Monument Healthcare Murray Creek Inspection Report, Violations & Safety Grade (Millcreek, Utah)

3855 South 700 East, Millcreek, Utah 84106

Phone: 8012684766

CMS Overall:2/5

Overview & Bed Count

Certified Beds

184

Avg Residents/Day

114.4

Ownership

For profit - Limited Liability company

Provider Type

Medicare and Medicaid

County

Salt Lake

Sprinkler Systems

Yes

Special Focus

None

Abuse Icon

Yes

CMS Star Ratings

Overall2/5

Health1/5

Staffing3/5

Quality5/5

Nurse Staffing Check

Metric	This Facility	Utah Avg	Difference
RN Hours per Resident per Day	1.08	1.24	-0.16
Total Nurse Hours per Resident per Day	3.93	4.08	-0.15
CMS Staffing Rating	3/5	3.2/5	-
Nursing Staff Turnover	47.2%	50%	-

Health Citation History

49 health citations on record

Date	Category	Description	Severity
2026-03-31	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G – Actual Harm
2026-03-31	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D – Moderate Harm Potential
2025-06-28	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.	H – Actual Harm
2025-06-28	Administration Deficiencies	Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.	F – Moderate Harm Potential
2025-06-28	Administration Deficiencies	Provide a neutral and fair arbitration process and agree to arbitrator and venue.	F – Moderate Harm Potential
2025-06-28	Administration Deficiencies	Have the Quality Assessment and Assurance group have the required members and meet at least quarterly	F – Moderate Harm Potential
2025-06-28	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	F – Moderate Harm Potential
2025-06-28	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	E – Moderate Harm Potential
2025-06-28	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Respond appropriately to all alleged violations.	E – Moderate Harm Potential
2025-06-28	Resident Rights Deficiencies	Allow residents to self-administer drugs if determined clinically appropriate.	D – Moderate Harm Potential
2025-06-28	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D – Moderate Harm Potential
2025-06-28	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D – Moderate Harm Potential
2025-06-28	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	D – Moderate Harm Potential
2025-06-28	Quality of Life and Care Deficiencies	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.	D – Moderate Harm Potential
2025-06-28	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D – Moderate Harm Potential
2025-06-28	Environmental Deficiencies	Ensure resident rooms meet each resident's needs.	D – Moderate Harm Potential
2024-01-31	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G – Actual Harm
2023-08-31	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F – Moderate Harm Potential
2023-08-31	Resident Rights Deficiencies	Allow residents to self-administer drugs if determined clinically appropriate.	E – Moderate Harm Potential
2023-08-31	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	E – Moderate Harm Potential
2023-08-31	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	E – Moderate Harm Potential
2023-08-31	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	E – Moderate Harm Potential
2023-08-31	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	E – Moderate Harm Potential
2023-08-31	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D – Moderate Harm Potential
2023-08-31	Resident Assessment and Care Planning Deficiencies	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.	D – Moderate Harm Potential
2023-08-31	Resident Assessment and Care Planning Deficiencies	Assure that each resident’s assessment is updated at least once every 3 months.	D – Moderate Harm Potential
2023-08-31	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D – Moderate Harm Potential
2023-08-31	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D – Moderate Harm Potential
2021-12-06	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F – Moderate Harm Potential
2021-12-06	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.	E – Moderate Harm Potential
2021-12-06	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	E – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	E – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	E – Moderate Harm Potential
2021-12-06	Nursing and Physician Services Deficiencies	Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.	E – Moderate Harm Potential
2021-12-06	Nutrition and Dietary Deficiencies	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.	E – Moderate Harm Potential
2021-12-06	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E – Moderate Harm Potential
2021-12-06	Infection Control Deficiencies	Perform COVID19 testing on residents and staff.	E – Moderate Harm Potential
2021-12-06	Resident Rights Deficiencies	Reasonably accommodate the needs and preferences of each resident.	D – Moderate Harm Potential
2021-12-06	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D – Moderate Harm Potential
2021-12-06	Resident Rights Deficiencies	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.	D – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.	D – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Provide enough food/fluids to maintain a resident's health.	D – Moderate Harm Potential
2021-12-06	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	D – Moderate Harm Potential
2021-12-06	Pharmacy Service Deficiencies	Ensure each resident’s drug regimen must be free from unnecessary drugs.	D – Moderate Harm Potential
2021-12-06	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D – Moderate Harm Potential
2021-12-06	Nutrition and Dietary Deficiencies	Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.	D – Moderate Harm Potential
2021-12-06	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D – Moderate Harm Potential

Fire Safety Citation History

1 fire safety citation on record

Date	Category	Description	Severity
2021-12-06	Emergency Preparedness Deficiencies	Develop and maintain an Emergency Preparedness Program (EP).	D – Moderate Harm Potential

Total Penalties & Fines

$59,188

Total Fine Amount (CMS)

Number of Fines

Total Penalties

Date	Type	Fine Amount	Payment Denial
2026-03-31	Fine	$14,380	-
2025-06-28	Fine	$36,660	-
2024-01-31	Fine	$8,148	-

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Need Help Finding Safe Care?

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3-Year Complete Report ($19)

Advisor service is free for families. We may receive referral compensation.