Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Hillcrest Nursing Center during CMS and state inspections, most recent first.
Food Storage and Labeling Deficiency: The facility failed to store food in accordance with professional standards by leaving expired milk in the refrigerator and by not labeling or dating opened food items, including an opened bag of breaded okra, a pitcher of tea, a covered plastic glass of milk, and an opened bag of breaded chicken patties. The DM stated opened items should be dated when opened and expired food should be discarded, and the NHA confirmed expired products must be removed immediately and should not be stored with food available for resident use.
Failure to Knock Before Entering Resident Room: A CNA entered a resident's room twice without knocking, despite facility policy requiring staff to knock, announce themselves, and protect privacy before entering. The DON confirmed this was the expected protocol, and the resident had severe cognitive impairment with a BIMS score of 03 and a history including cerebral infarction.
Out-of-Range Hot Water Temperature in Resident Room: A resident reported that bathroom sink water did not get hot and remained lukewarm even after running for two minutes. Surveyors measured the water at 98.2 degrees Fahrenheit, below the facility’s minimum standard of 100 degrees Fahrenheit. The MDS showed the resident was cognitively intact and had Type 2 DM. The Maintenance Director believed the water heater thermostat was causing the low temperature and noted prior water heater problems; the NHA acknowledged the out-of-range temperature and that it could cause resident discomfort.
Failure to Meet Minimum Nursing Staffing Ratio: The facility did not ensure nursing staff provided the required 2.8 hours of direct nursing care per resident per 24 hours on two reviewed days. The PBJ report showed excessively low weekend staffing, and the staffing grid documented ratios of 2.63 and 2.7, both below the state minimum. The Administrator confirmed the facility did not meet its established staffing level and stated the reports did not generate email alerts.
A nurse performed PEG tube care for a resident with hemiplegia, hemiparesis, and dysphagia without wearing a gown, contrary to facility policy and posted EBP signage requiring gown and gloves for high-contact device care. Interviews with staff and review of records confirmed that the resident was at high risk for infection and that proper EBP was not followed during the observed care event.
A resident with a history of asthma and moderate cognitive impairment was observed receiving oxygen at 3L/min, despite the care plan and physician's order specifying 2L/min via nasal cannula as needed for shortness of breath. Facility staff, including an LPN and the DON, confirmed that the oxygen flow rate did not match the prescribed interventions, resulting in a failure to implement the individualized plan of care.
A resident with an indwelling catheter did not have their care plan updated to include interventions for routine catheter care or specify which staff were responsible, despite care being provided and documented by CNAs. Staff interviews and record reviews confirmed the omission, which was not in accordance with facility policy requiring periodic care plan revisions.
A resident with a history of cough and wheezing was observed receiving oxygen at a flow rate above the physician-ordered 2 liters per minute, with staff confirming the oxygen was typically set higher than ordered. The LPN acknowledged the discrepancy and that the oxygen setting had not been changed, despite the order specifying a lower rate. The DON confirmed that staff are expected to check and follow physician orders for oxygen administration.
Staff failed to follow medication administration policy by leaving medications unattended at the bedside for a resident with moderate cognitive impairment and on the medication cart for another resident. Both LPNs involved acknowledged the error, and the DON confirmed that medications should not be left unattended to ensure proper administration.
Food Storage and Labeling Deficiency
Penalty
Summary
The facility failed to store food in accordance with professional standards by not removing expired food products and by not labeling or dating opened or prepared food items. During a kitchen observation with the Dietary Manager, an opened bag of breaded okra in the freezer was not labeled, the milk refrigerator contained a pitcher of tea without a preparation or discard date, a covered plastic glass containing milk without a date, and two half-pint cartons of milk with an expiration date of 7/12/2026. The Dietary Manager stated the milk vendor had instructed the facility to keep the expired milk in the refrigerator until credit was received for the products. The walk-in freezer also contained an opened bag of breaded chicken patties that was not labeled with the date it was opened. During interview, the Dietary Manager stated opened food items should be properly closed and dated when opened, and expired food items should be discarded because spoiled food could cause residents to become ill. The Nursing Home Administrator stated improperly labeled or expired foods presented a health hazard and could cause residents to become ill, and confirmed that expired products must be removed immediately and should not be stored with food available for resident use.
Failure to Knock Before Entering Resident Room
Penalty
Summary
The facility failed to ensure a resident's right to dignity by allowing a CNA to enter Resident #20's room twice without knocking. The facility's policy, Dignity and Respect, revised 07/22, stated that all staff should knock and wait for a response before entering any resident's room, and the DON confirmed that staff were expected to knock before entering, introduce themselves, announce the care to be performed, and protect privacy by pulling the curtain and closing the door. During observation on 07/13/2026, CNA #1 entered Resident #20's room twice without knocking, and later confirmed that she had done so and stated that the purpose of knocking is to announce oneself before entering. Resident #20 was admitted on 05/28/2002 with a diagnosis including cerebral infarction. The quarterly MDS with an ARD of 07/02/2026 showed a BIMS score of 03, indicating severe cognitive impairment. The DON was informed of the incident and confirmed that the facility's protocol required staff to knock before entering a resident's room and to respect residents' privacy.
Out-of-Range Hot Water Temperature in Resident Room
Penalty
Summary
The facility failed to ensure a resident had comfortable hot water temperatures in one of three resident rooms reviewed. Facility policy stated hot water at plumbing fixtures used by residents shall not exceed 115 degrees Fahrenheit and no less than 100 degrees Fahrenheit. Resident #53, who was admitted on 1/7/2026 with diagnoses including Type 2 Diabetes Mellitus and had a BIMS score of 14, reported that the bathroom sink water did not get hot and that the Maintenance Director had been informed of the problem, but it had not been corrected. During observation, the hot water was run for two minutes and remained lukewarm. On a later observation with the Maintenance Director present, the water temperature measured 98.2 degrees Fahrenheit after running for two minutes, which was below the facility’s minimum standard of 100 degrees Fahrenheit. The Maintenance Director stated he believed the thermostat on the water heater was causing the low temperatures and acknowledged the facility had experienced previous problems with the water heaters. The Nursing Home Administrator stated he had been informed of the out-of-range temperatures and acknowledged that water temperatures outside the acceptable range could cause resident discomfort.
Failure to Meet Minimum Nursing Staffing Ratio
Penalty
Summary
The facility failed to comply with state nursing facility staffing requirements by not ensuring nursing staff provided 2.8 hours of direct nursing care per resident per 24 hours on two of 13 days reviewed in the second quarter of 2026. The facility’s policy, Nursing Services - Staffing, stated that staffing would comply with established staffing requirements by the individual state governing agencies, and the state rule required a minimum of 2.80 hours of direct nursing care per resident per 24 hours based on resident census. A review of the PBJ Payroll Based Journal Data Report for fiscal year quarter 2 of 2026 showed the facility’s metric for excessively low weekend staffing was triggered, indicating the weekend staffing data submitted by the facility was excessively low. The facility’s staffing grid showed staffing ratios of 2.63 on 2/7/26 and 2.7 on 3/21/26, both below the state requirement of 2.8. During interview, the Administrator stated the reports for those dates did not generate email notifications to alert him that the facility fell below the 2.8 staffing ratio, and he confirmed the facility did not meet its established staffing level on those dates.
Failure to Implement Enhanced Barrier Precautions During PEG Tube Care
Penalty
Summary
The facility failed to implement Enhanced Barrier Precautions (EBP) in accordance with its own policy and current infection control standards during percutaneous endoscopic gastrostomy (PEG) tube care for one resident. During an observed care event, a registered nurse performed PEG tube care without donning a gown, despite facility policy and posted signage requiring both gown and gloves for high-contact care activities involving indwelling medical devices such as feeding tubes. Interviews with the nurse, the infection preventionist, and the director of nursing confirmed that a gown should have been worn during this procedure to protect the resident from potential contamination from the staff member's uniform. The resident involved had a history of hemiplegia and hemiparesis following a cerebral infarction, as well as dysphagia, and was assessed as having moderate cognitive impairment. Physician orders required daily cleaning and dressing of the PEG tube site. Facility records and staff interviews indicated that the resident was at high risk for infection due to the presence of the PEG tube, and that failure to use a gown during care could result in the transfer of organisms from staff to the resident.
Failure to Follow Care Plan for Oxygen Administration
Penalty
Summary
The facility failed to implement the care plan interventions as written for a resident with a history of asthma who required oxygen therapy. The resident's care plan specified the use of oxygen at 2 liters per minute via nasal cannula as needed for shortness of breath, and the physician's order matched this intervention. However, during an observation, the resident was found receiving oxygen at a flow rate of 3 liters per minute, which was not in accordance with the care plan or physician's order. Interviews with facility staff, including an LPN and the Director of Nursing, confirmed that the oxygen should have been set at 2 liters per minute and that staff are expected to follow the care plan and physician's orders as written. The discrepancy between the oxygen flow rate provided and the documented care plan and physician's order was acknowledged as a failure to follow the individualized plan of care. The resident involved had a moderately impaired cognitive status and diagnoses including cough and wheezing, and was receiving oxygen therapy at the time of the deficiency.
Failure to Revise Care Plan for Catheter Care
Penalty
Summary
The facility failed to revise the comprehensive care plan for a resident with an indwelling catheter to include specific interventions for routine catheter care. Observation revealed the resident had catheter tubing present, and record review showed that while CNAs documented catheter care tasks every shift, the care plan itself did not specify how often catheter care should be performed or which staff were responsible for providing the care. Interviews with staff confirmed that catheter care was being performed and documented, but the care plan was not updated to reflect these interventions or assign responsibility. The resident involved had been admitted with diagnoses including acute kidney failure and was noted to have moderately impaired cognition. The facility's policy required that care plans be reviewed and revised periodically to reflect the services provided, but this was not done for the resident's catheter care. The deficiency was identified through observation, record review, and staff interviews, which confirmed the omission in the care plan documentation.
Oxygen Administration Exceeded Physician Order
Penalty
Summary
The facility failed to ensure that oxygen was administered according to the physician's order for a resident with a history of cough and wheezing. The physician's order specified oxygen via nasal cannula at 2 liters per minute as needed for shortness of breath or oxygen saturation of 93% or below. However, during multiple observations, the resident was receiving oxygen at a flow rate above 3 liters per minute, with one instance recorded at 3.4 liters per minute. The LPN on duty confirmed that the oxygen was typically set at 3 liters per minute and acknowledged that the setting had not been changed that morning, despite the physician's order specifying a lower rate. Further interviews revealed that the LPN was aware that the oxygen should not be adjusted without a new physician order and that exceeding the prescribed rate could have adverse effects. The Director of Nursing also confirmed that nurses are expected to check and follow the physician's order every shift. The resident involved had moderately impaired cognition, as indicated by a BIMS score of 9, and was receiving oxygen therapy at the time of the deficiency.
Medications Left Unattended at Bedside and on Medication Cart
Penalty
Summary
Surveyors identified that staff failed to follow facility policy regarding the secure handling and administration of medications for two residents. In one instance, an LPN administered Polyethylene Glycol 3350 mixed in water to a resident with moderate cognitive impairment and left the medication at the bedside, instructing the resident to finish it at her own pace. The LPN later acknowledged that this practice was against policy, as it was not possible to confirm whether the full dose was consumed, and the medication should not have been left unattended. In another instance, an LPN prepared Ipratropium-Albuterol Inhalation Solution for a resident with moderate cognitive impairment and left the medication vial unattended on top of the medication cart while retrieving supplies. The LPN admitted awareness that this was improper and could result in another resident accessing the medication. The DON confirmed that facility policy prohibits leaving medications unattended on carts or in resident rooms, emphasizing that staff are expected to observe medication administration to ensure compliance with orders.
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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 Magee
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Bedford Care Center Of Mendenhall | 10.5 mi | ★★★★★ | 5 | 0 |
| Ms Care Center Of Raleigh | 15.2 mi | ★★★★★ | 1 | 0 |
| Arrington Living Center | 20.1 mi | ★★★★★ | 0 | 0 |
| Landmark Of Collins | 20.5 mi | ★★★★★ | 0 | 0 |
| Jefferson Davis Community Hospital Ecf | 21.7 mi | ★★★★★ | 7 | 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 October 2026) and official state health department websites.