Independent · Federal inspection records, searchable
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Nursing Home Violations Public inspection data, searchable
Facility profile · CCN 056322

Montrose Springs Skilled Nursing & Wellness Center

80 federal citations on record , and 2 federal enforcement actions totaling $32,139.

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Record summary

Federal record · Q1 2026
80
Total citations
61
Last 3 years
3
Actual harm+
2
Federal penalties
$32,139
Total fines
3
Overall ★ rating

Most common violation categories here

Quality of Care20 Resident Rights16 Care Planning15 Environment & Safety8 Medication & Pharmacy6

Most common F-tags at this facility

F6567 F7553 F7453 F9113 F9123

Citation history

80 on record
SurveyF-TagViolationSeveritySource
Jan 22, 2026F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.DComplaint
Jan 22, 2026F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Jul 3, 2025F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DComplaint
Jul 3, 2025F919Make sure that a working call system is available in each resident's bathroom and bathing area.DStandard
Jul 3, 2025F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.BStandard
Jul 3, 2025F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.BStandard
Jul 3, 2025F880Provide and implement an infection prevention and control program.DStandard
Jul 3, 2025F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EStandard
Jul 3, 2025F745Provide medically-related social services to help each resident achieve the highest possible quality of life.DStandard
Jul 3, 2025F692Provide enough food/fluids to maintain a resident's health.DStandard
Jul 3, 2025F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.DStandard
Jul 3, 2025F688Provide 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.DStandard
Jul 3, 2025F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DStandard
Jul 3, 2025F578Honor 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.DStandard
Jul 3, 2025F565Honor the resident's right to organize and participate in resident/family groups in the facility.DStandard
Jul 3, 2025F552Ensure that residents are fully informed and understand their health status, care and treatments.DStandard
Jul 3, 2025F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.DStandard
May 1, 2025F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Mar 28, 2025F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DComplaint
Mar 28, 2025F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.GComplaint
Mar 12, 2025F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.GComplaint
Feb 20, 2025F660Plan the resident's discharge to meet the resident's goals and needs.DComplaint
Jul 12, 2024F919Make sure that a working call system is available in each resident's bathroom and bathing area.DStandard
Jul 12, 2024F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.BStandard
Jul 12, 2024F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.BStandard
Jul 12, 2024F880Provide and implement an infection prevention and control program.DStandard
Jul 12, 2024F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.EStandard
Jul 12, 2024F802Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.EStandard
Jul 12, 2024F761Ensure 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.EStandard
Jul 12, 2024F759Ensure medication error rates are not 5 percent or greater.EStandard
Jul 12, 2024F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.EStandard
Jul 12, 2024F745Provide medically-related social services to help each resident achieve the highest possible quality of life.DStandard
Jul 12, 2024F732Post nurse staffing information every day.BStandard
Jul 12, 2024F730Observe each nurse aide's job performance and give regular training.EStandard
Jul 12, 2024F697Provide safe, appropriate pain management for a resident who requires such services.DStandard
Jul 12, 2024F695Provide safe and appropriate respiratory care for a resident when needed.DStandard
Jul 12, 2024F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.DStandard
Jul 12, 2024F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.DStandard
Jul 12, 2024F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DStandard
Jul 12, 2024F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DStandard
Jul 12, 2024F583Keep residents' personal and medical records private and confidential.DStandard
Jul 12, 2024F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DStandard
Jul 12, 2024F558Reasonably accommodate the needs and preferences of each resident.DStandard
Jul 12, 2024F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.DStandard
May 17, 2024F558Reasonably accommodate the needs and preferences of each resident.DComplaint
May 17, 2024F557Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.DComplaint
May 10, 2024F711Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.DComplaint
May 10, 2024F635Provide doctor's orders for the resident's immediate care at the time the resident was admitted.GComplaint
Apr 9, 2024F677Provide care and assistance to perform activities of daily living for any resident who is unable.DComplaint
Apr 9, 2024F576Ensure residents have reasonable access to and privacy in their use of communication methods.DComplaint
Apr 9, 2024F558Reasonably accommodate the needs and preferences of each resident.DComplaint
Mar 6, 2024F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DComplaint
Mar 6, 2024F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Feb 27, 2024F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DComplaint
Nov 29, 2023F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Jun 13, 2023F578Honor 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.DComplaint
Jun 7, 2023F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DComplaint
Jun 7, 2023F610Respond appropriately to all alleged violations.DComplaint
Jun 7, 2023F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DComplaint
Jun 2, 2023F745Provide medically-related social services to help each resident achieve the highest possible quality of life.DComplaint
Jun 2, 2023F698Provide safe, appropriate dialysis care/services for a resident who requires such services.DComplaint
Mar 24, 2022F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.BStandard
Mar 24, 2022F911Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.BStandard
Mar 24, 2022F881Implement a program that monitors antibiotic use.DStandard
Mar 24, 2022F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.DStandard
Mar 24, 2022F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.DStandard
Mar 24, 2022F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.EStandard
Mar 24, 2022F759Ensure medication error rates are not 5 percent or greater.DStandard
Mar 24, 2022F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.DStandard
Mar 24, 2022F698Provide safe, appropriate dialysis care/services for a resident who requires such services.DStandard
Mar 24, 2022F695Provide safe and appropriate respiratory care for a resident when needed.DStandard
Mar 24, 2022F693Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.DStandard
Mar 24, 2022F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.DStandard
Mar 24, 2022F658Ensure services provided by the nursing facility meet professional standards of quality.DStandard
Mar 24, 2022F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DStandard
Mar 24, 2022F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DStandard
Mar 24, 2022F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedDStandard
Mar 24, 2022F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.DStandard
Mar 24, 2022F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.DStandard
Mar 24, 2022F557Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.DStandard

Federal enforcement history

Federal regulators have imposed 2 enforcement actions against this facility, including 1 civil money penalties totaling $32,139 and 1 payment-denial actions spanning 6 days.

DateTypeFinePayment denial
Feb 20, 2025Fine$32,139—
May 10, 2024Payment Denial—Jun 8, 2024 · 6 days
About this record A citation is a finding by a state survey team working under federal contract. It is not a court judgment. The description above is drawn verbatim from federal public datasets. Facilities have the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.

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