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 July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Jennings Hall during CMS and state inspections, most recent first.
A resident with multiple health conditions and intact cognition was subjected to disrespectful language by a care partner, including being called 'Big Mama' and 'fat.' Despite prior counseling and disciplinary action for similar behavior, the care partner continued to use terms the resident found offensive, leading the resident to feel disrespected and mistreated. Facility policy required residents to be free from discrimination and reprisal, but this was not followed in this case.
A resident admitted with multiple medical conditions did not have a signed admission Agreement on file, as required by facility policy. The omission was discovered during an audit, and the responsible party was later contacted to complete the paperwork, confirming that the admission coordinator had not generated the document at the time of admission.
A resident dependent on staff for all mobility and transfers was repeatedly assisted by only one staff member during ceiling lift transfers and bed mobility, despite care plans and facility policy requiring two staff for safety. This resulted in the resident experiencing pain and distress, with video evidence and staff interviews confirming the deficiency.
A resident with multiple chronic conditions was found sitting at a dining table with a cup containing 19 medications left unattended. The DON acknowledged this was improper, and the facility could not provide a policy to ensure medications were consumed by residents, resulting in a failure to secure medications as required.
The facility failed to maintain sanitary conditions in food preparation and service, affecting 164 residents. The Dietary Manager was observed without a beard net and using insufficient sanitizer in the dishwashing process. Additionally, a staff member used a gloved hand that had touched a cabinet to serve food without washing hands or changing gloves. The facility's policy lacked specific guidelines on handwashing and the use of hair and beard nets.
The facility failed to complete comprehensive discharge MDS assessments for two residents, affecting the accuracy of their medical records. One resident, admitted with hyperlipidemia, dementia, and malnutrition, and another with renal insufficiency, dementia, and arthritis, were discharged without the necessary assessments. An LPN confirmed the oversight as human error, and the facility lacked a discharge MDS policy.
A facility failed to provide adequate nutritional care for a resident with visual impairment and protein-calorie malnutrition. The resident was not given meals on a divided dish as recommended, and her head was not positioned correctly during meals, contrary to her dietary precautions. She also lacked fluids within reach, which was necessary for her swallowing precautions. Interviews revealed a lack of awareness and communication among staff regarding her dietary needs.
Failure to Ensure Resident Dignity and Respect
Penalty
Summary
A deficiency occurred when a resident with multiple medical conditions, including transient cerebral ischemic attack, heart failure, atrial fibrillation, and anxiety disorder, was not treated with respect and dignity by facility staff. The resident, who was cognitively intact as indicated by a perfect BIMS score, was subjected to derogatory language by a care partner. The responsible party for the resident reported observing staff calling the resident 'fat' on video footage, and further review of another video showed the care partner referring to the resident as 'Big Mama' while alone in the resident's room. The resident expressed feeling that staff could be mean to her, and specifically felt disrespected and offended by the term 'Big Mama.' Interviews with facility leadership and the care partner confirmed that the care partner had previously been counseled not to use derogatory or potentially offensive terms with the resident. Despite prior counseling and disciplinary action, the care partner continued to use language that the resident found disrespectful. Facility policy states that residents are to be free from discrimination and reprisal, but this policy was not upheld in the interactions with the resident.
Failure to Obtain Signed Admission Paperwork at Admission
Penalty
Summary
The facility failed to ensure that required admission paperwork was signed for a resident upon admission. Record review showed that a resident was admitted with multiple diagnoses, including transient cerebral ischemic attack, heart failure, atrial fibrillation, hypertension, obstructive sleep apnea, peripheral autonomic neuropathy, anxiety disorder, abnormalities of gait and mobility, dysphagia, insomnia, muscle weakness, essential tremor, and foot drop. The resident was assessed as having intact cognition. During the investigation, it was found that the facility did not have a signed admission Agreement for this resident, and the responsible party was contacted to complete the paperwork after the fact. Interviews with the administrator confirmed that the admission Agreement was not completed at the time of admission, and the omission was discovered during an audit of admission Agreements. The administrator acknowledged that the document was not lost but had never been generated or signed. The facility's policy required a completed admission application, including financial disclosure and supporting documents, before review by the admissions team. The responsible party for the resident confirmed being contacted by the facility to sign the admission Agreement, as it had not been provided during the admission process.
Failure to Provide Required Assistance During Transfers and Bed Mobility
Penalty
Summary
Staff failed to provide a resident with the appropriate level of assistance during transfers and bed mobility, contrary to physician orders, care plan interventions, and facility policy. The resident, who had multiple diagnoses including heart failure, muscle weakness, gait abnormalities, and was at high risk for falls, was dependent on staff for all mobility and transfers. The care plan and therapy recommendations specified the use of a mechanical sling lift with two staff members present for transfers and bed mobility to ensure safety and prevent injury. Despite these requirements, there were multiple documented incidents where only one staff member assisted the resident during transfers and bed mobility. In one instance, a single aide used a hygiene sling that was too tight and performed a ceiling lift transfer alone, resulting in the resident's arm being extended and causing pain. The resident reported shoulder pain following the transfer, which persisted for several days and required medical evaluation and pain management. Video evidence confirmed that the transfer was performed by one aide, and the resident was visibly in distress during the process. Another incident involved a single aide providing peri-care and turning the resident in bed without assistance, during which the bed dropped and the aide's face and glasses collided with the resident's face. The resident reported feeling as if she had been hit with a bowling ball, though no injury was noted. Interviews with staff, therapy, and nursing leadership confirmed that two staff members were required for all transfers and bed mobility for this resident, and that the facility's policy mandated the appropriate number of staff for ceiling lift use. The failure to follow these protocols resulted in pain and distress for the resident and was observed to have occurred on more than one occasion.
Medications Left Unattended in Dining Area
Penalty
Summary
A deficiency was identified when a resident with diagnoses including type two diabetes mellitus, primary generalized osteoarthritis, and chronic diastolic heart failure was observed sitting at a dining room table with a medication cup containing 19 medications left unattended. The resident, who had intact cognition, reported no concerns, but the medications were not controlled substances. The DON confirmed that it was inappropriate for medications to be left on the table without staff supervision. The facility was unable to provide a policy ensuring that medications were consumed by residents, indicating a failure to secure medications until they were taken, as required.
Sanitation Deficiencies in Food Preparation and Service
Penalty
Summary
The facility failed to ensure food was prepared and served under sanitary conditions, affecting 164 residents who received meals from the kitchen. During an initial kitchen tour, the Dietary Manager (DM) was observed with a full facial beard approximately one inch long and was not wearing a beard net, which he confirmed was required. Additionally, the DM was observed testing the level of quaternary sanitizer in the three-compartment sink, and the test strip did not change color, indicating an insufficient amount of sanitizer to properly sanitize dishes. The DM was unable to provide evidence of chemical testing logs for the past month. Further observations revealed that a staff member served a resident's lunch meal using a gloved hand that had previously touched a cabinet door, without washing hands or changing gloves. The staff member confirmed the lapse in sanitation practice and retrieved a serving spoon to continue meal service. The facility's policy, dated May 2018, did not address specific handwashing procedures or the use of hair and beard nets. The Administrator confirmed the absence of a policy addressing these concerns.
Failure to Complete Discharge MDS Assessments
Penalty
Summary
The facility failed to ensure comprehensive discharge assessments were completed for two residents, affecting the accuracy of their medical records. Resident #27 was admitted with diagnoses including hyperlipidemia, dementia, and malnutrition, and an Admission MDS was completed. However, there was no evidence of a subsequent MDS following the resident's discharge home with family. Similarly, Resident #162, admitted with renal insufficiency, dementia, and arthritis, had a Quarterly MDS completed, but no discharge MDS was found after the resident was discharged home with family. Interviews with an LPN confirmed the absence of discharge MDS assessments for both residents, attributing the oversight to human error. Additionally, the facility administrator acknowledged via email that there was no existing discharge MDS policy in place.
Failure to Provide Adequate Nutritional Care and Services
Penalty
Summary
The facility failed to provide nutritional care and services consistent with a resident's assessed needs, specifically for a resident with glaucoma, unspecified visual loss, and unspecified protein-calorie malnutrition. The resident was supposed to receive meals on a divided dish to aid in her independence with eating, as recommended by occupational therapy. However, during an observation, the resident was served breakfast on a normal plate, and her head was positioned at approximately a 30-degree incline, contrary to the strict reflux and swallowing precautions that required her to be upright at 90 degrees. Additionally, she had no fluids within reach, which was against her dietary needs to alternate liquids and solids to assist swallowing. Interviews with the resident and staff revealed further deficiencies. The resident expressed difficulty in getting enough to drink and was unaware of the need for assistive devices like a divided plate. She also mentioned not being taught to sit up for meals or alternate food and liquids. A registered nurse confirmed these findings, and a speech therapist noted the resident's need for setup assistance due to vision problems. The dietician was not involved in the decision to use a divided dish and only observed its use recently, indicating a lack of communication and implementation of the resident's dietary plan.
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What surveyors actually found near you
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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 Garfield Heights
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Snf-the Villa At Marymount | 2.6 mi | ★★★★★ | 0 | 0 |
| Seven Hills Health & Rehab Center | 3.6 mi | ★★★★★ | 0 | 0 |
| Phoenix Of Maple Heights | 3.8 mi | ★★★★★ | 0 | 0 |
| Avenue Care And Rehabilitation Center, The | 3.8 mi | ★★★★★ | 42 | 0 |
| Harvard Gardens Rehabilitation & Care Center | 4.1 mi | ★★★★★ | 35 | 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.