Standing Stone Care & Rehabilitation Center

    410 W Crawford Ave, Monterey, TN, 38574
    3.9 · 42 reviews
    • Assisted living
    • Memory care
    • Skilled nursing
    AnonymousLoved one of resident
    2.0

    Compassionate staff but dangerous lapses

    I had a mixed experience. Some nurses, CNAs, therapists and the activity staff were compassionate, attentive, and made residents feel like family - clean spaces, good activities, and strong clinical care at times. But I also witnessed dangerous lapses: medication errors (double-dosing), staff not wearing gloves, ignored call lights, poor hygiene, UTIs/hospitalizations, pressure sores, delays in care, and understaffing. Because of those serious safety and communication failures, I cannot recommend this facility despite having met a few outstanding caregivers.

    Pricing

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    Amenities

    Healthcare services

    • Activities of daily living assistance
    • Assistance with bathing
    • Assistance with dressing
    • Assistance with transfers
    • Medication management
    • Mental wellness program

    Healthcare staffing

    • 12-16 hour nursing
    • 24-hour call system
    • 24-hour supervision

    Meals and dining

    • Diabetes diet
    • Meal preparation and service
    • Restaurant-style dining
    • Special dietary restrictions

    Room

    • Air-conditioning
    • Cable
    • Fully furnished
    • Housekeeping and linen services
    • Kitchenettes
    • Private bathrooms
    • Telephone
    • Wifi

    Transportation

    • Community operated transportation
    • Transportation arrangement
    • Transportation arrangement (non-medical)

    Common areas

    • Beauty salon
    • Computer center
    • Dining room
    • Fitness room
    • Gaming room
    • Garden
    • Outdoor space
    • Small library
    • Wellness center

    Community services

    • Concierge services
    • Fitness programs
    • Move-in coordination

    Activities

    • Community-sponsored activities
    • Planned day trips
    • Resident-run activities
    • Scheduled daily activities

    3.93 · 42 reviews

    Overall rating

    1. 5
    2. 4
    3. 3
    4. 2
    5. 1
    • Care

      3.7
    • Staff

      3.9
    • Meals

      1.7
    • Amenities

      4.0
    • Value

      1.0

    Pros

    • Friendly, caring, and compassionate staff
    • Attentive nurses and CNAs
    • Strong therapy program (physical and occupational)
    • Effective individual therapists (positive mentions of Danielle)
    • Skilled wound care nursing (positive mention of Ashley)
    • Engaging activities (arts, crafts, music, hands-on events)
    • Volunteer involvement and family-accessible cafeteria
    • Clean and pleasant facility reported by many reviewers
    • Director of Nursing and clinical team commended
    • Residents treated like family; warm, home-like environment
    • Medicare accepted; shared-room and private-pay options available
    • Many families feel well-informed and supported

    Cons

    • Understaffing and delayed call-light responses
    • Staff apathy, unprofessional communication, and rude behavior
    • Medication errors and mishandling (including double dosing)
    • Infection control lapses (gloves not worn, poor hygiene)
    • Serious clinical failures (aspiration events, dehydration, UTIs)
    • Neglect incidents (residents left soiled, uncovered, or unattended)
    • Severe wound issues (necrotic bedsore reported leading to sepsis and death)
    • Inaccurate or false documentation about care
    • Administration inaction, excuses, and ineffective social services
    • Belongings missing or stolen after resident death
    • Food quality concerns and reports that food was 'not fit to eat'
    • Strong odors reported in the building
    • Safety concerns for residents with impaired communication
    • Billing and financial complaints (private-pay hold fees, deductions)

    Summary review

    The reviews for Standing Stone Care & Rehabilitation Center present a starkly polarized picture. A substantial portion of reviewers praise the facility for compassionate, attentive care, strong therapy services, and an engaging, home-like environment. Several reviewers singled out specific staff and clinical leaders (including a praised Director of Nursing, therapists, and a wound nurse named Ashley) and described top-notch nursing and therapy that produced measurable improvements in mobility, pain reduction, and wound healing. Many family members reported feeling included in care decisions, receiving good communication, enjoying the cafeteria and visiting amenities, and observing residents participating in arts, music, and volunteer-led activities. Multiple reviewers explicitly recommended the facility and said their loved ones were treated like family.

    Counterbalancing these positive reports are repeated, serious allegations of neglect, clinical errors, and systemic problems. Multiple summaries describe understaffing and slow or absent responses to call lights, creating delays in basic care. There are repeated infection-control concerns — staff reportedly failing to wear gloves, questionable hygiene, and reports of UTIs and hospital transfers. Medication handling errors (including alleged double dosing) and inaccurate documentation were reported more than once. Most troubling are several accounts of life-threatening clinical failures: a feeding/assistance lapse resulting in aspiration, dehydration progressing to aspiration pneumonia, and at least one description of a necrotic bedsore that reportedly led to sepsis and death. Other distressing accounts include residents being left in feces, rooms without blankets, belongings missing after death, and family members feeling administratively ignored or given excuses by management.

    The pattern in the reviews suggests substantial inconsistency in care quality and professionalism. Many reviewers name individual staff members and teams as exemplary, implying that high-quality care is delivered by particular clinicians and shifts. At the same time, other reviewers report poor experiences that appear tied to different staff, shifts, or units. This mix of high praise for individual therapists, nurses, and activity staff alongside reports of understaffed shifts, apathetic or unprofessional employees, and serious clinical breakdowns points to variability in staffing, supervision, and clinical oversight. Some reviewers explicitly say there are "a few great employees" amid "lots of not-so-good staff," which supports the interpretation that care may depend heavily on which people are on duty.

    Operational and administrative concerns emerge as another major theme. Several reviewers described ineffective social services, billing disputes (such as requests for large private-pay hold fees), and administrative inaction when serious problems were raised. Communication also received mixed reviews: while many families praised updates and clear communication, others reported staff who hung up on callers, were unclear or unfriendly, or provided misleading medical information (including alleged life-support miscommunication). There are also complaints about documentation accuracy and discharge planning (including refusals of rehab or inadequate preparation for return home).

    Facility-related feedback is similarly split. Numerous reviewers compliment the building as clean, pleasant, and welcoming, and they appreciated activities and visitor access. Conversely, some reviews mention a strong odor, poor food quality, and shared-room arrangements that some found limiting. Safety concerns were raised for residents unable to effectively communicate needs, increasing the urgency of timely staffing and monitoring.

    In summary, Standing Stone appears to deliver excellent, compassionate care in many instances — particularly where committed clinical staff and therapists are present and engaged. However, the presence of multiple, severe negative reports (including potential neglect, infection control failures, medication errors, and catastrophic wound management outcomes) indicates significant variability and risk. The reviews point to inconsistent staffing levels, occasional administrative failures to remediate problems, and lapses in basic care and safety that have had serious consequences for some residents. Prospective residents and families should weigh both the strong positive testimonials and the serious negative incidents, and when evaluating the facility in person, prioritize asking about staffing ratios, wound and infection-control protocols, medication administration safeguards, documentation practices, recent inspection/complaint history, and continuity of care across shifts.

    Location

    Map showing location of Standing Stone Care & Rehabilitation Center

    About Standing Stone Care & Rehabilitation Center

    Standing Stone Care & Rehabilitation Center sits in Monterey, Tennessee, at 410 West Crawford Avenue, right off I-40, and you'll find it offers both skilled nursing care and rehabilitation services for seniors needing different levels of help, including memory care for Alzheimer's and dementia. The center has recently had some renovations, with fresh paint and updates to make living spaces safer and more welcoming, and there are both private and semi-private rooms, along with outdoor areas for fresh air. Standing Stone keeps a daily average of about 78 residents, has 115 certified beds, and reports a nurse staffing level of 3.50 hours per resident each day, though there's been a nurse turnover rate of about 41.5%, which is something the reports mention, along with a few common deficiencies like making sure assessments and care plans are really complete, following up with feeding tube care, and keeping infection control tight, but cleanliness and infection prevention are still written as priorities. The staff is described as caring, and they work on making care plans that fit each resident's needs, focusing on physical and emotional well-being, with therapy services like physical, occupational, respiratory, and speech therapies available, and programs for both short-term rehab and longer stays, including palliative and hospice support. There's a sense of community, with life enrichment programs, interfaith spiritual support, and quality of life activities, serving people from different cultures and backgrounds. The center is part of Signature HealthCARE and Kathryn Shaffer leads its administration, and they seem involved in education, leadership, and care navigation programs to help families understand long-term care and insurance, and to support recovery and comfort for residents. They have Certified Nursing Assistant training and take part in events with the Tennessee Health Care Association. The facility tries to create a warm setting where seniors can get help with daily activities, therapy, or just a little company if they're living at home, and while inspection summaries point out some areas that need work, many families have given 4.5-star feedback out of 21 reviews. Standing Stone aims to care for people with dignity, offering both medical help and life enrichment so residents can make the most of each day, whatever their physical needs may be.

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