Ridgewood Living & Rehabilitation Center
Ridgewood Living & Rehabilitation Center in Washington, NC — inspection on September 5, 2025.
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.
Inspection Findings
with Nurse #5 was conducted on 9/4/25 at 10:30 AM.
She stated Nurse #7 called her on her mobile phone and she came to the facility.
Nurse #7 told her the oxycodone had been replaced with Buspirone.
She revealed Nurses were documenting that Resident #22 often refused her Buspirone, she did not know how many had been replaced. Resident #22 did have more Buspirone available to her in the medication cart. An interview with the DON was held on 9/4/25 at 11:10 AM.
She revealed she did not remember who notified her of the incident.
After notification she went to the facility and spoke with Nurse #7.
Nurse #7 told her the Oxycodone had been replaced with Buspirone and taped closed with medical tape.
The DON then reported it to the Administrator.
Drug tests were administered to everyone that had worked on that medication cart.
The DON also stated she did not feel the resident was ever in pain or had anxiety due to the pills being taken.
She said Nurse #5 and herself wasted the 7 Buspirone pills.
The DON notified the pharmacy about the missing Oxycodone and wasted Buspirone. A delivery slip from the pharmacy dated 6/28/25 revealed 7 oxycodone 5 mg tablets were delivered on 6/28/25.An interview was held with the Pharmacy Director on 9/4/25 at 11:20 AM.
She stated she did not see any notes that the incident had been reported but did see on 6/28/25, 7 oxycodone pills were dispersed to the facility for Resident #22.
She could not tell me who requested the pills or paid for them.An interview with the Pharmacy Accounts receivable clerk on 9/4/25 at 11:35 AM revealed on 6/28/25, 7 oxycodone pills were dispersed for Resident #22. Resident #22's insurance was billed and paid for the medication.
There were no Buspirone ordered or sent out for Resident #22 in the month of June 2025.An interview with Resident #22 was conducted on 9/4/25 at 11:50 AM, she was lying in bed in her room.
She stated that if she was in pain she asks for pain medication, she also said when she asks for pain medication the nurses did give it to her.An interview was conducted with the Administrator on 9/4/25 at 2:00 PM.
She stated she was notified by the DON and Nurse #5 of the missing pills.
Local law enforcement was notified.
She also stated the facility paid to replace the oxycodone.
When asked, she stated she was not aware Resident #22's oxycodone was billed to and paid for by Resident #22's insurance.
She also stated education, and systems had been put into place to keep the incident from recurring.
The Administrator and DON completed the investigation including drug tests for Nurse #7 and Nurse #8 both of which were positive for Oxycodone.
The facility did not substantiate abuse or neglect. An interview with the Medical Director was held on 9/5/25 at 8:00 AM. He stated he was made aware of the incident of drug diversion. He also stated he did not feel the resident was adversely affected by the drug diversion.A follow up interview with the Pharmacy Director on 9/5/25 at 10:30 AM revealed she vaguely remembered the situation but felt there was a conversation with someone at the facility around payment of the oxycodone and the billing of Resident #22's insurance was a pharmacy error as the facility should have been billed.A review of the email to the Administrator from the Pharmacy Director dated 9/4/25 at 2:35 PM, revealed the pharmacy reversed the charges to Resident #22's insurance and billed the facility.
Facility ID:
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0641 during a standard health inspection conducted on 2025-09-05.
Category: Resident Assessment and Care Planning Deficiencies
The facility was found deficient in the following area: Ensure each resident receives an accurate assessment.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-16.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0656 during a standard health inspection conducted on 2025-09-05.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-16.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0689 during a standard health inspection conducted on 2025-09-05.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Scope/Severity Level G: isolated, actual harm that is not immediate jeopardy.
Actual harm to residents was documented as a result of this deficiency.
This was one of 11 deficiencies cited during this inspection of Ridgewood Living & Rehabilitation Center.
Correction Status: Past Non-Compliance.
The facility reported correction as of 2025-07-23.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0695 during a standard health inspection conducted on 2025-09-05.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Provide safe and appropriate respiratory care for a resident when 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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-23.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0700 during a standard health inspection conducted on 2025-09-05.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-20.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-09-05.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-23.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0883 during a standard health inspection conducted on 2025-09-05.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: Develop and implement policies and procedures for flu and pneumonia vaccinations.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-24.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0887 during a standard health inspection conducted on 2025-09-05.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: 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.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-23.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0925 during a standard health inspection conducted on 2025-09-05.
Category: Environmental Deficiencies
The facility was found deficient in the following area: Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Scope/Severity Level B: isolated, no actual harm with potential for 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 Ridgewood Living & Rehabilitation Center.
Correction Status: No revisit needed.
The facility reported correction as of 2025-09-20.
Federal health inspectors cited Ridgewood Living & Rehabilitation Center in Washington, NC for a deficiency under regulatory tag F-F0947 during a standard health inspection conducted on 2025-09-05.
Category: Nursing and Physician Services Deficiencies
The facility was found deficient in the following area: Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
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 Ridgewood Living & Rehabilitation Center.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-23.
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 Washington, 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 Ridgewood Living & Rehabilitation Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.