Bella Vita Health And Rehabilitation Center
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
outside the facility and to the appropriate State or Federal agencies in the applicable timeframes. A facility policy titled Freedom from Abuse, Neglect, Exploitation revised April 2025 directed that the facility to ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property are reported immediately but not later than two hours after the allegation is made if the events that cause the allegation involves abuse or results in serious bodily injury. Additionally, the policy noted that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property are reported to the State Survey Agency. Furthermore, the policy stated that the results of investigations are reported within five working days of the incident to the State Survey Agency.
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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
12/29/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Bella Vita Health and Rehabilitation Center
5125 North 58th Avenue Glendale, AZ 85301
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 F0628
F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
is transferred to a hospital, her expectation is that the information regarding the resident's name, age, allergy to medications, and synopsis of the reason for transfer is provided to the receiving facility. The DON said that in the case of resident #911, fire (paramedics) only wanted the face sheet and would not tell the facility where the resident was going. Staff #50 noted that a report was called into the hospital and was documented on the nurse's note. However, since the report was called in it does not say exactly what information was provided. Furthermore, there is no actual documentation of what was provided to the hospital. The DON said that the importance of providing the required documents during transfer for the resident can receive continuity of care when the hospital assumes care. Staff #50 stated that the impact of not having the required document is that the hospital would not be able to get ahold of the family to provide information or not know how to treat the resident. Review of the facility's policy titled Discharge or Transfer reviewed July 2025 stated that it is the facility's policy to provide the resident with a safe, organized structured transfer or discharge to the hospital. The policy directed that for transfer/discharge during an emergency, the transfer/discharge form will be completed and the following copies will be attached:Face SheetAdvance DirectivesCurrent physician's orders, H & P (History & Physical), copies of pertinent labs/x-rays
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Bella Vita Health and Rehabilitation Center in GLENDALE, AZ 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 GLENDALE, AZ, (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 Bella Vita Health and Rehabilitation Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.