Average — CMS composite of the measures below.
The next survey window likely opens around May 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 Hill View Skilled Nursing And Rehabilitation Cente during CMS and state inspections, most recent first.
Failure to prevent and timely identify a heel pressure ulcer. A resident with severe cognitive impairment, immobility, and multiple chronic conditions was admitted without skin breakdown and was identified as at risk for skin issues, but the facility did not implement a comprehensive, individualized PU prevention program. The resident later developed an unstageable left heel pressure injury that was not recognized until it had reached an advanced stage, despite routine skin checks and daily TED hose care.
Improper Storage of Dented Canned Food: Surveyors observed dented canned food items in the kitchen dry storage area, including a large can of vanilla pudding and two cans of ketchup. The DDS verified the dented cans should have been returned to the supplier and should not have been placed on the shelf for use. Facility policy required staff to check deliveries carefully and return damaged canned goods.
Uncovered Outdoor Dumpsters: Surveyors observed two outdoor dumpsters near the loading dock without lids on multiple occasions. The Administrator confirmed the dumpsters had been delivered without lids and stated the facility had notified city officials that lids were needed for all outdoor trash bins, but later observations still found the dumpsters uncovered.
A resident with Alzheimer's disease and severely impaired cognition was ordered Zyprexa and Risperdal for dementia-related use without an appropriate indication. The DON confirmed the meds were administered without a proper diagnosis, and online drug references showed both antipsychotics carry black box warnings and are not approved for dementia-related psychosis.
A resident with a right-hand contracture, chronic pain, and dementia was observed with the hand held in a pinched position and unable to open it when asked. The care plan did not include interventions to prevent further ROM decline or treat the contracture, and the DOR and ADON confirmed therapy had not addressed the contracture and no interventions had been implemented to prevent worsening.
A resident with a history of bone demineralization experienced severe pain after a transfer, repeatedly expressing that her arm was broken. Despite multiple CNAs reporting the incident and the resident's ongoing distress, the LPN delayed reassessment and further intervention after administering acetaminophen. The resident continued to suffer severe pain for several hours before being sent to the ER, where a new displaced humerus fracture was diagnosed. The facility failed to follow its pain management policy, resulting in actual harm.
Surveyors found that the facility environment was not maintained in good repair, with missing ceiling sections, discolored and mold-like ceiling tiles, active water leaks, and rusted vents in multiple areas. Water was leaking into trash cans in hallways and resident rooms, and wet carpets were observed, indicating ongoing water intrusion and lack of timely repairs.
The facility failed to update the PASARR for two residents diagnosed with serious mental illnesses after their initial assessments. One resident, initially admitted with various conditions, was later diagnosed with unspecified psychosis, which was not reflected in the PASARR. Another resident, with multiple diagnoses, was diagnosed with psychosis, but the PASARR remained unchanged. The Admissions Director confirmed these oversights, indicating a failure to complete new PASARRs for both residents.
A facility failed to provide adequate nail care to a dependent resident with a history of congestive heart failure, dementia, and diabetes. Despite documentation indicating nail care was completed, observations revealed the resident's nails were long and dirty. An RN confirmed the resident's dependency on staff for nail care and the need for attention to the resident's fingernails.
Failure to Prevent and Timely Identify a Heel Pressure Ulcer
Penalty
Summary
Provide appropriate pressure ulcer care and prevent new ulcers from developing. The facility failed to develop and implement a comprehensive, individualized pressure ulcer prevention program for Resident #61, who was admitted after surgical repair of a displaced left femur fracture and had diagnoses including Alzheimer's disease, chronic kidney disease, congestive heart failure, and depression. The resident was severely cognitively impaired, dependent on staff for bed mobility and transfers, and identified as at risk for skin breakdown, with a Braden score of 16 indicating mild risk. The admission assessment and early skin checks documented no pressure ulcers, and the care plan included general interventions such as turning and repositioning, a gel overlay, and barrier cream. Despite these identified risks, the resident developed a left heel wound that was first documented on 10/13/25 as an area measuring 5 cm in diameter. Physician orders were then written for cleansing the heel, applying betadine, wrapping with Kerlix, and using offloading boots to both heels while in bed and in the recliner as tolerated. The next day, the body check form documented an unstageable pressure ulcer to the left heel measuring 4 cm by 4 cm. The weekly pressure ulcer assessment also documented an unstageable pressure injury to the left heel of the same size, with no documentation regarding the presence or absence of drainage. The record further showed that the wound remained present and was later described as an unstageable blister and then as dark and hardening. By 05/26/26, the pressure ulcer had decreased in size to 1.2 cm by 0.3 cm by 0.2 cm with scant exudate, and during wound care observation on 06/02/26 the wound was dime-sized with scant yellow slough in the wound bed. The DON verified that the facility did not develop and implement a comprehensive and individualized pressure ulcer prevention program for the resident and that the unstageable pressure ulcer to the left heel was not identified until 10/13/25 despite daily TED hose application/removal and weekly skin checks.
Improper Storage of Dented Canned Food
Penalty
Summary
Food items were not properly stored in the kitchen dry storage area. On 06/01/26, surveyors observed a large 102 ounce can of vanilla pudding on the shelf with visible dents along the rim of the can, and the Director of Dietary Services verified that the dented can should have been sent back because the contents were not suitable for use. On 06/04/26, surveyors observed two 102 ounce cans of ketchup in the same area, both dented along the top seam, and the Director of Dietary Services verified that these cans should have been returned to the supplier and should not have been placed on the shelf for use. Review of the facility policy titled Food and Supply Purchasing stated staff were to check deliveries carefully and return damaged food items, including dented or rusted canned goods.
Uncovered Outdoor Dumpsters
Penalty
Summary
The facility failed to ensure that all kitchen garbage receptacles, including the outdoor dumpsters near the loading dock, were equipped with proper fitting lids to deter animals and pests. During observations on 06/01/26, surveyors found two outside dumpsters uncovered, and the same condition was observed again on 06/02/26 with the Administrator present. The Administrator confirmed the dumpsters did not have lids and stated the city had delivered them without lids the prior week, that he had notified city officials the facility needed lids on all outdoor trash bins because it had food service, and that the lids were expected to be brought out on 06/02/26 or 06/03/26. Subsequent observations on 06/03/26 and 06/04/26 continued to show the outside dumpsters were not covered with lids.
Inappropriate Antipsychotic Use for Resident With Dementia
Penalty
Summary
The facility failed to ensure antipsychotic medications were only ordered for an appropriate indication for one resident. Resident #23 was admitted with diagnoses including Alzheimer's disease, osteoporosis, and depression, and the MDS assessment showed severely impaired cognition. The physician's orders included Zyprexa 2.5 mg at bedtime for unspecified dementia and Risperdal 0.5 mg, three tablets by mouth every morning and every night, for dementia. During interview, the DON confirmed the facility had administered Zyprexa and Risperdal to the resident without an appropriate indication or diagnosis for use. Review of online medication resources showed both medications carry black box warnings stating they are not approved for dementia-related psychosis and that elderly patients with dementia-related psychosis treated with antipsychotic drugs are at increased risk of death.
Failure to Address Resident Hand Contracture and ROM Decline
Penalty
Summary
The facility failed to ensure a resident with a right-hand contracture received care and services to prevent further decline in range of motion. Resident #17 was admitted with diagnoses including contracture of the right hand, chronic pain, and dementia. The MDS assessment showed impaired cognition and functional limitation in range of motion to one side of the upper extremities, but the active care plan did not include interventions to prevent further decline in range of motion or to treat the resident's contractures. Observations showed the resident sitting in a wheelchair with the right hand closed in a pinching position and unable to open the hand when asked. On a later observation, the resident's right hand remained in a pinched position, and the DOR lifted the fingers and revealed slight contractures at the knuckles. The DOR confirmed the resident had a slight right-hand contracture that did not appear to have worsened since admission, but also stated the contractures had not been addressed by therapy services since admission and was unsure of any interventions implemented to prevent further decline. The ADON confirmed the facility had not implemented a care plan or interventions to prevent worsening of the resident's right-hand contractures or further decline in ROM.
Failure to Provide Adequate Pain Management Following Resident Injury
Penalty
Summary
A deficiency occurred when a resident with a history of osteoporosis, osteopenia, atherosclerosis, and prior bone demineralization experienced severe pain following a transfer using a mechanical lift. The resident began screaming in pain during the transfer, repeatedly stating that her arm was broken. Multiple CNAs responded to the resident's distress, and the incident was reported to the LPN on duty. Despite the resident's complaints and visible distress, the initial nursing assessment did not identify any dislocation or swelling, and the resident was administered acetaminophen as ordered for pain rated at nine out of ten. The post-administration pain level was documented as seven, but the time of reassessment was not recorded, and no further interventions were documented to address the ongoing pain. The resident continued to complain of severe pain for several hours, with staff interviews confirming that the resident was left in pain and that the nurse did not promptly reassess or provide additional interventions. The physician was not notified until approximately three hours after the initial complaint, at which point an order was given to send the resident to the emergency room. Upon arrival at the hospital, the resident was found to have a new, acute displaced transcondylar humerus fracture, which required immobilization and narcotic pain medication. The facility's pain management policy required documentation of pre- and post-pain levels, timely reassessment, and the use of non-pharmacological interventions, none of which were fully implemented in this case. Staff interviews revealed a lack of timely response and follow-up to the resident's pain complaints, with CNAs reporting the incident to the nurse and the nurse delaying assessment and intervention. The DON was unaware of any follow-up or reassessment after the initial administration of pain medication. The failure to provide adequate pain management and timely medical intervention resulted in actual harm to the resident, as evidenced by the prolonged period of severe pain and the need for emergency medical care.
Failure to Maintain Facility Environment in Good Repair Due to Water Damage
Penalty
Summary
Surveyors observed that the facility failed to maintain the environment in good repair, as evidenced by multiple areas with significant water damage and disrepair. A large section of the ceiling in the second-floor dining room was missing, with yellow caution tape placed to prevent access underneath. In the second-floor hallway outside a resident's room, ceiling tiles were discolored, water was actively leaking into trash cans, and the tiles had a black substance resembling mold or mildew. On the third floor, outside another resident's room, ceiling tiles were also discolored from apparent water damage, and the carpet below was wet. Additionally, water was observed dripping from ceiling vents inside the doorways of 14 residents' rooms, with rust present on many vents and trash cans used to collect the leaking water. During interviews, the Maintenance Director confirmed that the ceiling collapse in the dining room occurred due to water damage and, while the leak had been repaired, the drywall had not yet been replaced. The Maintenance Director also verified ongoing water leaks in the hallway ceilings and resident room vents, all of which required repair. Review of the facility's policy indicated a requirement to provide a safe, clean, and comfortable environment, which was not met according to the findings. The facility census at the time was 64 residents.
Failure to Update PASARR for Residents with New Mental Illness Diagnoses
Penalty
Summary
The facility failed to update the Preadmission Screening and Resident Review (PASARR) for two residents who were diagnosed with serious mental illnesses after their initial assessments. Resident #28 was admitted with diagnoses including congestive heart failure, hypertension, encephalopathy, and major depressive disorder. On a later date, the resident was diagnosed with unspecified psychosis, which was not reflected in the PASARR document. The plan of care for Resident #28 indicated symptoms such as paranoia, hallucinations, and increased anxiety, requiring monitoring and documentation. Despite these developments, the PASARR document remained unchanged, as confirmed by the Admissions Director. Similarly, Resident #33 was admitted with multiple diagnoses, including multisystem inflammatory syndrome, hypothyroidism, paranoid personality disorder, and dementia. The resident was later diagnosed with psychosis, a serious mental illness, which was not updated in the PASARR document. The quarterly Minimum Data Set (MDS) assessment revealed severe cognitive impairment and the use of antipsychotic medication. The Admissions Director confirmed that the PASARR document for Resident #33 did not reflect the new diagnosis, indicating a failure to complete a new PASARR for the resident.
Inadequate Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide adequate nail care to a dependent resident, identified as Resident #13, who was unable to perform activities of daily living independently. Resident #13 had a medical history that included congestive heart failure, dementia, and type two diabetes mellitus. The care plan for this resident, dated 08/31/22, specified that staff were responsible for cleaning and trimming the resident's nails weekly, as needed, and when soiled. However, observations made on multiple occasions revealed that the resident's fingernails were long, uncut, and had a black substance underneath them, indicating a lack of proper nail care. Despite documentation on a shower sheet indicating that nail care was completed on 06/30/24, subsequent observations on 06/30/24, 07/01/24, and 07/02/24 showed that the resident's nails remained untrimmed and dirty. An interview with RN #87 on 07/02/24 confirmed that Resident #13 was dependent on staff for nail care and that the resident's fingernails were indeed long and dirty, requiring attention. This deficiency affected one of the five dependent residents reviewed for bathing and nail care in a facility with a census of 53 residents.
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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 Portsmouth
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| River Run Healthcare Of Portsmouth | 1.2 mi | ★★★★★ | 7 | 1 |
| Portsmouth Health And Rehab | 1.7 mi | ★★★★★ | 1 | 0 |
| Bridgeport Health Care Center | 1.8 mi | ★★★★★ | 1 | 0 |
| South Shore Nursing And Rehabilitation | 2.8 mi | ★★★★★ | 0 | 0 |
| Ayden Healthcare Of Rosemount Pavilion | 3.1 mi | ★★★★★ | 3 | 0 |
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