Above average — CMS composite of the measures below.
A standard survey is most likely before 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 Mount Vernon Nursing And Rehabilitation during CMS and state inspections, most recent first.
The facility did not timely send required transfer/discharge notices to the State LTC Ombudsman for four residents moved from a secured memory care unit as it was converted to an unsecured LTC unit. Although the Social Services Director had informed the Ombudsman that residents were being reviewed for new placements and that involuntary discharge notices would be shared, the actual notices for these residents—issued prior to their discharges to other nursing facilities—were not emailed to the Ombudsman until well after all four had left the facility. This delay conflicted with the facility’s own policy requiring that transfer/discharge and appeal-rights notices be issued in advance and copies sent to the local and State Ombudsman, along with provision of the bed-hold policy to the resident and responsible party.
The facility failed to ensure a safe and sanitary environment, as observed during medication administration and resident care. Staff did not sanitize equipment or perform proper hand hygiene, and the infection prevention program inadequately tracked infections, missing several cases. Interviews confirmed non-compliance with facility policies.
A facility failed to create a comprehensive care plan for a resident on diuretics, missing critical monitoring for CHF and diuretic side effects. The resident, who was cognitively intact, experienced ongoing shortness of breath, dizziness, and nausea, which were not adequately addressed. The DON admitted that high-risk medication side effects were not included in care plans, relying on staff knowledge instead. The facility's policy required measurable goals and resident-specific interventions, which were not met.
The facility failed to properly store and label medications and biologicals in multiple medication and treatment carts. Observations revealed unlabeled CBD jars, loose pills, and food items in medication carts, as well as unlabeled creams and deodorants in treatment carts. Interviews with staff confirmed these practices were against protocol, and the DON acknowledged the issue with medications brought in by a resident's son.
Two residents in the facility were prescribed inappropriate antibiotics for UTIs. One resident received ceftriaxone based on symptoms without lab confirmation, while another was given ceftriaxone despite lab results showing resistance. The facility's Antibiotic Stewardship Program was not effectively implemented.
The facility failed to accurately post the actual hours worked by nursing staff for two days during the survey period. The staffing sheets did not specify which half of the shift was worked by CNAs, and the scheduler was unaware of the requirement to list half-shift coverage hours. The facility's policy requires detailed breakdowns of hours worked by RN, LPN, and CNA, and adjustments for staff absences.
Failure to Timely Notify Ombudsman of Resident Transfers/Discharges
Penalty
Summary
The facility failed to send copies of transfer or discharge notices to the State LTC Ombudsman in a timely manner for four residents who were reviewed for admission, transfer, or discharge. The Social Services Director had informed the Ombudsman by email that the secured memory care unit was being transitioned to an unsecured long-term care unit and that residents on the unit were being reviewed for appropriate placement, with the Ombudsman to be copied on any involuntary discharge notices. The Ombudsman responded requesting a resident list, their discharge plans, and indicated she would watch for transfer/discharge notices by email. Notices of transfer or discharge for four residents were issued in late September and early October, with three residents being discharged to another nursing facility and one resident discharged shortly thereafter. Record review showed that the notice of transfer or discharge for one resident was issued on 10/2/25, and for three other residents on 9/22/25, with corresponding discharge dates later in September and early October. However, the Social Services Director did not email the notices of transfer or discharge for these four residents to the Ombudsman until 11/21/25, after all four residents had already been discharged from the facility. During interview, the Social Services Director acknowledged there had been a delay in sending the notices. The facility’s own policy on inappropriate discharge prevention required issuing the Notice of Transfer or Discharge and Appeal Rights at least 30 days prior to transfer and sending a copy to the local and State Ombudsman, as well as providing the resident and responsible party with a copy of the bed-hold policy.
Inadequate Infection Control and Tracking in LTC Facility
Penalty
Summary
The facility failed to maintain a safe, sanitary, and comfortable environment, leading to the potential development and transmission of infections. During a medication pass, a Qualified Medication Aide (QMA) used the same blood pressure cuff on two residents without sanitizing it before or after use. Additionally, Certified Nurse Aides (CNAs) were observed performing resident care without proper hand hygiene and glove changes. For instance, CNAs did not wash their hands before putting on gloves, failed to change gloves between clean and dirty tasks, and did not clean equipment after use. The facility's infection prevention and control program was inadequate in tracking infections among residents. The Infection Preventionist (IP) did not track all infections on the facility's tracking map, as only those meeting McGeer's criteria were included. This resulted in several infections, such as urinary tract infections, cellulitis, pneumonia, and upper respiratory infections, not being tracked on the map, despite being documented in residents' clinical records. The Director of Nursing (DON) confirmed that not all active infections were indicated on the tracking maps. Interviews with staff revealed a lack of adherence to the facility's policies on hand hygiene and equipment cleaning. The Infection Preventionist and CNAs acknowledged the need for proper hand hygiene and equipment sanitation, yet observations showed non-compliance. The facility's policies required handwashing for at least 30 seconds and cleaning shared equipment between resident uses, but these practices were not consistently followed, contributing to the deficiency.
Failure to Develop Comprehensive Care Plan for Resident on Diuretics
Penalty
Summary
The facility failed to develop a person-centered comprehensive care plan for a resident receiving diuretics, specifically furosemide, which is used to manage conditions such as congestive heart failure (CHF) and chronic respiratory failure. The resident, who was cognitively intact, had been receiving diuretic medication and using oxygen. However, the care plan did not include specific monitoring for side effects related to CHF or fluid volume overload, such as daily weight changes or side effects from the diuretic medication. The clinical record lacked orders or care plans addressing these critical aspects, which are essential for managing the resident's conditions effectively. Interviews and observations revealed that the resident frequently experienced shortness of breath, dizziness, and nausea, which were not adequately addressed in the care plan. The Director of Nursing (DON) acknowledged that not all high-risk medications were included in the care plan for monitoring side effects, as staff were expected to know the side effects and only document abnormalities. The facility's practice was to monitor the resident's weight monthly and check for edema weekly, which was insufficient for the resident's needs. The facility's Comprehensive Care Plan Policy required measurable goals and resident-specific interventions, which were not met in this case.
Improper Storage and Labeling of Medications
Penalty
Summary
The facility failed to ensure proper storage and labeling of medications and biologicals across multiple medication and treatment carts. During observations, several deficiencies were noted, including jars of CBD with only a handwritten name, a package of donuts, and a drink in the Plaza medication cart for rooms 101-113. Loose pills were found in the Plaza medication cart for rooms 114-140 and the Cottage Short Hall medication cart, with no proper labeling or identification. Additionally, two daily medication containers with loose pills were found in the Cottage Long Hall medication cart, which were used to administer medications to a resident without proper labeling. Further observations revealed unlabeled tubes of antifungal cream, skin therapy, and opened deodorant cans in the Cottage Unit treatment cart. Similarly, the Plaza Unit treatment cart contained an unlabeled tube of Triamcinolone cream and a bottle of antifungal powder. Interviews with QMAs and an LPN confirmed that there should be no loose pills or food in medication carts, and that resident names should be on bottles in treatment carts. The DON acknowledged that medications brought in by a resident's son were not properly labeled, despite staff having compared them with orders.
Inappropriate Antibiotic Prescribing for UTIs
Penalty
Summary
The facility failed to ensure that residents requiring antibiotics were prescribed the appropriate medication, as evidenced by the cases of two residents. Resident 43, who had a diagnosis of anxiety and depression, reported burning upon urination on 7/17/24. The physician ordered ceftriaxone without waiting for lab results, based solely on the symptom of burning with urination. The clinical record did not document an Infection Event for the UTI, indicating a lack of proper documentation and assessment before prescribing the antibiotic. Resident 30, diagnosed with dementia, chronic kidney disease stage 3, and polyneuropathy, was prescribed ceftriaxone for a UTI confirmed by a culture and sensitivity test. However, the lab report indicated that the E. coli present in the urine was resistant to ceftriaxone. Despite this, the antibiotic was administered, and the Infection Preventionist acknowledged that she should have informed the physician about the resistance. The facility's Antibiotic Stewardship Program policy, dated 11/2017, was in place to monitor and manage antibiotic use, but it was not effectively implemented in these cases.
Inaccurate Posting of Nurse Staffing Hours
Penalty
Summary
The facility failed to post accurate actual hours worked for licensed and unlicensed nursing staff directly responsible for resident care per shift daily for two of six days during the annual survey period. On two separate days, the posted staffing sheets observed on the receptionist desk did not specify which half of the shift was worked by the CNAs, indicating 4.5 and 5.5 CNAs worked the evening shift without detailing the specific hours. During an interview, the scheduler admitted to being unaware that half-shift coverage hours should have been listed on the posted staffing forms. The facility's current Posted Nurse Staffing Data policy, dated July 2019, requires that total hours be broken down by RN, LPN, and CNA, and that the form should reflect staff absences and adjust total hours accordingly.
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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 Mount Vernon
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Terrace At Solarbron The | 12.5 mi | ★★★★★ | 25 | 0 |
| West River Health Campus | 13.1 mi | ★★★★★ | 10 | 0 |
| Premier Healthcare Of New Harmony | 13.8 mi | ★★★★★ | 28 | 0 |
| Park Terrace Village | 14.9 mi | ★★★★★ | 1 | 0 |
| Breckinridge Place | 16.4 mi | ★★★★★ | 8 | 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.