Hillside Heights: Treatment Plan Violations - OR
The facility's own written protocol said it plainly: any resident who goes more than three days without a bowel movement gets assessed by a nurse. That assessment is supposed to include a physical check of the gastrointestinal system, a look for signs of constipation, impaction, or obstruction, and a conversation with the resident or staff. If needed, medications follow, in a specific order, stool softeners first, then laxatives or bowel stimulants, then an enema. If none of that produces a bowel movement, the physician gets a call.
None of that happened for either resident.
The first, identified in the inspection report as Resident 5, was admitted to the facility in December 2025 with diabetes among their diagnoses. Bowel records covering December 31, 2025 through January 28, 2026 showed the resident went without a bowel movement on January 3, 4, 5, 6, and 7, five consecutive days. Inspectors reviewed the progress notes and medication administration records for each of those days. No bowel assessment had been completed. No additional bowel medications had been offered.
Five days. The protocol's threshold is three.
On January 29, the Director of Nursing acknowledged to inspectors that no bowel assessment had been completed for Resident 5 and that the resident had not received the bowel care interventions that were ordered during those dates.
The second resident, Resident 8, came to the facility in December 2025 with heart failure. Bowel records from January 1 through January 29, 2026 showed four consecutive days without a bowel movement, January 19, 20, 21, and 22. Again, inspectors pulled the progress notes and medication administration records for each of those days. Again, no assessment. No medications offered.
The Director of Nursing confirmed it the following morning, on January 30, telling inspectors that no bowel assessment had been completed for Resident 8 either, and that the required interventions had not been given.
Constipation in nursing home residents is not a minor inconvenience. In older adults, particularly those with limited mobility, it can escalate into fecal impaction, a condition where stool hardens and becomes impossible to pass without medical intervention. Left untreated, impaction can cause bowel perforation, sepsis, and death. For a resident with heart failure, straining from constipation puts direct stress on the cardiovascular system. For a diabetic resident, disrupted digestion can complicate blood sugar management and medication absorption.
The facility's protocol existed because the staff understood this. It was written down. It had a sequence. Someone had thought through the progression from assessment to stool softener to laxative to enema to physician notification. And then, for at least two residents in the same month, the staff did not follow it.
The inspection report does not explain why. It does not say whether the nurses on duty during those days were unaware of the missed bowel movements, aware and uncertain what to do, or aware and simply did not act. The Director of Nursing's acknowledgments, one on January 29 and one on January 30, came only after inspectors raised the issue.
CMS rated the harm level as minimal, with potential for actual harm. Inspectors identified the deficiency as affecting a few residents.
What the inspection record cannot say is how Resident 5 felt on January 7, four days past the point when someone was supposed to check on them, or whether Resident 8, managing heart failure in a facility they had been in for less than two months, said anything to anyone during those four days in January.
The protocol had an answer for that. Nobody used it.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Hillside Heights Rehabilitation Center from 2026-01-30 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: August 5, 2026 · Our methodology
HILLSIDE HEIGHTS REHABILITATION CENTER in EUGENE, OR was cited for violations during a health inspection on January 30, 2026.
The facility's own written protocol said it plainly: any resident who goes more than three days without a bowel movement gets assessed by a nurse.
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.