River Pointe Post-acute
River Pointe Post-Acute in Carmichael, CA — inspection on August 12, 2025.
Found 1 citation. 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
authorities.
incident involving two of five sampled residents (Resident 1 and Resident 3) was not reported to the
abuse.Findings:Resident 1 was admitted to the facility in July of 2025 with diagnoses that included violent behavior, restlessness, and agitation.Resident 3 was admitted to the facility in August of 2021 with diagnoses that included dementia. A review of Licensed Nurse 1 (LN 1)'s Nurses Notes (NN), dated 7/29/25, indicated, [Resident 1] was observed striking roommates [Resident 3] in the room and being verbally abusive.
During an interview on 8/12/25 at 10:57 a.m. with LN 1, LN 1 stated, [Resident 1] started taking all of [Resident 3]'s things from [Resident 3]'s closet. [Resident 3] saw her [Resident 1] and tried to take her things back and [Resident 1] started to hit her. I don't think it was reported to the state.I turned the corner and saw them tugging back and forth. [Resident 1] was kicking and slapping.I reported to the direct supervisor for the day which was [Nurse Supervisor]. He didn't tell me to fill out an SOC341 [Report of Suspected Dependent Adult/Elder Abuse form, required by law under California's Elder Abuse and Dependent Adult Civil Protection Act].
During an interview on 8/12/25 at 11:49 a.m. with the Administrator (ADM), the ADM stated, If there is a case of abuse between residents with dementia and no injury, we still report everything. We report to 3 agencies, which include Law Enforcement, ombudsman and CDPH [California Department of Public Health] as soon as possible within 2 hours.We are mandated reporters.
Our role is safety of patients and to communicate to the respective agencies with that information.During a review of the facility's policy and procedure (P&P) titled Abuse, Neglect, Exploitation and Misappropriation Prevention Program, revised 4/21, the P&P indicated, Investigate and report any allegations within timeframes required by federal requirements.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
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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.