Above average — CMS composite of the measures below.
The next survey window likely opens around January 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 Highbanks Care Center during CMS and state inspections, most recent first.
A resident with vascular dementia, kidney disorders, a history of UTIs, and frequent incontinence returned from the hospital with an acute UTI diagnosis and instructions to start cephalexin 500 mg PO four times daily for seven days after receiving Rocephin. Facility documentation showed no evidence that the AVS was reviewed or obtained from the hospital or the resident’s POA, and there was no record of the resident refusing care or refusing to provide the AVS. A physician order for cephalexin was not entered until two days after readmission, and the MAR showed the antibiotic was not started until that time. An RN reported being unaware of the UTI or need for antibiotics, while the DON acknowledged the lack of documentation and attempts to obtain the AVS, and the resident denied refusing to share the AVS.
The facility did not maintain a safe, clean, and homelike environment in a memory care unit, affecting two residents and common areas. A resident with severe cognitive impairment and total dependence for care had a large unrepaired hole and unpainted drywall above the bed, caused by repeated bed movement during care. Another resident with moderate cognitive impairment, frequent incontinence, and dependence for toileting had what appeared to be fecal matter on both sides of the bathroom door handle on two separate observations, despite housekeeping practices and policy requiring at least daily cleaning of doorknobs and similar surfaces. In a common TV area, surveyors also observed multiple holes and scratches in the drywall, brown marks near an electrical outlet, and missing wall trim, all confirmed by maintenance staff.
A resident with dementia and other diagnoses had a signed DNR-CCA order in the EMR and physician orders, but the hard chart still listed Full Code. RN staff confirmed the mismatch, and the DON acknowledged that the code status was not kept consistent across documentation systems.
Failure to Provide Resident-Specific Activities. A resident on the secured memory care unit with vascular dementia, mood disorders, and moderate cognitive impairment was care planned for pet visits, reading, TV, and movies, but observations and staff interviews showed she was not specifically offered activities aligned with her interests. Staff reported no activities were provided on the unit, the weekly activity display was blank, and a scheduled activity did not occur.
Call Light Left Out of Reach for Resident With Fall Interventions: A resident with cognitive impairment, extensive ADL dependence, and a wheelchair for mobility had a fall care plan intervention to keep the call light within reach. During observation, the call light was found tucked under the sheets at the end of the bed near the resident’s feet, and the resident stated she would have to shout for help because she could not reach it. RN confirmed it was out of reach, and CNA stated the resident could use it when placed within reach.
Oxygen Tubing and Cannula Not Maintained in Sanitary Condition. A resident receiving O2 therapy had tubing lying on the floor and a nasal cannula covered in dust, and the tubing was not dated to show when it was placed or last changed. An RN confirmed the condition of the tubing and cannula, and the facility’s policy required O2 tubing and the cannula or mask to be changed weekly and as needed if soiled or contaminated.
The facility failed to provide meaningful and resident-preferred activities, affecting several residents. Observations showed residents often left sitting in common areas watching TV, with limited engagement from staff. Activity logs revealed a lack of variety, primarily offering outdoor time and pet visits, not aligning with residents' interests. Interviews indicated a lack of structured activity planning, with staff waiting for the Activities Director to initiate activities. The facility's activity calendar and website suggested a focus on individualized activities, yet offerings were limited and repetitive.
The facility failed to assist residents with severe cognitive impairments in managing their finances, risking their SSI and Medicaid eligibility. Despite monthly notices about excess funds, the facility did not follow up or provide necessary support, as confirmed by interviews and financial records.
A facility failed to apply a physician-ordered resting hand splint for a resident with hemiplegia, hemiparesis, and a contracture of the left hand. Despite a care plan and visual reminders, observations and interviews confirmed the splint was not being used, and staff were unaware of the requirement.
A resident with severe cognitive impairment and schizoaffective disorder was administered an incorrect dosage of the antipsychotic medication Invega for nearly a month. The intended increase was from 1.5 mg to 3 mg daily, but the resident received a total of 4.5 mg at bedtime. This discrepancy was confirmed by the DON, despite pharmacy recommendations for dose clarification and a care plan indicating the use of the minimum effective dose.
The facility failed to maintain a homelike environment for two residents. One resident with severe cognitive impairment was in a room with peeling drywall/paint, which was reported but not repaired despite plans to do so. Another resident, cognitively intact, had filled holes in their room's walls that had not been painted over, with no updates provided on when this would occur. Maintenance acknowledged the delays in both cases.
Failure to Implement Hospital Discharge Orders for UTI Treatment
Penalty
Summary
The deficiency involves the facility’s failure to ensure continuity of care and timely implementation of hospital discharge orders for a resident treated for an acute urinary tract infection (UTI). The resident, who had vascular dementia, kidney and ureter disorders, a kidney cyst, a history of UTIs, and frequent urinary and bowel incontinence, was moderately cognitively impaired and required substantial assistance with toileting. A hospital after visit summary (AVS) documented diagnoses of kidney stone, kidney cyst, and acute UTI, with instructions to initiate cephalexin 500 mg by mouth four times daily for seven days following a dose of Rocephin. The hospital record also noted a left renal calculus with partial obstruction and abnormal urinalysis findings. Upon the resident’s return to the facility, a progress note recorded the readmission, but from that date until three days later there was no documentation of refusal of care or refusal to provide the AVS. The physician order for cephalexin 500 mg four times daily for seven days was not created until two days after the resident’s readmission, and the medication administration record showed the antibiotic was not started until that later date, with the first dose given upon rising. A registered nurse interviewed denied knowledge of the resident’s UTI or the need for antibiotic therapy upon readmission. The DON stated that the resident had refused to provide the AVS, but confirmed there was no documentation of such refusal and no evidence that staff attempted to obtain the AVS from the hospital or contact the resident’s power of attorney, who had been present at the time of hospital admission. The DON also confirmed that the resident returned with a diagnosis of acute UTI and an order to start cephalexin four times daily, which was not initiated until days later, and was unsure if the antibiotic was available in the emergency box. In contrast, the resident reported being welcoming and denied refusing to give staff the hospital AVS.
Failure to Maintain Safe, Clean, and Homelike Environment in Memory Care Unit
Penalty
Summary
The facility failed to maintain a safe, clean, and homelike environment in the memory care unit and in two resident rooms. One resident with severe cognitive impairment, total dependence for personal care, and multiple neurological and physical diagnoses had a large hole in the wall above the bed, approximately the size of a twelve‑ounce can. The Maintenance Director stated the damage was caused by the bed being raised and lowered during personal care, acknowledged the wall had been repaired multiple times, and confirmed that the current hole had not been repaired and the surrounding drywall had not been repainted, resulting in a non‑homelike appearance. Another resident with moderate cognitive impairment, dependence on staff for toileting and personal care, and frequent bowel and bladder incontinence had a brown substance that appeared to be bowel movement on both the front and back handles of the bathroom door on two consecutive observations. An RN confirmed the substance appeared to be bowel movement on both handles. Housekeeping staff reported that she cleaned resident rooms and bathrooms weekly and as needed and that facility policy required doorknobs and similar high‑touch surfaces to be cleaned at least daily and more often as needed. In the common television area of the memory care unit, surveyors observed multiple holes and scratches in the drywall from chairs, several brown marks of varying sizes near an electrical outlet, and missing wall trim along portions of the wall, all of which were confirmed by the Maintenance Director.
Inconsistent Code Status Documentation
Penalty
Summary
The facility failed to ensure that the resident's advance directive was consistent between the electronic medical record and the physical hard chart for one resident reviewed. The resident was admitted with diagnoses including unspecified mood disorder, obstructive and reflux uropathy, hyperlipidemia, and dementia of unspecified severity with mood disturbance, and the admission MDS indicated the resident was rarely or never understood. The electronic medical record contained a signed DNR-CCA order and physician orders reflected DNR-CCA status, but the hard chart contained a code status face sheet indicating Full Code. Staff confirmed the discrepancy, and the DON acknowledged that the resident had a signed DNR-CCA order but that both the electronic record and hard chart had not been updated to reflect the current code status.
Failure to Provide Resident-Specific Activities
Penalty
Summary
Provide activities to meet all resident's needs. The facility failed to ensure Resident #8, who was on the secured memory care unit, was specifically provided activities to meet her interests and psychosocial needs. Resident #8 was admitted on 12/26/24 with diagnoses including cerebrovascular disease, atherosclerotic heart disease, hemiplegia and hemiparesis, vascular dementia, asthma, unspecified mood affective disorder, anxiety disorder, major depressive disorder, hypertension, chronic pain, and gastro-esophageal reflux disease. Her quarterly MDS showed a BIMS score of eight, indicating moderate cognitive impairment, and her care plan identified her as sociable and interested in pet visits, reading, watching television and movies, with interventions to offer activities directed to her interests and needs. Observations showed Resident #8 lying in bed on 02/17/26 and later sitting in her wheelchair in the hallway and then in a chair in the common room on 02/18/26. From 10:22 A.M. to 3:55 P.M. on 02/17/26, no activities were offered to her, and at 3:00 P.M. on 02/18/26 there were no activities taking place in the dining room or common area of the memory care unit. RN #319 stated there were no activities provided that day on the memory care unit, and the activities screen was blank with no activities listed for the week. CNA #230 stated Resident #8 watches television and listens to music and had never seen her participate in activities other than balloon volley, while CNA #327 stated she had not seen Resident #8 participate in any activities since working there. The Activities Director stated Resident #8 likes music, arts and crafts, and reading, but needed to be read to now because it was harder for her to read; she also verified that the scheduled Mardi Gras activity did not take place.
Call Light Left Out of Reach for Resident With Fall Interventions
Penalty
Summary
The facility failed to ensure that the call light was within reach for one resident identified for fall interventions. Resident #3 was admitted on 05/28/24 with diagnoses including primary generalized osteoarthritis, COPD, type 2 diabetes mellitus without complications, and cerebral infarction unspecified. The resident’s Quarterly MDS assessment dated 01/05/26 showed a BIMS score of 07, indicating cognitive impairment, and documented that the resident required extensive assistance with bed mobility, was dependent for transfers and most ADLs including toileting and dressing, and used a wheelchair for mobility. The care plan for falls, dated 05/30/24, included an intervention dated 05/31/24 to ensure the call light was within reach. During observation on 02/17/26 at 10:07 A.M., the call light was found out of reach and tucked under the sheets at the end of the bed near the resident’s feet. The resident stated she needed help getting out of bed because of the perimeter mattress and said it made it difficult to get out of bed; she also stated she did not know why the call light was out of reach and that she would have to shout for assistance, which she had done in the past. RN #307 later confirmed the call light was at the end of the bed and out of reach, and CNA #311 stated the resident was able to use the call light when it was within reach and understood how and when to use it.
Oxygen Tubing and Cannula Not Maintained in Sanitary Condition
Penalty
Summary
Provide safe and appropriate respiratory care for a resident when needed was not met for one resident receiving oxygen therapy. Resident #3 was admitted on 05/28/24 and had diagnoses including primary generalized osteoarthritis, COPD, type 2 diabetes mellitus without complications, and cerebral infarction unspecified. The Quarterly MDS dated 01/05/26 indicated a BIMS score of 07, showing cognitive impairment. During observation on 02/17/26 at 10:10 A.M., the resident’s oxygen tubing was lying on the ground and the nasal cannula was on the floor covered in dust, and the tubing was not dated to show when it had been placed or last changed. RN #307 confirmed at 10:17 A.M. that the tubing was not dated and that the nasal cannula was on the ground in dust. Regional Nurse #512 stated on 02/18/26 at 10:30 A.M. that facility protocol was to change oxygen tubing weekly, and the facility policy titled Oxygen Administration, revised 07/30/24, stated oxygen tubing and mask or cannula were to be changed weekly and as needed if soiled or contaminated.
Deficiency in Providing Meaningful Activities
Penalty
Summary
The facility failed to provide meaningful and resident-preferred activities, affecting seven residents out of a census of 55. Observations revealed that residents were often left sitting around dining tables or in common areas watching television, with staff present but not engaging them in activities. Specific residents, such as Resident #3, were found in their rooms without engaging in any activities, despite having documented interests in various activities like card games, sports, and socializing. The activity logs showed a limited range of activities offered, primarily consisting of going outside and pet visits, with little variety or alignment with the residents' preferences. Resident #41, who had severe cognitive impairment, expressed a preference for creating artwork but was mostly offered activities like bingo and pet visits, with only one instance of adult coloring documented. Similarly, Resident #48, who preferred one-on-one activities, was mostly offered group activities that did not align with his interests. Interviews with staff, including the Activities Director, revealed a lack of structured activity planning and execution, with staff often waiting for the Activities Director to initiate activities. The facility's activity calendar and website suggested a focus on individualized and meaningful activities, yet the actual offerings were limited and repetitive. Residents like Resident #6 and Resident #16, who had severe cognitive impairments, were not observed participating in activities that matched their interests, such as music or religious services. The lack of a visible activities calendar and the reliance on a limited set of activities, such as pet visits and bingo, contributed to the deficiency in meeting the residents' needs for meaningful engagement.
Failure to Assist Residents in Financial Management
Penalty
Summary
The facility failed to provide adequate assistance to residents and their representatives in managing financial matters, which is crucial to maintaining eligibility for Supplemental Security Income (SSI) and Medicaid services. This deficiency affected four residents, each with severe cognitive impairments, as evidenced by their medical records and minimum data set (MDS) assessments. The residents' financial records showed that their funds exceeded the Medicaid limit of $2,000, with balances ranging significantly above this threshold over several months. Despite monthly notices being sent to the residents' representatives, indicating the need to spend down excess funds, there was no documented evidence of the facility following up to ensure compliance. Interviews with family members and the Business Office Manager (BOM) confirmed that while notices were provided, the facility did not assist or follow up with the residents or their representatives to manage the excess funds effectively. This lack of action could potentially jeopardize the residents' eligibility for essential benefits. The report highlights that the facility's inaction in assisting residents with financial management is a significant oversight. The BOM acknowledged that the residents had more money in their accounts than permitted for over nine months, yet the facility did not take the necessary steps to help them spend down the excess funds. This deficiency underscores the importance of proactive engagement and support in financial matters to protect residents' benefit eligibility.
Failure to Apply Physician-Ordered Hand Splint
Penalty
Summary
The facility failed to apply a physician-ordered resting hand splint for a resident with hemiplegia, hemiparesis, vascular dementia, and a contracture of the left hand. The resident was admitted with these diagnoses, and a physician order dated 11/30/23 specified the use of a left resting hand splint per the resident's tolerance. The care plan, dated 05/02/24, included interventions for the use of the splint, such as frequent skin checks and monitoring for pain or discomfort. A visual reminder was placed in the resident's room to ensure the splint was worn for at least 8 hours daily, from after breakfast until after dinner. Despite these orders and reminders, observations on multiple occasions revealed that the resident was not wearing the splint. Interviews with the resident's son and a State Tested Nursing Assistant (STNA) confirmed that the splint was not being applied. The STNA was unaware of the requirement for the resident to wear the splint and found it stored in a drawer next to the resident's bed, indicating a lack of communication and adherence to the care plan by the facility staff.
Incorrect Antipsychotic Dosage Administered
Penalty
Summary
The facility failed to ensure a resident was not receiving an unnecessary amount of an antipsychotic medication, specifically Invega. The resident, who had severe cognitive impairment and a history of schizoaffective disorder, was prescribed an increased dose of Invega from 1.5 mg to 3 mg at bedtime by a psychiatric physician. However, the medication administration record indicated that the resident was administered a total of 4.5 mg at bedtime, which was not the intended dosage. This discrepancy was noted from 11/08/23 through 12/07/23. A pharmacy recommendation highlighted the difficulty in assessing the proper dose and requested clarification on the total dose. The Director of Nursing confirmed that the intended increase was to 3 mg daily, not 4.5 mg. The resident's plan of care indicated a risk for adverse effects related to psychoactive medication use, with interventions to administer medications as ordered and use the minimum effective dose. Despite these interventions, the resident received an incorrect dose for nearly a month.
Failure to Maintain a Homelike Environment for Residents
Penalty
Summary
The facility failed to provide a homelike environment for two residents, affecting their living conditions. Resident #31, who has severe cognitive impairment and multiple diagnoses including hemiplegia and vascular dementia, was observed in a room with peeling drywall/paint next to their bed. Despite the issue being reported by a State tested Nursing Assistant and supplies being purchased to fix the wall, the repair had not been completed by the time of the survey. Maintenance Director #245 confirmed the delay in repairs, which were initially scheduled for the week of the survey. Resident #44, who is cognitively intact with a BIMS score of 15 and has diagnoses including schizophrenia and diabetes, was found in a room with multiple filled holes in the wall that had not been painted over. The resident reported that the holes had been filled a long time ago without any updates on when the painting would occur. Maintenance Director #245 acknowledged that the room was supposed to be painted during the week of the survey but had not been completed. No information was provided regarding how long the resident had been waiting for the painting to be done.
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| Willow Brook Christian Home | 0.2 mi | ★★★★★ | 8 | 0 |
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| Laurels Of Worthington, The | 2.8 mi | ★★★★★ | 0 | 0 |
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