Based on observation, interview and record review the facility did not ensure, 9 of 32 sampled residents, were free from abuse and neglect. Specifically, multiple residents with cognitive impairment were identified to have sexual contact and were not assessed for capacity to consent to a sexual relationship. In addition, 2 residents eloped from the facility and were returned to the facility without the staff's knowledge. These examples were cited at an Immediate Jeopardy level. Resident identifiers: 11, 21, 25, 27, 31, 33, 36, 42 and 49. NOTICE On 8/8/25 at 1:15 PM, Immediate Jeopardy (IJ) was identified when the facility failed to implement Centers for Medicare and Medicaid Services recommended practices to prevent various forms of abuse. …
F600 citations in Utah
Abuse and neglect · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Utah cites F600 less often than its own record predicts
0.85 times the national share — cited less often here than elsewhere.
Of every deficiency written in Utah in 2025, this is the portion that was F600.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Utah surveyors wrote
F600 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 protect each resident's right to be free from neglect for 1 of 19 residents. Specifically, facility staff failed to provide the necessary care and supervision required to maintain a safe environment for a resident with known impulsivity and severe cognitive impairment. This failure occurred when a Registered Nurse (RN) left a medication cart unlocked and unattended, in direct violation of facility policy and the resident's specific care plan interventions dated 9/17/25. This breach in safety protocols allowed the resident to access the unsecured cart and ingest multiple medications not prescribed to him. …
Based on interview and record review, the facility failed to ensure a resident was free from neglect. Specifically, for 1 out of 7 sampled residents, staff failed to provide timely assistance to transfer a resident with quadriplegia and Stage 3 pressure ulcers from a power wheelchair to bed, leaving the resident in the wheelchair for nearly 12 hours. This resulted in the resident experiencing increased buttock pain.The facility developed and implemented a corrective action plan before the survey start date. …
The short window
Recent years
| Year | Share of Utah citations | vs expected |
|---|---|---|
| 2023 | 2.78% | 1.57× |
| 2024 | 3.28% | 1.39× |
| 2025 | 2.23% | 0.85× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Utah surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction