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 City Scape Rehabilitation & Care Center Llc during CMS and state inspections, most recent first.
Multiple residents experienced physical abuse from other residents, including incidents resulting in injuries such as lacerations and scratches. In each case, staff failed to adequately supervise, document, or update care plans to address behavioral risks, and some staff lacked training on required supervision protocols. Care plans were not reviewed or revised after incidents, and documentation of the events was incomplete for several residents.
A resident with dementia and a high fall risk was not consistently supervised or provided with required non-skid footwear, as outlined in her care plan. The resident sustained a traumatic brain injury after an unwitnessed fall, and observations revealed lapses in staff supervision, including periods when no staff were present in the secured unit and staff not actively monitoring residents. Staff interviews confirmed gaps in awareness and training regarding fall prevention interventions.
A resident with Parkinson's disease and mobility issues experienced multiple falls, and the facility failed to implement fall prevention interventions in a timely manner after each incident. Despite the facility's policy requiring prompt action, interventions such as reminders to lock wheelchair brakes, ensuring items were within reach, and physical therapy evaluations were delayed by several days to over a month, leaving the resident at continued risk.
A resident with multiple diagnoses was involuntarily discharged to a homeless shelter without proper notice or preparation, contrary to the facility's policies. The resident, who had been planning to move to an ALF, was discharged without a 30-day notice, written discharge notice, or notification to the ombudsman. The facility failed to provide discharge instructions or medications, leading to psychosocial harm and subsequent hospitalizations. Staff interviews revealed a lack of clarity and consistency in the discharge process.
A resident with a history of aggressive behavior was not adequately monitored or provided with person-centered interventions, leading to two incidents of biting other residents. Despite initiating behavior monitoring, the facility failed to document consistently or implement effective interventions, resulting in physical abuse of two residents. Staff interviews revealed a lack of clear guidance on monitoring and interventions, contributing to the repeated incidents.
The facility did not complete annual performance reviews or provide in-service education for two CNAs, as required by policy. The DON, new to the facility, acknowledged the oversight and planned to audit the situation.
The facility failed to maintain sanitary conditions in food preparation and storage. A cook handled ready-to-eat foods with the same gloves after touching packaging, and a dietary aide's attire contaminated serving plates. Additionally, food items were not stored at safe temperatures, with vegetarian chorizo crumbles improperly refrigerated and MedPass Shakes exceeding safe temperature limits. Interviews revealed non-compliance with food safety protocols.
The facility failed to maintain proper infection control practices, as observed in the cleaning of residents' rooms and during mealtime. A maintenance assistant did not follow cleaning protocols, such as ensuring surfaces remained wet for the required disinfection time and changing gloves after cleaning dirty areas. Additionally, residents were not offered hand hygiene before meals, and staff did not use hand sanitizers when serving food, despite available dispensers. Interviews confirmed these practices did not align with facility policies.
The facility's pest control program was ineffective, leading to the presence of cockroaches, flies, gnats, and mice. Observations showed pests in various areas, and residents reported seeing mice and insects. Despite some pest control measures and a quality improvement plan, the issue persisted, with visible entry points for pests remaining unaddressed.
The facility failed to ensure CNAs received required annual training in dementia management and abuse prevention. A review of training records showed that two CNAs lacked documented training hours for the previous year, and a newly hired CNA did not receive necessary training upon hire. The DON, who was new to the facility, acknowledged the absence of a tracking system and planned to implement one.
A facility failed to provide a resident and the ombudsman with a written discharge notice, including the reason for discharge and appeal rights, as required by policy. The resident, who was cognitively intact and independent in ADLs, was discharged to a homeless shelter against his wishes without proper documentation or notification. Staff interviews confirmed the lack of a written notice and documentation of the discharge reason.
A resident with dementia and schizophrenia exhibited multiple exit-seeking behaviors, including leaving the facility and being reported missing. Despite these incidents, the facility delayed implementing a care plan to address the resident's elopement risk until after a significant elopement event. Staff interviews confirmed the delay in care planning, contributing to the deficiency identified by surveyors.
The facility reported a medication error rate of 7.14%, exceeding the acceptable threshold. Two residents did not receive their prescribed medications due to unavailability and untimely reordering. An LPN failed to administer Empagliflozin for diabetes, while another LPN did not provide Sinemet for Parkinson's disease. The DON noted issues with medication reordering and documentation.
A resident with multiple health issues, including cognitive impairment, had a pressure injury on the left heel inaccurately documented as being on the right heel in medical records. Despite observations and a wound physician's note confirming the correct location, physician orders and wound assessments repeatedly misidentified the wound's location, leading to a failure in maintaining accurate medical records.
A facility failed to maintain proper communication records with hospice providers for a resident receiving hospice services. Despite being under hospice care, there were no communication notes from hospice providers in the resident's hospice binder or electronic medical record for several months. Interviews with the DON and ADON revealed that the expected documentation process was not followed, indicating a failure to meet professional standards.
The facility did not ensure that residents received notices of their legal rights, as state contact information was not posted in an accessible area. Residents were unaware of how to file a complaint with the State Agency. Observations confirmed the absence of required postings, and staff interviews revealed difficulty in locating the necessary contact information.
Failure to Protect Residents from Physical Abuse and Inadequate Behavioral Care Planning
Penalty
Summary
The facility failed to protect multiple residents from physical abuse, as evidenced by several incidents involving resident-to-resident altercations. In one case, a resident with schizophrenia and a history of behavioral outbursts struck his roommate on the head with a belt buckle, causing a laceration that required emergency room treatment and sutures. The assailant was on one-to-one supervision for elopement risk, but the assigned caregiver was not able to visualize the resident at the time of the incident, as the room door was closed. The caregiver reported not receiving training on one-to-one supervision protocols, and there was no documentation that care plans were reviewed or updated with new interventions following the incident. Another incident involved a resident in the memory care unit who aggressively grabbed and kicked another resident, resulting in both residents sustaining scratches and abrasions. Staff separated the residents and assessed their injuries, but the investigation concluded that physical abuse had occurred, even though neither resident could recall the event. The care plan for the assailant included interventions for behavioral problems, but there was no documentation of a care plan focus for behaviors for the victim, nor was there documentation in the victim's medical record regarding the incident. A third incident involved two residents in the memory care unit who engaged in a physical altercation, resulting in scratches and a skin tear. Staff were unable to determine what precipitated the altercation, and there was no documentation in the medical record for one of the residents regarding the incident. Additionally, the care plan for one of the residents did not include a focus on behaviors, despite the occurrence of the altercation. Across these incidents, the facility failed to ensure that care plans were reviewed and updated for effectiveness, and staff lacked adequate training and documentation to prevent and respond to resident-to-resident abuse.
Failure to Implement and Monitor Fall Prevention Interventions
Penalty
Summary
The facility failed to ensure adequate supervision and implementation of person-centered fall interventions for a resident with dementia and a high risk for falls. The resident, who had severe cognitive impairment, muscle weakness, abnormal mobility, confusion, and a history of falls, was admitted for long-term care and required maximal assistance with toileting and moderate assistance with transfers. Despite being identified as a high fall risk, the resident was observed multiple times without appropriate supervision and was not consistently provided with required non-skid footwear as outlined in her care plan. On one occasion, the resident was found on the floor in her room with a head injury, having sustained a traumatic brain injury and subdural hematomas after an unwitnessed fall. The facility's investigation revealed that the last staff check on the resident was nearly an hour before the fall, and the resident was attempting to go to the bathroom unassisted. Observations during the survey also showed periods when no staff were present in the secured unit, and staff left the unit unattended, leaving the resident and others unsupervised. Additionally, staff were seen not actively monitoring the resident, with some engaged in personal activities such as using cell phones. The care plan for the resident included interventions such as providing hands-on assistance for standing and sitting, ensuring the use of non-skid footwear, and anticipating and meeting the resident's needs. However, these interventions were not consistently implemented, as evidenced by the resident ambulating alone in the hallway, wearing inappropriate footwear, and being left unsupervised. Staff interviews confirmed a lack of awareness and training regarding additional fall prevention interventions, and the facility's own policy required systematic monitoring and modification of interventions, which was not followed.
Delayed Implementation of Fall Interventions Following Multiple Resident Falls
Penalty
Summary
The facility failed to ensure timely implementation of person-centered fall interventions for a resident identified as high risk for falls. Despite having a policy that required the interdisciplinary team to review falls and implement interventions promptly, there were repeated delays in putting fall prevention measures in place after each incident. The resident, who had Parkinson's disease, gait and balance issues, and required assistance with transfers, experienced multiple unwitnessed and witnessed falls over several months. In each case, specific interventions such as reminders to lock wheelchair brakes, ensuring frequently used items were within reach, and physical therapy evaluations were not implemented until several days to over a month after the falls occurred. The resident reported frequent falls due to long wait times for staff assistance and a lack of fall interventions. Record review confirmed that interventions were consistently delayed, with some not implemented until after subsequent falls had already occurred. Staff interviews corroborated that interventions should have been implemented more promptly to prevent further incidents, but this did not happen, resulting in the resident remaining at risk for additional falls during the periods of delay.
Inappropriate Facility-Initiated Discharge Without Proper Notice
Penalty
Summary
The facility failed to follow appropriate procedures for a facility-initiated discharge for a resident diagnosed with rheumatoid arthritis, anxiety disorder, depression, ADHD, and chronic pain. The resident was admitted to the facility and later involuntarily discharged to a homeless shelter without proper preparation or a valid reason. The facility did not provide a 30-day discharge notice, written discharge notice, or notify the ombudsman, as required by their policy. Additionally, the resident did not receive discharge instructions or medications, leading to psychosocial harm and subsequent hospitalizations. The resident had been involved in discharge planning with the facility, expressing a desire to move to an assisted living facility (ALF). However, the facility suddenly discharged the resident to a homeless shelter against his wishes, without updating the care plan or providing necessary documentation. Interviews with the resident and his representative revealed that the discharge was perceived as retaliatory, following a complaint about the facility's conditions. The resident experienced confusion, anxiety, and a lack of support during the discharge process. Staff interviews indicated a lack of clarity and consistency in the discharge process. The nursing home administrator and regional operations consultant were unable to provide a clear reason for the facility-initiated discharge or why the required 30-day notice was not issued. The director of nursing confirmed that there was no documentation of medication education or provision prior to the resident's discharge. The facility's failure to adhere to its own policies and procedures resulted in significant distress and harm to the resident.
Failure to Prevent Resident-to-Resident Abuse
Penalty
Summary
The facility failed to protect two residents from physical abuse by another resident with a known history of aggressive behavior. Resident #38, who had dementia with behavioral disturbances, exhibited physically aggressive behaviors, including biting and scratching, during activities of daily living and care refusals. Despite initiating behavior monitoring on 3/22/24, the staff did not consistently document these behaviors, nor did they identify specific person-centered interventions to address them. This lack of intervention led to Resident #38 biting her roommate, Resident #155, on 4/9/24, causing a wound that required medical treatment. Following the incident on 4/9/24, the facility did not implement effective interventions to prevent further aggressive behavior from Resident #38. The facility's internal investigation failed to substantiate or unsubstantiate the allegation of physical abuse. The care plan for Resident #38 did not include effective personalized communication or behavioral interventions to prevent triggers for aggressive behavior. As a result, Resident #38 bit another resident, Resident #25, on 7/8/24, although this incident did not result in injury. Interviews with staff revealed a lack of consistent monitoring and documentation of Resident #38's behavior. Staff were aware of Resident #38's history of aggression but did not have clear guidance on interventions or monitoring frequency. The facility's Director of Nursing (DON) and Nursing Home Administrator (NHA) acknowledged the need for personalized interventions and care plan updates, but these were not implemented in a timely manner, contributing to the repeated incidents of resident-to-resident abuse.
Failure to Conduct Annual Performance Reviews for CNAs
Penalty
Summary
The facility failed to conduct annual performance reviews and provide regular in-service education for two certified nurse aides (CNAs), as required by their policy. The policy, dated August 2022, mandates that performance reviews be completed every 12 months, with in-service training based on these reviews. However, the facility was unable to provide the necessary performance evaluations for the years 2023/2024 for CNA #1, hired in 2008, and CNA #3, hired in 2021. Consequently, these CNAs did not receive an in-service education plan tailored to their performance review outcomes. During an interview, the Director of Nursing (DON) acknowledged the need for these evaluations and expressed uncertainty about why they had not been completed, citing her newness to the facility. The DON indicated an intention to audit the situation to identify which employees required performance reviews.
Food Safety and Sanitation Deficiencies
Penalty
Summary
The facility failed to ensure that food was prepared, distributed, and served under sanitary conditions in the kitchen. During an observation of the lunch meal service, a cook was seen handling ready-to-eat foods with gloves that were not changed after touching the outside of packaging, which is against the facility's policy and professional standards. The cook used the same pair of gloves to handle various food items, including lettuce and cucumbers, without changing them between tasks. Additionally, a dietary aide's name tag and apron strings were observed dragging across the surface of plates used to serve food to residents. The facility also failed to maintain safe holding temperatures for food items. During a kitchen tour, an opened bag of vegetarian chorizo crumbles was found in the refrigerator, despite instructions to keep the product frozen. Furthermore, cartons of MedPass Shake were found on a nurse's medication cart in a plastic bin with insufficient ice, resulting in temperatures above the safe parameter for cold foods. One carton was measured at 58 degrees Fahrenheit, exceeding the recommended temperature range for safe storage. Interviews with the dietary manager revealed a lack of adherence to proper food handling and storage protocols. The dietary manager acknowledged that ready-to-eat foods should be handled with gloves and that gloves should be changed between tasks. The manager also admitted that the chorizo crumbles should have been kept frozen and that the MedPass Shakes were not maintained at the correct temperature on the nurses' carts. These deficiencies indicate a failure to follow established food safety practices, potentially compromising the safety and quality of food served to residents.
Inadequate Infection Control Practices in Facility
Penalty
Summary
The facility failed to maintain an effective infection control program, as evidenced by improper cleaning practices in residents' rooms and inadequate hand hygiene during mealtime. Observations revealed that a maintenance assistant (MA) did not follow proper cleaning protocols, such as ensuring surfaces remained wet for the required disinfection time and changing gloves or performing hand hygiene after cleaning dirty areas. The MA also placed the disinfectant bottle on the floor, which compromised its sanitation, and cleaned the bathroom before the resident's room, contrary to recommended practices. Additionally, during mealtime observations, neither ambulatory nor wheelchair-bound residents were offered or assisted with hand hygiene before meals. Staff members were seen serving food without using hand sanitizers, despite the availability of dispensers near the kitchen doors. This lack of hand hygiene was noted on multiple occasions, indicating a systemic issue in the facility's infection control practices. Interviews with staff, including the Director of Nursing (DON) and the regional maintenance supervisor, confirmed that the observed practices did not align with the facility's policies or professional guidelines. The DON acknowledged that residents should be encouraged to wash their hands before meals and that staff should perform hand hygiene when serving food. The regional maintenance supervisor also emphasized the importance of cleaning from clean to dirty areas and changing mop heads after cleaning bathrooms.
Ineffective Pest Control Program in LTC Facility
Penalty
Summary
The facility failed to maintain an effective pest control program, resulting in the presence of pests such as cockroaches, flies, gnats, and mice within the premises. Observations during the survey revealed several instances of pests, including house flies and gnats in the main hallway and memory care unit, and cockroaches under a resident snack refrigerator. Additionally, gaps in doors were noted, allowing daylight and potentially pests to enter the facility. Interviews with residents indicated that they had observed pests, including mice and a squirrel, within the facility, which caused them distress. Some residents reported being bitten by insects. Staff interviews revealed that the facility had been experiencing an increase in pest activity, and while some measures were taken, such as deep cleaning and pest control treatments, these efforts were insufficient to address the issue comprehensively. The facility's pest control records showed treatments for German cockroaches and house mice but did not document any measures for house flies or gnats. The quality improvement plan implemented by the facility failed to address the visible entry points for pests, and despite efforts to educate staff and residents on cleaning and food storage, the pest problem persisted. The facility was considering switching pest control companies to better manage the situation.
Deficiency in CNA Training for Dementia and Abuse Prevention
Penalty
Summary
The facility failed to ensure that certified nurse aides (CNAs) received the required annual training in dementia management and abuse prevention. This deficiency was identified through a review of training records and staff interviews. Specifically, the facility did not have a system in place to track the CNAs' training to ensure compliance with the annual 12-hour training requirement. The training records for three CNAs were reviewed, revealing that CNA #1 and CNA #3 did not have documented training hours for the previous calendar year. Additionally, CNA #2, who was recently hired, did not receive the necessary abuse and dementia training upon hire. Interviews with the Director of Nursing (DON) revealed that the facility lacked a staff development coordinator, and the DON, along with the Assistant Director of Nursing (ADON), had been managing these responsibilities. Both the DON and ADON were new to the facility, with the DON starting in May 2024. The DON acknowledged the absence of a record-keeping system for tracking training hours and expressed plans to implement a spreadsheet to monitor staff training. The DON also mentioned the intention to conduct a skills fair to address the training needs and planned to audit the staff to identify those requiring training.
Failure to Provide Written Discharge Notice
Penalty
Summary
The facility failed to provide a written discharge notice to a resident and the ombudsman, which is a requirement for facility-initiated discharges. The resident, who was under 65 years old and had diagnoses including rheumatoid arthritis, anxiety disorder, depression, ADHD, and chronic pain, was discharged to a homeless shelter against his wishes. The facility did not provide the resident with a written notice that included the reason for discharge, the effective date, the location to which the resident was discharged, or the resident's appeal rights. The facility's policy requires a 30-day advance written notice for facility-initiated discharges, including specific information about the discharge and the resident's rights to appeal. However, the facility did not adhere to this policy for the resident in question. The resident was cognitively intact and independent in activities of daily living, and there was no documentation of behavioral issues or rejection of care. Despite active discharge planning for the resident to move to an assisted living facility, the facility suddenly discharged him to a homeless shelter. Interviews with facility staff, including the social services director, nursing home administrator, and regional operations consultant, confirmed that no written discharge notice was issued to the resident or the ombudsman. The facility also failed to document the reason for the discharge or provide a discharge summary or assessment. The resident was escorted from the facility by law enforcement, and the ombudsman was only contacted after the discharge had occurred.
Failure to Timely Implement Care Plan for Exit-Seeking Resident
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident with exit-seeking behaviors, which was necessary to ensure the resident's safety and well-being. The resident, who was under 65 years old and diagnosed with dementia and schizophrenia, exhibited multiple instances of attempting to leave the facility. Despite these behaviors being documented in progress notes, the facility did not implement a care plan until after a significant elopement incident occurred. The resident's exit-seeking behaviors were noted in several progress notes, starting with an incident on 5/19/24 where the resident was found with stolen items. Subsequent notes detailed the resident's desire to leave the facility, including an incident on 6/15/24 where the resident shoved a staff member and left the facility, requiring paramedics to intervene. Despite these repeated attempts and the resident's high risk for elopement, the care plan addressing these behaviors was not initiated until 6/28/24, after the resident had already eloped and was reported missing. Interviews with facility staff, including the SSD and DON, revealed that the resident's exit-seeking behaviors were recognized early on, yet the care plan was delayed. The SSD noted that the resident's behaviors began to escalate around the second or third week of admission, and the DON confirmed that the care plan for elopement behaviors was not initiated until after the resident's last elopement incident. This delay in care planning contributed to the deficiency identified by the surveyors.
Medication Error Rate Exceeds Acceptable Threshold
Penalty
Summary
The facility failed to maintain a medication error rate below five percent, with a reported rate of 7.14%, resulting from two errors out of 28 opportunities. The first error involved a resident who did not receive their prescribed Empagliflozin for diabetes management because the medication was not available. The LPN responsible for administering the medication was aware that the medication had been ordered but not received, and acknowledged the need to notify the provider and document the unavailability in the medication administration record (MAR) and progress notes. The second error involved another resident who did not receive their prescribed Sinemet for Parkinson's disease due to the medication not being reordered in a timely manner. The LPN administering the medication confirmed that the order had been placed two days prior, but the medication was still unavailable. The DON explained that the medication was not reordered because the nursing staff failed to remove the old medication card from the cart. The facility's policy required medications to be reordered eight days before running out, but this was not adhered to, leading to the medication error.
Inaccurate Documentation of Pressure Injury Location
Penalty
Summary
The facility failed to maintain accurate medical records for a resident, specifically regarding a pressure injury on the resident's left heel. The resident, aged 66, was admitted with multiple diagnoses including traumatic brain injury and type 2 diabetes, and was significantly cognitively impaired, requiring full assistance for care and mobility. Observations revealed a pressure injury on the left heel, but the medical records inaccurately documented the wound as being on the right heel multiple times. The physician's orders and wound assessments consistently misidentified the location of the wound, leading to incorrect documentation in the resident's medical records. Despite the wound being on the left heel, several entries in the computerized physician orders and weekly wound assessments incorrectly noted it as being on the right heel. This discrepancy was noted in observations and confirmed by a wound physician's note, which correctly identified the wound on the left heel. Interviews with the facility's director of nursing and assistant director of nursing, as well as the wound physician, highlighted the confusion regarding the wound's location. The assistant director of nursing confirmed the left heel wound was discovered during an assessment of the resident's buttock wounds. The wound physician also mistakenly described the wound as being on the right heel during an interview, despite having documented it correctly in a written note. This inconsistency in record-keeping reflects a failure to maintain medical records in accordance with accepted professional standards.
Failure to Maintain Hospice Communication Records
Penalty
Summary
The facility failed to maintain proper communication records with hospice providers for a resident receiving hospice services. The resident, who was over 65 years old and had severe cognitive impairment, was admitted to hospice care due to senile degeneration of the brain. Despite being under hospice care, there were no communication notes from hospice providers in the resident's hospice binder between April 22 and July 15, nor was there any documentation in the resident's electronic medical record (EMR) regarding the care provided by hospice staff. Interviews with the Director of Nursing (DON) and Assistant Director of Nursing (ADON) revealed that the facility's process involved hospice providers documenting their services in a binder at the nurses' station, which should also be reflected in the resident's EMR. However, the DON noted that the documentation in the hospice binder was not as expected, with the most recent entry dated April 22. The ADON found an updated hospice care plan dated May 10, but it did not detail the care provided at each visit. This lack of documentation indicates a failure to ensure that hospice services met professional standards and principles.
Failure to Post State Contact Information for Residents
Penalty
Summary
The facility failed to ensure that residents received notices of their legal rights both orally and in writing, specifically by not posting the state contact information in a readable font size and in an accessible area for residents. During a resident council interview, seven alert and oriented residents reported that they did not know how to file a complaint with the State Agency. Observations on two separate occasions did not reveal the required postings throughout the facility. Interviews with the social services director and nursing home administrator revealed that they were initially unable to locate the contact information for the State Agency and advocacy groups. Although a poster with corporate contact information was found in the common area, the required State Agency posting was only found in the administration office, making it inaccessible to residents.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 508 citations issued within 25 miles in the last 12 months — including the 7 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Denver
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| City Park Healthcare And Rehabilitation Center | 1.8 mi | ★★★★★ | 9 | 0 |
| Briarwood Health Care Center | 2.4 mi | ★★★★★ | 0 | 0 |
| Denver North Care Center | 2.4 mi | ★★★★★ | 17 | 0 |
| Health Center At Franklin Park | 2.7 mi | ★★★★★ | 14 | 0 |
| Uptown Care Center | 3 mi | ★★★★★ | 11 | 0 |
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