Center At Rock Creek, Llc
Inspection Findings
F-Tag F684
F-F684: The facility failed to effectively assess, treat and report a worsening wound timely.
IV. Interview
The NHA was interviewed on 8/1//24 at 11:30 a.m. The NHA said the QAPI committee met monthly to discuss identified concerns and development improvement activities. The NHA said the committee discussed resident wounds for consideration for improvement plans but had not specifically identified the concerns regarding Resident #1's wounds.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 12 of 13 065423 Department of Health & Human Services Printed: 09/17/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 065423 B. Wing 08/01/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Center at Rock Creek, LLC 4880 Ziegler Rd Fort Collins, CO 80528
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0867 The NHA said that she and the director of nursing (DON) would provide oversight and monitoring of the corrective actions and QAPI actions until the committee's findings were considered resolved through the Level of Harm - Minimal harm or QAPI process. potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 13 of 13 065423