Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Rolling Hills Care Center during CMS and state inspections, most recent first.
A dietary cook in an LTC facility improperly thawed frozen meat by submerging it in a bucket of water without running cold water, contrary to safe food handling practices. The cook, who had limited training, was unaware of the correct procedure, which could have led to unsafe food being served to 29 residents. Interviews with the Certified Dietary Manager and Registered Dietitian confirmed the importance of following proper thawing methods as outlined in the facility's food safety policy.
The facility failed to follow food safety standards, including unlabeled pancake mix, resident snacks, and muffins, and improper storage of pesticides and uncooked meat. The CDM and RD acknowledged these lapses, which could lead to foodborne illnesses.
The facility did not meet the required square footage per resident in 11 out of 20 rooms, potentially affecting privacy and space for care. Some rooms lacked adequate storage and accessibility for wheelchairs and toilet facilities. A waiver is recommended to continue except for the room not meeting conditions.
The facility failed to maintain a pest-free environment as ants were observed in the kitchen, leading to potential cross-contamination of food. The Certified Dietary Manager confirmed the presence of ants and expressed concerns about food safety. The Maintenance Supervisor was notified of the issue but delayed contacting pest control. The Administrator acknowledged the lack of a pest control contract and the ineffectiveness of the current pest control program.
A facility failed to develop comprehensive care plans for three residents, leading to deficiencies. One resident's care plan lacked provisions for the use and storage of an Incentive Spirometer, posing an infection risk. Another resident's care plan did not address the use and storage of a nebulizer and oxygen tubing, also posing infection risks. Additionally, outside food was improperly stored in two residents' rooms, increasing the risk of food-borne illness. A third resident's care plan for an indwelling catheter was not developed in a timely manner, potentially leading to unmet needs.
The facility failed to follow physician orders for two residents. One resident's oxygen was set incorrectly, and another resident's refusal of a lidocaine patch was not reported to the physician. Additionally, the second resident was given medication for severe pain despite reporting moderate pain, without notifying the physician for a medication adjustment.
The facility failed to store and label medications properly, as observed with an unlabeled bottle of folic acid, an expired pill packet, and unlabeled artificial tears and inhaler. The LVN acknowledged the need for proper labeling and disposal of expired items, while the DON emphasized the importance of checking labels and expiration dates. The facility's policy mandates routine inspections by the consultant pharmacist.
Two residents in a LTC facility were at risk for infections due to improper storage of medical equipment. A resident's CPAP mask was found on the ground, and another resident's oxygen tubing and nebulizer were improperly stored, contrary to facility policy. Both residents had significant medical histories and were cognitively intact, highlighting the importance of proper infection control measures.
Two residents in a facility faced challenges due to inadequate room space and cluttered environments, hindering their access to personal belongings and medical equipment. One resident, with multiple medical conditions, struggled with movement and storage of personal items, while the other, with a history of hemiplegia and COPD, found it difficult to access necessary medical equipment. Staff confirmed the cramped conditions, and the room size was deemed insufficient for two residents with adaptive equipment.
A resident left the facility against medical advice without a post-discharge plan of care, despite having serious medical conditions. The facility's policy requires such a plan, but it was not completed, and the physician was not notified. Interviews with staff confirmed the oversight.
The facility failed to provide hot water for showers, affecting three residents' rights to dignity and self-determination. A resident reported the issue, confirmed by a CNA, but the Assistant Administrator and LVN were unaware. The Maintenance Director knew of the problem but did not notify leadership, leading to residents enduring cold showers or none at all, violating facility policies on resident rights.
Improper Thawing of Meat by Dietary Cook
Penalty
Summary
The facility failed to ensure that a dietary cook was competent in carrying out the functions of the food and nutrition services safely and effectively. During an observation, it was noted that the dietary cook thawed frozen meat by submerging it in a bucket of water without running cold water, which is not in accordance with safe food handling practices. The dietary cook had been working for nine months and had received only a rapid three-day training from a previous supervisor. The cook was unaware of the requirement to have cold water running when thawing meat submerged in water and typically thawed meat in the refrigerator. However, on this occasion, the cook had to thaw the meat in a bucket of water due to the kitchen staff not having thawed it in advance. Interviews with the Certified Dietary Manager and the Registered Dietitian revealed that the correct procedure for thawing meat involves submerging it in running cold water, thawing it in the refrigerator, using a microwave, or cooking it directly. The facility's policy and procedure for food safety require adherence to these methods to prevent foodborne illness. The dietary cook did not follow the established policy and procedure, which could have led to unsafe food being served to 29 residents. The facility's job description for dietary cooks and its food safety policy emphasize the importance of following proper food service practices and procedures.
Food Safety and Storage Deficiencies
Penalty
Summary
The facility failed to adhere to professional standards of practice for food service safety, as evidenced by several observations and interviews. An open box of pancake batter mix was found without an open date label, which the Certified Dietary Manager (CDM) acknowledged should have been labeled to prevent the use of expired food. The Registered Dietitian (RD) confirmed the importance of labeling to avoid foodborne illnesses. Additionally, residents' snacks in the refrigerator were not labeled with a prepared-on date, which the CDM admitted was necessary to ensure snacks were not consumed past their expiration date. Further deficiencies were noted with the storage of a hornet and wasp pesticide bottle under the kitchen sink, which the CDM and RD both stated could lead to cross-contamination and foodborne illnesses. Six bags of muffins in the freezer lacked a received-on date, which the CDM and RD agreed was crucial for preventing the serving of expired food. The facility's policy required all food to be appropriately dated to ensure proper rotation by expiration dates, which was not followed in this instance. The resident refrigerator contained unlabeled foods, including a raisin carrot salad, beef and potatoes, yogurt, a hot pocket, and mozzarella, which were not labeled with resident names or received dates. The CDM stated that labeling was essential to ensure residents received their correct food and to prevent cross-contamination. Additionally, uncooked frozen meat was found in the resident refrigerator, contrary to facility policy, which prohibited raw meat in resident refrigerators. The CDM acknowledged that the dietary and housekeeping staff were responsible for maintaining compliance with these policies.
Inadequate Room Size and Space in Facility
Penalty
Summary
The facility failed to provide the minimum required square footage per resident in multiple resident bedrooms and single resident rooms for 11 out of 20 rooms. Specifically, rooms 1, 5, 6, 8, 9, 10, 11, 12, 18, 19, and 20 did not meet the regulatory requirements of at least 80 square feet per resident in shared rooms and 100 square feet in single rooms. This deficiency was identified during an environmental tour with the Maintenance Director. The lack of adequate space had the potential to compromise residents' privacy and space for ambulation and nursing care. Additionally, certain rooms lacked sufficient closet and storage space, and accessibility for wheelchairs and toilet facilities was inadequate in some instances. The report suggests that a waiver should continue except for the room that did not meet the necessary conditions, although specific room numbers were not provided for these exceptions.
Ant Infestation in Kitchen Due to Ineffective Pest Control
Penalty
Summary
The facility failed to maintain a pest-free environment in accordance with its Pest Control Program policy and procedure, as ants were observed in the kitchen. During an observation and interview with the Certified Dietary Manager (CDM), multiple live and dead ants were found on the kitchen floor and under the sink cabinet. The CDM acknowledged that ants should not be present in the kitchen and confirmed the presence of ants. The CDM expressed concerns about the potential for cross-contamination of food, which could lead to residents becoming ill. The CDM also noted that kitchen staff were responsible for cleaning up the dead ants and that the Maintenance Supervisor (MS) should have been notified to contact pest control. The Administrator (ADM) confirmed that the facility did not have a pest control contract and stated that the MS was informed of the ant issue on 11/19/24 but should have contacted pest control immediately. The MS admitted to being notified about the ants on 11/17/24 and acknowledged that pest control should have been contacted sooner. The pest control company was eventually contacted on 11/19/24, and the kitchen was baited for ants. The ADM and MS both agreed that the current pest control program was ineffective, and the kitchen required more frequent pest control services due to the pest issue.
Deficiencies in Care Plan Development and Implementation
Penalty
Summary
The facility failed to develop and implement comprehensive person-centered care plans for three residents, leading to several deficiencies. Resident 9's care plan did not address the use and storage of an Incentive Spirometer (IS), which posed a risk of infection due to improper storage and use. Additionally, Resident 9's care plan lacked provisions for changing the IS mouthpiece and tubing, which should have been done periodically to prevent infection. Furthermore, Resident 9 and another resident had outside food stored in their rooms for more than three days, increasing the risk of food-borne illness and pest attraction. Resident 23's care plan was also found lacking in several areas. There was no care plan for the use and storage of a nebulizer, which was observed on the floor, posing an infection control problem. Additionally, Resident 23's care plan did not address non-compliance with the proper use and storage of oxygen tubing and nasal cannula, which were improperly stored and used, increasing the risk of infection. The facility's policy required care plans to be developed and implemented to address such issues, but this was not done. Resident 3's care plan was not developed in a timely manner to address the use of an indwelling catheter. The care plan should have been completed within 48 hours of admission, but it was delayed, potentially leading to unmet needs and missed goals and interventions for the resident's catheter care. The facility's policy emphasized the importance of developing care plans promptly to guide resident care and interventions, but this was not adhered to, resulting in deficiencies in the care provided to Resident 3.
Failure to Follow Physician Orders and Notify Physician of Medication Refusal
Penalty
Summary
The facility failed to adhere to professional standards of practice in the care of Resident 23 by not following the prescribed oxygen flow rate. Resident 23's oxygen was set at 3 liters per minute instead of the ordered 2 liters per minute. This discrepancy was observed during an interview and record review, where it was confirmed that the nurse responsible did not adjust the oxygen rate according to the physician's orders. Resident 23, who was cognitively intact, had a history of chronic obstructive pulmonary disease and other respiratory conditions, which necessitated precise oxygen management. In the case of Resident 3, the facility did not notify the attending physician of the resident's repeated refusal of a prescribed lidocaine patch for pain management. Despite the resident's refusal on multiple occasions, the nursing staff failed to inform the physician, which prevented any potential adjustments to the pain management plan. Resident 3, who was also cognitively intact, had a complex medical history including chronic pain and other serious health conditions, making effective pain management crucial. Additionally, the facility did not follow the physician's orders regarding pain medication for Resident 3. The resident was administered oxycodone-acetaminophen, a medication intended for severe pain, despite reporting moderate pain levels. The nursing staff did not contact the attending physician to adjust the medication to better suit the resident's pain level, which was a deviation from the prescribed care plan. This oversight in medication administration could have impacted Resident 3's quality of life, as the pain management was not aligned with the resident's reported pain levels.
Medication Storage and Labeling Deficiencies
Penalty
Summary
The facility failed to ensure that drugs and biologicals were stored and labeled according to professional standards. During an observation, a bottle of folic acid was found without a readable expiration date, and a pill packet was expired. The Licensed Vocational Nurse (LVN) acknowledged the need to discard these items, expressing concern about the potential loss of efficacy and the risk of fungal development in expired medications. Additionally, a bottle of artificial tears and an inhaler were found without labels indicating the resident's name or expiration date. The LVN confirmed that these items should have been properly labeled. The Director of Nursing (DON) stated that no expired medications should be present in the medication cart and emphasized the importance of checking labels and expiration dates before administering medications. The facility's policy requires routine inspections by the consultant pharmacist to identify and destroy discontinued, outdated, or improperly labeled medications.
Infection Control Deficiencies in Equipment Storage
Penalty
Summary
The facility failed to maintain an effective infection control program, as evidenced by the improper storage of medical equipment for two residents. Resident 30's CPAP mask was found on the ground next to the bed, rather than being stored in a bag as required. This was confirmed by both the resident and a Certified Nursing Assistant (CNA), who acknowledged the risk of cross-contamination and infection due to the mask's improper storage. The Director of Staff Services and the Director of Nursing both confirmed that the CPAP mask should have been stored in a bag and disinfected once found on the ground. The Infection Preventionist also noted the risk of respiratory infection due to the mask's condition. Resident 30 had been in the facility for three weeks and had a history of type 2 diabetes, asthma, hypertension, and anemia. The resident was cognitively intact, with a BIMS score of 13, and used the CPAP mask nightly to assist with breathing. The facility's policy required the CPAP mask to be cleaned daily and stored in a bag when not in use, but this was not adhered to, placing the resident at risk for respiratory infections. Similarly, Resident 23's oxygen tubing was improperly stored, wrapped around the bed rail, and the nebulizer was found on the ground. The CNA and the Minimum Data Set Nurse both recognized the infection control issue and the risk of infection due to the equipment's condition. Resident 23 had a history of hemiplegia, COPD, and other serious health conditions, and was also cognitively intact with a BIMS score of 15. The facility's policy required oxygen and nebulizer equipment to be stored in a bag when not in use, but this was not followed, increasing the risk of infection for the resident.
Inadequate Room Space and Cluttered Environment for Residents
Penalty
Summary
The facility failed to provide a safe, comfortable, and homelike environment for two residents, resulting in their inability to access and use personal belongings and medical equipment. Resident 9, who was admitted with multiple medical conditions including osteomyelitis, schizoaffective disorder, and anxiety disorder, was observed in a room cluttered with plastic grocery bags, food, and a wheelchair obstructing movement. Resident 9 expressed difficulty moving around due to the cramped space and had to store personal items in inconvenient locations, such as under his pillow and on his bed, leading to a non-homelike environment. Similarly, Resident 23, who had a history of hemiplegia, COPD, and heart failure, faced challenges in accessing necessary medical equipment like a nebulizer due to the room's layout. The resident's power strip was out of reach, and the room was cluttered with boxes, papers, and medical equipment, making it difficult for the resident to move around safely. Both residents reported feeling that their rooms were too small and not conducive to a homelike atmosphere, with Resident 23 specifically mentioning the danger of moving around in such a confined space. Interviews with facility staff, including the Infection Preventionist Nurse and a Certified Nursing Assistant, confirmed the residents' concerns about the cluttered and cramped conditions. The Maintenance Director verified the room's small size, measuring only 110 square feet, which was inadequate for two residents with adaptive equipment. The Director of Nursing acknowledged the safety risks posed by the room's size, especially in emergencies, and the Administrator noted the need for a safe environment for residents. The facility's policies emphasized the importance of providing a safe and homelike environment, which was not achieved in this case.
Failure to Provide Post-Discharge Plan for Resident Leaving AMA
Penalty
Summary
The facility failed to ensure that a resident, who left the facility against medical advice (AMA), had a post-discharge plan of care. This deficiency was identified during a review of the resident's records, which revealed that there was no post-discharge summary plan available for the resident. The resident, who had been admitted with multiple serious medical conditions including osteomyelitis, gas gangrene, cellulitis, dyspnea, anxiety disorder, acute kidney failure, and chronic pain, left the facility without the necessary documentation to assist in their transition to a new living environment. Interviews with facility staff, including the Director of Staff Development (DSD) and the Director of Nursing (DON), confirmed that the required discharge summary plan of care was not completed. The facility's policy and procedure for transfers and discharges, including those against medical advice, mandates that a post-discharge plan of care be developed with the participation of the resident and their representative. However, this was not adhered to, as the physician was not notified, and the discharge summary was not documented, resulting in a failure to follow the established protocol.
Failure to Provide Hot Water for Resident Showers
Penalty
Summary
The facility failed to honor the residents' rights to a dignified existence and self-determination by not providing hot water for showers, affecting three residents. On the evening of September 19, 2024, Resident 1 reported that the facility did not have hot water, preventing her from taking a scheduled shower. Observations confirmed that the shower water was not hot, and a Certified Nursing Assistant (CNA) acknowledged the lack of hot water, stating that residents could only receive cold bed baths. The Assistant Administrator and Licensed Vocational Nurse were unaware of the issue, indicating a communication breakdown. Resident 6 expressed dissatisfaction with taking cold showers, which he endured to maintain personal hygiene. He mentioned that the hot water issue had persisted for weeks and had been reported to maintenance. The Maintenance Director was aware of the problem by 11 a.m. on September 19, 2024, and had called a plumber, but failed to notify facility leadership or follow emergency procedures. This lack of communication and action resulted in residents being unable to take hot showers, compromising their dignity and personal preferences. The Director of Nursing and Administrator were informed of the issue only after it had been ongoing, highlighting a failure in the facility's communication and emergency response protocols. The facility's policy on resident rights emphasizes the importance of providing a safe, comfortable, and respectful environment, which was not upheld in this instance. The deficiency was further compounded by the Maintenance Director's failure to report the issue promptly, as required by the facility's emergency operations plan.
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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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Nursing homes near Selma
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Bethel Lutheran Home | 0.7 mi | ★★★★★ | 19 | 0 |
| Kingsburg Center | 4.3 mi | ★★★★★ | 3 | 0 |
| Fowler Care Center | 4.6 mi | ★★★★★ | 1 | 0 |
| Vineyards At Fowler | 5 mi | ★★★★★ | 25 | 0 |
| Manning Gardens Care Center, Inc | 8.1 mi | ★★★★★ | 21 | 0 |
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