Rolling Hills Healthcare: Trauma-Informed Care Gap - SD
The resident had an extensive treatment history documented in hospital discharge summaries and psychiatry progress notes. A psychiatrist was identified in the resident's April 15 hospital discharge summary. A therapist was referenced in a June 16 psychiatry progress note. The resident had seen a counselor as recently as September 16, just days before the inspection.
Social Services Director G made no attempt to reach any of them.
She never requested records from the psychiatrist who had treated the resident. She didn't contact the therapist mentioned in the psychiatric notes. She failed to follow up with the counselor who had recently worked with the resident on anxiety management exercises.
The resident had a caseworker at a developmental disabilities program who served as the resident's contact person and had managed an individual service plan addressing the resident's PTSD and mental health concerns. SSD G never requested a copy of that plan either.
When questioned by inspectors, SSD G acknowledged the counselor's anxiety exercises "may have been appropriate to have been carried over and implemented by the nursing home staff." She agreed the resident would likely sign a release allowing her to obtain records from the mental health professionals.
She simply hadn't tried.
The facility's own Trauma Informed Care policy, revised on June 16, explicitly outlined a "multi-pronged approach" to identifying residents' trauma histories. The policy required collaboration "with resident trauma survivors, and as appropriate, the resident's family, friends, the primary care physician, and any other health care professionals such as psychologists and mental health professionals to develop and implement individualized care plan interventions."
Point four of the policy was unambiguous about this requirement.
For residents reluctant to share trauma history, the policy mandated that staff "still try to identify triggers which may re-traumatize the resident, and develop care plan interventions which minimize or eliminate the effect of the trigger on the resident."
The Social Services Director job description made her responsible for ensuring "the medically related emotional and social needs of the resident are met and maintained on an individual basis."
Federal inspectors found SSD G had access to multiple sources of crucial information about the resident's mental health treatment. Hospital records identified specific providers. Recent psychiatry notes referenced ongoing therapeutic relationships. A counselor had worked with the resident on coping strategies just weeks earlier.
The resident's caseworker at the DD program had direct knowledge of successful interventions used to manage the resident's PTSD symptoms in the community setting.
None of this information made it into the nursing home's care planning process.
The failure meant staff lacked guidance on potential trauma triggers that could re-traumatize the resident. They had no knowledge of proven anxiety management techniques the resident had learned to use. Care plan interventions remained generic rather than individualized to the resident's specific trauma history and successful coping mechanisms.
The inspection revealed a gap between written policy and actual practice. Rolling Hills Healthcare had developed comprehensive trauma-informed care protocols that recognized the importance of mental health collaboration. The facility understood, at least on paper, that effective trauma care requires input from the full treatment team.
But the social services director responsible for implementing those protocols had made no effort to gather the information her own policies required.
The resident's mental health providers remained uncontacted. Their expertise in managing the resident's PTSD went unused. Successful interventions from the community setting were never transferred to the nursing home environment.
Federal regulations require nursing homes to provide comprehensive assessments that inform individualized care planning. When residents arrive with complex mental health histories, facilities must actively seek information from treating professionals to ensure continuity of care.
SSD G had the resident's permission to obtain records. She had contact information for multiple providers. She had a clear policy mandate to collaborate with mental health professionals.
The phone calls were never made.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Rolling Hills Healthcare from 2025-09-29 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 26, 2026 · Our methodology
ROLLING HILLS HEALTHCARE in BELLE FOURCHE, SD was cited for violations during a health inspection on September 29, 2025.
The resident had an extensive treatment history documented in hospital discharge summaries and psychiatry progress notes.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.