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Complaint Investigation

Lone Tree Post Acute

April 27, 2026 · Antioch, CA · 4001 Lone Tree Way
Citations 2
CMS Rating 4/5
Beds 99
Provider ID 056021
Healthcare Facility
Lone Tree Post Acute
Antioch, CA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

LONE TREE POST ACUTE in ANTIOCH, CA — inspection on April 27, 2026.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0755
Pharmacy Service Deficiencies

CDRs and corresponding MARs. ADON inspected the CDRs and MARs. ADON stated the CDRs and

Hydrocodone-Acetamin 5-325 mg #60 date 9/9/239/20/23 015710/6/23 44010/9/23 170010/11/23

085811/19/23 0200Resident 7, 4757090 Oxycodone (narcotic pain reliever) 5 mg tablet #30 date 10/12/2310/14/23 100010/16/23 83010/16/23 213010/22/23 211210/29/23 2000Resident 8, 4763608 Hydrocodone-Acetamin 10-325 mg #30 date 10/18/2311/4/23 183011/5/23 1002Continuing the concurrent interview and record review, on 4/10/26 at 10:35 a.m. ADON acknowledged the facility did not have the Shipping Manifests that match the CDRs as documented above.

She further acknowledged that information was inaccurate between CDRs and corresponding MARs as documented above.

She stated that it was the facility's expectation that all documents were to be available and accurate.

Continuing the concurrent interview and record review, on 4/10/26 at 10:35 a.m. ADON was requested to provide the Pharmacist inspection reports for 9/1/23 through 12/31/23.

ADON identified the Pharmacy QAPI (Quality Assurance and Performance Improvement, process to improve resident safety and compliance) Report, Q4 2023, October, November, December and Pharmacy QAPI Report, Q1 2024, January, February, March.

She inspected the reports and stated they did not document issues with incomplete or inaccurate scheduled medication records.

Durning a concurrent interview and record review, on 4/10/26 at 11:04 a.m. ADON identified the Consultant Pharmacist Policy for Pharmacy Services-Role of the Consultant Pharmacist.

She stated that it was the facility's expectation that issues with scheduled medications should have been identified.

Durning a concurrent interview and record review, on 4/10/26 at 11:07 a.m. ADON identified the policy for Controlled Substances.

She reviewed the policy and acknowledged it required the documentation (Shipping Manifests, CDRs and MARs) to be complete and accurate (monitored and reconciled). An administrative record review of the Facility's Policy for Controlled Substances (November 2022) showed, Dispensing and Reconciling Controlled Substances, 2.

The system of reconciling the receipt (Shipping Manifest) dispensing and disposition of controlled substances includes the following: a.

Records of personnel access and usage (CDR, destruction log): b.

Medication administration records (MAR): c.

Declining inventory records (CDR): and d.

Destruction, waste and return to pharmacy records. An administrative record review of the facility's Policy for Controlled Substances (November 2022) showed, Dispensing and Reconciling Controlled Substances, 1.

Controlled substance inventory is monitored and reconciled to identify loss or potential diversion in a manner that minimizes the time between loss/diversion and detection/follow-up. An administrative record review, of the Policy for Pharmacy Services-Role of the Consultant Pharmacist (Revision Date April 2019) showed, Policy Interpretation and Implementation, 3.

The consultant pharmacist shall provide consultation on all aspects of pharmacy services in the facility, and collaborate with the facility and medical director to:, a. develop, implement, evaluate, and revise (as necessary) the procedures for the provision of all aspects of pharmacy services.

056021 04/27/2026

Lone Tree Post Acute 4001 Lone Tree Way Antioch, CA 94509

Based on observation, interview and record review, the facility failed to follow state Title 22

worker which affected all 98 residents.This failure resulted in all residents receiving social services care from unqualified staff.

During an interview on 4/9/26, at 1:24 p.m., with the Social Services Director (SSD), SSD stated they were the primary staff responsible for the social services department. SSD stated they had bachelor's degree in engineering.During a concurrent interview and record review on 4/10/26, at 9:40 a.m., with Human Resources (HR), SSD's two job descriptions both titled, Job Description: Social Services Director, dated 3/2017 and 2/2024 was reviewed. HR stated after review of the job descriptions, both job descriptions indicate a minimum education requirement of Bachelor's Degree in Social Work or Human Services. HR stated they did not have record of SSD's past education but stated SSD had a bachelor's degree in engineering.

During an interview on 4/10/26, at 3:50 p.m., with the administrator (ADM), the ADM stated they were aware SSD did not meet the qualifications based the facility job description and the facility did not have a qualified social worker to supervise or direct the department.

The ADM stated SSD possessed a bachelor's degree but the subject of study did not meet the job requirement.During a review of facility assessment titled, [Facility] Facility Assessment, dated 2/26, the facility assessment indicated the facility staffing plan included a full-time social worker.During a review of facility policy and procedure (P&P) titled, Social Services, dated 2001, the P&P indicated the facility provides medically related social services.the director of social services is a qualified social worker.During a review of California state regulation titled, Title 22 S72433, the state regulation indicated 'Social Work Service' means those services which assist.a patient and a patient's family to understand and cope with.personal, emotional and related health and environmental problems.During a review of California state regulation titled, Title 22 S72105, the state regulation indicated a Clinical Social Worker was person who is a licensed clinical social worker by the Board of Behavioral Sciences.During a review of California state regulation titled, Title 22 S72437, the state regulation indicated Social Work Service Unit-Staff.the social work service unit shall be organized, directed and supervised by a social worker, who is responsible for supervision of other social work staff, including social work assistants.

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 ANTIOCH, CA, (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 LONE TREE POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.