Map showing the location of Monument Rehabilitation and Care Center in Scottsbluff, Nebraska
111 West 36th Street, Scottsbluff, NE, 69361

Overall Score

CMS Five-Star Quality Rating
1/5Much below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • NebraskaLowest tier among peers178 rated homes · average 2.9★
  • United StatesLowest tier among peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs NE avg
  • StaffingCan add or remove a star2★−1.4 vs NE avg
  • Quality measuresCan add or remove a star1★−2.0 vs NE avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

  • Special Focus Facility candidateThis facility is on the CMS candidate list for the Special Focus Facility program, meaning it is among the poorest-performing facilities in its state on recent inspections.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersNE avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover2★Above only 11% of peersNE avg3.4★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments1★Lowest tier among peersNE avg3.0★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.78hrsAbove only 39% of peersNE avg4.17Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.33hrsAbove only 5% of peersNE avg0.71Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better61%Above only 26% of peersNE avg49%RN turnover64%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$68,398Above only 4% of peersNE avg$10,100Fines · denials3 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
48citations
8inspection dates
1actual harm (G–I)
2immediate jeopardy (J–L)
Aug 16, 2025most recent

Citations by monthMar 2023 – Aug 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Aug 16, 202510 citationsCycle 1worst F · no actual harm
  1. F882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.Infection ControlD · isolatedCorrected Sep 10, 2025
  2. F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.Resident RightsC · widespreadCorrected Sep 10, 2025
  3. F628Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.Resident RightsD · isolatedCorrected Sep 10, 2025
  4. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Sep 10, 2025
  5. F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.Nutrition and DietaryD · isolatedCorrected Sep 10, 2025
  6. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Sep 10, 2025
  7. F814Dispose of garbage and refuse properly.Nutrition and DietaryF · widespreadCorrected Sep 10, 2025
  8. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected Sep 10, 2025
  9. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Sep 10, 2025
  10. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Sep 10, 2025
Jul 9, 20251 citationCycle 1worst D · no actual harm
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jul 25, 2025
Apr 3, 20256 citationsCycle 1worst G · actual harm$25,760
  1. Ensure each resident’s drug regimen must be free from unnecessary drugs.Pharmacy ServiceG · isolatedCorrected Apr 28, 2025
  2. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Apr 28, 2025
  3. F758Implement 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.Pharmacy ServiceD · isolatedCorrected Apr 28, 2025
  4. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Apr 28, 2025
  5. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Apr 28, 2025
  6. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Apr 28, 2025
Dec 16, 20242 citationsCycle 2worst D · no actual harm
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Jan 10, 2025
  2. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Jan 10, 2025
Aug 1, 202415 citationsCycle 2worst J · immediate jeopardy$11,438
  1. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsD · isolatedCorrected Aug 29, 2024
  2. Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.Quality of Life and CareJ · isolatedCorrected Aug 29, 2024
  3. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareE · patternCorrected Aug 29, 2024
  4. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesE · patternCorrected Aug 29, 2024
  5. F584Honor 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.Resident RightsE · patternCorrected Aug 29, 2024
  6. F606Not hire anyone with a finding of abuse, neglect, exploitation, or theft.Freedom from Abuse, Neglect, and ExploitationC · widespreadCorrected Aug 29, 2024
  7. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningE · patternCorrected Aug 29, 2024
  8. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Aug 29, 2024
  9. F758Implement 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.Pharmacy ServiceD · isolatedCorrected Aug 29, 2024
  10. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Aug 29, 2024
  11. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Aug 29, 2024
  12. F925Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.EnvironmentalD · isolatedCorrected Aug 29, 2024
  13. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Aug 29, 2024
  14. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceE · patternCorrected Aug 29, 2024
  15. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected Aug 29, 2024
Nov 15, 20231 citationCycle 3worst D · no actual harm
  1. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Dec 27, 2023
Jul 13, 20239 citationsCycle 3worst F · no actual harm
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Aug 25, 2023
  2. F791Provide or obtain dental services for each resident.Quality of Life and CareD · isolatedCorrected Aug 25, 2023
  3. F850Hire a qualified full-time social worker in a facility with more than 120 beds.AdministrationC · widespreadCorrected Aug 25, 2023
  4. F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.Resident RightsD · isolatedCorrected Aug 25, 2023
  5. F606Not hire anyone with a finding of abuse, neglect, exploitation, or theft.Freedom from Abuse, Neglect, and ExploitationC · widespreadCorrected Aug 25, 2023
  6. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsD · isolatedCorrected Aug 25, 2023
  7. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsD · isolatedCorrected Aug 25, 2023
  8. F637Assess the resident when there is a significant change in conditionResident Assessment and Care PlanningD · isolatedCorrected Aug 25, 2023
  9. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Aug 25, 2023
Mar 28, 20234 citationsCycle 3worst L · immediate jeopardy$31,200
  1. F885Report COVID19 data to residents and families.Infection ControlF · widespreadCorrected Apr 26, 2023
  2. F886Perform COVID19 testing on residents and staff.Infection ControlE · patternCorrected Apr 26, 2023
  3. F882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.Infection ControlF · widespreadCorrected Apr 26, 2023
  4. F880Provide and implement an infection prevention and control program.Infection ControlL · widespreadCorrected Apr 26, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.78hrsAbove only 39% of peers−0.39 vs NE avg
  • Registered nursesRN hours only0.33hrsAbove only 5% of peers−0.38 vs NE avg
  • Licensed practical nursesLPN hours0.83hrs
  • Nurse aidesCNA hours2.63hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.58hrs
  • Nebraska average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better61%Above only 26% of peersNE avg 49%
  • RN turnoverRegistered nurses only64%Not ranked by CMS
  • Administrators who leftIn the past year2Leadership changed
  • Occupancy160 certified beds · ~82 residents a day51%Above only 8% of peersNE avg 73%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $68,398In fines
  • 3Fines
  • 0Payment denials
  • $10,100NE avg in fines
Above only 4% of peersFewer fines than 4% of rated homes in Nebraska

Actions on record

  1. Apr 3, 2025Civil money penalty$25,760
  2. Aug 1, 2024Civil money penalty$11,438
  3. Mar 28, 2023Civil money penalty$31,200

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Lme Family Holdings15 facilities in the chain2.2★ chain average
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Lme Family Holdings LLC
  • Ydgk LLC
  • Steven Friedman
  • Ephraim Halpert
Indirect owners (5%+)
  • Abbass Jam Trust
  • Mgjr Equity LLC
  • Mordechai Getz
  • Brian Kohn
Operational or managerial control
  • Steven Friedman
  • Ephraim Halpert
  • Lindsey Mosel
  • Charlene Zander

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 285095 · 111 West 36th Street, Scottsbluff, NE, 69361.
  • Percentiles compare this facility with every rated nursing home in Nebraska and Scott Bluff County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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