Deficiency Records for Monument Rehabilitation and Care Center
Updated as of March 01, 2024
A list of the most recent deficiencies for Monument Rehabilitation and Care Center. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Respond appropriately to all alleged violations. | Health | 2023-11-15 | 2023-12-27 | Y |
| Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | Health | 2023-07-13 | 2023-08-25 | N |
| Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Health | 2023-07-13 | 2023-08-25 | N |
| Assess the resident when there is a significant change in condition | Health | 2023-07-13 | 2023-08-25 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-07-13 | 2023-08-25 | N |
| Provide or obtain dental services for each resident. | Health | 2023-07-13 | 2023-08-25 | N |
| Hire a qualified full-time social worker in a facility with more than 120 beds. | Health | 2023-07-13 | 2023-08-25 | N |
| 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. | Health | 2023-07-13 | 2023-08-25 | Y |
| Not hire anyone with a finding of abuse, neglect, exploitation, or theft. | Health | 2023-07-13 | 2023-08-25 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-07-13 | 2023-08-25 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-07-18 | 2023-08-25 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2023-07-18 | 2023-08-25 | N |
| Ensure that testing and maintenance of electrical equipment is performed. | Fire Safety | 2023-07-18 | 2023-08-25 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-03-28 | 2023-04-26 | N |
| Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Health | 2023-03-28 | 2023-04-26 | N |
| Report COVID19 data to residents and families. | Health | 2023-03-28 | 2023-04-26 | N |
| Perform COVID19 testing on residents and staff. | Health | 2023-03-28 | 2023-04-26 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2021-12-16 | 2022-01-12 | Y |
| Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. | Health | 2021-12-16 | 2022-01-12 | Y |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2021-12-16 | 2022-01-12 | Y |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2021-12-16 | 2022-01-12 | Y |
| Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | Health | 2021-12-16 | 2022-01-12 | Y |
| Ensure medication error rates are not 5 percent or greater. | Health | 2021-12-16 | 2022-01-12 | Y |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-12-16 | 2022-01-12 | Y |
| Provide and implement an infection prevention and control program. | Health | 2021-12-16 | 2022-01-12 | Y |
| Implement a program that monitors antibiotic use. | Health | 2021-12-16 | 2022-01-12 | Y |
| 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. | Fire Safety | 2021-12-14 | 2022-01-12 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2021-12-14 | 2022-01-12 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2021-12-14 | 2022-01-12 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2021-12-14 | 2022-01-12 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2021-12-14 | 2022-01-12 | N |
| Assist a resident in gaining access to vision and hearing services. | Health | 2020-08-20 | 2020-10-19 | N |
| 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. | Health | 2020-08-20 | 2020-10-19 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-08-20 | 2020-10-19 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-08-20 | 2020-10-19 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2020-08-20 | 2020-10-19 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2020-08-24 | 2020-10-16 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2020-08-24 | 2020-10-16 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2020-08-24 | 2020-10-16 | N |
