Hillside Place

Last inspection

May 28, 2026

Inspections

6, 44 deficiencies cited

Substantiated abuse

7

Substantiated licensing violations

6

Regulatory actions

0

Fines assessed

$3,875.00 (7 violations)

Current owner since

June 4, 2020

Inspections

• May 28, 2026: Re-Licensure, 10 deficiencies cited report
  • C0260: Service Plan: General severity level 2, scope L2 Pattern
  • C0270: Change of Condition and Monitoring severity level 2, scope L2 Pattern
  • C0280: Resident Health Services severity level 2, scope L2 Pattern
  • C0362: Acuity Based Staffing Tool - ABST Time severity level 2, scope L2 Pattern
  • C0363: Acuity Based Staffing Tool - Updates & Staffing Plan severity level 2, scope L2 Pattern
  Show all 10

  • C0370: Staffing Requirements and Training ? Pre-service severity level 2, scope L2 Pattern
  • C0372: Training Within 30 Days of Hire ? Direct Care Staff severity level 2, scope L2 Pattern
  • C0420: Fire and Life Safety: Safety severity level 2, scope L2 Widespread
  • C0613: General Building: Doors-Walls, Cleanable severity level 2, scope L2 Widespread
  • L0370: Staffing Requirements and Training ? Pre-service severity level 2, scope L2 Pattern
• November 24, 2025: Kitchen, 1 deficiency cited report
  • C0240: Resident Services Meals, Food Sanitation Rule severity level 2, scope L2 Widespread
• January 9, 2025: Re-Licensure, 10 deficiencies cited report
  • C0252: Resident Move-in & Evaluation: Res Evaluation severity level 2, scope L2 Pattern
  • C0260: Service Plan: General severity level 2, scope L2 Pattern
  • C0270: Change of Condition and Monitoring severity level 2, scope L2 Isolated
  • C0280: Resident Health Services severity level 2, scope L2 Isolated
  • C0325: Systems: Self-Administration of Meds severity level 2, scope L2 Isolated
  Show all 11

  • C0363: Acuity Based Staffing Tool - Updates & Staffing Plan severity level 2, scope L2 Isolated
  • C0372: Training Within 30 Days of Hire ? Direct Care Staff severity level 2, scope L2 Pattern
  • C0420: Fire and Life Safety: Safety severity level 2, scope L2 Widespread
  • C0422: Fire and Life Safety: Training for Residents severity level 2, scope L2 Widespread
  • C0455: Inspections and Investigation: Insp Interval severity level 2, scope L2 Pattern
  • C0640: Heating and Ventilation severity level 2, scope L2 Widespread
• June 13, 2024: Complaint Investig., 4 deficiencies cited report
  • C0303: Systems: Treatment Orders severity level 2, scope L2 Isolated
  • C0350: Administrator Qualification and Requirements severity level 2, scope L2 Isolated
  • C0360: Staffing Requirements and Training: Staffing severity level 2, scope L2 Isolated
  • C0361: Acuity-Based Staffing Tool severity level 2, scope L2 Widespread
• October 5, 2023: State Licensure, 0 deficiencies cited report
  • C0000: Comment severity level 0
• January 3, 2022: Validation, 19 deficiencies cited report
  • C0000: Comment severity level 0
  • C0150: Facility Administration: Operation severity level 3, scope L3 Isolated, corrected March 6, 2022
  • C0160: Reasonable Precautions severity level 2, scope L2 Isolated, corrected March 6, 2022
  • C0231: Reporting & Investigating Abuse-Other Action severity level 2, scope L2 Isolated, corrected March 6, 2033
  • C0252: Resident Move-In and Eval: Res Evaluation severity level 2, scope L2 Isolated, corrected August 12, 2022
  Show all 21

  • C0260: Service Plan: General severity level 2, scope L2 Pattern, corrected March 6, 2022
  • C0262: Service Plan: Service Planning Team severity level 2, scope L2 Pattern, corrected March 6, 2022
  • C0270: Change of Condition and Monitoring severity level 3, scope L3 Isolated, corrected August 12, 2022
  • C0280: Resident Health Services severity level 3, scope L3 Isolated, corrected March 6, 2022
  • C0303: Systems: Treatment Orders severity level 2, scope L2 Isolated, corrected August 12, 2022
  • C0325: Systems: Self-Administration of Meds severity level 2, scope L2 Isolated, corrected March 6, 2022
  • C0350: Administrator Qualification and Requirements severity level 2, scope L2 Isolated, corrected March 6, 2022
  • C0360: Staffing Requirements and Training: Staffing severity level 2, scope L2 Widespread, corrected March 6, 2022
  • C0370: Staffing Requirements and Training – Pre-Serv severity level 2, scope L2 Pattern, corrected March 6, 2022
  • C0372: Training Within 30 Days: Direct Care Staff severity level 2, scope L2 Pattern, corrected March 6, 2022
  • C0420: Fire and Life Safety: Safety severity level 2, scope L2 Widespread, corrected August 12, 2022
  • C0422: Fire and Life Safety: Training For Residents severity level 2, scope L2 Widespread, corrected August 12, 2022
  • C0455: Inspections and Investigation: Insp Interval severity level 2, scope L2 Widespread, corrected October 8, 2022
  • C0610: General Building Exterior severity level 2, scope L2 Widespread, corrected October 8, 2022
  • C0613: General Building: Doors-Walls, Cleanable severity level 2, scope L2 Widespread, corrected March 6, 2022
  • C0655: Call System severity level 2, scope L2 Widespread, corrected March 6, 2022

Substantiated abuse or neglect

• December 12, 2025: Failed to administer medication as ordered Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0055 (Medications and Treatments)
  State’s findings

  The Alleged Victim (AV) relied on the facility for care, medication administration, and medication management. Between December 12, 2025, and December 13, 2025, AV missed approximately 4 doses of their scheduled narcotic pain medication and was in repeated unreasonable discomfort. According to an investigation, AV's scheduled narcotic pain medication was not reordered timely and was unavailable to administer to AV, resulting in repeated unreasonable discomfort. The facility failed to administer medication as ordered, which is a violation of resident rights is considered neglect of care and constitutes abuse as defined by Oregon Administrative Rule 411-020-0002(1)(b)(A)(i).

• December 12, 2025: Failed to administer medication as ordered Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0055 (Medications and Treatments)
  State’s findings

  The Alleged Victim (AV) relied on the facility for care, medication administration, and medication management. Between October 11, 2025, and October 16, 2025, AV missed approximately 8 doses of their scheduled narcotic pain medication and was in repeated unreasonable discomfort. According to an investigation, AV's scheduled narcotic pain medication was not reordered timely and was unavailable to administer to AV, resulting in repeated unreasonable discomfort. The facility failed to administer medication as ordered, which is a violation of resident rights is considered neglect of care and constitutes abuse as defined by Oregon Administrative Rule 411-020-0002(1)(b)(A)(i).

• December 11, 2025: Failed to provide safe environment Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $250.00; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0030 (Resident Services); 411-054-0036 (Service Plan – General)
  State’s findings

  The Alleged Victim (AV) has cognitive deficits and relies on the facility for their care. AV has a history of wandering behaviors and is care planned for staff to assist AV back to their room if appearing lost or turned around. According to an investigation, on or about December 11, 2025, AV was observed wandering through the facility halls naked from the waist down and unable to locate his/her room. Another resident was present in the hall and could see AV without adequate clothing, resulting in a loss of dignity for AV. AV's current service plan, dated November 17, 2025, did not provide new interventions for staff to implement to address AV's need for increasing supervision and wandering behavior. The facility failed to properly address the resident's behavior and ensure resident's dignity, which is a violation of resident’s rights, is neglect of care and constitutes abuse.

• February 11, 2025: Failed to provide service Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0040 (Change of Condition and Monitoring)
  State’s findings

  The Alleged Victim (AV) relied on the facility for care and was service planned as independent with transferring, ambulation, and toileting. According to an investigation, AV fell on or about February 11, 2025, and remained on the floor until they crawled to the bed. For approximately three (3) days, AV did not get out of bed and told staff they were hurting and did not want to get up to use the toilet. AV was not taking care of their pet and staff had to clean animal feces off the floor. AV gave their pet away to a friend due to not being able to take care of it. The facility did not evaluate AV, and/ or document the change of condition and update the service plan. On or about February 14, 2025, EMS was called to take AV to the hospital due to AV being weak and in pain. AV arrived at the hospital covered in urine from the chest down. The facility failed to provide services, to include responding to AV’s change of condition and monitoring, which is a violation of resident rights, is considered neglect of care and constitutes abuse.

• February 11, 2025: Failed to assure timely medical treatment Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0040 (Change of Condition and Monitoring); 411-054-0045 (Resident Health Services)
  State’s findings

  The Alleged Victim (AV) relied on the facility for care and was service planned as independent with transferring, ambulation, and toileting. According to an investigation, AV fell on or about February 11, 2025, and remained on the floor until they crawled to the bed. For approximately three (3) days, AV did not get out of bed and told staff they were hurting and did not want to get up to use the toilet. AV was not taking care of their pet and staff had to clean animal feces off the floor. AV gave their pet away to a friend due to not being able to take care of it. The facility did not assess AV regarding their significant change of condition or provide AV with additional monitoring. On or about February 14, 2025, EMS was called to take AV to the hospital due to AV being weak and in pain. AV arrived at the hospital covered in urine from the chest down. The facility failed to provide timely medical treatment to AV, resulting in unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.

• October 17, 2023: Failed to provide service Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to provide appropriate services according to Alleged Victim (AV)'s needs, number of falls with lack of appropriate interventions. According to an investigation, AV experienced approximately eleven falls from March 6, 2023, and October 17, 2023, which resulted in bruises, skin tears and two head injuries. The facility's failure is a violation of resident rights, is considered neglect of care and constitutes abuse.

• November 4, 2021: Failed to properly plan care Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $1,125.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to implement interventions and appropriately care plan related to The Alleged Victim’s (AV) skin care needs. The failure resulted in the AV experiencing physical harm and unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.

Substantiated licensing violations

• June 19, 2025: Failed to administer medication as ordered Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0055 (Medications and Treatments)
  State’s findings

  The facility failed to provide a safe medication administration system to ensure the Alleged Victim’s (AV) medications were administered as ordered. There was no observable or documented evidence of a negative outcome. The failure is a violation of Oregon Administrative Rules.

• September 27, 2023: Failed to meet the scheduled and unscheduled needs of residents Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0070 (Staffing Requirements and Training)
  State’s findings

  The facility failed to respond in a timely manner to a call light. An investigation determined this is a violation of Oregon Administrative Rules.

• September 27, 2023: Failed to use an ABST Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0037 (Acuity-Based Staffing Tool)
  State’s findings

  The facility failed to have an updated Acuity-Based Staffing Tool (ABST) that accurately reflected the resident population and their care needs. Inconsistencies were identified between the resident roster, care plans, and the data entered into the ABST. An investigation determined this is a violation of Oregon Administrative Rules.

• September 27, 2023: Failed to properly plan care Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to complete quarterly evaluations on residents. An investigation determined this is a violation of Oregon Administrative Rules.

• September 27, 2023: Failed to provide appropriate activities Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0030 (Resident Services)
  State’s findings

  The facility failed to provide a daily program of social and recreational activities for the residents. An investigation determined this is a violation of Oregon Administrative Rules.

• December 1, 2022: Failed to submit timely or adequate staffing documentation Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-061-0010
  State’s findings

  On or about December 1, 2022, the Oregon Health Authority reported to the Department that Respondent failed to comply with weekly reporting requirements of vaccinated individuals, residents and staff, to the proper authority as required by law. This failure has been ongoing from November 1, 2022 to November 30, 2022, for a total of 30 days.

Read the full record on the state’s site →

ODHS lists only substantiated violations: “either a substantiated instance of abuse or a licensing violation. Open investigations and complaints that are being appealed by the provider are not listed.” Oregon counts neglect as a form of abuse; see the state’s definitions of abuse. Each violation shows the level ODHS gives it, in the state’s words (for example “2 - Minor harm or potential for moderate harm”), and any fine ODHS assessed. Inspection citations show the state’s severity level and scope, and the date ODHS recorded the problem as corrected when it lists one. Rule names come from the Oregon Administrative Rules. ODHS: “Formal regulatory actions can range from a condition placed upon a license due to non-compliance or a notice to revoke a license.” This community is licensed for 25 residents; larger communities are inspected and reported on more often, so read counts with size in mind. Source: Oregon Department of Human Services, Long-Term Care Licensing, data as of October 15, 2026, showing the last five years. Always visit in person and ask the community about anything listed here.