Hearth Record

Rock Canyon Respiratory and Rehabilitation Center

A nursing home in Pueblo, Colorado 81004

2515 Pitman Pl, Pueblo, Colorado 81004. (719) 564-0550.

  • Cited for abuse (CMS flag)
CMS’s own record, on Care Compare

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The short answer

Record last released by CMS on Oct 28, 2026.

The last 24 months 26 citations in 6 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). Every month

Each figure’s source sits beside it, in its section below.

What these words mean7
Star ratings
CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
Inspection (survey)
A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
Deficiency, citation, violation
What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
Scope and severity (A to L)
CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
Nurse staffing hours
The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
Fines and payment denials
A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
Capacity
The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.

What did inspectors find?

8 health citations at the latest inspection cycle

The Colorado average is 8.7.

Last standard inspection Jun 5, 2025.

Most serious in three years: actual harm (G), at a complaint inspection on Apr 3, 2025

Source:

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

26 citations in 6 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.

26 citations by month over the last 3 years. Each cell is one month.
JanFebMarAprMayJunJulAugSepOctNovDec
2023 Dec
2024 JanFebMarAprMayJunJulAugSepOctNovDec
2025 JanFebMarAprMayJunJulAugSepOctNovDec
2026 JanFebMarAprMayJunJulAugSepOctNov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most
Source:

Hearth Record drew this from the dates and levels in the source’s own records.

All 26 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 18 came from complaint inspections.

Source:

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Aug 6, 2026: complaint inspection1 citation

  • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 28, 2026.

Dec 11, 2025: complaint inspection1 citation

  • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Dec 26, 2025.

Jun 5, 2025: standard and complaint inspection6 citations

  • Reasonably accommodate the needs and preferences of each resident.

    Rule F0558. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

  • Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident’s ability to function.

    Rule F0605. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

  • Ensure services provided by the nursing facility meet professional standards of quality.

    Rule F0658. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

  • 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.

    Rule F0688. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

  • Ensure that residents are free from significant medication errors.

    Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

  • Provide and implement an infection prevention and control program.

    Rule F0880. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 1, 2025.

Apr 3, 2025: complaint inspection1 citation

  • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Rule F0600. G: actual harm. From a complaint. Correction date, as CMS recorded it: May 2, 2025.

Jul 12, 2024: complaint inspection7 citations

  • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Rule F0689. G: actual harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Provide enough food/fluids to maintain a resident’s health.

    Rule F0692. G: actual harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Rule F0550. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Provide care and assistance to perform activities of daily living for any resident who is unable.

    Rule F0677. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

    Rule F0693. F: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Have a plan that describes the process for conducting QAPI and QAA activities.

    Rule F0865. F: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

  • Make sure that a working call system is available in each resident’s bathroom and bathing area.

    Rule F0919. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 9, 2024.

Mar 21, 2024: standard inspection8 citations

  • 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.

    Rule F0584. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

    Rule F0622. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

    Rule F0744. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Ensure medication error rates are not 5 percent or greater.

    Rule F0759. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Ensure that residents are free from significant medication errors.

    Rule F0760. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Rule F0812. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Rule F0842. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

  • Provide and implement an infection prevention and control program.

    Rule F0880. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 12, 2024.

Mar 21, 2024: standard and complaint inspection2 citations

  • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 12, 2024.

  • Make sure that a working call system is available in each resident’s bathroom and bathing area.

    Rule F0919. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 12, 2024.

Is it certified, and in good standing?

  • Certified for Medicare and Medicaid since Mar 24, 1968.
  • Not on CMS’s special focus list.
  • CMS marks it with its abuse icon: cited for abuse or neglect that harmed a resident.
  • No change of ownership in the last 12 months.
  • CMS lists its ownership as for profit, limited liability company.
  • 151 certified beds.
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

  • 2 fines in the last three years, $67,298 in all.
  • No Medicare payment denials in the last three years.
  • 18 citations in the last three years came from complaint inspections.
Source:

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Fines and payment denials, newest first
DateKindAmount
Apr 3, 2025Fine$36,569
Jul 12, 2024Fine$30,729

Who does the caring?

2.86 nurse hours per resident per day

The Colorado average is 3.69.

CMS publishes staffing about four months after the fact.

Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
MeasureThis homeColorado average
Nurse hours per resident per day2.863.69
Of which registered nurses0.570.81
At weekends2.583.26
Nursing staff turnover45.9%47%
Registered nurse turnover25%44.4%
Administrators who left0Not given

Who owns it?

  • Endura Healthcare LLC owns 100% directly since Jan 1, 2022.
  • 11 owners or officers are people: Mark Gardner (runs it (operational or managerial control)); Mark Gardner (on the governing body (managing control)); Mark Gardner (additional disclosable party (controls, leases property to, or provides services to the home)); Barry Port (corporate director, 0%); David Jorgensen (runs it (operational or managerial control)); David Jorgensen (on the governing body (managing control)); Chad Keetch (corporate officer, 0%); Vikas Thouti Reddy (on the governing body (managing control)); Vikas Thouti Reddy (additional disclosable party (controls, leases property to, or provides services to the home)); Soon Burnam (corporate officer, 0%); Soon Burnam (on the governing body (managing control)).
  • Part of The Ensign Group (347 homes in CMS’s data).
  • No private-equity firm among the owners CMS lists.
  • No real-estate investment trust among the owners CMS lists.
Source:

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
OrganisationRoleShareSince
The Ensign Group Inc.Owns 5% or more through other companies100%Jan 2, 2015
Endura Healthcare LLCOwns 5% or more directly100%Jan 1, 2022
Standard Bearer Healthcare Op LPAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2022
Kettle Creek Health Holdings LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2022
The Ensign Group Inc.Additional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2022
Ensign Services Inc.Additional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2022
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2015

How do residents fare?

  • CMS rates its quality measures 5 of 5 (Colorado average 4.2).
Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
MeasureRating
Overall rating3 of 5
Health inspections2 of 5
Staffing2 of 5
Quality measures5 of 5

How does it compare nearby?

  • Among the 12 nearest homes, within 35.3 miles, this one had the 5th most health citations at the latest inspection cycle (8; the middle value was 6).
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
PlaceMiles awayCitations, latest cycle
Rock Canyon Respiratory and Rehabilitation Center This nursing home8
Atlas Post Acute0.26
Lakeshore Post Acute and Rehabilitation Center1.310
Life Care Center of Pueblo1.85
High Plains Post Acute LLC2.15
Vista Ridge Care and Rehabilitation4.06
Pueblo Heights Nursing and Rehabilitation4.714
The Center at Park West LLC5.111
University Park Care Center5.513
Bruce Mccandless Co State Veterans Nursing Home27.65
Fowler Health Care34.54
Hildebrand Care Center35.33

What the record doesn’t say

  • Complaints that didn’t lead to a citation aren’t published.
  • Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
  • CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
  • Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.

Sources

  • Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

    Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).

    Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.

Source:

This copy of the record was made on Nov 5, 2026.

From the home

The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.

Replies

None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.

Paid listing

None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.

How to read a record

Four things every record does, shown on an example record made up for this guide.

An example record, made up for this guide

An example nursing home

Made up for this guide: no real place is shown

Not fully inspected in over two years (CMS flag)

11 health citations at the latest inspection cycle

The state average is 14.3.

Source:

CMS, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

From the homeNone yet. Replies and paid listings aren’t open, and when they open they will sit here, below the record.

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Who published it, when, and how often it changes sit beside each fact, with a link to the agency’s own file.

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