Menger Springs Medical Resort

Penalties

• Nov 24, 2024 — Fine ($88,390)
• Nov 24, 2024 — Payment Denial · payment denial 6 days

Inspection findings

1. Jan 23, 2026 Fire Safety · 7 findings
   • Not serious Scope/severity F

     E0020 Emergency Preparedness Deficiencies

     Establish policies and procedures including evacuation.

     Corrected Feb 27, 2026 · CMS fire safety

   • Not serious Scope/severity D

     F0585 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.

     Corrected Mar 6, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Mar 6, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0759 Pharmacy Service Deficiencies

     Ensure medication error rates are not 5 percent or greater.

     Corrected Mar 9, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0760 Pharmacy Service Deficiencies

     Ensure that residents are free from significant medication errors.

     Corrected Mar 9, 2026 · CMS health inspection

   • Not serious Scope/severity E

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Mar 9, 2026 · CMS health inspection

   • Not serious Scope/severity F

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Feb 27, 2026 · CMS fire safety

2. Jan 2, 2025 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0656 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.

     Corrected Jan 29, 2025 · CMS health inspection

3. Nov 24, 2024 Health · 1 finding
   • Serious Scope/severity J Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected Dec 30, 2024 · CMS health inspection

4. Oct 11, 2024 Health · 5 findings
   • Not serious Scope/severity D

     F0584 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.

     Corrected Nov 19, 2024 · CMS health inspection

   • Not serious Scope/severity E

     F0655 Resident Assessment and Care Planning Deficiencies

     Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

     Corrected Nov 19, 2024 · CMS health inspection

   • Not serious Scope/severity E

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Nov 19, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0804 Nutrition and Dietary Deficiencies

     Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

     Corrected Nov 19, 2024 · CMS health inspection

   • Not serious Scope/severity F

     K0918 Gas, Vacuum, and Electrical Systems Deficiencies

     Have generator or other power source capable of supplying service within 10 seconds.

     Corrected Nov 19, 2024 · CMS fire safety

5. Sep 8, 2023 Health · 10 findings
   • Not serious Scope/severity D

     F0607 Freedom from Abuse, Neglect, and Exploitation Deficiencies

     Develop and implement policies and procedures to prevent abuse, neglect, and theft.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0641 Resident Assessment and Care Planning Deficiencies

     Ensure each resident receives an accurate assessment.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0656 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.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0730 Nursing and Physician Services Deficiencies

     Observe each nurse aide's job performance and give regular training.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0761 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.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0944 Administration Deficiencies

     Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0945 Infection Control Deficiencies

     Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.

     Corrected Sep 11, 2023 · CMS health inspection

   • Not serious Scope/severity D

     K0918 Gas, Vacuum, and Electrical Systems Deficiencies

     Have generator or other power source capable of supplying service within 10 seconds.

     Corrected Oct 11, 2023 · CMS fire safety

6. Aug 18, 2023 Health · 2 findings
   • Not serious Scope/severity D Complaint

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Oct 5, 2023 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Oct 5, 2023 · CMS health inspection

Owners and managers (as published by CMS)

• ASIS, RISSA — operational/managerial control, NOT APPLICABLE, since 04/03/2023
• BRYAN, SCOTT — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• BRYAN, SCOTT — corporate director, NOT APPLICABLE, since 01/01/2024
• CRUMP, PATRICK — adp of the snf, NOT APPLICABLE, since 02/13/2017
• CRUMP, PATRICK — corporate officer, NOT APPLICABLE, since 02/13/2017
• DROUGHT, JESSICA — corporate director, NOT APPLICABLE, since 01/01/2023
• DROUGHT, JESSICA — trustee of the snf, NOT APPLICABLE, since 01/01/2023
• FORGIONE, DANA — corporate director, NOT APPLICABLE, since 01/01/2023
• FORGIONE, DANA — trustee of the snf, NOT APPLICABLE, since 01/02/2023
• GARZA, EDWARD — corporate director, NOT APPLICABLE, since 01/01/2021
• GARZA, EDWARD — trustee of the snf, NOT APPLICABLE, since 01/01/2021
• HACKETT, GREG — corporate director, NOT APPLICABLE, since 01/01/2022
• HACKETT, GREG — trustee of the snf, NOT APPLICABLE, since 01/01/2022
• KERCHEVILLE, SCOTT — corporate director, NOT APPLICABLE, since 01/01/2022
• KERCHEVILLE, SCOTT — trustee of the snf, NOT APPLICABLE, since 01/01/2022
• MCCULLOUGH, ROBERT — corporate director, NOT APPLICABLE, since 01/01/2024
• MCCULLOUGH, ROBERT — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• MCRAE, THOMAS — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• MCRAE, THOMAS — corporate director, NOT APPLICABLE, since 01/01/2024
• MENDOZA, DORA — corporate director, NOT APPLICABLE, since 01/01/2020
• MENDOZA, DORA — trustee of the snf, NOT APPLICABLE, since 01/01/2020
• MOBLEY, JESSICA — corporate director, NOT APPLICABLE, since 01/01/2023
• MOBLEY, JESSICA — trustee of the snf, NOT APPLICABLE, since 01/01/2023
• MONFREY, MARGARET — adp of the snf, NOT APPLICABLE, since 07/31/1989
• MONFREY, MARGARET — operational/managerial control, NOT APPLICABLE, since 05/21/2015
• MOORE, JOE — corporate director, NOT APPLICABLE, since 01/01/2024
• MOORE, JOE — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• MORENO, CHELSEA — adp of the snf, NOT APPLICABLE, since 01/30/2023
• MORENO, CHELSEA — corporate officer, NOT APPLICABLE, since 01/30/2023
• MORENO, CHELSEA — operational/managerial control, NOT APPLICABLE, since 01/30/2023
• MUNOZ, DIONICIO — adp of the snf, NOT APPLICABLE, since 09/24/2023
• MUNOZ, DIONICIO — operational/managerial control, NOT APPLICABLE, since 09/24/2023
• NGUYEN, CHRISINE — adp of the snf, NOT APPLICABLE, since 03/19/2018
• NGUYEN, CHRISINE — operational/managerial control, NOT APPLICABLE, since 03/19/2018
• ORTIZ, ROBERT — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• ORTIZ, ROBERT — corporate director, NOT APPLICABLE, since 01/01/2024
• OSANYINLUSI, LISA — adp of the snf, NOT APPLICABLE, since 07/01/2024
• OSANYINLUSI, LISA — operational/managerial control, NOT APPLICABLE, since 07/01/2024
• PHIPPS, AMY — trustee of the snf, NOT APPLICABLE, since 01/01/2024
• PHIPPS, AMY — corporate director, NOT APPLICABLE, since 01/01/2024
• POWELL, BROOKS — adp of the snf, NOT APPLICABLE, since 11/11/2022
• POWELL, BROOKS — operational/managerial control, NOT APPLICABLE, since 11/11/2022
• PRATER, MYRANDA — operational/managerial control, NOT APPLICABLE, since 12/07/2020
• PRATER, MYRANDA — adp of the snf, NOT APPLICABLE, since 12/18/2024
• READ, DAVID — corporate director, NOT APPLICABLE, since 01/01/2022
• READ, DAVID — trustee of the snf, NOT APPLICABLE, since 01/01/2022
• ROBERTSON, CASSANDRA — operational/managerial control, NOT APPLICABLE, since 08/16/2021
• ROBERTSON, CASSANDRA — adp of the snf, NOT APPLICABLE, since 08/16/2021
• SCOFIELD, GEORGE — trustee of the snf, NOT APPLICABLE, since 01/01/2022
• SCOFIELD, GEORGE — corporate director, NOT APPLICABLE, since 01/01/2022
• TYE, RICHARD — corporate director, NOT APPLICABLE, since 01/01/2020
• TYE, RICHARD — trustee of the snf, NOT APPLICABLE, since 01/01/2020
• YOUNGQUIST, HOLLY — trustee of the snf, NOT APPLICABLE, since 01/01/2023
• YOUNGQUIST, HOLLY — corporate director, NOT APPLICABLE, since 01/01/2023
• MORNINGSIDE MINISTRIES — direct ownership interest, NOT APPLICABLE, since 10/28/2009
• MORNINGSIDE MINISTRIES — adp of the snf, NOT APPLICABLE, since 10/28/2009