Durango Health And Rehabilitation
DURANGO HEALTH AND REHABILITATION in DURANGO, CO — inspection on March 31, 2026.
Found 1 citation. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
According to the
MDS assessment revealed the resident was severely cognitively impaired with a BIMS score of 0 out of 15. He required maximum assistance with ADLs.
The MDS assessment indicated the resident did not have behaviors directed towards others. 2.
Record review Resident #4's behavior care plan, dated 1/14/25, revealed the resident was at risk for the potential to demonstrate verbally abusive behaviors.
The care plan documented he had the potential for psychosocial issues due to an incident of receiving unprovoked agitation with physical abuse from another resident.
Pertinent interventions included monitoring the resident for signs and symptoms of aggression as well as signs and symptoms of fear or psychosocial trauma, documenting behavior and attempted interventions and reporting physical contact from another resident. Resident #4's antipsychotic medication care plan, dated 7/2/25, revealed the resident was at risk for aggressive behaviors.
Pertinent interventions included monitoring for aggressive behaviors, such as throwing medications, cursing at others, and non-redirectable agitation and if agitation was observed, intervening immediately to prevent an increase in behaviors.III.
Staff interviews Registered nurse (RN) #1 was interviewed on 3/30/26 9:10 a.m. RN #1 said there was one staff member on the unit for seven residents.
She said at times it was hard, as she tried to complete personal care with the residents and keep an eye on them too.
She said she had seen residents get into each other's space and fights did occur.
Certified nurse aide (CNA) #1 was interviewed on 3/31/26 at 9:15 a.m. CNA #1 said she was the only staff member who worked on the unit for seven residents.
She said it was very hard at times, especially when the residents had moods,' which was pretty often.
She said when the residents' behaviors increased, it was harder.
She said the cares were easy to complete, except for Resident #3, who urinated all over the place. CNA #1 said she followed him around all day with the mop bucket.
She said she left him alone often and let him do his thing because he was known to hit staff and get aggressive.
She said he was not aggressive toward other residents, but he did get in their space often.
She said Resident #4 did not like it when others got in his space.
She said she had seen Resident #3 and Resident #4 get into a fist fight on 11/26/25.
The director of nursing (DON) was interviewed on 3/31/26 at 12:45 p.m.
The DON said she was involved with abuse investigations.
She said the incident between Resident #3 and Resident #4 on 11/26/25 was substantiated because of the injury for Resident #3.
She said the facility monitored and redirected residents away from each other as part of the interventions for safety.