Vasona Creek Healthcare Center
Inspection Findings
F-Tag F0684
F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to follow its own policies and procedures to ensure social services carried out physician orders for referrals for one of three sampled residents (Resident 1). This failure resulted in referral delays for Resident 1.Findings:Review of Resident 1's clinical record indicated
she was admitted [DATE REDACTED] with diagnoses including chronic pain syndrome and rheumatoid arthritis (chronic disease that occurs when the body's immune system attacks its own tissues, usually affecting small joints
in the hands and feet). A review of Resident 1's Order Summary Report indicated a physician order, dated 5/8/25, for Referral for retinal screening. A second physician order, dated 5/16/25, indicated a referral to Consult Rheumatology. During a concurrent interview and record review of Resident 1's physician orders
on 7/7/25 at 1:30 p.m. with the social service assistant (SSA), she confirmed Resident 1 had physician orders on the above-mentioned dates for referrals. The SSA stated she could find no evidence in Resident 1's clinical record that the physician orders for the two consultations had been carried out. The SSA further stated there was no documentation in Resident 1's clinical record to indicate that Resident 1 had been seen by any physicians for a rheumatology consult or a retinal screening. The SSA confirmed she is the person who arranges the consults and transportation to the appointments. The SSA stated I must have missed those consult orders. During a concurrent interview and record review of Resident 1's physician orders on 7/7/25 at 2:43 p.m. with the assistant director of nursing (ADON), she confirmed resident 1 had physician orders for a rheumatology consult and a referral for retinal screening. The ADON stated the physician orders should have been carried out and arrangements should have been made for Resident 1 to have the rheumatology consult and retinal screening referral as ordered by the physician. Review of the facility's policy Referrals, Social Services, dated 2001, indicated social services shall coordinate resident referrals that have been prescribed by the physician. Social Services will document the referral in the resident's medical record and arrange transportation to outside agencies.
Residents Affected - Few
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 REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
VASONA CREEK HEALTHCARE CENTER in LOS GATOS, CA 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 LOS GATOS, 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 VASONA CREEK HEALTHCARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.