Based on interview and record review it was determined, for 1 out of 5 sampled residents, that the facility did not immediately consult with the resident's physician when there was a significant change in the resident's physical status or a need to alter treatment. Specifically, a resident experienced a change in condition after a fall and the medical provider was not notified of the change timely. This resulted in a finding of harm to the resident. Resident identifier: 2.Findings included: Resident 2 was admitted to the facility on [DATE] with diagnoses which included, traumatic subarachnoid hemorrhage, nontraumatic acute subdural hemorrhage, difficulty in walking, epileptic seizures, and obstructive hydrocephalus.Resident 2's medical record was reviewed on 12/1/25. …
F580 citations in Utah
Notifying of changes · 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.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Utah cites F580 more often than its own record predicts
1.20 times the share F580 takes of citations nationally.
Of every deficiency written in Utah in 2025, this is the portion that was F580.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Utah surveyors wrote
F580 findings written in Utah, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interview and record review, the facility failed to consult the resident's physician when there was a need to alter treatment significantly. Specifically, for 1 of 16 sampled residents, a resident's physician was not notified when diabetic medication was unavailable for administration. Resident identifier: 45.Findings include:Resident 45 was admitted to the facility on [DATE] with diagnoses which included Diabetes Mellitus (DM), Epilepsy, Peripheral Vascular Disease, and Acquired Absence of Right Leg Above Knee.Resident 45's physician orders initiated 5/30/26 revealed metFORMIN HCl Oral Tablet 500 MG (milligrams): Give 1 tablet by mouth 2 times a day for DM (Arise and HS).Resident 45's May 2026 Medication Administration Record (MAR) revealed on 5/30/26 at 7:09 AM Metformin 500 mg… …
The short window
Recent years
| Year | Share of Utah citations | vs expected |
|---|---|---|
| 2023 | 1.16% | 0.81× |
| 2024 | 1.38% | 0.91× |
| 2025 | 1.78% | 1.20× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Utah surveyors cite →
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