Average — CMS composite of the measures below.
The next survey window likely opens around February 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 Seneca Health & Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to store oxygen tubing, NCs, and masks in a sanitary manner for three residents, and one resident had no oxygen order. A resident with respiratory failure and CHF was observed with an uncovered NC in a plastic bag on the floor, another resident with COPD had oxygen tubing and an NC lying on the floor and later hanging off the bed without a plastic cover, and a third resident with chronic respiratory failure, COPD, and Alzheimer’s disease had oxygen tubing and an NC on a food tray and a nebulizer mask on the overbed table. Staff stated the NC should be stored in a plastic bag when not in use, and the DON stated tubing/NC/masks should always be stored in a clear plastic bag and not reused after being dropped on the floor.
A microwave in a 200-hall nourishment room had burn spots, chipped and peeling paint, exposed metal, and rust. Staff stated it was used for popcorn and residents’ personal food, but the RN and DM did not know the cleaning schedule or who cleaned it, and the Administrator said it would need to be replaced.
Failure to Use Required PPE for Enteric Precautions: Staff entered a resident’s room without hand hygiene or the required PPE while the resident was on enteric precautions for a potential C. difficile infection. CNA5 and CNA6 entered without following the posted precautions, and CNA5 later provided care wearing only gloves and did not perform hand hygiene when leaving the room. Interviews showed staff were unaware of the precautions or had not been informed of the requirements.
A resident admitted for rehab after a leg fracture, with intact cognition, kept his wallet in his bedside drawer and did not take it to therapy sessions, while staff, including a CNA, entered his room for care and cleaning. During and shortly after his stay, multiple unauthorized purchases totaling several hundred dollars were made on his credit and bank cards at a sporting goods retailer and Nike.com. Law enforcement traced an online order made with the resident’s card to the home address of a CNA who worked throughout the building, including the resident’s area, and linked the IP address and shipping information to that CNA. The resident and his representative confirmed that this CNA frequently cared for him, and the Administrator acknowledged she was employed at the facility. Although police and the state’s vulnerable adult fraud unit connected the fraudulent transactions to the CNA, the facility did not substantiate the misappropriation allegation internally because the CNA had not yet been criminally charged, resulting in a failure to ensure the resident’s right to be free from misappropriation of property.
The facility did not adhere to preplanned menus, serving incorrect portion sizes and substituting menu items, which altered the nutritional content of meals. Cooks served smaller portions of hot cereal and creamed corn instead of scalloped corn, and residents on altered texture diets received mashed potatoes instead of rice. The Dietary Director confirmed these deviations, which could increase the risk of weight loss for residents.
The facility failed to maintain sanitary conditions in food storage, preparation, and distribution, risking foodborne illness. Observations included improper thawing of meats, unsanitary equipment, undated health shakes, and insufficient sanitizer solution. Scrambled eggs were served at an inadequate temperature, corrected only after intervention.
The facility failed to maintain an effective infection prevention and control program, with the DON not consistently using McGeer's Criteria or documenting infection trends and corrective actions. Additionally, staff failed to perform proper hand hygiene, as observed with a CNA and housekeeping staff not washing hands or using gloves appropriately. These deficiencies indicate lapses in infection control protocols.
The facility failed to monitor and evaluate antibiotic use for three residents, lacking documentation of tracking or trending of antibiotic usage and infection locations. A resident was started on Bactrim DS for a suspected infection before a urinalysis was completed, another was prescribed Nitrofurantoin for UTI prevention without timely urinalysis, and a third was given Azithromycin before confirming an infection. The Infection Preventionist did not document discussions about meeting criteria, and the NP ordered antibiotics for high-risk residents before lab results to prevent sepsis.
The facility failed to ensure adequate time for the Infection Preventionist (IP) to manage the Infection Prevention and Control Program (IPCP). The Director of Nursing (DON) was performing IP duties due to the absence of a dedicated IP, as the newly hired IP was still completing certification. The facility's policy emphasized maintaining a safe environment, but the DON was responsible for all infection control documentation, indicating a lack of dedicated IP oversight.
A facility failed to provide written notification to a resident and their representative regarding a hospital transfer, as required by their policy. The resident, with a history of IBS, was transferred due to symptoms of pain, nausea, and vomiting. The Director of Nursing confirmed that only verbal notifications were given, which is inconsistent with the policy requiring written notices.
A resident was transferred to the hospital without receiving a written bed hold notice, as required by the facility's policy. The resident, who had a history of IBS, was sent to the emergency department due to pain, nausea, and vomiting. The Director of Nursing confirmed that there was no documentation of the notice being provided, which could impact the resident's return to the facility.
The facility failed to maintain proper hygiene and maintenance of oxygen equipment for three residents, including undated tubing and dusty concentrators. The DON confirmed these deficiencies, which were contrary to the facility's policy requiring weekly changes and cleaning.
The facility failed to offer alternate meals to two residents who refused their served meals. One resident, with diabetes, heart failure, and hypertension, was unaware of the option for an alternate meal and did not receive the sandwich listed on her tray card. Another resident refused his meal, and a CNA confirmed no alternative was offered, citing kitchen policy. The DON stated that alternatives are available if requested.
The facility failed to prevent verbal abuse by a CNA towards a resident who was cognitively intact. Multiple interviews confirmed that the CNA was rude, disrespectful, and loud, leading to her suspension and termination after an investigation substantiated the abuse allegations.
Improper Storage of Oxygen Equipment and Missing Oxygen Order
Penalty
Summary
The facility failed to ensure that oxygen tubing, nasal cannula, and masks were stored in a sanitary manner for three residents, and one resident did not have an order for oxygen use. The facility policy stated that oxygen is administered under physician orders except in an emergency, and that oxygen tubing and masks/cannulas are to be changed weekly and as needed if soiled or contaminated, with delivery devices kept covered in a plastic bag. R105, who had diagnoses including acute right heart failure, acute respiratory failure with hypoxia, and acute on chronic diastolic congestive heart failure and was cognitively intact, was observed in bed with the nasal cannula uncovered in a plastic bag lying on the floor next to the bed. R119, who had COPD and severe cognitive impairment, was observed with oxygen tubing and nasal cannula without a plastic cover and lying on the floor, and later the tubing was seen hanging off the mobility bar of the bed without being stored in a plastic cover. R4, who had chronic respiratory failure with hypoxia, COPD, and Alzheimer's disease and was severely cognitively impaired, was observed with oxygen tubing and nasal cannula lying on the food tray while the oxygen concentrator was running, and later the nebulizer and mask were lying directly on the overbed table. R4 had no physician order for oxygen, and staff stated the resident had been on oxygen since admission; an LPN acknowledged the tubing/cannula should have been changed after being on the floor, and the DON stated the tubing, nasal cannula, and masks should always be stored in a clear plastic bag and should never be put back on the resident if dropped on the floor.
Unsafe Microwave in Nourishment Room
Penalty
Summary
The facility failed to provide a safe, clean microwave for 1 of 3 nourishment rooms on the 200 hall. During observation, the microwave in the 200-hall nourishment room had burn spots in the bottom front left corner, chipped paint on the front bottom in two places, chipped paint on the front top in two places, and paint peeling with metal exposed on four inches of the fan area, with rust also exposed. The report stated that the microwave was used for popcorn and residents’ personal food. Facility staff acknowledged the condition of the microwave during interviews. An RN stated the microwave looked burnt and overcooked and did not know the cleaning schedule, while also stating housekeeping was typically in the area. The Dietary Manager stated the paint was peeling, the microwave was dirty, and she would not use it, and she did not know who cleaned it. The Administrator observed the microwave and stated it would need to be replaced.
Failure to Use Required PPE for Enteric Precautions
Penalty
Summary
Facility staff failed to use the required PPE of eye protection, gowns, and gloves before entering the room of Resident 102, who was on enteric precautions for a potential C. difficile stool infection. Review of the facility policy for Management of C. Difficile Infection stated that when C. difficile infection is suspected, licensed nurses may implement preemptive contact precautions, and that staff are to wear gloves and a gown upon entry into the resident’s room and perform hand hygiene with soap and water. Resident 102 had been admitted after hospitalization for treatment of bowel obstruction. During observation, a sign for enteric precautions was posted on the resident’s door and a PPE cart with eye protection, gowns, and masks was located nearby, but CNA5 entered the room to answer the call light without hand hygiene or PPE. CNA6 also entered the room without hand hygiene or the required PPE. Later, CNA5 provided personal care while wearing only gloves, exited the room with one glove still on, and did not perform hand hygiene before leaving the room or after placing a garbage bag in the soiled utility room. Interviews with CNA5 and CNA6 showed they were unaware of the resident’s precautions, and LPN3 stated staff were not educated or informed about the rationale and requirements for the enteric precautions. LPN4 stated the stool specimen had been obtained the prior evening and the PPE cart and sign were placed the next morning, while the DON and IP were unable to state why the precautions were not put into place earlier.
Failure to Protect Resident From Misappropriation of Financial Information by CNA
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident’s belongings and money from misappropriation, as required by its abuse, neglect, and exploitation policy. The facility’s written policy defined exploitation as taking advantage of a resident for personal gain through manipulation, intimidation, threats, or coercion, and misappropriation of resident property as the wrongful use of a resident’s belongings or money without consent. Despite this policy, a certified nursing assistant (CNA) employed at the facility was identified by law enforcement as the individual who used a resident’s bank and credit card information to make unauthorized purchases. The facility had not substantiated the allegation internally because the CNA had not yet been criminally charged, even though law enforcement had linked the fraudulent transactions to the CNA. The resident involved had been admitted with a displaced fracture of the right tibia, muscle weakness, dysphagia, and cognitive communication deficit, and was assessed as cognitively intact with a BIMS score of 13 out of 15. He reported that during his stay he kept his wallet in the bedside drawer and did not take it with him to therapy sessions, only removing it when leaving the facility for outside medical appointments. While he was out of his room for therapy or appointments, staff, including CNAs, were in and out of his room providing care and cleaning. During and shortly after his stay, multiple unauthorized purchases were made using his Discover and Bank of America cards, including several transactions at a sporting goods retailer and one at Nike.com, totaling approximately $592–$597. Law enforcement records showed that an online order using the resident’s Bank of America Visa card was placed for several pairs of shoes and boots, with the items shipped to a name different from the CNA but to the same physical address the CNA had provided to the facility and for her CNA license. The payment facilitator for the sporting goods store confirmed the fraudulent order details, and the IP address used for the order was consistent with an internet provider in the CNA’s home area. The resident, his representative, and the facility Administrator all confirmed that the CNA had provided care to the resident and could have had access to his room. The police and the Attorney General’s Vulnerable Adult & Medicaid Provider Fraud Unit were able to connect the fraudulent purchases, including items mailed to the CNA’s home address, to the CNA who worked at the facility, demonstrating that the resident’s financial information was misappropriated while he was under the facility’s care. The facility Administrator initially told law enforcement that he did not believe staff would steal the resident’s card information and noted that the resident’s family also visited and that the resident usually kept his cards with him except during physical therapy. However, the resident later described receiving text alerts from his banks about purchases at the sporting goods store and Nike.com that he did not recognize or authorize. He contacted his banks, the Sheriff’s Department, and the facility Administrator to report the fraud, stating that he believed a staff member at the facility had taken his card information. Law enforcement subsequently identified the CNA as the person associated with the fraudulent transactions, including purchases made while she was working at the facility and shipped to her home address, confirming that the resident’s property had been wrongfully used without his consent. Despite the law enforcement findings, the Administrator and DON stated that they had not substantiated the misappropriation allegation in their own investigation because the CNA had not yet been formally charged with a crime. The survey findings note that this failure to ensure the resident’s right to be free from misappropriation of property occurred for one resident and had the potential to affect all residents cared for by the CNA. The survey team chose not to interview the CNA during the survey to avoid interfering with the ongoing criminal investigation and to protect the resident, who was now living in the community, from potential further exposure of his personal information.
Failure to Follow Preplanned Menus and Portion Sizes
Penalty
Summary
The facility failed to adhere to preplanned menus, which compromised the nutritional content of meals served to residents. On multiple occasions, cooks were observed serving incorrect portion sizes and substituting menu items. For instance, a cook used a three-ounce scoop to serve hot cereal, whereas the menu specified a six-ounce portion for regular diets. Similarly, creamed corn was served instead of the scalloped corn listed on the menu, and the portion size was also incorrect. These deviations from the menu were confirmed by the Dietary Director, who acknowledged that the preplanned menus were not followed. Additionally, there was a failure to serve the correct side dishes for altered texture diets. Residents on mechanical soft and puree diets were served mashed potatoes instead of the rice specified in the menu. The Dietary Director and the Administrator were unable to provide an explanation for these discrepancies. The failure to follow the preplanned menus altered the nutritional content of the meals, potentially increasing the risk of weight loss for residents.
Sanitation and Food Safety Deficiencies in Dietary Department
Penalty
Summary
The facility failed to ensure that food was stored, prepared, and distributed under sanitary conditions, which could lead to foodborne illnesses among residents. Observations revealed that ground beef and pork cubes were thawing in a walk-in refrigerator on sheet pans with pooled blood, and a cooked ham was stored on the same pan as raw meat, risking cross-contamination. Can openers had sticky, black food matter on their blades, and commercial food processors had dried food splashes on their surfaces. Health shakes were undated in the refrigerator, preventing staff from tracking their 14-day use or discard date. Additionally, the reach-in refrigerator had spills and sticky handles, and two of three sanitizer buckets lacked sufficient sanitizer solution. During a meal service observation, scrambled eggs were served at an inadequate temperature of 119 degrees Fahrenheit, below the required 165 degrees Fahrenheit for reheated foods. The Dietary Director corrected the cook, who then reheated the eggs to 170 degrees Fahrenheit. Other items in the warmer were also reheated to ensure they reached appropriate temperatures. The facility's failure to maintain proper food storage, preparation, and sanitation practices posed a risk of foodborne illness to all residents receiving food from the dietary department.
Inadequate Infection Control and Hand Hygiene Practices
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program (IPCP). The Director of Nursing (DON), who also served as the Infection Preventionist (IP), admitted to not using McGeer's Criteria consistently when nursing staff contacted physicians about infections. The DON also lacked documentation of data collection, infection trends, or corrective actions taken, and did not share this information during Quality Assurance and Performance Improvement (QAPI) meetings. Additionally, there was no documentation of conversations with physicians regarding antibiotic stewardship, and the facility did not monitor or evaluate antibiotic use effectively. The facility staff also failed to perform proper hand hygiene. A Certified Nurse Aide (CNA) was observed not washing hands or using gloves after picking up a contaminated item and before assisting a resident. Similarly, housekeeping staff were observed not performing hand hygiene after removing soiled gloves and before donning clean ones. These lapses in hand hygiene practices were acknowledged by the staff involved, indicating a lack of adherence to infection control protocols.
Deficiency in Antibiotic Stewardship Program
Penalty
Summary
The facility failed to adequately monitor and evaluate antibiotic use, as well as track measures of antibiotic usage for three residents reviewed for antibiotic usage. The Antibiotic Stewardship Program lacked documentation of tracking or trending of antibiotic usage and infection locations within the facility. This deficiency was identified through interviews, record reviews, and policy reviews, revealing a lack of adherence to CDC guidance and facility policies regarding antibiotic stewardship. Resident 5 was admitted with diagnoses including diabetes, epilepsy, and schizoaffective disorder. A hospice nurse requested a urinalysis with culture and sensitivity due to confusion, and Bactrim DS was started for a suspected bacterial infection before the urinalysis was completed. Resident 29, with diagnoses including lupus and diabetes, was prescribed Nitrofurantoin Macrocrystal for UTI prevention by hospice, but a urinalysis with culture and sensitivity was not obtained until 14 days after the antibiotic was started. Resident 26, with multiple diagnoses including infection due to internal orthopedic prosthetic devices, was started on Azithromycin before a urinalysis with culture and sensitivity confirmed an infection. The Director of Nursing, who also serves as the Infection Preventionist, admitted to not questioning antibiotic use for hospice residents and not documenting discussions with practitioners about meeting McGeer's criteria. The Infection Preventionist stated that tracking and trending of infections were done mentally without written documentation. The Nurse Practitioner confirmed ordering antibiotics for high-risk residents before receiving laboratory results to prevent sepsis, acknowledging discussions with the Infection Preventionist about meeting criteria but relying on personal knowledge of the residents.
Inadequate Infection Preventionist Oversight
Penalty
Summary
The facility failed to ensure that the Infection Preventionist (IP) had sufficient time to effectively manage the Infection Prevention and Control Program (IPCP). The job description for the IP role was undated, but it outlined responsibilities such as developing and implementing infection prevention programs, overseeing the antibiotic stewardship program, and leading the Infection and Prevention Control Committee. However, the facility's Director of Nursing (DON) was performing the IP duties due to the absence of a dedicated IP, as the newly hired IP was still in the process of completing her certification. The facility's policy on infection prevention and control was also undated, but it emphasized the importance of maintaining a safe environment and conducting surveillance activities. Despite this, the DON was responsible for all documentation related to infection control for 2023, 2024, and early 2025, indicating a lack of dedicated IP oversight. The facility assessment did not specify the hours allocated for the IP position, and the Administrator acknowledged difficulties in retaining qualified IPs, resulting in the DON temporarily filling the role.
Failure to Provide Written Notification for Resident Transfer
Penalty
Summary
The facility failed to provide written notification to a resident and their responsible party regarding a transfer to the hospital. The facility's policy on transfer and discharge, dated 2025, mandates that residents and their representatives receive a written notice that includes the reason for the transfer, the effective date, the new location, and information about the right to appeal. However, the policy did not address providing written information for emergency transfers to acute care. In the case of Resident 64, who was admitted to the facility on an unspecified date, there was no documentation of written notification for the hospital transfer due to symptoms of pain, nausea, and vomiting, which were consistent with the resident's history of irritable bowel syndrome. During an interview, the Director of Nursing confirmed that the facility only provides verbal notification to families when residents are transferred out of the facility, without any written documentation. This practice is inconsistent with the facility's policy, which requires written notification to ensure that residents and their representatives have complete information about the transfer or discharge process, including their appeal rights. The lack of written notification created the potential for misunderstandings regarding the transfer or discharge process.
Failure to Provide Bed Hold Notice During Hospital Transfer
Penalty
Summary
The facility failed to provide a written bed hold notice to a resident, identified as R64, or their representative prior to or within 24 hours of an emergency transfer to the hospital. The facility's policy, dated 03/11/24, mandates that such a notice should be given at the time of transfer for hospitalization or therapeutic leave. This notice should specify the duration of the bed-hold policy, the reserve bed payment policy, and the conditions for the resident's return to the facility. However, upon review of R64's electronic medical record, there was no documentation indicating that the resident or their representative received this notice. R64 was admitted to the facility on an unspecified date and was transferred to the emergency department on 11/01/24 due to complaints of pain, nausea, and vomiting, which were consistent with their history of irritable bowel syndrome (IBS). During an interview, the Director of Nursing confirmed the absence of documentation regarding the provision of the bed hold notice to R64 or their representative. This oversight created the potential for residents or their representatives to lack necessary information to ensure their return to the facility.
Failure to Maintain Oxygen Equipment Hygiene
Penalty
Summary
The facility failed to ensure proper maintenance and hygiene of oxygen equipment for three residents, which included changing and dating oxygen tubing and cleaning oxygen concentrators. Resident 27, who was admitted with acute respiratory failure, was observed with undated oxygen tubing and a dusty concentrator with a filter covered in white dust. The Director of Nursing (DON) confirmed these observations during an interview. Similarly, Resident 89, admitted with chronic diastolic heart failure, had undated oxygen tubing with dried food on it and a dirty air intake filter on the concentrator, as confirmed by the DON. Resident 64, admitted with pneumonia and heart disease, also had undated oxygen tubing and a dirty air intake filter on the concentrator. The DON confirmed these findings during an interview. The facility's policy requires weekly changes of oxygen tubing and masks/canulas, and cleaning of concentrators as needed, but these protocols were not followed. The DON stated that the night nurse on Sundays was responsible for these tasks, indicating a lapse in adherence to the facility's policy and procedures for respiratory care equipment maintenance.
Failure to Offer Alternate Meals to Residents
Penalty
Summary
The facility failed to ensure that residents who refused the meals served were offered an alternate meal, affecting two residents. Resident 26, who was admitted with diagnoses of diabetes, heart failure, and hypertension, was cognitively intact with a BIMS score of 15 out of 15. During an interview, Resident 26 stated that the facility did not honor her meal preferences and she was unaware that an alternate meal could be requested. An observation confirmed that her meal tray did not include the ham and cheese sandwich as stated on the tray card, and she was not informed about the availability of an alternative meal. Similarly, Resident 21, who was also cognitively intact with a BIMS score of 15 out of 15, refused the meal served to him. A CNA confirmed that Resident 21 did not like the lunch tray and refused it, but no alternative meal was offered. The CNA mentioned that the kitchen does not provide an alternate meal after trays are served unless informed in advance. The LPN corroborated this by stating that residents need to inquire about the menu or check the posted menu themselves. The DON, however, stated that residents are always provided with an alternate meal if requested, and sandwiches are available on each unit.
Failure to Prevent Verbal Abuse by CNA
Penalty
Summary
The facility failed to prevent verbal abuse of a resident by a Certified Nursing Assistant (CNA). The resident, who was cognitively intact with a BIMS score of 15 out of 15, reported that CNA1 had a bad attitude, yelled at her, and was rough with her. Multiple interviews corroborated the resident's claims, with other residents and staff members reporting that CNA1 was rude, disrespectful, and loud. CNA1 was suspended and subsequently terminated following an investigation that substantiated the allegations of abuse and neglect. The facility's policy on abuse, neglect, and exploitation was reviewed, and it was found that the policy mandates protections for the health, welfare, and rights of each resident. Despite this policy, CNA1's behavior towards the resident and other residents was found to be abusive. The Director of Nursing and other staff members confirmed that there had been multiple complaints about CNA1's behavior, leading to her termination. The facility's administrator confirmed that the appropriate steps were taken to report the incident and remove CNA1 from the property pending the investigation.
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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 Seneca
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lila Doyle Post Acute | 3 mi | ★★★★★ | 1 | 0 |
| Pruitthealth - Pickens | 14.3 mi | ★★★★★ | 4 | 0 |
| Linley Park Post Acute | 19.4 mi | ★★★★★ | 8 | 0 |
| Nhc Healthcare - Anderson | 20.6 mi | ★★★★★ | 0 | 0 |
| Hart Care Center | 21.2 mi | ★★★★★ | 0 | 0 |
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