Average — CMS composite of the measures below.
The next survey window likely opens around December 2026
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 Montezuma Health And Rehabilitation during CMS and state inspections, most recent first.
Improperly labeled and dated food items were found during a kitchen tour with the DM. Surveyors observed unlabeled turkey sausage patties and cinnamon roll dough in the freezer, unlabeled opened cod fillets and pimento cheese in the refrigerator, and two boxes of expired ketchup in the pantry. The DM confirmed the findings and stated she was responsible for ensuring food is labeled with open and expired dates.
A resident with COPD and acute and chronic respiratory failure with hypoxia had a physician order for oxygen at 3 LPM via NC, but observations showed the oxygen set at 2.5 LPM on multiple occasions. The resident stated she did not know what the oxygen should be set on, and the DON confirmed the setting was incorrect and should have been 3 LPM.
The facility failed to maintain a medication error rate below 5%, resulting in a 14.2% error rate. Errors involved two residents, including the administration of incorrect aspirin and failure to administer prescribed medications such as eye drops, divalproex, and senna. These errors were confirmed by CMAs during interviews.
Improper Food Labeling and Storage in Dietary Areas
Penalty
Summary
Food items were found improperly labeled, dated, and stored during a kitchen tour with the Dietary Manager, in violation of the facility policy titled Storage Areas. In the reach-in freezer, a box of turkey sausage patties and traditional cinnamon roll dough were not labeled or dated. In the walk-in refrigerator, a bag of opened pub-style battered cod fillets and a container of pimento cheese were not labeled or dated. The pantry also contained two boxes of expired ketchup. During the tour, the Dietary Manager confirmed all of the surveyor-identified concerns and stated that she was responsible for ensuring all food is labeled with open dates and expired dates.
Oxygen Setting Did Not Match Physician Order
Penalty
Summary
Provide safe and appropriate respiratory care for a resident when needed was deficient for one resident receiving oxygen therapy. R10 had diagnoses including chronic obstructive pulmonary disease and acute and chronic respiratory failure with hypoxia. The resident’s MDS showed a BIMS score of 15 and indicated little to no cognitive impairment, and the record included a physician’s order for oxygen at 3 liters per minute via nasal cannula with a start date of 03/21/2024. Observations on 1/16/2026 and 1/17/2026 showed R10’s oxygen set at 2.5 LPM instead of the ordered 3 LPM. During interview, R10 stated she was not sure what her oxygen should be set on and said she does not touch her oxygen control. The DON confirmed that R10’s oxygen was set at 2.5 LPM but should have been set at 3 LPM, and stated that all nurses should check oxygen settings throughout the day to make sure the settings are correct.
Medication Administration Errors Result in 14.2% Error Rate
Penalty
Summary
The facility failed to maintain a medication error rate below 5%, resulting in a 14.2% error rate during the survey. This was identified through observations, staff interviews, and record reviews. The errors involved two residents, R6 and R11. For R6, the errors included the administration of a chewable aspirin instead of the prescribed delayed-release aspirin, and the failure to administer both Artificial Tears eye drops and divalproex ER as ordered. These medications were crucial for managing R6's conditions, including aphasia following cerebral infarction and a mood disorder. For R11, the error involved the failure to administer the prescribed senna tablet for constipation, which was scheduled to be given every 12 hours. The Certified Medication Aide (CMA) responsible for R11 confirmed the omission during an interview. These errors indicate a significant deviation from the facility's policy on medication administration, which requires adherence to prescriber orders and verification of correct medication, dose, and directions prior to administration.
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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 Montezuma
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| 4angels Of Byromville Healthcare Center | 9.4 mi | ★★★★★ | 15 | 0 |
| Oaks Nursing Home, Inc, The | 10.5 mi | ★★★★★ | 0 | 0 |
| Miona Geriatric & Dementia Center | 10.8 mi | ★★★★★ | 8 | 0 |
| Fort Valley Crossing Of Journey Llc | 19.6 mi | ★★★★★ | 9 | 0 |
| Summerhill Elderliving Home & Care | 19.8 mi | ★★★★★ | 15 | 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.