Hilltop Park Rehabilitation and Care Center

In the surveyor’s words

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

• Immediate jeopardy, patternF580Feb 14, 2025

  Based on interview and record review, the facility failed to immediately inform the resident, consult with the resident's physician; and notify, consistent with his or her authority, the resident representative where there was a significant change in the resident's physical, mental, or psychosocial status and when there was a need to alter treatment significantly for one of six (Resident #1) residents reviewed for notification of change in condition. The facility failed to notify Resident #1's attending physician of nausea, vomiting and diarrhea which lasted from 12/22/2024 to 12/30/2024 without improvement. An Immediate Jeopardy (IJ) situation was identified on 01/29/2025 at 4:21 pm . The IJ was removed on 01/31 /2025 at 10:24 AM. […]

• Immediate jeopardy, patternF684Feb 14, 2025

  Based on interview and record review, the facility failed to provide treatment and care in accordance with professional standards of practice and the comprehensive care plan for one of six (Resident #1) residents reviewed for notification of change in condition. The facility failed to ensure Resident #1's feedings were administered as ordered by the physician over a period of 8 days, from 12/22/2024 to 12/30/2024. The facility failed to notify Resident #1's attending physician of feedings being held due to nausea, vomiting and diarrhea. On 12/30/24 Resident #1 required hospitalization for hypovolemic shock, sepsis, UTI, and required emergency surgical intervention for treatment of a rectus abdominus hematoma. An Immediate Jeopardy (IJ) situation was identified on 01/29/2025 at 4:20 pm . […]

• No harm, potential for more than minimal, widespreadF812Sep 4, 2025

  Based on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen and 1 of 3 nourishment refrigerators (200/300 hall) reviewed for food services in that:The facility failed to store foods in the kitchen refrigerator and freezer that were sealed and labeled with an identifier and/or opened/expiration date for 1 of 2 refrigerator/freezers.The facility failed to store foods and drinks in a unit nourishment refrigerator that were sealed and labeled with an opened date for 1 of 2-unit refrigerators. […]

• No harm, potential for more than minimal, widespreadF812Aug 22, 2024

  Based on observation, interview, and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen and 1 of 2 resident nourishment rooms, in that: 1. Knife blades and serving utensils were stored on a rack and suspended in the air with their sanitized food surfaces exposed to contaminants in the air. 2. Appliances and equipment were soiled with grease and food. 3. A cardboard case with diced potatoes was stored on the floor in the walk-in freezer. 4. The ice scoop was placed on top of the ice inside the ice machine. 5. […]

• No harm, potential for more than minimal, patternF761Sep 4, 2025

  Based on observation, interview and record review, the facility failed to ensure medications were secured on 1 of 6 medication carts (medication cart E) and 1 of 3 medication rooms (medication room B) reviewed for pharmacy services. The facility did not ensure medication carts and medication storage rooms were secured and locked. This failure could put residents at risk for drug diversions. Findings included: During an observation on 9/3/25 at 9:10 am, medication room on hall 300 was observed to be unlocked and the door open with no nurse or staff at nurses' station for approximately 10 minutes. Upon entering unlocked medication storage room, medication was observed on counter in plain sight. Medication storage refrigerator was unlocked with medications inside. […]