Public Record
Hilltop Healthcare Rehabilitation and Skilled Nurs
From CMS
Facility profile
- CMS overall rating
- 1 / 5
- Certified beds
- 140
- Avg. residents per day
- 105.3
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Citations on record
- 101
- Inspections on file
- 11
- Last inspection
- 2026-03-12
*CMS
*CMS
*CMS
Citations
101 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0345Generalpotential for harm
Have approved installation, maintenance and testing program for fire alarm systems.
- 0347Generalpotential for harm
Properly provide smoke detection systems in areas open to corridors.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0921Generalpotential for harm
Ensure that testing and maintenance of electrical equipment is performed.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0222Generalpotential for harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- 0802Generalpotential for harm
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- 0757Generalpotential for harm
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- 0732Generalno actual harm
Post nurse staffing information every day.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0628Generalpotential for harm
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- 0610Generalpotential for harm
Respond appropriately to all alleged violations.
- 0605Generalpotential for harm
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0726Generalpotential for harm
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
- 0757Generalpotential for harm
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- 0761Generalpotential for harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- 0809Generalpotential for harm
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
- 0605Generalpotential for harm
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- 0346Generalpotential for harm
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- 0354Generalpotential for harm
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- 0355Generalpotential for harm
Properly select, install, inspect, or maintain portable fire extinguishes.
- 0363Generalpotential for harm
Install corridor and hallway doors that block smoke.
- 0372Generalpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 0511Generalpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0901Generalpotential for harm
Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel.
- 0914Generalpotential for harm
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0641Generalpotential for harm
Ensure each resident receives an accurate assessment.
- 0645Generalpotential for harm
PASARR screening for Mental disorders or Intellectual Disabilities
- 0656Generalpotential for harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0698Generalpotential for harm
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- 0689Seriousactual harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0678Seriousimmediate jeopardy
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
- 0944Generalno actual harm
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
- 0689Seriousimmediate jeopardy
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0947Generalpotential for harm
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0761Generalpotential for harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0883Generalpotential for harm
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- 0346Generalpotential for harm
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- 0324Generalpotential for harm
Provide properly protected cooking facilities.
- 0363Generalpotential for harm
Install corridor and hallway doors that block smoke.
- 0222Generalpotential for harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- 0211Generalpotential for harm
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0521Generalpotential for harm
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0920Generalpotential for harm
Ensure proper usage of power strips and extension cords.
- 0291Generalpotential for harm
Install emergency lighting that can last at least 1 1/2 hours.
- 0354Generalpotential for harm
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0577Generalno actual harm
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- 0641Generalpotential for harm
Ensure each resident receives an accurate assessment.
- 0622Generalpotential for harm
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
- 0759Generalpotential for harm
Ensure medication error rates are not 5 percent or greater.
- 0041Generalno actual harm
Implement emergency and standby power systems.
- 0293Generalpotential for harm
Have properly located and lighted "Exit" signs.
- 0324Generalpotential for harm
Provide properly protected cooking facilities.
- 0351Generalpotential for harm
Install an approved automatic sprinkler system.
- 0353Generalpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0355Generalpotential for harm
Properly select, install, inspect, or maintain portable fire extinguishes.
- 0372Generalpotential for harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 0511Generalpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0711Generalpotential for harm
Provide a written emergency evacuation plan.
- 0712Generalpotential for harm
Have simulated fire drills held at unexpected times.
- 0761Generalpotential for harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- 0914Generalpotential for harm
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- 0918Generalpotential for harm
Have generator or other power source capable of supplying service within 10 seconds.
- 0557Generalpotential for harm
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
- 0677Generalpotential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0554Generalpotential for harm
Allow residents to self-administer drugs if determined clinically appropriate.
- 0558Generalpotential for harm
Reasonably accommodate the needs and preferences of each resident.
- 0567Generalpotential for harm
Honor the resident's right to manage his or her financial affairs.
- 0578Generalpotential for harm
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- 0583Generalpotential for harm
Keep residents' personal and medical records private and confidential.
- 0585Generalpotential for harm
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
- 0657Generalpotential for harm
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- 0659Generalpotential for harm
Provide care by qualified persons according to each resident's written plan of care.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0695Generalpotential for harm
Provide safe and appropriate respiratory care for a resident when needed.
- 0698Generalpotential for harm
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- 0758Generalpotential for harm
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- 0039Generalno actual harm
Conduct testing and exercise requirements.
- 0806Generalpotential for harm
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0882Generalpotential for harm
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- 0037Generalno actual harm
Establish staff and initial training requirements.
FAQ
Questions and answers
- What is Hilltop Healthcare Rehabilitation and Skilled Nurs?
- Hilltop Healthcare Rehabilitation and Skilled Nurs is a Medicare- and Medicaid-certified nursing home in Duluth, MN, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 245366.
- What is the CMS rating for Hilltop Healthcare Rehabilitation and Skilled Nurs?
- Hilltop Healthcare Rehabilitation and Skilled Nurs has a CMS overall rating of 1 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does Hilltop Healthcare Rehabilitation and Skilled Nurs have?
- Hilltop Healthcare Rehabilitation and Skilled Nurs is certified for 140 beds. It serves an average of 105.3 residents per day.
- How many citations does Hilltop Healthcare Rehabilitation and Skilled Nurs have?
- Hilltop Healthcare Rehabilitation and Skilled Nurs has 101 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was Hilltop Healthcare Rehabilitation and Skilled Nurs last inspected?
- Hilltop Healthcare Rehabilitation and Skilled Nurs was last inspected on March 12, 2026. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
/nursing-home/245366-hilltop-healthcare-rehabilitation-and-skilled-nurs