Montrose Springs Skilled Nursing & Wellness Center
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 72 Google reviews
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Abuse citation on record
- Above-median deficiencies (21 vs median 13.0)
Below average in CA · Below recommended RN staffing · Chain outperformer · $32,139 in fines · Abuse citation
What this means for your family
This facility offers excellent physical therapy and a clean environment for rehabilitation. However, families should exercise extreme caution regarding the security of personal belongings and verify that management is responsive to your specific concerns regarding care oversight.
Google Reviews
Google Reviews
72 reviews on Google“Families considering Montrose Springs will find a polarizing environment where many praise the compassionate rehabilitation and physical therapy teams. However, significant concerns exist regarding administrative responsiveness, potential theft of personal belongings, and inconsistent nursing care during off-hours.”
Quality Themes
Tap a score for detailsStrengths
- Compassionate rehabilitation and physical therapy staff
- Clean and organized facility environment
- Attentive and friendly front desk/reception
- Effective communication regarding changes in patient condition
Concerns
- Loss or theft of residents' personal clothing (mentioned by 3 reviewers)
- Unprofessional or unresponsive administration/management (mentioned by 3 reviewers)
- Inconsistent nursing responsiveness/staffing levels (mentioned by 2 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 80 analyzed
How They Respond to Reviews
Questions for Your Tour
- 1We've heard great things about your physical therapy team; could you tell us more about how the rehab process works for new residents?
- 2What specific steps are in place to ensure that residents' personal belongings and clothing are kept safe and organized?
- 3How does the nursing team ensure consistent communication with families when there are any changes in a resident's health or condition?
- 4Could you describe the current dining experience and what improvements are being made to the meal service and variety?
- 5What is the protocol for handling medical emergencies or urgent care needs during the overnight hours?
- 6What kind of daily activities or social events are planned to keep residents engaged and connected with one another?
Personalized based on this facility's data
Key Review Excerpts
“The place is very clean and organized and the staff is great at what they do . Whenever there is any issue or change in my mom’s condition they call me right away and it is very much appreciated .”
“My sis in law, loves it there, she's safe and clean. Above and beyond care🫶🏼”
“My husband’s clothes was stolen. Try to contact the administrator Ani, she never returned my calls.”
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
9
measures
6
measures
2
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose bladder or bowel control got worse
Residents whose walking got worse
Residents needing more daily help over time
Residents on antipsychotic medication
Residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
This facility shows a concerning pattern of protection failures with families filing multiple complaints about resident abuse and neglect, including recent incidents in March 2025. The most recurring issues involve care planning, medication management, and resident rights violations. While all 87 deficiencies across 17 surveys show correction dates, the high volume of complaint-driven investigations (25 deficiencies) and repeated problems in core care areas suggest ongoing challenges with consistent quality care and resident safety.
Apr 20, 2026Complaint1
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.
Apr 7, 2026Complaint1
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Feb 26, 2026Complaint3
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.
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.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Jan 22, 2026Complaint2
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.
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Jul 3, 2025Routine16
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
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.
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.
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.
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Environmental Deficiencies
Ensure resident rooms hold no more than 4 residents; for new construction after November 28, 2016, rooms hold no more than 2 residents.
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Jul 3, 2025Complaint1
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Federal Penalties
Fine
Feb 20, 2025
$32,139
Payment Denial
May 10, 2024
6-day denial
Ownership & Operations
Who Operates This Facility
Montrose Springs Skilled Nursing & Wellness Center
for profit
Chain Affiliation
Pacific Healthcare Holdings
15 facilities nationwide
Chain avg rating: 2.3/5 · Rank 6 of 15
Ownership & Management
Owners
Pacific Healthcare Holdings, INC.
Owner · Organization
Key personnel
Contact
Get in Touch
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References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
72 reviews from families & visitors
Official Website
Visit verdugovalleywc.com
Medicare data downloads
Original nursing home datasets
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Safer Alternatives Nearby
Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.
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