Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Rim Country Health & Retirement Community during CMS and state inspections, most recent first.
Failure to Update Fall Care Plan After Repeated Falls: A resident with multiple chronic conditions and documented fall risk had repeated floor incidents, including being found near the bed and later on the floor again, yet the care plan was not revised after the falls. Records showed moderate fall risk, antihypertensive use, occasional incontinence, gait issues, and no new interventions added after the events, despite staff stating that fall-related care plans are expected to be updated with new interventions.
Two residents with cognitive and behavioral health issues were involved in a physical altercation in the dining room when one became agitated and physically confronted the other, resulting in a nosebleed. The incident occurred without staff present in the dining area, as staff were occupied elsewhere, allowing the altercation to escalate before intervention. The facility's failure to provide adequate supervision and prevent abuse was substantiated by staff interviews and clinical records.
Staff did not promptly inform a resident, the resident's doctor, and a family member about situations such as injury, decline, or room changes that affected the resident, as required by regulation.
The facility did not adequately protect resident-identifiable information or maintain medical records according to professional standards, as observed by surveyors during their review of documentation and information handling practices.
A resident with severe cognitive impairment physically struck another resident multiple times in a common area, despite staff presence and the facility's zero-tolerance abuse policy. The incident was witnessed by a CNA, who intervened and separated the residents, and was subsequently reported by staff.
Two residents with cognitive and behavioral impairments engaged in a physical altercation after one demanded the other move from a chair. Despite existing care plans and behavior monitoring, staff were unable to prevent the incident, which occurred during a period of short staffing and resulted in injuries to both residents. CNAs intervened to separate the residents, and the event was documented by staff.
Two residents were involved in a physical altercation resulting in visible injuries, but the facility failed to document head-to-toe assessments or injuries in their medical records. Staff interviews confirmed that assessments were performed and injuries were observed, yet no documentation was found. The DON acknowledged the deficiency and confirmed the absence of a facility policy on clinical record documentation.
A resident was hospitalized after being found unresponsive with medications that were not securely stored. The resident's family had given a box of medications to a nurse, who reportedly placed them in the medication cart. However, the medications were later found with the resident, leading to hospitalization. Interviews with staff revealed a lack of adherence to medication security protocols, as the medications were not properly secured, resulting in the resident's hospitalization.
A resident with severe cognitive impairment was struck by another resident in the dining room after a wheelchair bump, despite staff presence. The incident, which occurred quickly, was not addressed in the facility's investigation regarding staff absence. The facility's zero-tolerance policy on abuse was not effectively enforced.
A resident with dementia and moderate cognitive impairment physically assaulted another resident, resulting in a deficiency for the facility. The aggressive resident's care plan was only revised to address potential physical behaviors after the incident. Despite no physical injuries being noted, the event highlights a failure in the facility's responsibility to protect residents from abuse.
A resident with a history of aggressive behaviors was involved in multiple incidents of physical aggression towards staff and other residents. Despite these incidents, the resident's care plan was not updated to reflect their potential for physical behaviors until after the second incident. The facility's Director of Nursing acknowledged the oversight, and the MDS coordinator confirmed the care plan was not updated after the initial altercation, contrary to facility policy.
A resident with dementia and another with schizoaffective disorders were involved in a physical altercation, resulting in injuries. The facility failed to update care plans to address aggressive behaviors, despite a history of incidents. Staff intervened verbally but did not prevent the altercation.
A resident with severe cognitive impairment was physically abused by her roommate, who has mild cognitive impairment and a history of aggressive behavior. The incident occurred when the aggressor became upset after soiling herself and struck the other resident, resulting in a hematoma. The facility's investigation confirmed the altercation, and the Director of Nursing noted the actions were not malicious but a reaction to distress.
A resident with a history of heart and respiratory issues was involved in an altercation with an RN over medication administration, resulting in the resident sustaining a skin tear. The incident was reported to the ADON, and a CNA observed the resident's injuries. The facility's policy defines such actions as physical abuse.
Failure to Update Fall Care Plan After Repeated Falls
Penalty
Summary
The facility failed to update and revise the care plan after falls for one resident. The resident had multiple diagnoses including type 2 diabetes mellitus with hyperglycemia, anemia in chronic kidney disease, chronic kidney disease stage 3, osteoporosis, alcoholic cirrhosis of the liver, hypertension, major depressive disorder, gastro-esophageal reflux disease, and a wedge compression fracture of T11-T12. An admission MDS documented a BIMS score of 13 and no falls, and an admission fall risk assessment showed a low fall risk score of 2 with no fall history in the prior six months. The resident later had a fall-related event on December 3, 2025, when therapy alerted nursing that the resident was on the floor. The resident was found kneeling and leaning against the bed, stated she was trying to ambulate to the bathroom and slipped, and denied that she fell. She was assessed, no injuries were noted, she was assisted back to bed, vital signs were within normal limits, and the family, MD, and DON were notified. A fall risk assessment completed that day showed a score of 7, indicating moderate fall risk, with the reason for assessment being a recent fall. The assessment documented a history of falls 1-2 times, antihypertensive use, occasional incontinence, and no gait analysis. A care plan initiated on December 4, 2025, identified the resident as at risk for falls related to deconditioning and unawareness of safety needs, but the record showed no evidence that the care plan was updated or revised after the December 5, 2025 fall. On that date, the resident was found lying supine on the floor near the side of the bed, stated she was getting up to leave, and again had no injuries. The resident’s vitals were within normal limits, she was assisted back to bed, and neuro checks were completed without concerns. The record also showed no evidence of care plan update, revision, or new interventions after this fall. A subsequent fall on December 6, 2025 resulted in the resident being found on the floor with slurred and broken speech, sluggish pupils, low blood pressure, low heart rate, and low oxygen saturation, and she was sent to the hospital. The facility’s policy stated that safety interventions would be included in the resident’s care plan and discussed at care plan meetings.
Failure to Prevent Resident-to-Resident Abuse Due to Lack of Supervision
Penalty
Summary
A deficiency occurred when the facility failed to protect a resident from abuse by another resident. The incident involved two residents with significant cognitive and behavioral health issues. One resident, who had a history of agitation and impulse control problems, became agitated in the dining room and physically confronted another resident who was exhibiting disruptive behaviors. The aggressor stood up from her wheelchair, placed her hands on the other resident's shoulders and neck, and during the altercation, her arm made contact with the other resident's nose, resulting in a nosebleed. Staff interviews and clinical record reviews revealed that there was no staff present in the dining room at the time of the incident, allowing the altercation to occur without immediate intervention. The incident was witnessed by a CNA through a window, who then called for assistance and separated the residents. The lack of supervision in the dining area was identified as a contributing factor, as staff were occupied with other duties such as medication administration, admissions, and communicating with family members. The facility's policies required prompt reporting and intervention in cases of abuse, but the absence of staff in the dining room allowed the situation to escalate. Both residents involved had complex medical and psychiatric histories, including cognitive impairment, behavioral symptoms, and a tendency toward agitation. The facility's failure to ensure adequate supervision and prevent resident-to-resident abuse resulted in physical harm to one resident. The incident was substantiated by staff interviews, clinical documentation, and policy review, confirming that the facility did not uphold its obligation to protect residents from abuse as outlined in its own policies.
Failure to Immediately Notify Resident, Physician, and Family of Significant Events
Penalty
Summary
Facility staff failed to immediately notify the resident, the resident's physician, and a family member about situations that affected the resident, such as injury, decline, or changes in room assignment. This lack of timely communication was observed and documented by surveyors during the review of facility practices and records. The deficiency centers on the facility's failure to ensure that all required parties were promptly informed when significant events impacting the resident occurred, as required by regulation.
Failure to Safeguard Resident Information and Maintain Medical Records
Penalty
Summary
The facility failed to safeguard resident-identifiable information and/or did not maintain medical records for each resident in accordance with accepted professional standards. This deficiency was identified through surveyor observation and review of facility practices related to the handling and documentation of resident medical records. The report notes that the required standards for protecting confidential information and maintaining accurate, complete records were not met.
Failure to Prevent Resident-to-Resident Physical Abuse
Penalty
Summary
The facility failed to protect a resident from abuse by another resident, as evidenced by an incident in which one resident with severe cognitive impairment struck another resident multiple times. Both residents had significant cognitive deficits, with one diagnosed with dementia and anxiety disorder, and the other with Alzheimer's disease and chronic kidney disease. The incident occurred in a common area near the nursing station, where a certified nursing assistant observed one resident hitting another on the arms and using profane language. The staff member intervened and separated the residents after witnessing the altercation. Interviews with staff confirmed that the event was observed and reported according to facility protocol, but the incident still occurred despite the facility's zero-tolerance policy for abuse. The facility's policy defines physical abuse as hitting, slapping, pinching, or kicking, and the event was documented in the resident's electronic health record. The deficiency centers on the facility's failure to prevent this episode of resident-to-resident abuse, which was directly observed by staff.
Failure to Prevent Resident-to-Resident Physical Abuse
Penalty
Summary
The facility failed to protect two residents from physical abuse during a resident-to-resident altercation. One resident, who had a history of anxiety disorder, moderate cognitive impairment, and behavioral issues such as striking out at others, was involved in multiple incidents of aggressive behavior prior to the altercation. Care plans for this resident included interventions to monitor and document behaviors, analyze triggers, and attempt de-escalation, but these interventions did not prevent the incident. The other resident involved had recently been readmitted with altered mental status and other medical conditions, and had not yet received a BIMS assessment. This resident was noted to be exit-seeking, agitated, and resisting care, with a care plan focused on behavior management and safety. On the day of the incident, both residents were in front of the nurse's station when one resident demanded the other move so he could sit in an empty chair. When the request was not met, the resident struck out and fell, leading to a physical altercation where both residents exchanged blows and kicks. Certified nursing assistants (CNAs) witnessed the event and intervened to separate the residents. The incident resulted in visible injuries, including bruising and skin tears, and was documented by staff through behavior and incident notes, as well as witness statements. Interviews with staff revealed that the facility was short-staffed at the time of the incident, with fewer CNAs present than usual. Staff described the sequence of events and the actions taken to separate the residents and provide care for their injuries. The facility's policy on abuse and neglect emphasizes a zero-tolerance approach and outlines responsibilities for identifying at-risk residents and developing intervention strategies, but the policy was not effectively implemented to prevent this altercation.
Failure to Document Post-Incident Assessments Following Resident Altercation
Penalty
Summary
The facility failed to ensure that complete and accurate medical records were maintained for two residents following an incident of abuse. Both residents were involved in a physical altercation witnessed by CNAs, during which one resident attempted to sit in an empty chair, leading to a confrontation that escalated to physical contact, including punching, kicking, and grabbing. The incident was documented in incident notes and witness statements, but there was no evidence in the clinical records of a head-to-toe assessment or documentation of any injuries sustained by either resident after the altercation. One resident had a history of anxiety disorder, insomnia, hemiplegia, dysphagia, and other conditions, and was noted to have moderate cognitive impairment. The other resident had diagnoses including altered mental status, cognitive communication deficit, atrial fibrillation, chronic kidney disease, and rhabdomyolysis. Despite the altercation resulting in visible injuries such as bruising, scabs, and skin tears, the clinical records for both residents lacked documentation of assessments or injuries following the incident. Interviews with staff, including an LPN and the DON, confirmed that assessments were performed and injuries were observed, but these were not documented in the residents' medical records. The DON acknowledged that the lack of documentation did not meet expectations for adequate medical record-keeping. Additionally, the facility did not have a policy on documentation in the clinical record, as confirmed by the DON.
Medication Security Lapse Leads to Resident Hospitalization
Penalty
Summary
The facility failed to ensure medications were securely stored, leading to a serious incident involving a resident. The resident, who had been admitted with multiple diagnoses including essential hypertension and major depressive disorder, was found unresponsive with unknown medications. The nursing note indicated that the resident was sent to the emergency department for further evaluation. Interviews revealed that the resident's family had given a box of medications to a nurse, who reportedly placed them in the medication cart. However, the medications were later found with the resident, leading to hospitalization. Interviews with staff highlighted a lack of clarity and adherence to medication security protocols. An LPN reported that upon starting his shift, he was informed about missing medications that belonged to the resident. Shortly after, the resident was found unresponsive with a blue box containing medication bottles, including an opened clonazepam bottle. Additional empty medication bottles were discovered on the resident's bed. The LPN secured the box in the medication room, but its whereabouts were unknown afterward. The CNA corroborated the LPN's account, noting the resident's low blood pressure and the presence of the medication box. The Director of Nursing (DON) confirmed that medications should be secured in the medication cart or room until reconciliation. However, the DON could not account for the medications after the LPN secured them. The facility's policy mandates that all medications be secured to ensure resident safety, but this protocol was not followed, resulting in the resident's hospitalization. The incident raised concerns about the facility's medication security practices and communication among staff.
Resident-to-Resident Altercation Due to Inadequate Supervision
Penalty
Summary
The facility failed to protect a resident from abuse by another resident, resulting in a physical altercation. Resident #32, who has severe cognitive impairment and a history of wandering, was struck by Resident #21 in the dining room. Resident #21, also severely cognitively impaired, has a history of verbally abusive behaviors and was noted to have slapped Resident #32 after being bumped by his wheelchair. The incident was witnessed by another resident and staff intervened to separate the individuals involved. The facility's investigation revealed that the altercation occurred in the secured behavioral unit's dining room, where Resident #32 was propelling his wheelchair and accidentally bumped into Resident #21, prompting her to slap him. Despite the presence of staff on the unit, the incident happened quickly, and no injuries were observed on Resident #32. The facility's policy on resident abuse and neglect, which has a zero-tolerance stance, was not effectively enforced in this situation. Interviews with staff and residents highlighted that while behavioral health training had been conducted, the absence of staff in the dining room at the time of the incident was not addressed in the facility's investigation. The Human Resource Director acknowledged the expectation for effective interventions to prevent resident-to-resident altercations and the importance of staff presence during meal times to prevent such incidents.
Failure to Protect Resident from Abuse by Another Resident
Penalty
Summary
The facility failed to protect a resident from abuse by another resident, resulting in a deficiency. Resident #1, who was admitted with diagnoses including dementia and moderate cognitive impairment, exhibited physical aggression towards Resident #2. The care plan for Resident #1 was revised to include potential for physical behaviors only after the incident occurred, indicating a lack of prior preventive measures. On the day of the incident, Resident #1 punched Resident #2 twice in the head, an event witnessed by a CNA who intervened by separating the residents. Resident #2, who was admitted with diagnoses such as Major Depressive Disorder and cognitive impairment, was the victim of the physical aggression. Despite the altercation, a subsequent assessment revealed no physical injuries to Resident #2. Interviews with staff confirmed the sequence of events, with staff members responding to the incident by separating the residents and assessing them for injuries. Resident #2 was unable to recall the incident but expressed feeling safe at the facility. The Director of Nursing confirmed the incident and the facility's zero-tolerance policy for violence. The facility's policy on abuse and neglect defines abuse as the willful infliction of injury, which was not adequately prevented in this case. The deficiency highlights a failure in the facility's responsibility to protect residents from abuse, as evidenced by the lack of prior interventions in Resident #1's care plan to address his potential for physical aggression.
Failure to Update Care Plan for Resident with Aggressive Behaviors
Penalty
Summary
The facility failed to update the care plan of a resident who had a history of physical behaviors, which was not reflected in the care plan until after multiple incidents occurred. The resident, who was admitted with diagnoses including acquired absence of left leg below the knee, dementia, and aphasia, exhibited aggressive behaviors towards staff and other residents. Notably, the resident punched a CNA, resulting in a large bruise, and later punched another resident in the head. Despite these incidents, the care plan was not updated to address the resident's potential for physical behaviors until after the second incident. Interviews with facility staff revealed that the Director of Nursing acknowledged the oversight and took responsibility for the care plan not being updated after the initial altercation. The MDS coordinator, responsible for updating care plans, confirmed that she did not update the care plan after the resident-to-staff altercation, although she did so after the resident-to-resident incident. The facility's policy requires care plans to be updated as needed, but this was not adhered to, leading to a deficiency in ensuring the resident's care plan accurately reflected their needs and behaviors.
Failure to Prevent Resident-to-Resident Abuse
Penalty
Summary
The facility failed to protect a resident from physical abuse by another resident, resulting in an altercation that caused injury. Resident #9, who has mild cognitive impairment due to dementia and Alzheimer's disease, was involved in a physical altercation with Resident #23, who has moderate cognitive impairment and a history of schizoaffective disorders and lobotomy. The incident occurred in the dining room when Resident #23 grabbed Resident #9's arm, leading Resident #9 to retaliate by smacking Resident #23 in the face and pushing her, causing Resident #23 to fall and sustain injuries. Staff intervened verbally but did not prevent the physical altercation. The facility's documentation and care plans were found lacking, as there were no updated care plan measures addressing the aggressive behaviors of either resident involved in the incident. Interviews with staff revealed that Resident #23 had a history of violent actions and that both residents had been involved in previous resident-to-resident interactions. Despite the facility's policy of zero tolerance for abuse, the care plans for both residents were not updated following the incident, and there was no documentation in the progress notes for Resident #23 regarding the altercation.
Failure to Prevent Resident-to-Resident Abuse
Penalty
Summary
The facility failed to protect a resident from physical abuse by another resident. Resident #50, who was admitted with diagnoses including depression and severe cognitive impairment, was found with a hematoma on her forehead after an altercation with her roommate, resident #99. The incident occurred when resident #99, who has mild cognitive impairment and a history of aggressive behavior, became upset after soiling herself and struck resident #50. Resident #50 reported being hit by her roommate, although she could not specify whether it was with an open hand or a closed fist. Resident #99 admitted to hitting resident #50 but claimed not to remember the details of the incident. The facility's investigation confirmed that resident #99 struck resident #50 while angry. Interviews with the Director of Nursing revealed that resident #99's actions were not believed to be malicious, but rather a reaction to her own distress. The facility's policy on resident abuse and neglect emphasizes a zero-tolerance approach, yet the incident highlights a failure to prevent abuse between residents.
Resident Abuse by Staff Member
Penalty
Summary
The facility failed to protect a resident from abuse by a staff member, resulting in a physical altercation. The incident involved a resident who was cognitively intact and had a history of congestive heart failure, edema, paroxysmal atrial fibrillation, and chronic respiratory failure with hypercapnia. The resident expressed a preference to only take necessary medications, which led to a disagreement with a registered nurse (RN). During the altercation, the resident attempted to return a cup of medication to the RN, who then grabbed the resident's wrist, causing a skin tear. The incident was reported by the RN to the Assistant Director of Nursing (ADON), who initiated an investigation. A Certified Nurse Assistant (CNA) also witnessed the aftermath, noting the resident's claim of being attacked and observing fresh skin tears. The facility's policy on abuse defines such actions as physical abuse, which includes the willful infliction of injury. The report highlights the failure of the facility to ensure the resident was free from abuse, as required by their policy.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Payson
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Payson Care Center | 0.8 mi | ★★★★★ | 0 | 0 |
| Haven Of Camp Verde | 37.3 mi | ★★★★★ | 10 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.