Pueblo Heights Nursing and Rehabilitation
1601 Constitution Rd · Pueblo, CO · 81001 · 7195627200
120 certified beds For profit - Individual Chain: Madison Creek Partners
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results are getting worse cycle over cycle, not better.
- No federal fines or payment denials in CMS’s 3-year window.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
1 immediate-jeopardy citation in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
Cited under the freedom-from-abuse rule
Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 2 of 5 Staffing: 3 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 3.00 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.60 | 0.55–0.75 |
| Weekend hours / resident-day | 2.76 | ≈ weekday level |
| Nursing turnover / year | 54% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (26 in the current record)
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Immediate jeopardy · J April 14, 2026 · found via complaint
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Corrected May 8, 2026 · Quality of Life and Care
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Potential for harm · D July 18, 2024
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected August 5, 2024 · Resident Rights
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Potential for harm · D July 18, 2024
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected August 1, 2024 · Resident Rights
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Potential for harm · D July 18, 2024
Reasonably accommodate the needs and preferences of each resident.
Corrected August 9, 2024 · Resident Rights
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Potential for harm · D July 18, 2024
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected August 1, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D July 18, 2024
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Corrected August 6, 2024 · Quality of Life and Care
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Potential for harm · D July 18, 2024
Provide activities to meet all resident's needs.
Corrected August 5, 2024 · Quality of Life and Care
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Potential for harm · D July 18, 2024
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected August 6, 2024 · Quality of Life and Care
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Potential for harm · E July 18, 2024
Ensure medication error rates are not 5 percent or greater.
Corrected August 6, 2024 · Pharmacy Service
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Potential for harm · D July 18, 2024
Ensure that residents are free from significant medication errors.
Corrected August 1, 2024 · Pharmacy Service
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Potential for harm · D July 18, 2024
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 August 5, 2024 · Pharmacy Service
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Potential for harm · E July 18, 2024
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected August 7, 2024 · Nutrition and Dietary
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Potential for harm · E July 18, 2024
Provide and implement an infection prevention and control program.
Corrected August 5, 2024 · Infection Control
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Potential for harm · F July 18, 2024
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected August 7, 2024 · Environmental
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Potential for harm · E February 16, 2023
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 April 28, 2023 · Resident Rights
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Potential for harm · D February 16, 2023
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected April 28, 2023 · Quality of Life and Care
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Potential for harm · D February 16, 2023
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected April 28, 2023 · Quality of Life and Care
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Potential for harm · E February 16, 2023
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 May 4, 2023 · Pharmacy Service
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Potential for harm · F February 16, 2023
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected April 28, 2023 · Nutrition and Dietary
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Potential for harm · D February 16, 2023
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected March 31, 2023 · Infection Control
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Potential for harm · E February 16, 2023
Perform COVID19 testing on residents and staff.
Corrected March 31, 2023 · Infection Control
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Potential for harm · D November 4, 2021
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected December 8, 2021 · Resident Rights
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Potential for harm · D November 4, 2021
Provide safe and appropriate respiratory care for a resident when needed.
Corrected December 8, 2021 · Quality of Life and Care
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Potential for harm · D November 4, 2021
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Corrected December 8, 2021 · Quality of Life and Care
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Potential for harm · D November 4, 2021
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected December 8, 2021 · Pharmacy Service
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 065169 · certified since July 1, 1982. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.