Highland Park Rehabilitation & Care Center

In the surveyor’s words

From the most serious findings on record at Highland Park Rehabilitation & Care Center, in the surveyor’s own words.

• Actual harm, isolatedF689Jul 28, 2025

  Based on record review and interviews, the facility failed to ensure supervision and monitor assistive devices to prevent accidents for one (#1) of three residents reviewed for accidents out of 20 sample residents. Resident #1 was admitted to the facility for skilled nursing care on 6/13/25 .The resident's care plan directed staff to utilize a mechanical lift for transfers. On 6/18/25, Resident #1 was noted to have pain to her left upper extremity and bilateral lower extremities after being lowered to the floor with the use of a mechanical lift by certified nurse aide (CNA) #1. […]

• No harm, potential for more than minimal, widespreadF800May 22, 2025

  Based on observations, record review and interviews, the facility failed to provide each resident with a nourishing, palatable and well-balanced diet that meets his or her daily nutritional and special dietary needs, taking into consideration the preferences. Specifically, the facility failed to ensure weekly menus were balanced and included a variety of menu items. Findings include: I. Resident interviews Resident #4 was interviewed on 5/21/25 at 11:18 a.m. Resident #4 said she wished the menu had better variety and the menu options changed more frequently. Resident #4 said lately the menu was too repetitive and there was too much chicken and pork on the menu. Resident #8 was interviewed on 5/21/25 at 3:55 p.m. Resident #8 said the menus were too repetitive. […]

• No harm, potential for more than minimal, widespreadF812May 4, 2022

  Based on observations, interviews, document review, and policy review, the facility failed to ensure one of one facility kitchen was maintained in accordance with professional food service/safety standards. This deficient practice had the potential to affect all 93 residents residing in the facility. Specifically, the facility failed to ensure dietary staff: - regularly cleaned soiled areas in the kitchen; - dated and discarded perishable food appropriately; - regularly measured and recorded food temperatures; and - maintained freezer temperatures at or below zero degrees Fahrenheit (F). Findings include: Review of the facility policy titled, Subject: Food Wholesomeness, dated as reviewed March 2021, revealed, Kitchen and serving areas are clean at all times. […]

• No harm, potential for more than minimal, patternF925Aug 6, 2026

  Based on observations, record review and interviews, the facility failed to provide an effective pest control program to ensure the facility was free of pests. Specifically, the facility failed to ensure the facility was kept free from cockroaches, beetles, and other insects.Findings include: I. Professional referenceAccording to the Centers for Disease Control's (CDC) Guidelines for Environmental Infection Control in Health-Care Facilities (revised July 2019), retrieved on 8/10/26 from https://www.cdc.gov/infection-control/media/pdfs/Guideline-Environmental-H.pdf,From a public health and hygiene perspective, pests should be eradicated from all indoor environments. […]

• No harm, potential for more than minimal, patternF695Dec 5, 2024

  Based on observations, record review and interviews, the facility failed to ensure three (#19, #54 and #25) of four residents who required respiratory care received care consistent with professional standards of practice out of 34 sample residents. Specifically, the facility failed to: -Follow physician's orders to maintain, clean, sanitize and store Resident #19's continuous positive airway pressure (CPAP) mask and machine and Resident #54's bilevel positive airway pressure (BiPAP) mask and machine; and, -Rinse and store cup and mouthpiece for Resident #25's nebulizer (a small machine that turns liquid medication into a mist that can be inhaled to treat lung conditions.) Findings include I. […]