55 South Professional Way, Payson, UT 84651 · Utah County · (801) 465-9211
76 certified beds, about 53 residents a day · For profit - Corporation · Medicare and Medicaid since 1992
CMS Care Compare ratings, data as of September 1, 2026 · CCN 465129 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on August 28, 2024, inspectors cited 12 health deficiencies (the Utah average is 8.8, the national average 9.2).
Of 80 health citations since July 2021, 6 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $12,735 in the last three years; the largest was $12,735, and the latest is dated May 5, 2026.
Nurses and nurse aides worked 3.64 hours per resident per day, against 4.09 across Utah and 3.86 nationally. Registered nurses accounted for 1.44 of those hours.
43.4% of nursing staff left within the year CMS measured (Utah average 50.7%).
CMS links it to Rocky Mountain Care, an affiliated group of 10 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 80 health citations on file.
Inspectors wroteBased on interview and record review, the facility failed to ensure one resident (Resident #2) was free from significant medication errors for one of 12 residents sampled for medication administration. Specifically, Resident #2 was inadvertently administered 13 medications intended for their roommate, including high-risk antihypertensives and antidiabetics, resulting in hypoglycemia, hypotension, and the need for acute hospitalization. The facility's noncompliance was determined to be Past Noncompliance. The facility developed and implemented a corrective action plan which was completed and verified by March 28, 2026. Resident #2 was admitted to the facility on [DATE], with diagnoses including Cerebral Infarction, Dementia, and Hypertension. [...]
Inspectors wroteBased on observation and interview, the facility did not store, prepare, distribute and serve food in accordance with professional standards for food service safety. Specifically, food items in the walk-in freezer and walk-in refrigerator were not labeled and were open to air, personal items of kitchen staff were observed to be in the food preparation area, kitchen staff were handling food with bare hands, and the dish machine was not operating with water temperatures necessary to ensure the dishware was properly sanitized. Findings Include: On 8/25/24 at 9:25 AM, an initial walk-through was conducted in the kitchen. In the walk-in refrigerator, 4 packages of a green substance were found with no label and no date. In the walk-in freezer, a box of beef patties was open to air, and a box of cookie dough was open to air. [...]
Inspectors wroteBased on interview and record review, it was determined, for 5 of 42 sampled residents, that the facility, in response to allegations of abuse, neglect, exploitation, or mistreatment, failed to provide evidence that all alleged violations were thoroughly investigated. Specifically, allegations of neglect resulted in emergency department visits and hospitalizations, two of which resulted with surgical intervention, and one allegation of abuse by a staff member were not thoroughly investigated. Resident identifiers: 15, 53, 156, 158, and 161.
Inspectors wroteBased on interview and record review it was determined, for 1 of 42 sampled residents, that the facility did not provide routine and emergency drugs and biological's to its residents. Specifically, a resident was not administered medications as ordered by the physician due to the medications not being available by the pharmacy. Resident identifier: 16 Findings Included: Resident 16 was admitted to the facility on [DATE] with diagnoses which included type II diabetes mellitus, protein calorie malnutrition, morbid obesity with alveolar hypoventilation, vascular dementia, mood disorder, opiod dependence, anxiety disorder, obstructive sleep apnea, Bell's palsy, chronic pain, muscle weakness, unsteadiness on feet and lack of coordination. On 8/27/24 at 8:15 AM, an observation was made as resident 16 received his morning medications. [...]
Inspectors wroteBased on observation, interview and record review, for 4 of 42 sampled residents, the facility did not have menus that met the nutrition needs of residents in accordance with established nutrition guidelines. In addition, the menus were not followed. Specifically, residents complained about the portion sizes being too small. Resident identifiers: 8, 12, 34, and 167.
Inspectors wroteBased on observation, interview and record review, the facility did not provide food prepared by methods that conserve flavor and appearance or provide food and drink that is palatable, attractive, and at an appetizing temperature. Specifically, there were multiple complaints from residents about the quality of the food, and when surveyors pulled a test tray during the lunch meal, the food was found to be lacking in flavor and appearance. Resident identifiers: 4, 8, 9, 12, 19, 29, 30, 32, 34, 36, 39, 45, 166 and 206.
Inspectors wroteBased on interview, record review, and observation, the facility did not establish and implement written policies and procedures for feedback, data collections systems and monitoring to include adverse event monitoring. Specifically, on the previous recertification survey conducted on 10/3/22, F609, F697, F755, F761, F804, F812, F867, and F880 were cited. These deficiencies were cited again during the current recertification survey. Resident identifiers: 4, 5, 8, 9, 12, 14, 15, 16, 19, 21, 23, 28, 29, 30, 32, 34, 36, 38, 39, 45, 48, 53, 156, 158, 161, 166, and 206.
Inspectors wroteBased on observation and interview it was determined, the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Specifically, for 2 out of 42 sampled residents, a staff member was observed to touch a resident medications with bare hands with each medication administration.
Inspectors wroteBased on observation and interview it was determined the facility did not maintain an effective pest control program so that the facility was free of pests. Specifically, residents complained of and were observed to have flies around and on them. Resident identifiers: 2, 5, 6, 24, 37 and 40.
Inspectors wroteBased on observation, interview, and record review, for 2 of 42 residents sampled, the facility did not ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source, were reported immediately, but not later than 2 hours after the allegation was made, to the State Survey Agency. Specifically, a resident had a fall while in a mechanical lift and was not reported to the State Survey Agency and a resident had a fall which resulted in a fracture and the State Survey Agency was not notified within 2 hours after the allegation was identified. Resident identifiers: 28 and 156.
Inspectors wroteBased on observation, interview, and record review, the facility did not ensure that pain management was provided to residents who required such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals preferences. Specifically, for 1 out of 42 sampled residents, a resident was observed to complain about pain and pain medications were not available. Resident identifier: 16.
Inspectors wroteBased on observation and interview it was determined that the facility did not label all drugs and biological's used in the facility in accordance with currently accepted professional principles, and include appropriate accessory instructions and the expiration date when applicable. Specifically, medication carts were left unlocked and unattended, insulin pens were open and available for use past the expiration date. In addition, narcotics were repackaged into the narcotic cards. Resident Identifiers: 4, 5, 15, 21, 23, 34, 38, 39 and 48.
Inspectors wroteBased on interview, the facility did not employ a clinically qualified full-time dietitian or another clinically qualified nutrition professional to serve as the director of nutrition services. Specifically, the facility did not employ a full time Registered Dietitian (RD) and the Dietary Manager (DM) did not meet the requirements to serve as the Director of Nutrition Services.
Inspectors wroteBased on interview and record review it was determined, for 2 out of 34 sampled residents, the facility did not ensure residents who were incontinent of bladder received appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible. Specifically, a resident had a urinalysis (UA) test completed with no follow up and the resident went to hospital for treatment. In addition, a resident with signs and symptoms of a urinary tract infection (UTI) went to the hospital for treatment. Resident identifiers: 29 and 44.
Inspectors wrote3. Resident 45 was admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses which included major depressive disorder, adult failure to thrive, abdominal pain, hydroureter, anemia, opioid dependence, and anxiety disorder. On 9/26/22 at 10:57 AM, an interview was conducted with resident 45. Resident 45 stated that she had pain in the left foot. Resident 45 stated that she wrapped the foot herself with an ace bandage to help alleviate the pain. Resident 45 stated that the foot pain had been present since May. Resident 45 also reported chronic pain all over her body with diagnoses of fibromyalgia and complex regional pain syndrome. Resident 45 appeared calm, no facial grimacing noted, and no outward signs and symptoms of pain were noted. Resident 45 never stated their current pain score when asked multiple times. [...]
Inspectors wroteBased on observation, interview, and record review, it was determined, the facility did not have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. [...]
Inspectors wroteBased on interview and record review it was determined, for 1 out of 34 sampled residents, that the facility did not provide medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being. Specifically, a resident had expressed desires to die by refusal of treatment for diabetes and was not evaluated and seen by social services. Resident identifier: 20.
Inspectors wroteBased on observation and interview, the facility did not provide housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. Specifically, the carpets in the facility had multiple stains and the couches were worn and had holes in the cushions.
Inspectors wroteBased on observation, interview, and record review it was determined, for 3 out of 34 sampled residents, the facility did not ensure that residents were free from abuse, neglect, misappropriation of resident property, and exploitation. Specifically, a Certified Nursing Assistant (CNA) was observed to verbally abuse a resident and two other residents reported the same CNA verbally abused them. In addition, the CNA was able to finish her shift with the residents. Resident identifiers: 16, 36, and 37.
Inspectors wroteBased on observation, interview, and record review it was determined, for 3 out of 34 sampled residents, in response to an allegation of abuse, neglect, exploitation, or mistreatment the facility did not ensure that all alleged violations were reported immediately, but not later than two hours after the allegation was made, if the events that caused the allegation involve abuse or resulted in serious bodily injury. Specifically, the State Survey Agency was not notified until five days after an abuse allegation was made. Resident identifiers: 16, 36, and 37.
Inspectors wroteBased on interview and record review, the facility did not assess residents using the quarterly review instrument specified by the State and approved by Centers for Medicare and Medicaid Services not less frequently than once every three months. Specifically, for 3 out of 34 sampled residents, quarterly Minimum Data Set (MDS) assessments were not completed every three months. In addition, quarterly MDS assessments were not completed no later than 14 days after the assessment reference date (ARD). Resident identifiers: 3, 4, and 7.
Inspectors wroteBased on interview and record review, it was determined that for 3 out of 34 sampled residents, the facility assessments did not accurately reflect the resident's status. Specifically, two resident's Minimum Data Set (MDS) assessments were coded incorrectly by indicating that the two residents were on an anticoagulant when the residents were not, and a resident who was receiving dialysis was not coded as receiving dialysis. Resident identifier: 8, 36, and 44.
Inspectors wrote6. Resident 155 was admitted to the facility on [DATE] with diagnoses which included unspecified fracture of left femur, hyperkalemia, nonrheumatic aortic stenosis, and acute on chronic combined systolic and diastolic heart failure. On 9/27/22, resident 155's medical record was reviewed. Resident 155's care plan was reviewed, and it revealed that there was no baseline care plan related to falls. On 9/7/22 at 5:19 PM, a Nursing Progress Note revealed, Res [Resident] had fall, called to shower by CNA [Certified Nursing Assistant] res was lying on back. Res said he slipped. Fall was not witnessed. Res denied pain at this time. Assessed, no apparent injury at time. Neuro [neurological] checks started and were wnl [within normal limits] . On 9/11/22 at 3:33 PM, a progress note revealed that resident 155 was here with a L [Left] hip fx [fracture] after a fall. [...]
Inspectors wroteBased on observation, interview, and record review, it was determined, the facility did not develop and implement a comprehensive person-centered care plan for each resident. Specifically, for 7 out of 34 sampled resident, residents that had care areas trigger on the Minimum Data Set (MDS) Care Area Assessment (CAA) Summary did not have care plans developed and implemented in a timely manner. In addition, residents with identified concerns did not have care plans developed and implemented in a timely manner. Resident identifiers: 8, 20, 23, 29, 45, 49, and 53.
Inspectors wrote2. Resident 25 was admitted to the facility on [DATE] with diagnoses which included hypothyroidism, hyperlipidemia, depression, hypertension, borderline personality disorder, pain, and edema. On 9/26/22 at 12:32 PM, an interview was conducted with resident 25. Resident 25 stated she should get a shower today, but did not get one because staff did not show up. Resident 25 stated she got a shower on 9/24/22, but did not have one for two weeks prior to that. Resident 25 stated she took showers by herself because she became very disgusted by herself. Resident 25's medical record was reviewed on 9/29/22. An admission MDS assessment dated [DATE], revealed resident 25 had a Brief Interview of Mental Status (BIMS) score of 11 which revealed mild cognitive impairment. The MDS further revealed resident 25 required one person limited assistance to transfer only and physical assistance with bathing. [...]
Inspectors wroteBased on observation, interview, and record review it was determined, for 5 out of 34 sampled residents, that the facility failed to ensure that the resident environment remained as free of accident hazards as was possible and each resident received adequate supervision and assistance devices to prevent accidents. Specifically, multiple residents did not receive preventative interventions and/or adequate supervision to prevent future falls. In addition, a resident with a history of wandering did not receive adequate supervision to prevent accidents and the resident did not receive adequate supervision due to being an unsafe smoker. Resident identifiers: 8, 43, 49, 53, and 155.
Inspectors wrote3. Resident 29 was admitted to the facility on [DATE] with diagnoses which included low back pain, injury to left lower leg, hypothyroidism, edema, chronic pain, and nausea. On 9/26/22 at 12:32 PM, an interview was conducted with resident 29. Resident 29 stated she was unable to stand her pain last night and was groaning. Resident 29 stated there was no nurse on her hallway from 12:00 AM until 6:00 AM. Resident 29 stated she needed Tramadol at 2:00 AM but the nurse told resident 29 it was not her problem because she would not be there and there was not a nurse to administer the medication. Resident 29 stated she had scoliosis that made a hole in her spine and she had no control over her left lower extremities. Resident 29 stated she needed her Tramadol regularly because her pain never quit. Resident 29 stated her Tramadol was not administered at 2:00 AM when she wanted it. [...]
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that each resident's drug regimen was free from unnecessary drugs. An unnecessary drug is any drug when used in excessive dose; or for excessive duration; or without adequate monitoring; or without adequate indications for its use; or in the presence of adverse consequences which indicate the dose should be reduced or discontinued; or any combinations of the reasons above. Specifically, for 4 out of 34 sampled residents, a resident's beta blocker medication to treat high blood pressure was not monitored according to the physician ordered parameters. A resident's alpha-adrenergic agonists medication to treat low blood pressure was held without physician's orders. In addition, resident medications were not administered per physician's orders due to nursing staff not completing the task. [...]
Inspectors wroteBased on observation and interview, it was determined, the facility did not ensure that all drugs and biologicals were stored in locked compartments, and were labeled in accordance with currently acceptable professional principles and included the appropriate accessory and cautionary instructions, and the expiration date when applicable. Specifically, observations were made of medications left on top of the medication cart unattended, the medication cart was observed unlocked and unattended, and medications located in the locked medication fridge were expired and still available for use. Resident identifiers: 9, 12, 29, and 53.
Inspectors wroteBased on interview and record review it was determined, for 4 of 34 sampled residents, that the facility did not provide or obtain laboratory services to meet the needs of the residents. Specifically, residents had laboratory tests ordered by the provider and the facility did not obtain them. Resident identifiers: 23, 30, 53, and 160.
Inspectors wroteBased on observations, interview, and record review it was determined, the facility did not provide food prepared by methods that conserve nutritive value, flavor, and appearance; food and drink that was palatable, attractive, and at a safe and appetizing temperature. Specifically, for 9 out of 34 sampled residents, multiple residents complained about the palatability and temperature of the food, and a sample test tray revealed that the food was not palatable. Resident identifiers: 7, 16, 20, 23, 29, 38, 45, 48, and 53. Findings Included: 1. On 9/26/22 at 11:00 AM, an interview was conducted with resident 48. Resident 48 stated that the food was getting better. Resident 48 stated that there was an alternative menu which she ordered from. Resident 48 stated she ordered a hamburger and received a bun, lettuce, cucumber, and no hamburger patty. 2. [...]
Inspectors wroteBased on observation and interview, it was determined, the facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Specifically, food items were not labeled and dated, trash was found on the floor, food splatter on the cooking equipment, and food items were left open to the air.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that the Quality Assessment and Assurance (QAA) committee developed and implemented appropriate plans of action to correct identified quality deficiencies. Specifically, the facility was found to be in non-compliance with F584, F655, F656 and F880 which were cited within the facility's 2019 and 2021 recertification survey. The facility was also found to be in non-compliance with F755, F757, F759, and F812 which were cited within the facility's 2018, 2019, and 2021 recertification survey. In addition, the facility was found to be in non-compliance and cited at a harm level with F690, F697, F725, and F745.
Inspectors wroteBased on observation and interview, it was determined, the facility did not maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Specifically, observations were made during a meal service and assisted dining without hand hygiene being performed. Additionally, observations were made of bare handed contact during medication dispensing and administration. Resident identifiers: 3, 6, 12, 23, and 53.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure the resident's medical record included documentation that indicates, at a minimum, the following: that the resident or resident representative was provided education regarding the benefits and potential risks associated with Coronavirus Disease-2019 (COVID-19) vaccine; each dose of COVID-19 vaccine administered to the resident; or if the resident did not receive the COVID-19 vaccine due to medical contraindications or refusal. Specifically, for 4 out of 34 sampled residents, the facility did not provide the resident or resident representative with education of the benefits and potential risks associated with the COVID-19 vaccination. In addition, the resident's medical record did not include documentation regarding the residents' COVID-19 vaccination refusal or acceptance. Resident identifiers: [...]
Inspectors wroteBased on observation, interview, and record review it was determined, for 1 out of 34 sampled residents, that the facility did not ensure that the resident could exercise their rights without interference, coercion, discrimination, or reprisal from the facility. Specifically, a resident was denied access to their cigarettes and had their quantity of cigarettes limited when the resident asked for more. Resident identifier: 8.
Inspectors wroteBased on observation, interview, and record review, it was determined, the facility did not ensure that the resident's right to self-administer medications was evaluated and determined to be safe. Specifically, for 2 out of 34 sampled residents, resident's had medications stored in their rooms without an evaluation to determine if the resident's were safe to self-administer medications. Resident identifiers: 25 and 48.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure the resident's right to request, refuse, and/or discontinue treatment, and to formulate an advance directive. Specifically, for 1 out of 34 sampled resident, a resident did not have an advance directive accessible to the nursing staff. Resident identifier: 48.
Inspectors wroteBased on observation, interview, and record review it was determined, for 2 out of 34 sampled residents, that the resident did not have the right to voice grievances to the facility or other agencies or entity that hears grievances without discrimination or reprisal and without fear of discrimination or reprisal. In addition, the facility did not maintain evidence demonstrating the results of all grievances for a period of no less than three years from the issuance of the grievance decision. Specifically, there were no grievances for a period of time during transition of staff into the Resident Advocate position. In addition, residents reported grievances that were not followed up. Resident identifiers: 16 and 29.
Inspectors wroteBased on interview and record review it was determined, the facility did not ensure that a transfer or discharge was documented in the resident's medical record and that appropriate information was communicated to the receiving health care institution or provider. Specifically, for 2 out of 34 sampled residents, residents that were transferred to the hospital did not have a transfer assessment or a reason for the transfer documented in the medical record. In addition, no documentation was found in the resident's medical record to indicate the receiving provider was provided contact information of the practitioner responsible for the resident's care, resident representative contact information, advance directive information, all special instructions for care, a discharge summary, and any other documentation necessary for a safe and effective transition of care. Resident identifiers: [...]
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan and the residents' choice. Specifically, for 1 out of 34 sampled residents, a resident was admitted with two different admission orders, a chest x-ray revealed congestive heart failure with edema and no interventions were provided, a cardiologist had different medication orders, and laboratory services were not provided according to physician's orders. Resident identifier: 160.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that residents who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences. Specifically, for 1 out of 34 sampled residents, a resident who was receiving dialysis services did not have a physician's order for dialysis services or monitoring of the fistula. The resident did not receive ongoing assessments and oversight before and after dialysis treatments. In addition, ongoing communication and collaboration with the dialysis facility regarding the residents dialysis care and services was not completed by facility staff. Resident identifier: 44.
Inspectors wroteBased on observation, interview, and record review it was determined that the facility did not ensure that the medication error rates was not 5 percent or greater. Observations were made of 28 medication opportunities, on 9/28/22, revealed two medication errors which resulted in a 7.14 percent medication error rate. Specifically, an enteric coated Aspirin (ASA) was administered instead of a chewable and Omeprazole was substituted for Pantoprazole. Resident identifier: 53.
Inspectors wroteBased on interview and record review it was determined, for 2 of 34 sampled residents, the facility must obtain laboratory services only when ordered by a physician, physician assistant, nurse practitioner, or clinical nurse specialist. In addition, the facility must promptly notify the ordering physician of laboratory results that fall outside of clinical reference ranges. Specifically, a resident's laboratory (lab) tests were obtained without a provider order. In addition, a resident's urinalysis (UA) results were not obtained from the lab and reported to the ordering physician. Resident identifiers: 29 and 30.
Inspectors wroteBased on interview and record review it was determined, for 1 out of 34 sampled residents, the facility did not establish an infection prevention and control program that included antibiotic use protocols and a system to monitor antibiotic use. Specifically, a resident was receiving a prophylactic antibiotic without a diagnosis to treat. Resident identifier: 53.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that each resident's medical record included documentation that indicated that the resident or resident's representative was provided education regarding the benefits and potential side effects of the influenza and pneumococcal immunizations; and that the resident either received the influenza and pneumococcal immunizations or did not receive the influenza and pneumococcal immunizations due to medical contraindications or refusal. Specifically, for 1 out of 34 sampled residents, a resident's pneumococcal vaccine was not documented as administered after the resident's responsible party consented to the pneumococcal vaccine. Resident identifier: 10.
Inspectors wroteBased on interview and record review, it was determined, the facility did not ensure that all staff including contracted staff were fully vaccinated for Coronavirus Disease-2019 (COVID-19), except for those staff who had been granted exemptions to the vaccination. Specifically, for 2 out of 8 sampled staff members (SM), who were not temporarily delayed, had not completed the vaccination series for a multi-dose COVID-19 vaccine. Staff identifiers: SM 1 and SM 2.
Inspectors wrote28. On 7/16/21 at 1:17 PM, resident 186, who was on isolation, walked outside of her room to place an old, dirty lunch tray on the plastic folding table near her front door. [Note: This plastic folding table was present outside of resident 186's room was used to assist staff with donning and doffing PPE.] On 7/16/21 at 1:45 PM, CNA 7 gathered the used meal tray from the plastic folding table outside of 186's room. CNA 7 walked down the 100 hall with the uncovered, used food tray and placed the used tray on a table in dining area. On 7/16/21 at 1:46 PM, CNA 7 collected three, used meal trays from 185's room, who was also on isolation precautions. CNA 7 placed all 4 used trays on one table in dining area. At this time the used meal trays from isolation rooms were not covered and included used plates with lids, Styrofoam cups, napkins, utensils, and an empty yogurt containers. [...]
Inspectors wroteBased on interview and record review, it was determined that the facility did not employ a clinically qualified full-time dietitian or other clinically qualified nutrition professional to serve as the director of food and nutrition services. Specifically, the facility did not employ a full time Registered Dietitian (RD) and the Dietary Manager (DM) did not meet the requirements to serve as the director of food and nutrition services.
Inspectors wroteBased on interview, the facility did not designate one or more individual as the infection preventionist who was responsible for the facility's Infection Control Policy. Specifically, the facility did not have an infection preventionist for approximately 5 months.
Inspectors wroteBased on interview and observation, the facility did not treat residents with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality. Specifically, residents were referred to as feeders, and residents reported having to wait for extended periods of time for their call lights to be answered.
Inspectors wroteBased on interview and record review, the facility did not ensure that residents had the right to make choices about aspects of his or her life in the facility that were significant to the resident; nor did the facility ensure that residents had the right to choose activities consistent with his or her interests. Specifically, residents were not allowed to leave the facility. Resident identifiers: 8, 12, and 18.
Inspectors wroteBased on interview and observation, the facility did not allow residents to receive visitors of their choosing at the time of their choosing. Specifically, the facility did not allow residents to leave the building and did not allow immediate family to visit residents in their rooms. Residents and families were made to schedule appointments during the week to visit each other in a facility meeting room. Resident identifiers: 12, 18, 26, 86, 136, and 192.
Inspectors wroteBased on interview and observation, the facility did not provide housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. Specifically, dead and living insects were observed in 3 residents' rooms, a resident complained of poor housekeeping, couches were observed to be soiled, tablecloths were observed to be sticky, and areas of the facility had odors of feces and urine. Resident identifiers: 188, 191, 192, and 193.
Inspectors wroteBased on interview and record review, the facility did not send a copy of the transfer notice to a representative of the Office of the State Long-Term Care Ombudsman for 3 of 32 residents. Specifically, three residents were transferred to the hospital for overnight stays and the Ombudsman was not notified. Resident identifiers: 7, 23, and 136.
Inspectors wroteBased on interview and record review, the facility did not conduct initially and periodically a comprehensive, accurate, standardized reproducible assessment of each resident's functional capacity for 5 of 32 sample residents. Resident identifiers: 85, 86, 135, 136, and 189.
Inspectors wroteBased on interview and record review, it was determined for 5 of 32 sample residents, the facility did not develop and implement a baseline care plan for each resident that included instructions needed to provide effective and person-centered care of the resident to meet professional standards of quality care within 48 hours of a resident's admission. Specifically, several residents had unfinished baseline care plans that were not completed until weeks after admission, and others had not yet been completed. Resident identifiers: 29, 36, 86, 187, and 189.
Inspectors wroteBased on record review and interview, the facility did not have an activities program that was directed by a qualified professional who is a qualified therapeutic recreation specialist. Specifically, the facility did not employ a Certified Therapeutic Recreation Specialist.
Inspectors wroteBased on interview, observation, and record review, the facility did not have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility's resident population. Specifically, residents voiced concern with the level of staffing at the facility, and the wait times for call lights to be answered. In addition, staff were observed to not respond timely to a resident who subsequently fell out of bed. Also, review of the facility's call light logs revealed patterns of extended wait times. Resident identifiers: 12, 18, 26, 29, 135, 136, 185, 189, 191, and 192.
Inspectors wroteBased on interview, observation, and record review, the facility did not have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility's resident population in accordance with the facility assessment. Specifically, two residents were transferred onto the scale by staff inappropriately, one of whom experienced a fall. In addition, a staff member's certification had expired, a resident had an unwitnessed fall but was not appropriately assessed, and a pain pill was given to an unlicensed staff member to administer to a resident. Resident identifiers: [...]
Inspectors wroteBased on observation and interview, it was determined that the facility did not have the nurse staffing information posted. The facility must post the following information on a daily basis: Facility name, the current date, the total number and the actual hours worked by the following categories of licensed and unlicensed nursing staff directly responsible for resident care per shift: Registered Nurses, Licensed practical nurses, Certified Nurse aides, and resident census. The facility must post the nurse staffing data on a daily basis at the beginning of each shift and maintain the posted daily nurse staffing data for a minimum of 18 months. Additionally, the information must be displayed in a prominent place readily accessible to residents and visitors.
Inspectors wroteBased on observation, record review, and interviews, the facility failed to provide pharmaceutical services to meet the needs of 4 of 32 sample residents. Specifically, the 4 residents were not given scheduled medication due to it not being available. Resident identifiers: 4, 10, 29, and 136.
Inspectors wroteBased on interview and record review it was determined that for 3 of 32 sample residents, the facility did not ensure that the monthly drug regimen recommendations by a licensed pharmacist were implemented in a timely manner. Resident identifiers: 16, 20, and 29.
Inspectors wroteBased on record review, and interviews, the facility failed to ensure each resident's drug regimen was free from unnecessary drugs. Specifically, 3 of 32 residents were given medication outside of ordered parameters. Resident identifiers: 3, 135, and 136.
Inspectors wroteBased on observation, interview, and record review, it was determined the facility failed to ensure that it's medication error rates are not 5 percent or greater for 3 of 32 sample residents. Specifically, 2 residents did not have scheduled medication available, and 1 resident was given the incorrect dose of insulin. This resulted in a 12 percent medication error rate. Resident identifiers: 4, 19, and 34.
Inspectors wroteBased on interview and record review, the facility did not ensure that 5 of 32 sample residents were free of significant medication errors. Specifically, residents were not administered medications due to the medications being unavailable, were administered the incorrect dose, and/or were administered medications outside of physician prescribed parameters. Resident identifiers: 4, 19, 29, 34, and 136.
Inspectors wroteBased on observation, interview and record review it was determined that the facility did not store, prepare, distribute, and serve food in accordance with professional standards of food service safety. Specifically, food in the freezer was not dated and open to air, food items in the dry storage room were not sealed and open to air, staff members entered the kitchen during tray line without hair nets, and food was plated for a resident's lunch tray without checking the temperature.
Inspectors wroteBased on observation, record review and interview the facility was not administered in a manner that enabled it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Specifically, the facility was found to be in non-compliance with F880, which was cited at an Immediate Jeopardy, scope and severity of L. In addition, several deficiencies were cited during the 2019 recertification survey, and again during the 2021 survey. Resident identifiers: 85, 86, 185, 186 and 187.
Inspectors wroteBased on observation, interview and record review, it was determined for 2 of 32 sample residents that the facility did not maintain medical records on each resident that were complete and accurately documented. Specifically, a newly admitted resident's COVID testing results were not included in the medical record. Additionally, facility staff failed to keep resident medical records confidential and out of public view, and a resident's hospital records were not in the electronic health record. Resident identifiers: 86 and 193.
Inspectors wroteBased on interview and record review, the facility did not ensure that the Quality Assessment and Assurance (QAA) committee developed and implemented appropriate plans of correction to correct identified quality deficiencies. Specifically, the facility was found to be in non-compliance with F880, which was cited at an Immediate Jeopardy, scope and severity of L. In addition, several deficiencies were cited during the 2019 recertification survey, and again during the 2021 survey. Resident identifiers: 85, 86, 185, 186 and 187.
Inspectors wroteBased on interview and record review, the facility did not inform residents, their representatives, and families of those residing in facilities by 5 p.m. the next calendar day following the occurrence of either a single confirmed infection of COVID-19, or three or more residents or staff with new-onset of respiratory symptoms occurring within 72 hours of each other. Specifically, the facility experienced two positive staff members/residents, and did not inform residents, their representatives, and families of the outbreaks.
Inspectors wroteBased on observation, interview and record review it was determined that for 1 of 32 sample residents the facility interdisciplinary care team (IDT) did not determine a resident to be safe for self-administration of medication before the resident exercised the right to do so. Specifically, an unlicensed staff member was provided medication by a licensed nursing staff to administer to a resident, and the resident did not have a self-administration evaluation. Resident identifier: 187.
Inspectors wroteBased on interview and record review it was determined that the facility did not develop and implement a comprehensive person-centered care plan for 1 of 32 sample residents, consistent with the resident right that included measurable objectives and time frames to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment. Specifically, a fall care plan was not developed as required. Resident identifier: 29.
Inspectors wroteBased on interview and record review, it was determined that the facility did not complete a discharge summary for 1 of 32 sample residents. When the facility anticipates a discharge, a resident must have a discharge summary that includes, but is not limited to, the following: (a) A recapitulation of the resident's stay that includes but is not limited to, diagnoses, course of illness/treatment or therapy, and pertinent lab, radiology and consultation results. (b) A final summary of the resident's status at the time of discharge that is available for release to authorized persons and agencies, with the consent of the resident or resident's representative. (c) Reconciliation of all pre-discharge medications with the resident's post discharge medications (both prescribed and over-the-counter). [...]
Inspectors wroteBased on observation, interview, and record review, it was determined the facility did not ensure that 2 of 32 sample residents who were unable to carry out activities of daily living, received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene. Specifically, one resident did not receive a shower after asking for one several times, and one resident did not receive the feeding assistance she needed at meal time. Resident identifiers: 136 and 193.
Inspectors wrote2. Resident 29 was admitted to the facility on [DATE] with diagnoses that included combined systolic and diastolic heart failure, atrial fibrillation, diabetes mellitus, iron deficiency anemia, hyperlipidemia, cardiomyopathy, heart failure, major depressive disorder, long QT syndrome, chronic fatigue, and thyrotoxicosis. Resident 29's medical record was reviewed on 7/12/21 and again on 7/19/21. On 7/14/21 at approximately 1:00 PM, an observation was made of resident 29. Resident 29 was being wheeled by the Van Driver (VD) onto the wheelchair scale. The front wheels of the wheelchair were observed to catch on the lip of the scale, causing the resident to jerk forward. Resident 29's feet were observed to drag under the frame of the wheelchair as the resident was being wheeled onto the scale. The VD was observed to reach down and reposition the resident's feet. [...]
Inspectors wroteBased on interviews, observation, and record review, it was determined the facility failed to offer sufficient fluid intake to maintain proper hydration and health to 2 of 32 sample residents. Specifically, two residents who were at risk for dehydration were not consistently provided fresh drinking water. Resident identifiers: 136 and 193.
Inspectors wroteBased on interview, record review and observation, the facility did not ensure that a staff member was currently registered to work as a Certified Nursing Assistant.
Inspectors wroteBased on record review and interview, the facility did not provide or obtain laboratory services to meet the needs of 1 of 32 sample residents. Resident identifier: 29.
Inspectors wroteBased on interview and record review, the facility did not develop policies and procedures to ensure that 1 of 32 sample residents was educated about and offered the COVID-19 vaccine. Resident identifier: 86.
6 fire safety citations on file: 4 on August 28, 2024, 1 on October 3, 2022, 1 on July 21, 2021.
| Date | Penalty | Amount or length |
|---|---|---|
| May 5, 2026 | Fine | $12,735 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Utah | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.64 | 4.09 | 3.86 |
| Registered nurses | 1.44 | 1.25 | 0.69 |
| All nursing staff on weekends | 3.27 | 3.58 | 3.42 |
| Nurse aides | 2.09 | ||
| Licensed practical nurses | 0.12 | ||
| Nursing staff turnover (share who left in a year) | 43.4% | 50.7% | 45.8% |
| Registered nurse turnover | 17.6% | 40.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.80 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.79 on weekdays and 3.27 on weekends, 14% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 10.7% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.47 in April to June 2025 to 3.64 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.64 | 1.44 | 3.79 | 3.27 | 10.7% | 0 of 90 | 53 |
| Oct to Dec 2025 | 3.49 | 1.35 | 3.61 | 3.19 | 9.7% | 0 of 92 | 51 |
| Jul to Sep 2025 | 3.56 | 1.38 | 3.66 | 3.33 | 9.7% | 0 of 92 | 52 |
| Apr to Jun 2025 | 3.47 | 1.24 | 3.55 | 3.27 | 6.9% | 0 of 91 | 53 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Utah, Jan to Mar 2026 | 3.91 | 1.11 | 4.10 | 3.44 | 2.8% | 0.2% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Utah, all employers | |||
| CNAs (nursing assistants) | $19.15 | $17.81 to $21.32 | 12,260 |
| LPNs and LVNs | $30.40 | $25.71 to $35.86 | 1,680 |
| Registered nurses | $40.67 | $38.49 to $50.54 | 27,420 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Utah | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 20.3 | 11.3 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.2 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 2.5 | 1.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 7.3 | 2.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 0.9 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 24.6 | 15.1 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.8 | 3.9 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 7.2 | 14.2 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 14.7 | 16.6 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 7.8 | 11.6 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Rocky Mountain Care - Maple Dell's Medicare short-stay residents. On returning residents home or to the community, CMS rates it better than the national rate (62.8% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
62.8% this home
Better than the national rate
US median of homes 51.5% · Utah: 40 better, 0 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 36 eligible stays.
9.5% this home
No different from the national rate
US median of homes 10.7% · Utah: 3 better, 0 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 52 eligible stays.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
US median of homes 7.1% · Utah: 2 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 21 eligible stays.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Utah63.5% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 18 residents counted.
3.7% this home
Median of homes: Utah0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 27 residents counted.
2.9% this home
Median of homes: Utah1.3% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 27 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Utah100.0% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 5 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: CANYONLANDS HEALTH CARE SPECIAL SERVICE DISTRICT. CMS links this home to Rocky Mountain Care, a group of 10 nursing homes averaging 3 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Canyonlands Health Care Special Service District | 5% or greater direct ownership interest | Organization | 100% | 04/01/2025 |
| Bangerte, Nathan | Managing control - governing body | Individual | 06/23/2025 | |
| Bangerter, Edward | Managing control - governing body | Individual | 06/23/2025 | |
| Bangerter, Johnathan | Managing control - governing body | Individual | 06/23/2025 | |
| Darby, Megan | Managing control - governing body | Individual | 06/23/2025 | |
| Gatherum, Jason | Managing control - governing body | Individual | 06/23/2025 | |
| Neves, Courtney | Managing control - governing body | Individual | 06/23/2025 | |
| Snowball, Kelly | Managing control - governing body | Individual | 06/23/2025 | |
| Ballantyne, Kenneth | Corporate director | Individual | 01/01/2025 | |
| Cook, Daniel | Corporate director | Individual | 01/01/2023 | |
| Knuteson, Tawny | Corporate director | Individual | 01/01/2025 | |
| Langianese, Joette | Corporate director | Individual | 01/01/2022 | |
| Trujillo, Camille | Corporate director | Individual | 01/01/2025 | |
| Irby, Martha | Corporate officer | Individual | 01/01/2022 | |
| Lyman, Colette | Corporate officer | Individual | 01/01/2022 | |
| McCandless, Melodie | Corporate officer | Individual | 01/01/2025 | |
| Dej Payson Operating LLC | Operational/managerial control | Organization | 02/13/2025 | |
| Parsons, Weston | Operational/managerial control | Individual | 05/15/2024 | |
| Schellenberg, Matthew | Operational/managerial control | Individual | 04/15/2024 | |
| Dej Payson Operating LLC | Adp of the SNF | Organization | 07/31/2025 | |
| Rocky Mountain Care LLC | Adp of the SNF | Organization | 07/31/2025 | |
| Bangerter, Edward | Adp of the SNF | Individual | 12/30/2019 | |
| Bangerter, Johnathan | Adp of the SNF | Individual | 12/30/2019 | |
| Parsons, Weston | Adp of the SNF | Individual | 05/15/2024 | |
| Schellenberg, Matthew | Adp of the SNF | Individual | 04/15/2024 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in Utah. NursingHomeClear cannot take or act on complaints.