications and just signed the delivery paperwork and could not verify if 30 or 60 oxycodone tablets were delivered from the pharmacy.

The Director of Nursing reported she spoke with multiple other staff members who were present at the time of the delivery but was unable to locate a staff member who could verify 2 cards (60 pills) of Oxycodone were delivered for Resident #62 on 09/04/25.

The Director of Nursing reported she had no idea whether the pharmacy failed to bring both cards (60 tablets) of Oxycodone medications for Resident #62 or if one of the two Oxycodone medication cards went missing between delivery by the pharmacy and delivery to the medication cart.An interview with the Former Administrator, who was the Administrator at the time of the incident on 09/04/25, was completed via telephone on 02/19/26 at 6:31 PM.

The Former Administrator stated it was hard to remember this incident as he believed it occurred shortly after he started. He stated he believed the Director of Nursing reported to him that there was some missing medication and when they began investigating, it seemed to had been going on for a couple weeks before it was discovered.

The Former Administrator reported he recalled that the situation was discovered when a nurse went to try and reorder an Oxycodone medication for Resident #62 and the pharmacy reported it was too early to refill. He stated he remembered this investigation centered around Nurse #4 as she was the nurse assigned to the medication cart the Oxycodone medication went to after delivery.

However, he stated they were ultimately unable to determine what actually happened to the missing card of medication and that they ordered another card of opioid medication at the facility's expense. He reported he had no further knowledge of the investigation due to him not being at the facility any longer.

345329 02/26/2026

Hibriten Mountain Nursing and Rehabilitation 2030 Harper Avenue NW Lenoir, NC 28645

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0644 during a standard health inspection conducted on 2026-02-26.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

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Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0656 during a standard health inspection conducted on 2026-02-26.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0657 during a standard health inspection conducted on 2026-02-26.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0687 during a standard health inspection conducted on 2026-02-26.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide appropriate foot care.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0755 during a standard health inspection conducted on 2026-02-26.

Category: Pharmacy Service Deficiencies

The facility was found deficient in the following area: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-26.

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remember that and realized that she did not prime the pen.

She stated she should have primed the pen

2:10 PM who explained that it was important to prime the needle when giving insulin via an insulin pen

was administered.

During an interview with the Director of Nursing (DON) on 02/19/26 at 10:19 AM the DON stated Nurse #3 should have primed the insulin pen before administering the insulin to Resident #85.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0761 during a standard health inspection conducted on 2026-02-26.

Category: Pharmacy Service Deficiencies

The facility was found deficient in the following area: 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.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Federal health inspectors cited Hibriten Mountain Nursing and Rehabilitation in Lenoir, NC for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2026-02-26.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 11 deficiencies cited during this inspection of Hibriten Mountain Nursing and Rehabilitation.

Correction Status: Deficient, Provider has plan of correction.

The facility reported correction as of 2026-03-23.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Lenoir, NC, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Hibriten Mountain Nursing and Rehabilitation or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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