Mt. Olympus Rehabilitation Center
Inspection Findings
F-Tag F0689
F 0689
regarding the use of Hoyer lifts and Hoyer slings. CNA 5 stated that there were about five residents in the facility that currently used Hoyer lifts.
Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
10/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Mt. Olympus Rehabilitation Center
2200 East 3300 South Salt Lake City, UT 84109
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-Tag F0726
F 0726 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
tabs at the shoulders and some about mid-thigh that were used to help lift the patient. CNA 1 stated that
the straps for the transfer sling appeared like they were intact and did not have any wear or tear. CNA 1 stated that the transfer sling that resident 3 came into the facility with was not a Hoyer lift sling, it was a transfer sling. CNA 1 stated that she had used those types of transfer slings in the past with the Hoyer lift and has not had any issues with them. CNA 1 stated that the facility did have these types of slings available
in the facility that they have gotten from other facility transfers.On [DATE REDACTED] at 5:25 PM, a telephone interview was conducted with CNA 2. CNA 2 stated that resident 3 came to the facility on a gurney and that she was responsible for the section that resident 3 was going to be in. CNA 2 stated that they knew from the report that resident 3 would require the Hoyer lift due to her size. CNA 2 stated that if a resident came to the facility with a sling underneath them, then she would use it. CNA 2 stated that resident 3 had a sling underneath her that was not unfamiliar as the facility used the same type of sling. CNA 2 stated that the sling was made from a plastic like material and that it was tarp-like. CNA 2 stated that the sling had multiple straps on the sides and two straps on each corner. CNA 2 stated they used the sling underneath resident 3 because it was familiar to them and they did not usually get admissions in the evening. CNA 2 stated she was familiar with the sling and knew it was a Hoyer sling. CNA 2 stated they looked at the straps and she told CNA 1 there was an option to use multiple straps and they did that. CNA 2 stated she personally had only used the blue ones that were tarp-like just like the one that resident 3 was on and she had never used
a mesh one. CNA 2 stated that they figured because it was tarp-like that it would be good to use. CNA 2 stated that CNA 1 brought in the Hoyer lift that also weighed residents. CNA 2 stated that they put resident 3 on the Hoyer lift with four straps on each side and got a weight of 325 pounds. CNA 2 stated that she bent down to move the bed control and resident 3's oxygen tubing when the sling straps snapped and resident 3 fell on top of the Hoyer lift. CNA 2 stated that she fell over the two metal legs of the Hoyer lift and one of the legs was behind resident 3's neck and the other was on resident 3's coccyx area. CNA 2 stated that a nurse came in and they pulled resident 3 off the Hoyer lift legs to lay her flat on the floor and began CPR. CNA 2 stated that EMS arrived and they took over CPR. CNA 2 stated that EMS found that resident 3 was a DNR and CPR was stopped and pronounced deceased . CNA 2 stated that police officers arrived at the facility and they turned the room into a crime scene and asked her and CNA 1 how they had hooked up the straps
on the Hoyer lift.On [DATE REDACTED] at 9:21 AM, an interview was conducted with CNA 5. CNA 5 stated that she had been employed at the facility for about 9 years. CNA 5 stated that Hoyer slings were kept downstairs in the laundry room. CNA 5 stated that she had not received any hands-on training regarding the use of Hoyer lifts and Hoyer slings. CNA 5 stated that there were about five residents in the facility that currently used Hoyer lifts. On [DATE REDACTED] at 9:22 am, an interview was conducted with CNA 6. CNA 6 stated that she had training on the Hoyer lift but it had been a couple years. [NAME] stated that she had worked at the facility for 40 years. CNA 6 stated there might have been another training since that she had missed but she was unsure. On [DATE REDACTED] at 9:36 AM, an interview was conducted with CNA 7. CNA 7 stated that he had training
a couple days ago on the Hoyer lift policies. On [DATE REDACTED] at 10:22 AM, an interview was conducted with CNA
- 8. CNA 8 stated the last hands on Hoyer lift training was about a month ago. CNA 8 stated when the facility
got new Hoyer slings the staff had to visualize the new slings and sign off that they saw them.
Event ID:
Facility ID:
If continuation sheet
Mt. Olympus Rehabilitation Center in Salt Lake City, UT inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Salt Lake City, UT, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Mt. Olympus Rehabilitation Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.