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Complaint Investigation

Seneca District Hospital D/p Snf

Inspection Date: October 8, 2025
Total Violations 2
Facility ID 555022
Location CHESTER, CA
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Inspection Findings

F-Tag F0600

Freedom from Abuse, Neglect, and Exploitation Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0600

1 and Resident 2.*CNA 1 and CNA 2 worked the night shift together on 10/1/25 from 4:00 pm to 4:30 am and provided care for Resident 1 and Resident 2.

Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

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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

10/08/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Seneca District Hospital D/P Snf

130 Brentwood Dr Chester, CA 96020

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)

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F-Tag F0609

Freedom from Abuse, Neglect, and Exploitation Deficiencies
Harm Level: Actual Harm

F 0609 Level of Harm - Actual harm Residents Affected - Few Note: The nursing home is disputing this citation.

FORM CMS-2567 (02/99) Previous Versions Obsolete

about how CNA 2 was very verbally aggressive or dominate with her speech with residents. LN B stated

she did not report this to anyone.5. During an interview on 10/3/25 at 3:03 pm, LN B said she noticed a bruise on Resident 1's left forearm on 10/1/25 in the morning. LN B stated the bruise measured 9 centimeters (cm, a measurement of length) X 3 cm. LN B stated she did not know how the bruise happened and did not do an investigation concerning the bruise but just assumed she had hit the bed rail.During an

interview on 10/3/25 at 3:07 pm, DON confirmed that Resident 1 had a obtained a bruise on her left forearm that was unwitnessed. DON stated that she assumed it came from Resident 1 hitting her arm on

the bed railing but that there had been no investigation done to determine this. DON confirmed that the bruise should have been reported to the state and federal agencies, and an investigation should have been carried out to determine root cause.During a concurrent observation and interview with Resident 1 and the DON in the DON's office on 10/3/25 at 3:20 pm, Resident 1's left forearm was observed to have a bandage wrapped around the left hand and up to half of the left forearm. The DON removed the bandage, and a purple and reddish bruise was noted on the top of her forearm about 3 to 4 inches (approximately 9 cm) long and a skin tear was on the bruised area. The DON indicated it was not normal for Resident 1 to get bruises.6. During a concurrent interview with the DON and policy review on 10/6/25 at 2:21 pm, the facility's P&P titled Abuse Prevention and Reporting revised 3/27/25 was reviewed. The P&P did not indicate that all suspected Abuse was required to be reported to the CDPH within 2 hours. The DON confirmed that their policy was incorrect and needed to be revised to indicate that all suspected abuse was to be reported to the CDPH, local Sheriff's office and the Ombudsman within 2 hours.

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📋 Inspection Summary

SENECA DISTRICT HOSPITAL D/P SNF in CHESTER, CA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

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

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 CHESTER, 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 SENECA DISTRICT HOSPITAL D/P SNF or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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