Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 Monroe Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to document and communicate its response to repeated Resident Council complaints about cold meals, particularly breakfast items, over several months. Multiple cognitively intact residents reported voicing concerns about cold food and late meal service during Resident Council meetings, and being told by the Activities Director that the issues would be addressed, but they did not receive written grievance responses or follow-up. Meeting minutes for the relevant period reflected only general discussion and did not record these concerns, and there was no evidence of completed Resident Council grievance forms. The Activities Assistant and Activities Director confirmed that concerns were handled verbally, with the Activities Director unaware that documentation of Resident Council grievances and follow-up was required, and the Administrator acknowledged that concerns from these meetings were addressed verbally rather than in writing.
A nurse aide used a personal cell phone to record a video of a resident during personal care without consent, exposing the resident's chest and capturing the resident verbally and physically resisting care. The aide continued providing care despite the resident's objections and later admitted to recording the video for personal reasons, violating facility policy and the resident's right to privacy. The incident was discovered when the video was shared by a third party, leading to distress for the resident's representative.
The facility did not maintain an effective pest control program after several snakes were observed inside the building, with entry points identified at the front entrance and under office doors. Staff reported the incidents inconsistently, and the contracted pest control company was not promptly notified. Structural gaps and vegetation touching the building contributed to the issue, and the facility lacked immediate access to snake deterrent materials.
A resident with cognitive impairment and mobility needs experienced difficulty self-transferring and possible hip pain, as reported by a nurse aide and the resident's roommate. Despite these reports, nursing staff did not perform a physical assessment or document the change in condition, instead deferring evaluation until the next day. The resident was later found to have a left hip fracture requiring hospitalization.
A resident with severe cognitive and mobility impairments was injured during van transport when the facility's driver failed to properly secure the wheelchair and occupant according to manufacturer instructions. The driver did not tighten tie-down straps or verify that the lap and shoulder belts were fully engaged, leading to the resident and wheelchair tipping over during transit. The resident sustained a head laceration, finger fracture, and cervical spine fracture as a result.
A resident with dementia and Parkinson's disease was injured during care when a nurse aide failed to manage the resident's combative behavior properly. The resident sustained multiple injuries, including a bruise, a bloody nose, and a skin tear, during a hard transfer from a wheelchair to a bed. The nurse aide did not seek assistance or stop care despite the resident's aggression, leading to the deficiency.
The facility failed to properly label and manage medications on two medication carts, leading to deficiencies. On the 3W cart, several medications were improperly labeled or expired, including a Lantus Solostar insulin pen without a resident's name and expired insulin pens and vials. On the 3E cart, an expired CO Q-10 50 bottle was found. Nurses and the DON acknowledged responsibility for checking and discarding expired medications, but the facility did not ensure proper labeling and timely removal of expired medications.
The facility was found deficient in maintaining a clean and sanitary environment, with multiple resident rooms and common areas exhibiting stains, grime buildup, and unclean conditions. Residents expressed dissatisfaction, and staff interviews revealed inconsistencies in cleaning protocols, contributing to the unsanitary conditions.
A resident with severe cognitive impairment and no order to self-administer medications was found with amantadine left at the bedside. Nurse #1, who was training, forgot to administer the medication after setting it down to give other medications. The DON confirmed that medications should not be left at the bedside, and the NP noted that missing the dose was not a significant error as the medication was given three times daily.
A resident with a gastrostomy tube was at risk of bacterial growth due to improper storage of a feeding tube syringe. The syringe was observed with the plunger inside and liquid at the tip, contrary to protocol. Nurse #3 was unaware of the correct storage procedure, and the Director of Nursing expected compliance with the protocol.
A resident with dementia and Alzheimer's, requiring substantial assistance with eating, was not provided a dignified dining experience. A nursing assistant fed the resident while standing, without making eye contact, despite available seating. The facility's protocols require staff to assist residents at eye level to ensure dignity, which was not followed in this instance.
The facility failed to maintain a pest-free environment, with roaches observed in resident rooms and a community restroom. Residents reported frequent sightings, and staff confirmed regular roach presence despite monthly pest control treatments. The Maintenance Director acknowledged the issue, but the Administrator was unaware of recent complaints.
The facility did not post required contact information for State agencies and advocacy groups, including the State Survey Agency and Adult Protective Services, during a recertification survey. Observations over several days confirmed the absence of necessary postings, and the Administrator acknowledged the oversight.
The facility failed to provide written notification of hospital transfers for two residents, one cognitively intact and the other severely impaired. Both residents were transferred due to changes in condition without their representatives receiving the required notifications. The Social Worker did not complete the notifications, and the Administrator was unaware of the lapse, leading to a deficiency in communication and regulatory compliance.
Failure to Document and Follow Up on Resident Council Food Temperature Complaints
Penalty
Summary
The deficiency involves the facility’s failure to document and communicate its efforts to address concerns raised in Resident Council meetings, specifically regarding repeated complaints of cold food. Review of Resident Council minutes from three meetings showed only "open discussion" with no recorded concerns about cold food, despite multiple residents reporting that such concerns were voiced. There was no written evidence from December 2025 through February 2026 demonstrating the facility’s response to grievances or recommendations made by the Resident Council. One cognitively intact resident, serving as Resident Council President, reported that during the February Resident Council meeting she complained about cold food, specifically grits that were not warm enough for cheese to melt. She stated the Activities Director told her the concern would be addressed with the Dietary Manager but did not specify when, and the Resident Council never received any follow-up from either the Dietary Manager or the Activities Director. Another cognitively intact resident reported attending Resident Council meetings regularly and stated she had voiced concerns on several occasions, including during the January meeting, about cold food at breakfast and dinner. She reported submitting a verbal complaint to the Activities Director and was told the concern would be looked into, but she did not receive any grievance response or follow-up. A third cognitively intact resident reported regularly receiving cold breakfast meals and that breakfast was often served late, and stated these concerns were discussed during the December, January, and February Resident Council meetings. The Activities Assistant, who supported Resident Council meetings, stated the Activities Director was responsible for documenting resident concerns and acknowledged hearing concerns about cold coffee and food months earlier, but was unsure if they were documented or if a Resident Council grievance form was completed. The Activities Director confirmed she led the meetings and was responsible for the minutes, acknowledged hearing occasional concerns about cold food, and stated she verbally notified department heads and the Administrator but did not document concerns in the minutes or through the grievance process because she was unaware documentation was required. The Administrator stated he was aware of cold food concerns the prior year and that concerns after Resident Council meetings were addressed verbally, not in writing.
Unauthorized Video Recording and Privacy Violation During Personal Care
Penalty
Summary
A nurse aide (NA) used her personal cellular phone to record a video of a resident while providing personal care, without the resident's consent. During the recording, the resident's chest area was exposed, and the resident was observed holding a pink baby doll for comfort. The video captured the resident verbally and physically resisting care, including swinging her arm at the NA and verbally asking to be left alone. Despite the resident's resistance and request, the NA continued to provide care and record the incident. The NA later admitted to recording the video to capture the resident's combative behaviors, which she found amusing, and acknowledged she had been trained not to record residents or use personal devices in care areas. The resident involved had a history of dementia, was moderately cognitively impaired, and was care-planned for resisting care. The care plan included interventions such as providing choices during personal care. The resident's representative expressed distress upon learning of the video, stating that the resident's right to privacy had been violated and that the video was distributed without consent. The video was discovered by a third party who accessed the NA's phone and subsequently shared it with another individual, leading to the facility being notified of the incident. Interviews with facility staff and other caregivers indicated that the resident was dependent on staff for most activities of daily living and that her response to care depended on the approach used by staff. The DON and other staff confirmed that the NA had received training on abuse prevention and the prohibition of recording residents. The NA's actions were found to be in violation of facility policy and the resident's rights, resulting in the exposure of the resident's nudity and humiliation through the unauthorized recording and sharing of the video.
Failure to Maintain Effective Pest Control Program Following Multiple Snake Sightings
Penalty
Summary
The facility failed to implement an effective pest control program to maintain a pest-free environment after multiple sightings of snakes within the building. The initial incident involved a small snake entering through a gap at the bottom of the front entrance doors and subsequently being observed in the admissions office. The gap between the doors, as well as a one-inch space under the admissions office door, provided easy access for pests. Staff members, including a nurse and a housekeeper, observed and reported the presence of snakes, but the maintenance logs did not reflect these sightings, and the maintenance director was not immediately notified after the first incident. Communication regarding the pest issue was inconsistent, with notifications being sent via group text to the Administrator and DON, but not to the Maintenance Director in a timely manner. The Administrator and DON did not become aware of the initial snake sighting until hours after it was reported. Subsequent sightings of snakes occurred in other areas of the building, including a resident bathroom in a hall that was closed for renovations and near the dining room. The contracted pest control company was not notified until after the second snake was found, and their technician reported that their contract did not cover snake removal or treatment, only visual inspection. The wildlife department was eventually contacted to address the issue. Structural issues, such as the open space at the bottom of the front entrance doors and vegetation touching the building exterior, were identified as contributing factors to the pest problem. The facility did not have snake repellent materials on hand and relied on external sources to obtain them, which were not immediately available. The contracted pest control company and wildlife department both conducted inspections, but no further snakes were found during their visits. The wildlife department applied snake deterrent material around the exterior doors, but the structural gap at the front entrance remained unaddressed at the time of the last observation.
Failure to Assess Resident After Reported Change in Mobility and Possible Fall
Penalty
Summary
A deficiency occurred when nursing staff failed to perform a physical assessment of a resident after a change in the resident's ability to self-transfer was reported. The resident, who had a history of dementia, stroke, and legal blindness, was known to require supervision for all mobility tasks and had a care plan focused on fall prevention. On the evening in question, a nurse aide observed the resident having difficulty transferring from a wheelchair to bed and reported that the resident mentioned possible hip pain. Additionally, the resident's roommate reported that the resident had fallen a couple of nights prior. Despite these reports, neither the assigned nurse nor other nurses on duty conducted a physical assessment of the resident at that time. Multiple staff interviews confirmed that the nurse aide communicated the resident's difficulty and the roommate's report of a fall to the nursing staff. However, the nurses involved reviewed the electronic medical record and found no documentation of a recent fall, and after consulting with each other, did not proceed with a physical assessment. The resident was observed sleeping and did not verbalize pain during subsequent checks, leading staff to defer assessment and instead make a note in the physician communication book for evaluation the following day. No immediate nursing documentation or assessment was completed regarding the reported change in the resident's condition. The following morning, the resident was found to have increased pain and physical signs consistent with a left hip injury, including the left leg being rotated inward. Upon assessment by the DON and a nurse, the resident was sent to the hospital, where a left hip fracture was diagnosed and surgically treated. Interviews with staff and the resident confirmed that the resident did not initially report pain or the fall to staff, but did experience difficulty with mobility and later reported pain. The failure to assess the resident promptly after a change in condition and reports of a possible fall constituted the deficiency.
Failure to Secure Wheelchair and Resident During Transport Results in Serious Injury
Penalty
Summary
A facility failed to ensure the safe transport of a resident with severe cognitive impairment and mobility limitations following an orthopedic appointment. The designated van driver did not properly secure the resident's wheelchair to the van floor or ensure that the resident was restrained according to the manufacturer's instructions. Specifically, the driver did not tighten the tie-down straps, did not verify that the lap and shoulder belts were fully engaged, and did not check the security of the wheelchair or restraints before departure. The driver later admitted to rushing and skipping these safety checks due to time constraints. During transport, after making a right turn onto a main road, the resident and her wheelchair tipped over, resulting in the resident falling onto the van floor. The driver found the resident with a bleeding head laceration, the wheelchair tipped on its side, the seat and lap belt disconnected, and one of the front tie-down straps unhooked. Emergency medical services were called, and the resident was transported to the emergency department, where she was diagnosed with a frontal scalp laceration, a left middle finger fracture, and a cervical spine fracture. The incident was directly attributed to the failure to secure the wheelchair and occupant per the manufacturer's guidelines. Interviews and reenactments with facility staff and the van driver confirmed that the required safety procedures were not followed. The driver demonstrated during reenactments that she did not tighten the tie-downs or check the restraints for proper engagement. Staff interviews and medical records indicated that the resident was unable to stand or transfer independently, further emphasizing the necessity of proper securement during transport. The facility's failure to ensure adherence to safety protocols resulted in significant injury to the resident.
Removal Plan
- Resident was assessed and transported to the emergency department for evaluation and treatment after the incident.
- The Van Driver was suspended pending the results of the investigation.
- The facility notified the resident’s legal guardian and Medical Director of the incident.
- A reenactment of the incident was conducted with facility leadership to determine how the wheelchair was secured.
- The facility’s van driver education records were audited to ensure the Van Driver received necessary education and training.
- The Director of Nursing reviewed facility incidents and accidents to ensure no other falls/incidents had occurred related to van transport.
- An audit of all appointments via van transport was completed to ensure residents were rescheduled with a contracted wheelchair transport company and that residents and/or responsible parties were notified.
- All appointments requiring van transportation were reviewed during the center’s morning clinical meeting to verify transfer vehicle and resident/responsible party notification.
- An audit was completed to identify any interviewable residents that were transferred to ensure no incident or accident occurred during their van transport.
- The contracted wheelchair transport company’s staff training and certification were reviewed and validated to be in place before use.
- The facility van was sent to the wheelchair transport van service center for inspection; no problems were found.
- All transport appointments requiring the facility van were scheduled through a contracted wheelchair transport company.
- The facility contracted all resident van transports with a contracted wheelchair transport company.
- All appointments requiring van transportation were reviewed in the morning clinical meeting to determine if additional assistance was necessary.
- The Administrator received education on checking the locking mechanisms/restraints on the van for the wheelchair and seatbelt prior to transporting residents per manufacturer’s instructions.
- The Administrator provided education to the Maintenance Director and Director of Nursing regarding van safety and checking locking mechanisms/restraints per manufacturer’s instructions.
- The facility will continue to use the contracted wheelchair transport company instead of transporting residents in the facility van.
- An ADHOC quality assurance (QA) meeting was held to review the incident and identify the root cause.
- An audit will be completed of two residents receiving transport services by the Administrator twice a week to ensure the contracted wheelchair transport company is compliant with safety guidelines.
- Once a new van driver is identified, they will go through the facility’s motor vehicle and driver safety program, including a return demonstration and education/training by the Administrator and President of Operations.
- The Quality Assurance Improvement committee will review the results of the weekly audits during monthly QA meetings to determine if further actions are needed.
- The Administrator and Director of Nursing are responsible for ensuring implementation of the immediate jeopardy removal and that education and training are provided.
Failure to Protect Resident from Abuse During Care
Penalty
Summary
The facility failed to protect a resident from abuse by a nurse aide during care. The resident, who was diagnosed with dementia and Parkinson's disease, was severely cognitively impaired and required assistance with daily activities. During an incident, the resident sustained multiple injuries, including a bruise to the left eye, a bloody nose, a skin tear to the left elbow, and a scratch on the left cheek. The nurse aide involved stated that the resident was combative and resistive to care, which led to a hard transfer from the wheelchair to the bed. The resident's care plan indicated that he was resistive to care due to dementia and required specific interventions to manage his behavior. However, during the incident, the nurse aide continued to provide care despite the resident's aggression, resulting in the resident falling onto the bed and sustaining injuries. The nurse aide did not call for assistance or stop the care when the resident became combative, which contributed to the deficiency. Interviews with staff and the resident's family member revealed that the resident was known to be aggressive during care, and the nurse aide was aware of this behavior. Despite this knowledge, the nurse aide proceeded with the transfer and care without seeking help, leading to the resident's injuries. The facility's investigation concluded that the injuries were likely caused by the resident hitting the headboard during the transfer.
Medication Labeling and Expiration Deficiencies
Penalty
Summary
The facility failed to properly label and manage medications on two of its medication carts, leading to deficiencies in medication storage and labeling. On the 3W medication cart, several medications were found improperly labeled or expired. A Lantus Solostar insulin pen was not labeled with the resident's name, and an Insulin lispro pen, a Novolog vial, and an Insulin glargine injector were all past their manufacturer-recommended discard dates. Additionally, an Albuterol sulfate nebulizer was stored beyond its recommended usage period. Nurse #5 confirmed the lack of labeling and was unaware of the missing label, while the Director of Nursing (DON) and the Administrator acknowledged that nurses were responsible for checking and discarding expired medications. On the 3E medication cart, a CO Q-10 50 multidose bottle was found expired. Nurse #4 and the DON both stated that the Unit Manager and nurses were responsible for ensuring expired medications were removed. The DON also mentioned that the pharmacy and Unit Manager were supposed to check the medication carts regularly. Despite these protocols, the facility failed to ensure proper labeling and timely removal of expired medications, leading to the observed deficiencies.
Facility Fails to Maintain Clean and Sanitary Environment
Penalty
Summary
The facility failed to maintain a clean and sanitary environment across multiple resident rooms and common areas, as observed during a survey. Specifically, 16 rooms on the 200 hall, 4 rooms on the 300 hall, 8 rooms on the 100 hall, 3 community restrooms, and 1 shower room were found to have significant cleanliness issues. These included dark brown and black stains on walls, grime buildup around baseboards, and thick substances on commode seats. Residents expressed dissatisfaction with the cleanliness of their rooms, indicating that the lack of proper cleaning was a persistent issue. Interviews with residents revealed that the unclean conditions were distressing to them. One resident mentioned that the Maintenance Director attempted to cover grime with grout instead of cleaning it, and another resident expressed a desire to clean the room herself if she were able. These statements highlight the residents' awareness and concern about the inadequate cleaning practices in their living spaces. Staff interviews indicated a breakdown in the facility's cleaning protocols. Housekeeping staff claimed to perform daily cleaning tasks and monthly deep cleans, but the observed conditions contradicted these claims. The Housekeeping Manager and Administrator acknowledged the deficiencies, noting that the rooms should be cleaned daily and deep cleaned monthly. However, the Floor Technician admitted that he was unable to perform his duties due to staff shortages, which contributed to the failure to maintain a sanitary environment.
Failure to Administer Amantadine to Cognitively Impaired Resident
Penalty
Summary
The facility failed to administer amantadine to a resident who was observed with medications at the bedside. The resident, admitted with diagnoses including nontraumatic intracerebral hemorrhage and hypertension, was severely cognitively impaired and had no physician order to self-administer medications. A physician order required the administration of amantadine three times per day. During an observation, a medication cup containing 20 milliliters of clear liquid was found on the resident's bedside table, which the resident identified as his medication. Nurse #1, who was training, admitted to setting the amantadine down on the bedside table while administering other medications and forgetting to administer it to the resident. The Director of Nursing confirmed that no medication should be left at a resident's bedside and that all medications should be administered before leaving the room. The Nurse Practitioner stated that the resident was not capable of self-administering medications and missing the dose would not have been a significant medication error since the medication was administered three times daily.
Improper Storage of Feeding Tube Syringe
Penalty
Summary
The facility failed to properly store a tube feeding syringe for a resident with a gastrostomy tube, which created a potential for bacterial growth. The resident, who was admitted with diagnoses of stroke and difficulty swallowing, was receiving tube feedings and water flushes as per physician's orders. During observations, the syringe was found with the plunger inside and clear liquid at the tip, stored in a plastic bag hanging from the feeding pole. This improper storage was noted on two separate occasions. Nurse #3, responsible for the resident's care, was unaware of the requirement to separate the plunger from the syringe to prevent bacterial contamination. The Director of Nursing expected the nurses to follow this protocol, but it was not being adhered to. The facility's Administrator did not provide a qualified statement on the matter but acknowledged that the nurse should follow the correct protocol to prevent bacterial growth in the syringe.
Failure to Provide Dignified Dining Experience
Penalty
Summary
The facility failed to provide a dignified dining experience for a resident diagnosed with vascular dementia and Alzheimer's disease, who required substantial assistance with eating. During an observation, the resident was in bed with the meal tray positioned across his lap. A nursing assistant (NA) entered the room and fed the resident while standing, without making eye contact, despite the availability of chairs in the room. The resident expressed a preference for staff to sit while assisting with meals, indicating a lack of adherence to the facility's training and protocols for maintaining resident dignity during meal assistance. The Director of Nursing (DON), Administrator, and Regional Clinical Director confirmed that staff were trained to assist residents at eye level to ensure dignity. The DON stated that staff should be seated when assisting residents with meals in their rooms, aligning with the resident's care plan and facility protocols. The failure to adhere to these protocols resulted in a deficiency in providing a dignified dining experience for the resident.
Pest Control Deficiency in Resident Rooms and Restroom
Penalty
Summary
The facility failed to maintain an environment free of pests, specifically roaches, in several resident rooms and a community restroom. Observations revealed dead roaches in the room of a cognitively intact resident, who reported that roaches frequently appeared at night and disturbed her sleep by crawling on her bed. Another resident occasionally observed roaches on the floor of her room, while a third resident frequently saw roaches in her bathroom. Additionally, a live roach was observed in a community restroom on the 300-hall. Interviews with staff indicated that roaches were seen in the building once or twice a week, with the 100-hall being particularly affected. Despite the facility's pest control company conducting monthly treatments and responding to reports of roaches, the issue persisted. The Maintenance Director acknowledged the presence of roaches but denied an infestation, while the Administrator was unaware of recent resident complaints. Pest Control Reports from July to November indicated no observed pest activity during treatments, suggesting a disconnect between reported sightings and documented pest control efforts.
Failure to Post Required Contact Information for State Agencies
Penalty
Summary
The facility failed to post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups, including the State Survey Agency, Complaint Intake, Adult Protective Services, the Office of the State Long-Term Care Ombudsman program, and the Protection and Advocacy network. This deficiency was observed during an onsite recertification survey conducted over four days. Specifically, on three of these days, surveyors noted the absence of required signage or postings that would provide residents, families, or visitors with the necessary contact information to file concerns or complaints. Observations were made on multiple occasions, including a tour of the facility with the Administrator, which confirmed the lack of appropriate postings. During an interview, the Administrator acknowledged that such information should be accessible to residents and their families. However, the facility did not have the required postings in place, leading to the deficiency noted in the survey report.
Failure to Notify Residents of Hospital Transfers
Penalty
Summary
The facility failed to provide written notification of transfer to the hospital for two residents, leading to a deficiency in communication and compliance with regulatory requirements. Resident #29, who was cognitively intact, was transferred to the hospital twice due to a change in condition, but neither she nor her representative received written notification of these transfers. Interviews with the resident and her representative confirmed the lack of notification, and the Social Worker (SW) admitted to not completing the notifications, citing a lack of clarity on responsibility. Similarly, Resident #19, who was severely cognitively impaired, was transferred to the hospital without written notification being provided to their representative. The SW again acknowledged not completing the notifications, and the Administrator expressed an expectation that the SW should handle these notifications but was unaware of why they were not being done. This lack of communication and procedural clarity resulted in a failure to meet the regulatory requirement for notifying residents and their representatives of hospital transfers.
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Illustrative
What surveyors actually found near you
We read the 98 citations issued within 25 miles in the last 12 months — including the 6 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
A prioritized, do-first checklist
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Illustrative
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Nursing homes near Monroe
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Jesse Helms Nursing Center | 0.6 mi | ★★★★★ | 3 | 0 |
| Rock Rest Nursing And Rehabilitation | 2 mi | ★★★★★ | 0 | 0 |
| Pruitthealth-union Pointe | 4.2 mi | ★★★★★ | 0 | 0 |
| Autumn Care Of Marshville | 9.1 mi | ★★★★★ | 5 | 0 |
| Lake Park Nursing And Rehabilitation Center | 9.5 mi | ★★★★★ | 11 | 0 |
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