Average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
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 Seven Hills Health & Rehab Center during CMS and state inspections, most recent first.
A resident did not receive sufficient food and fluids to maintain their health, as required. The facility failed to ensure the necessary provision of nutrition and hydration.
A resident with multiple complex diagnoses and full cognition was discharged without the facility completing the required discharge summary or discharge planning process. Facility policy requires discharge notices to include the reason, effective date, and location of discharge, but these were not documented, as confirmed by the administrator.
The facility did not consistently provide meals that were palatable and served at appropriate temperatures, as evidenced by multiple resident complaints about cold food, poor taste, and inaccurate meal orders. Observations showed that food temperatures dropped significantly by the time meals reached residents, and several residents reported not receiving requested food items or portions.
The facility did not adequately protect resident-identifiable information or maintain medical records according to accepted professional standards, resulting in a deficiency related to the handling and documentation of resident information.
Three residents with significant medical and mobility needs were found unable to access their call lights, which were observed on the floor or out of reach. CNAs and an LPN confirmed the call lights were not accessible, and facility policy requires call lights to be within easy reach for residents who are in bed or confined to a chair.
A resident with severe cognitive and physical impairments was not provided medications as ordered with yogurt or pudding, despite a clear physician order and the resident's stated preference. Staff administered medications with applesauce when yogurt was available in the kitchen but not on the unit, and did not check for its availability. Additionally, staff failed to assist the resident out of bed before lunch as ordered, documented the task as completed without performing it, and did not record any refusals. These actions were confirmed through staff interviews, record reviews, and direct observation.
A resident with severe cognitive and physical impairments did not receive consistent, meaningful one-on-one activities as required by their care plan. Documentation of activity visits was incomplete, and the resident was often left in bed for extended periods without engagement or proper support. Staff interviews revealed uncertainty about activity preferences and inconsistent efforts to involve the resident in individualized activities.
Staff did not follow physician orders and facility policy for safe transfers, repeatedly moving a resident with severe mobility impairments without the required mechanical lift and failing to complete new fall risk assessments after multiple falls. Video evidence also showed a CNA operating a mechanical lift while using a personal cell phone, in violation of facility policy.
A resident who was dependent on staff for personal hygiene did not consistently receive colostomy care as ordered or according to their preferences. Documentation showed multiple missed shifts where the colostomy pouch was not emptied, and staff interviews revealed that CNAs only emptied the pouch when directed by a nurse, often not cleaning it as the resident preferred. Observations confirmed the pouch was left full and not properly maintained, and the ADON could not verify that care was provided as required.
A resident with chronic pain from cancer and fractures did not receive scheduled Morphine ER doses as ordered, instead receiving only ineffective Acetaminophen, with no documented alternative interventions. Nursing staff confirmed pharmacy delivery procedures and stock medication availability, but the missed doses were verified by the DON, and facility policies for pain management and medication delivery were not followed.
The facility failed to properly date, label, and discard insulin for several residents, as observed during a survey. Insulin injector pens were found without proper labeling, including missing dates and names, despite the facility's policy requiring such documentation. LPNs confirmed the oversight, acknowledging that insulin should be labeled and discarded after 28 days. This affected residents with type two diabetes, some of whom had additional health conditions.
Two residents were affected by medication administration errors due to LPNs failing to prime insulin pens before use, resulting in a medication error rate of 8.33%. Both LPNs were unaware of the facility's policy requiring insulin pens to be primed to ensure proper dosage and function.
A facility failed to adhere to infection control standards when an LPN placed medications into her bare hand before transferring them to a medication cup, contrary to the facility's policy. This affected a resident with a history of diabetes, liver cirrhosis, and bipolar disorder, who was cognitively intact.
Failure to Provide Adequate Nutrition and Hydration
Penalty
Summary
A deficiency was identified regarding the facility's failure to provide adequate food and fluids to maintain a resident's health. The report notes that the necessary provision of nutrition and hydration was not met, which is required to support the resident's overall well-being. Specific details about the actions or inactions of staff, or the resident's medical history and condition at the time, are not provided in the report.
Failure to Complete Required Discharge Summary and Planning
Penalty
Summary
A resident with multiple complex medical conditions, including acute and subacute endocarditis, methicillin resistant staph aureus, anxiety, obesity, obstructive sleep apnea, hypertension, congestive heart failure, pacemaker, dysphagia, and muscle weakness, was admitted and required partial to moderate assistance with activities of daily living and hygiene. The resident was cognitively intact and used a wheelchair for mobility. Review of the medical record and baseline care plan showed that while goals for safety, nutrition, medication, and activities were documented, there was no evidence that a discharge summary or discharge planning process was completed as required by facility policy. The facility's policy mandates that discharge notices include the reason for discharge, the effective date, and the location to which the resident is transferred or discharged. The administrator confirmed that the required discharge summary was not completed for this resident.
Failure to Provide Palatable and Properly Tempered Meals
Penalty
Summary
The facility failed to ensure that meals provided to residents were palatable, attractive, and served at safe and appetizing temperatures. Multiple concerns were documented in food committee and resident council meeting minutes, including complaints about the taste and quality of specific menu items, requests for more juice options, issues with overcooked rice, requests for fresh fruit, reports of sour milk, insufficient food portions, and food not being hot when served. Residents also reported not receiving requested double portions, snacks not being available when requested, and dietary staff not accurately reading meal tickets. One resident stated she sometimes received foods she disliked despite making requests, and another reported not receiving meat with a meal. Observations of food temperatures during meal service revealed that while initial temperatures in the kitchen were high, the temperatures of food on test trays delivered to residents were significantly lower, with some items only warmish and not at preferred temperatures. Interviews with residents confirmed that meals were frequently served cold, leading some residents to not eat their food. The facility's policy required hot foods to be palatable at the time of delivery, but evidence from observations, interviews, and meeting minutes indicated that this standard was not consistently met. The deficiency affected three identified residents and had the potential to impact 56 residents who received food from the kitchen, excluding those identified as nothing by mouth.
Failure to Safeguard Resident Information and Maintain Medical Records
Penalty
Summary
The facility failed to safeguard resident-identifiable information and/or did not maintain medical records for each resident in accordance with accepted professional standards. This deficiency was identified through observations or review of facility practices and documentation, indicating that resident information was not properly protected or that medical records were not kept as required by professional guidelines.
Failure to Ensure Call Lights Were Within Reach for Dependent Residents
Penalty
Summary
The facility failed to ensure that call lights were within reach for residents who required assistance, as observed in three separate cases. One resident with diabetes, hypertension, anxiety, depression, bipolar disorder, and chronic kidney disease was found lying in bed calling for help with the call light on the floor and out of reach. This was confirmed by a CNA and later by an LPN, who found the resident still unable to access the call light and needing assistance to get dressed. The resident's roommate also needed help and had activated the call light, which was not accessible to the resident. Another resident with acute respiratory failure, catatonic disorder, dysphagia, major depressive disorder, multiple contractures, and dependence on supplemental oxygen was observed unable to perform any self-care and used a pressure pad call light. The call light was found on the floor, out of reach, and the CNA had to reposition it next to the resident's contracted arm. A third resident with severe infections, morbid obesity, malnutrition, chronic kidney disease, and muscle weakness was also unable to reach the call light, which was wrapped around the bed rail and out of reach. The CNA confirmed this and repositioned the call light within reach. Facility policy requires that call lights be within easy reach for residents in bed or confined to a chair.
Failure to Honor Resident Preferences and Physician Orders for Medication Administration and Positioning
Penalty
Summary
The facility failed to honor a resident's preferences as ordered by the physician, specifically regarding medication administration and positioning before meals. The resident, who had severe cognitive impairment and multiple physical limitations, had a physician's order for medications to be crushed and given only with pudding or yogurt, and to be assisted out of bed before lunch and returned to bed after lunch as tolerated. Despite these orders, staff administered medications with applesauce when yogurt was unavailable in the unit, even though yogurt was present in the kitchen. Staff confirmed the resident's preference for yogurt and acknowledged not checking the kitchen supply. Additionally, staff did not consistently assist the resident out of bed before lunch, as ordered, and documented completion of this task in the MAR/TAR without actually performing it or documenting any refusals by the resident. Multiple observations showed the resident remained in bed during lunch and was not assisted out of bed as required. Interviews with staff confirmed that the resident was not routinely assisted out of bed before lunch, and that refusals were not documented. The failure to follow physician orders and honor the resident's preferences was corroborated by staff interviews, medical record reviews, and direct observations, demonstrating a lack of adherence to both the resident's rights and prescribed care.
Failure to Provide Resident-Centered Activities for Cognitively Impaired Resident
Penalty
Summary
The facility failed to provide meaningful, resident-centered activities for a resident with significant cognitive impairment and physical dependency. The resident, admitted with diagnoses including metabolic encephalopathy, malnutrition, dysphagia, and diabetes, was rarely able to communicate or make needs known and required extensive assistance for mobility and personal care. The activities care plan indicated a preference for activities related to the resident's prior lifestyle, with goals for satisfaction in daily routines and leisure, and interventions such as allowing expression of feelings and peer interaction. However, documentation showed inconsistent and infrequent one-on-one activity visits, with several refusals and limited engagement, such as eye contact or brief verbal sounds. There was no evidence of anxiety or restlessness in the medical record, and activity assessments were inconsistently documented and not always signed or dated. Observations revealed the resident was often left in bed for extended periods without repositioning devices or support, and staff were not observed entering the room for long stretches of time. The resident was not on bed rest, but staff interviews indicated she was rarely gotten out of bed, with no clear reason provided. The resident required a mechanical lift for transfers and was expected to be dressed and out of bed per her wishes, but this was not consistently implemented. Activity staff reported difficulty assessing preferences due to the resident's cognitive status and noted that refusals were sometimes based on the resident being asleep, without clear evidence of re-approaching when awake. Documentation of one-on-one activities was incomplete, with visitation records unsigned and inconsistent with assessment requirements. The Life Enrichment Director acknowledged challenges in assessing and providing appropriate activities for the resident and could not verify the accuracy or timing of assessments. The lack of consistent, meaningful engagement and incomplete documentation led to the finding that the facility did not meet the resident's needs for individualized activities.
Failure to Ensure Safe Transfers and Fall Risk Reassessment
Penalty
Summary
Staff failed to perform safe transfers for a resident with significant mobility impairments, despite physician orders requiring the use of a mechanical lift. Multiple video reviews and documentation showed that staff transferred the resident manually or with a gait belt, rather than using the required mechanical lift, even after falls occurred. The resident's care plan and therapy recommendations specified the need for a mechanical lift, and therapy had not cleared the resident for any other transfer method. Staff reported that the resident's representative requested transfers without the mechanical lift, but no documentation indicated that this was approved by therapy or the physician. After the resident experienced several falls, there was no evidence that staff completed new fall risk assessments as required by facility policy. The facility's fall prevention and management policy stated that residents should be reassessed for fall risk after each fall, and the results should be reviewed by the interdisciplinary team (IDT). However, interviews with the DON confirmed that no new fall risk scores were calculated after the resident's falls, and there was no documentation of increased fall risk or updated assessments following these incidents. Additionally, video evidence showed that a CNA operated a mechanical lift while talking on a personal cell phone, which was against facility policy prohibiting personal phone use during work. The facility's policies required two staff for total body lifts and specified that residents unable to be elevated from the floor with minimal assistance should only be lifted using a mechanical lift. Despite these policies, staff did not consistently follow safe transfer procedures or reassess fall risk after incidents, directly leading to the deficiency.
Failure to Provide Ordered and Preferred Colostomy Care
Penalty
Summary
The facility failed to provide colostomy care as ordered and according to the resident's preferences for one resident who was alert, oriented, and dependent on staff for personal hygiene. The resident had a physician's order to have the colostomy bag emptied every shift, with documentation of the procedure and any changes in stool. The care plan, reflecting the resident's preference, specified that the colostomy pouch should be emptied, rinsed well with water, and reapplied, or replaced if not clean. However, review of CNA documentation showed multiple instances where there was no evidence that the colostomy pouch was emptied on various shifts and days. Interviews with the resident confirmed that the pouch was not emptied or cleaned as required, leading to discomfort and nausea due to the buildup of gas and fecal matter. Further interviews with staff revealed that CNAs only emptied the colostomy pouch when instructed by a nurse and typically did not follow the resident's preference for cleaning the pouch. Observations confirmed that the resident's colostomy pouch was often left more than half full and puffed up with gas. The Assistant Director of Nursing verified the lack of documentation and could not confirm that the required care was provided. These findings demonstrate a failure to ensure that colostomy care was consistently provided as ordered and per the resident's stated preferences.
Failure to Timely Administer Scheduled Pain Medication
Penalty
Summary
The facility failed to ensure timely administration of pain medication for a resident with chronic pain related to cancer and pathological fractures. The resident, who had intact cognition and required significant assistance with activities of daily living, was admitted with multiple serious diagnoses including malignant neoplasms and malnutrition. Physician orders specified scheduled administration of Morphine Extended Release twice daily, but the resident did not receive any scheduled doses on the first two mornings after admission. Instead, the resident received a single dose of Acetaminophen, which was ineffective in managing the reported pain, and there was no documentation of alternative interventions while awaiting the prescribed morphine. Interviews with nursing staff confirmed that the pharmacy delivered medications twice daily and that some medications were kept in stock for immediate use. Staff also indicated that emergency pharmacy deliveries were possible for urgent needs. Despite these procedures, the resident's medication was not administered as ordered, and the missing doses were verified by the Director of Nursing. Facility policies required assessment and management of pain and documentation of any medication delivery discrepancies, but there was no evidence these policies were followed in this instance.
Improper Insulin Labeling and Storage
Penalty
Summary
The facility failed to ensure that insulin was properly dated, labeled, and discarded, affecting six residents who were prescribed insulin. During observations, insulin injector pens were found on medication carts without proper labeling, including missing dates and names. Specific instances included an injector pen of Aspart for one resident dated over 28 days prior, and multiple injector pens of Lispro and Glargine for other residents that were not dated at all. These observations were confirmed by interviews with LPNs, who acknowledged that insulin should be labeled with names and dates and discarded after 28 days of being opened. The facility's policy, as noted in their Pharmacy Services and Procedure Manual, requires staff to document the date opened on medications with shortened expiration dates, such as insulin. Despite this policy, the facility did not adhere to these guidelines, leading to the deficiency. The residents involved had diagnoses including type two diabetes, with some having additional conditions such as impaired cognition, alcoholic cirrhosis of the liver, and bipolar disorder. The failure to properly label and discard insulin could potentially impact the care and safety of these residents.
Medication Administration Errors Due to Improper Insulin Pen Use
Penalty
Summary
The facility failed to maintain a medication error rate of less than 5%, as evidenced by an observed error rate of 8.33%. This deficiency was identified during the observation of medication administration for two residents. Resident #39, who has diagnoses including type two diabetes with diabetic neuropathy, major depressive disorder, and bipolar disorder, was administered 45 units of Novolin insulin by an LPN. The LPN did not prime the insulin pen before administration, which is a necessary step to ensure proper dosage and function of the pen. The LPN admitted to not knowing the requirement to prime the pen. Similarly, Resident #41, diagnosed with type two diabetes and a foot ulcer, was administered 14 units of insulin Glargine by another LPN. This LPN also failed to prime the insulin pen before administration. During an interview, the LPN revealed a lack of awareness regarding the need to prime the pen. The facility's policy on using insulin pen delivery systems clearly states the requirement to prime the pen to remove air bubbles and ensure the needle is functioning properly, which was not followed in these instances.
Infection Control Breach During Medication Administration
Penalty
Summary
The facility failed to maintain infection control standards during medication administration, affecting one resident. The incident involved a Licensed Practical Nurse (LPN) who, during a medication pass, placed nine medications into her bare hand before transferring them to a medication cup. This action was observed during a survey and was acknowledged by the LPN, who admitted that the medications should not have been handled with bare hands. The facility's policy, as outlined in the Pharmacy Services and Procedure Manual dated 2022, explicitly states that staff should not touch medications when opening a bottle or unit dose package. The resident involved had a medical history that included type two diabetes, alcoholic cirrhosis of the liver, and bipolar disorder, and was noted to have intact cognition according to a recent assessment.
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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 Seven Hills
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Parma Care Center | 0.8 mi | ★★★★★ | 25 | 0 |
| Broadview Multi Care Center | 0.8 mi | ★★★★★ | 9 | 0 |
| Mt Alverna Home Inc | 2.4 mi | ★★★★★ | 0 | 0 |
| Snf-the Villa At Marymount | 2.4 mi | ★★★★★ | 0 | 0 |
| Avenue At Brooklyn | 3.3 mi | ★★★★★ | 0 | 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 June 2026) and official state health department websites.