Above average — CMS composite of the measures below.
The next survey window likely opens around March 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Highland Palms Healthcare Center during CMS and state inspections, most recent first.
Improper Food Thawing and Storage in Walk-In Refrigerator: A wet box of individually rapid cold cuts was found sitting on top of a thawing roast beef inside a plastic container in the walk-in refrigerator. The DS stated the cold cuts should have been removed from the box and placed on a pan, and the Admin confirmed the facility P&P required a drip pan under food being thawed so drippings do not contaminate other food.
Infection prevention and control practices were not maintained when a resident’s Foley drainage bag was observed touching the floor while the resident sat in a wheelchair in the dining room. The resident had diagnoses including UTI, bacteremia, and CKD, and the TN stated the bag should have been securely hung because it was an infection control issue. Infection control was also not maintained when an RN carried a pre-prepared IV Daptomycin bag in his scrub pocket before administering it through a PICC line to a resident with necrotizing fasciitis; the DON stated this was not acceptable and that the policy was not followed.
Missing documentation for catheter care and APP mattress checks was identified for a resident with an indwelling urinary catheter and an APP mattress order. The TAR lacked evidence that the catheter was monitored, the catheter site was cleansed, and the mattress was checked on multiple evening shifts, and the TN confirmed the omissions. The resident reported catheter leakage, and the DON stated the care was not recorded as completed in the TAR.
An LVN left a resident’s EHR open on a computer atop a med cart and unattended in the hallway while administering meds in the resident’s room. The resident’s health information remained visible and accessible, and the Administrator agreed the confidentiality policy was not followed.
A resident with diagnoses of schizophrenia and bipolar disorder had a PASARR Level I screen documented incorrectly by an RN, who marked the serious mental illness question as negative and indicated that a Level II screen was not needed. The RN acknowledged the error, and the DON verified that the PASARR was documented incorrectly and that the facility’s PASARR policy was not followed.
Unattended medication cart left unlocked in accessible common area. Medication cart 1 was observed unattended and unlocked in front of Nurses' Station I near the main entrance, where residents, staff, and visitors could access it. The cart contained eight drawers and a binder labeled Station I Narcotic & Antibiotic Record. An LVN was administering medications elsewhere, and a consultant confirmed the cart had been left unsecured. The LVN acknowledged the cart may have been left open after medication administration, and the DON reviewed policy stating medication carts must be locked when not in use.
A resident with acute respiratory failure, DM, and HTN left AMA after an out-on-pass during which she told a family member she had been sexually abused by staff. The family member reported the allegation to law enforcement and then took the resident home. The DON acknowledged that police came to the facility regarding the allegation but stated the facility did not initiate an investigation or report the allegation to CDPH because the resident had already been discharged, despite facility policy requiring identification, investigation, and timely reporting of all abuse allegations.
The facility failed to investigate or report an allegation of sexual abuse made by a resident with acute respiratory failure, DM, and HTN, who later left AMA. The resident’s family member reported that during an out-on-pass, the resident alleged sexual abuse by a staff member and that he notified law enforcement before taking the resident home. The DON confirmed that police came to the facility regarding the allegation but stated no internal investigation was initiated and no report was made to the state agency because the resident had already been discharged, despite facility policy requiring identification, investigation, and timely reporting of all abuse allegations.
A resident with a history of stroke, diabetes, and benign prostatic hyperplasia experienced moisture-associated skin damage (MASD) but the facility failed to document this change in condition. Despite new physician orders for treatment, the Director of Nursing confirmed the absence of documentation in the resident's records, violating the facility's policy on recording changes in a resident's condition.
A resident with multiple diagnoses, including schizophrenia and anxiety disorder, was found to smoke regularly without a comprehensive care plan in place. The resident kept smoking supplies and a lighter, but the facility failed to document a smoking care plan, as confirmed by the DON. This oversight was contrary to the facility's policy requiring evaluation and documentation of smoking-related concerns.
A resident's enteral feeding was administered at 65 mL/hr instead of the prescribed 60 mL/hr, as observed by surveyors. The discrepancy was confirmed by the DON, who acknowledged that the facility's policy for implementing physician orders was not followed. This failure could result in the resident receiving more calories than ordered.
A resident with a tracheostomy was not monitored for redness, discharge, and discoloration every shift as ordered by the physician. Instead, the monitoring was documented only once per day for two months. The DON confirmed the oversight, which contradicted the facility's policy on ostomy site care, potentially delaying the identification and treatment of complications.
The facility failed to follow its medication disposal policy when six tablets were found on top of the medication waste receptacle instead of inside it. An LVN and an RN confirmed the improper disposal, and the DON acknowledged that the facility's procedures were not followed, as per the 2019 policy on discarding and destroying medications.
An expired IV antibiotic was found in a medication supply room, still available for use. A nurse and the DON confirmed the oversight, acknowledging that expired medications should have been removed according to facility policy.
A CNA failed to don a gown when entering the room of a resident on contact precautions for MRSA, despite clear signage and facility policy requiring it. This breach in infection control was confirmed by the facility's IP and DON, highlighting a potential risk of spreading infectious disease.
A resident with multiple health conditions, including diabetes and HIV, was found to have medications stored unlocked at his bedside, contrary to the facility's policy. The medications, Genvoya and Ozempic, were confirmed by both the LVN and DON to be kept at the bedside, although administered by a nurse. The facility's policy requires medications to be stored in locked compartments, which was not adhered to, potentially risking the resident's health.
A facility failed to follow a physician's order to cover a resident's surgical site with a dry dressing, as the wound treatment nurse did not apply the dressing due to the resident's reported tape allergy. The resident had a history of orthopedic aftercare, alcoholic cirrhosis, a left artificial hip joint, and osteoarthritis. The DON confirmed that nurses are expected to follow orders, and the facility's wound care policy emphasized adherence to physician's orders.
A facility failed to create a care plan for a resident who tested positive for methamphetamine, despite being informed by the hospital. The resident had a history of stroke and drug abuse, and was admitted with multiple health issues. Interviews with staff revealed a lack of communication and care planning, contrary to the facility's policies on behavioral health services.
Improper Food Thawing and Storage in Walk-In Refrigerator
Penalty
Summary
The facility failed to maintain a sanitary kitchen when a wet box containing individually rapid cold cuts was found sitting on top of a thawing roast beef inside a plastic container in the walk-in refrigerator. During observation with the Dietary Supervisor, the wet box was lifted and a thawed roast beef was observed underneath it. The Dietary Supervisor stated that the box contained cold meat and that it should have been removed from the box and placed on a pan. During record review, the facility's policy and procedure titled Thawing of Meats stated to use a drip pan under food being thawed so drippings do not contaminate other food, and the Administrator stated the cold cut should have been taken out of the box and placed on a drip pan.
Infection Control Failures With Foley Bag Placement and IV Medication Handling
Penalty
Summary
Infection prevention and control practices were not maintained for a resident with a Foley catheter when the drainage bag was observed in the dining room touching the floor while the resident was seated in a wheelchair. The resident’s record showed diagnoses including urinary tract infection, bacteremia, and chronic kidney disease. During the observation, the urine in the catheter bag appeared yellow and cloudy, and the Treatment Nurse stated the bag was not supposed to be dragging on the floor and needed to be securely hung on the side of the wheelchair because it was an infection control issue. The facility’s Catheter Care, Urinary policy stated the catheter tubing and drainage bag are to be kept off the floor when identified, and the Administrator and DON stated the policy was not followed. Infection control was also not maintained during IV medication administration for a resident with necrotizing fasciitis who had an order for Daptomycin sodium chloride 660 mg daily through a PICC line. RN 1 was observed wearing PPE, then removing a pre-prepared 50 mL IV medication bag from his scrub pants pocket and priming the IV tubing before connecting it to the resident’s PICC line. RN 1 stated he usually brings pre-prepared medication in his pocket to all residents and that he brings the IV cart to the front of the resident’s room when he prepares the powdered medication form. The DON stated it was not acceptable to carry medication in a scrub pants pocket for administration and acknowledged the process was not followed.
Missing Documentation for Catheter Care and APP Mattress Checks
Penalty
Summary
Resident 10, who was admitted with diagnoses including benign prostatic hyperplasia with lower urinary tract symptoms, COPD, and acute respiratory failure with hypoxia, had physician orders for an indwelling urinary catheter to be checked every shift for intactness and function, and for catheter site cleansing with warm soap and water, rinsing, and patting dry every shift. The resident was observed in bed awake and alert with an indwelling urinary catheter in place, and during interview reported leakage from the catheter and stated he had previously told facility staff about the concern, but it had not been resolved. A review of the March 2026 TAR showed no documented evidence that the catheter monitoring order was completed on the evening shift for March 3, 4, 5, 10, 11, and 12, 2026. The same six evening shifts also had no documented evidence that catheter site cleansing was completed. The Treatment Nurse confirmed the missing documentation and stated the treatments should have been documented as completed. Resident 10 also had an order for an APP mattress to be set to the resident's weight and checked every shift for proper placement and function. The March 2026 TAR showed no documented evidence that the APP mattress check was completed on the same six evening shifts, and the Treatment Nurse confirmed those omissions as well. A later review of the April 2026 TAR showed missing documentation on the evening shift of April 9, 2026 for catheter monitoring, catheter site cleansing, and APP mattress checks. The DON reviewed the facility policy on physician orders and stated the policy was not followed because care was not recorded as completed in the TAR.
EHR Left Open and Visible on Medication Cart
Penalty
Summary
The facility failed to keep Resident 132’s electronic health record secure when an LVN left the resident’s health information open on a computer screen on top of a medication cart and unattended in the hallway. During observation on April 29, 2026, the LVN logged into the computer, reviewed Resident 132’s EHR, prepared the medication, and then went into the resident’s room to administer the medications without logging off the computer. Resident 132’s information remained visible and accessible on the medication cart. When asked, the LVN stated she was not supposed to keep the computer unattended. During review of the facility’s Confidentiality Information and Personal Property policy with the Administrator on April 30, 2026, the Administrator agreed the policy was not followed.
Incorrect PASARR Screening for Resident with Mental Health Diagnoses
Penalty
Summary
The facility failed to follow its policy and procedure for PASARR when RN 1 completed the Level I screening for one resident and documented the screening incorrectly. The resident’s PASARR dated December 20, 2025, indicated a negative Level I screen for serious mental illness and intellectual/developmental disability or related conditions, and stated that a Level II screening was not required. A review of the resident’s admission record showed diagnoses of schizophrenia and bipolar disorder. During interview, RN 1 stated he was responsible for completing PASARR screenings for admitting residents and acknowledged that he incorrectly marked “no” for the question regarding serious mental illness. The DON also reviewed the policy titled admission Criteria PASARR and verified that the PASARR was documented incorrectly and that the policy was not followed because RN 1 did not complete the Level I screening correctly.
Unattended medication cart left unlocked in accessible common area
Penalty
Summary
Medication cart 1 was observed unattended and unlocked in a common area directly in front of Nurses' Station I near the main entrance, where it was accessible to residents, staff, and visitors. The cart contained eight drawers, and a binder labeled Station I Narcotic & Antibiotic Record was on top of it. At the time of the observation, LVN 1 was down the hallway administering medications, leaving the cart unsecured. During a concurrent observation and interview, Consultant 1 noted that the lock on Medication cart 1 was dislodged from its secured position, leaving the cart unsecured and accessible, and manually pushed the lock back into place. Consultant 1 confirmed the cart had been left unlocked and stated it should not be left unlocked because it can be accessible to anyone, including residents and visitors. LVN 1 acknowledged that leaving the cart unattended and unlocked was not safe and stated the cart may have been left open after medication administration. The DON reviewed the facility policy stating that compartments containing drugs and biologicals must be locked when not in use and that carts used to transport such items shall not be left unattended if open or otherwise potentially available to others.
Failure to Report and Investigate Allegation of Sexual Abuse
Penalty
Summary
The facility failed to timely report an allegation of sexual abuse and to initiate an investigation as required by its abuse, neglect, exploitation, and misappropriation prevention program. Resident 1 was admitted with diagnoses including acute respiratory failure, diabetes mellitus, and hypertension, and later left the facility against medical advice on February 17, 2026. During an out-on-pass with a family member on February 15, 2026, Resident 1 allegedly reported that she had been sexually abused by a staff member in the facility. The family member stated that he reported the allegation to the sheriff and police department and then took Resident 1 home after discharging her AMA on February 17, 2026. The DON confirmed that law enforcement came to the facility in response to the resident’s allegation of abuse. However, the DON stated that the facility did not initiate its own investigation or report the allegation to CDPH because Resident 1 had already been discharged when the facility became aware of the alleged abuse. A subsequent review of the facility’s policy and procedure on Abuse, Neglect, Exploitation and Misappropriation Prevention Program showed that the facility was required to identify and investigate all possible incidents of abuse and to investigate and report any allegations within timeframes required by federal requirements. Despite this policy, the facility did not investigate or report the allegation involving Resident 1.
Failure to Investigate Allegation of Sexual Abuse After Resident Discharge
Penalty
Summary
The facility failed to investigate an allegation of sexual abuse involving one of four sampled residents. The resident was admitted with diagnoses including acute respiratory failure, diabetes mellitus, and hypertension. According to the resident’s AMA (against medical advice) Release Form, the resident left the facility against medical advice on February 17, 2026. During a telephone interview on February 23, 2026, the resident’s family member reported that during an out-on-pass on February 15, 2026, the resident alleged she had been sexually abused by a staff member at the facility. The family member stated he reported the allegation to the sheriff’s and police departments and then took the resident home after discharging her AMA on February 17, 2026. In a subsequent interview, the DON stated that law enforcement came to the facility in response to the resident’s allegation of abuse. The DON acknowledged that the facility did not initiate an internal investigation or report the allegation to the California Department of Public Health because the resident had already been discharged when the facility became aware of the allegation. During a later record review, the DON reviewed and acknowledged the facility’s Abuse, Neglect, Exploitation and Misappropriation Prevention Program policy, which requires the facility to identify and investigate all possible incidents of abuse, neglect, mistreatment, or misappropriation of resident property, and to investigate and report any allegations within timeframes required by federal requirements.
Failure to Document Change in Condition for Resident with MASD
Penalty
Summary
The facility failed to document a significant change in condition for one of its residents, identified as Resident 42, who experienced moisture-associated skin damage (MASD). On October 30, 2024, new physician orders were issued for Resident 42 to treat MASD on the right buttocks, which included cleansing with normal saline, applying calcium alginate, and covering with a dry dressing daily for 14 days. However, the Director of Nursing (DON) confirmed that there was no documented evidence of this change in condition in Resident 42's clinical records, indicating a lapse in following the facility's policy and procedure for documenting changes in a resident's condition. Resident 42, who was admitted with diagnoses including hemiplegia and hemiparesis following a cerebral infarction, type 2 diabetes mellitus, and benign prostatic hyperplasia, reported discomfort and redness in the genital area to a nurse on October 28, 2024. Despite this report, the nurse did not document the change in condition, as confirmed by the DON during a review of the facility's policy titled 'Change in a Resident's Condition or Status.' This policy mandates that any change in skin integrity should be recorded in the resident's medical record, which was not adhered to in this case.
Failure to Develop Smoking Care Plan for Resident
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident who was identified as a smoker. The resident, who had been admitted with diagnoses including muscle wasting, schizophrenia, anxiety disorder, and major depressive disorder, reported smoking regularly and keeping smoking supplies, including cigarettes and a lighter, in his possession. Despite these circumstances, there was no evidence of a smoking care plan in the resident's medical record. During an interview, the Director of Nursing confirmed the absence of a smoking care plan for the resident, acknowledging that such a plan should have been created. The facility's smoking policy requires an evaluation of a resident's smoking status upon admission and mandates that any smoking-related privileges, restrictions, and concerns be documented in the care plan. The lack of a care plan for the resident's smoking habits was a deviation from the facility's established policies and procedures, which aim to ensure safe smoking practices and address the resident's needs comprehensively.
Failure to Follow Physician Orders for Enteral Feeding
Penalty
Summary
The facility failed to adhere to physician orders for a resident's enteral feeding, resulting in a discrepancy in the feeding rate. Specifically, Resident 44 was observed to have their enteral feeding running at 65 mL/hr instead of the prescribed 60 mL/hr. This deviation from the physician's order was noted during an observation on October 31, 2024, and was confirmed by the Director of Nursing (DON) during a concurrent observation and interview. The physician's order, dated July 13, 2024, clearly specified that the enteral feeding should be administered at 60 mL/hr for 20 hours, totaling 1200 mL and 1440 calories. The facility's policy and procedure for accepting, transcribing, and implementing physician orders were not followed, as acknowledged by the DON. The policy mandates that licensed nursing personnel ensure all physician orders are accurately recorded and implemented. Despite this, the enteral feeding for Resident 44 was not administered according to the specified rate, potentially leading to the resident receiving more calories than ordered. The failure to follow the physician's order was identified through observations and interviews conducted over several days, highlighting a lapse in the facility's adherence to its own procedures.
Failure to Monitor Tracheostomy as Ordered
Penalty
Summary
The facility failed to provide adequate respiratory care for a resident with a tracheostomy, as specified by the physician's orders. The resident, who had a tracheostomy due to conditions such as muscle wasting, asthma, dysphagia, and immunodeficiency, was supposed to have their tracheostomy site monitored for redness, discharge, and discoloration every shift. However, the Treatment Administration Records for September and October showed that the monitoring was only documented once per day instead of the required three times per day. During an interview and record review, the Director of Nursing confirmed that the physician's orders were not followed, emphasizing the importance of monitoring to promptly identify and address potential infections. The facility's policy on ostomy site care also highlighted the need for regular assessment to prevent irritation, breakdown, and infection. This oversight in monitoring had the potential to delay the identification and treatment of complications, affecting the resident's health and safety.
Improper Disposal of Medications
Penalty
Summary
The facility failed to adhere to its policies and procedures for the destruction and disposal of medications, as evidenced by the discovery of six medication tablets on top of the medication waste receptacle. During an observation and interview, a Licensed Vocational Nurse (LVN) acknowledged that the tablets, which were not narcotics, were improperly placed on the lid of the receptacle instead of being disposed of inside it. This was confirmed by a Registered Nurse (RN) who also observed the tablets and stated that they should have been properly disposed of within the receptacle. Further investigation with the Director of Nurses (DON) revealed that the facility's policy and procedure, titled "Discarding and Destroying Medications" and revised in 2019, was not followed. The policy mandates that both controlled and non-controlled substances be disposed of in the authorized onsite receptacle and documented on the medication disposition record. The DON confirmed that the facility's procedures were not adhered to, as the tablets were left accessible on top of the waste receptacle, contrary to the established guidelines.
Expired Medication Found in Supply Room
Penalty
Summary
The facility failed to ensure that expired medications were removed from one of its medication supply rooms. During an observation and interview, a registered nurse identified an expired intravenous antibiotic, Daptomycin, in the medication refrigerator. The medication had expired the previous day, yet it was still readily available for use. The registered nurse acknowledged that expired medications should have been removed and discarded. Further investigation with the Director of Nurses confirmed the oversight. The facility's policy and procedure, which mandates the removal and destruction of expired medications, was not followed. The Director of Nurses admitted that the nursing staff was responsible for maintaining medication storage and ensuring expired drugs were not used, highlighting a lapse in adherence to the facility's established protocols.
Infection Control Breach Due to Improper PPE Use
Penalty
Summary
The facility failed to maintain proper infection control practices when a Certified Nursing Assistant (CNA 1) did not don a gown upon entering the room of a resident on contact precautions. The resident, identified as Resident 391, was admitted with diagnoses including sepsis, a local infection of the skin and subcutaneous tissue, and a methicillin-resistant Staphylococcus aureus (MRSA) infection. The resident's care plan required contact isolation precautions due to the MRSA infection, which included the use of personal protective equipment such as gowns. Despite a sign at the entryway of the resident's room indicating the need for gowning, CNA 1 entered the room without a gown, touched the resident's phone, and handed it to the resident. The incident was observed on October 29, 2024, and was later discussed with the facility's Infection Preventionist (IP) and Director of Nursing (DON). Both confirmed that staff were expected to don gloves and gowns when entering the room of a resident on contact precautions. The facility's policy on transmission-based precautions, dated September 2022, also required staff and visitors to wear a disposable gown upon entering such rooms. The failure to adhere to these precautions had the potential to spread infectious disease to other residents and staff in the facility.
Improper Medication Storage at Resident's Bedside
Penalty
Summary
The facility failed to ensure medications were stored properly according to its policies and procedures and standards of practice. During an observation, a resident was found to have medications stored at his bedside unlocked, including an opened bottle of Genvoya and an injection pen of Ozempic. The resident, who has a medical history of type 2 diabetes mellitus, cirrhosis of the liver, chronic kidney disease, and is HIV positive, stated that he kept the medications with him at his bedside. Both the LVN and the DON confirmed that the resident kept these medications at his bedside, although a nurse administered them. The facility's policy and procedure for medication storage, dated November 2020, requires that all drugs and biologicals be stored in locked compartments under proper conditions. The DON acknowledged that the facility did not follow its policy, as the medications should have been stored in a locked compartment. This oversight had the potential to place the resident's health at risk for drug abuse and ingestion of unsanitary drugs.
Failure to Follow Physician's Orders for Wound Care
Penalty
Summary
The facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice. Specifically, the deficiency involved a failure to cover the surgical site on the resident's left hip with a dry dressing as per the physician's order. The resident had been admitted with diagnoses including orthopedic aftercare, alcoholic cirrhosis of the liver, a left artificial hip joint, and osteoarthritis. The physician's order clearly stated that the surgical site should be cleansed with normal saline, patted dry, and covered with a dry dressing daily. However, during a dressing change, the wound treatment nurse did not cover the surgical site because the resident reported an allergy to the tape. The Director of Nursing (DON) confirmed that licensed nurses are expected to verify and follow physician's orders for resident care, and expressed that the nurse should have adhered to the order to cover the surgical site with a dry dressing. The facility's policy and procedure for wound care, revised in October 2010, also emphasized the importance of following physician's orders and assessing any special needs of the resident. This oversight had the potential to delay and promote wound healing for the resident.
Failure to Implement Care Plan for Resident with Illicit Drug Use
Penalty
Summary
The facility failed to provide a comprehensive person-centered care plan for a resident who had tested positive for an illicit drug, specifically methamphetamine. The resident, who had a history of stroke and methamphetamine abuse, was admitted to the facility with diagnoses including shortness of breath, opioid use, respiratory failure, and major depressive disorder. Despite being informed by the hospital about the resident's positive drug test, the facility did not develop a care plan to monitor or provide treatment for the resident's condition. Interviews with facility staff, including a Licensed Vocational Nurse and the Director of Nursing, revealed that there was no formal communication or care plan in place regarding the resident's illicit drug use. The facility's policies on Behavioral Health Services and Behavioral Assessment, Intervention, and Monitoring were reviewed, indicating that a care plan should have been implemented to address the resident's needs. However, the interdisciplinary team did not evaluate the resident's behavioral symptoms or develop a plan of care, leading to a deficiency in meeting the resident's health and safety needs.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Illustrative
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Nursing homes near Highland
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Sierra Vista | 1.7 mi | ★★★★★ | 18 | 0 |
| Del Rosa Villa | 2.6 mi | ★★★★★ | 14 | 0 |
| Haven Post Acute | 3.3 mi | ★★★★★ | 1 | 0 |
| Totally Kids Rehabilitation Hospital - D/p Snf | 3.6 mi | ★★★★★ | 10 | 0 |
| Arrowhead Springs Healthcare | 4 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.