01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-20 | 10 | 2025-11-20 | 0 |
| Cycle 2 | 2023-11-02 | 6 | 2023-11-02 | 0 |
| Cycle 3 | 2021-12-28 | 0 | 2021-12-28 | 2 |
CMS CCN 4651392026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Monument Healthcare Millcreek
1201 East 4500 South · Salt Lake City, UT 84117 · Salt Lake County
Certified beds120CMS provider file
Recent citation rows18current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
18 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-21 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-02-16 · complaint2026-01-21 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2026-02-16 · complaint2025-11-20 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0757Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0773Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0779Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Keep signed and dated reports of x-rays and other diagnostic services in the residents record.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2025-11-20 · HEALTHF0919Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2025-12-26 · complaint2023-11-02 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2023-12-312023-11-02 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2023-12-312023-11-02 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2023-12-312023-11-02 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-12-312023-11-02 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2023-12-312023-11-02 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2023-12-312021-12-28 · FIREE0004Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2022-01-312021-12-28 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2022-01-3103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- MILFORD AREA HEALTH CARE SERVICE DISTRICT #3Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 02/01/2024
- MONUMENT HEALTH PROPERTIES LLCOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 02/01/2024
- MONUMENT REAL ESTATE MILLCREEK LLCOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 02/01/2024
- DANSIE, GUYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/01/2024
- LANGFORD, SCOTTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/01/2024
- MOSS, TYLERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/01/2024
- BEAVER VALLEY HOSPITALOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/06/2024
- HEALTH GROUP MANAGEMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/05/2024
- ALLEN, RICHARDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- CARTER, LAURELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/06/2024
- CLAWSON, TRAVISIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- DEVASHRAYEE, TRAVISIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- DOTSON, WARDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/06/2024
- ESPINOSA, STEPHANIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- FRAGOSO, LINDSAYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- IZATT, BRENDAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
- MAYER, SHAUNAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/06/2024
- MOSS, TYLERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.74per resident day
RN hours1.05per resident day
Weekend nurse hours3.28per resident day
Staff turnover46.9%CMS reported field
06 / LOCAL RECORDS
Open the Salt Lake City ledger →Other published facilities nearby
City Creek Post Acute108 beds · CMS overall 3/521 citation rowsHolladay Healthcare Center120 beds · CMS overall 3/534 citation rowsMaple Ridge Rehabilitation And Nursing36 beds · CMS overall 1/547 citation rowsMeadow Brook Rehabilitation And Nursing41 beds · CMS overall 2/565 citation rowsMidtown Manor82 beds · CMS overall 1/542 citation rowsMillcreek Rehabilitation And Nursing61 beds · CMS overall 2/545 citation rowsMonument Healthcare Cottonwood Creek77 beds · CMS overall 3/529 citation rowsMonument Healthcare South Salt Lake140 beds · CMS overall 1/560 citation rows