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Complaint Investigation

Oroville Hospital Post-acute Center

Inspection Date: August 14, 2025
Total Violations 1
Facility ID 555281
Location OROVILLE, 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 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

document dated 7/27/25 titled, Suspected Abuse, indicated Licensed Nurse (LN) C walked by Resident 2's room and found RN B exiting the room and closing the door. RN B explained to LN C she had been in the room to lower the bed from a high position to a low position and left the bed remote on the bed. LN C reported RN B stated, We are not supposed to do this, but I am not going to put up with bad behavior. RN told LN C to leave the door closed and then walked away. During an observation and attempted interview

on 8/7/25 at 12:58 pm, Resident 2 was lying in bed with eyes closed. The surveyor attempted to speak with and interview Resident 2, but she did not speak. Resident 2 opened her eyes and then shut them again, but did not verbally respond. During a follow up observation and attempted interview on 8/7/25 at 2:50 pm, Resident 2 was lying in bed, on her left side, no signs or symptoms of pain or discomfort, but did not try to communicate. Resident 2 had no restlessness noted or any signs of anxiety, opened her eyes, then quickly shut them without speaking. During an interview on 8/7/25 at 3:12 pm, LN C confirmed she had reported RN B for closing the door to Resident 2's room, while resident 2 was yelling for help and was asked by RN B to not open the door. LN C confirmed RN B stated to her at the time of closing the door we are not going to put up with these bad behaviors and RN B then walked away. During an interview on 8/7/25 at 3:45 pm,

the Executive Nurse Director (END) confirmed RN B had abused Resident 2 by withholding services and confinement. END stated, I will send you the termination report, RN B will no longer work at this facility. We will not tolerate abuse. During a review of a facility document dated 8/8/25 titled, Employee Termination Report, indicated RN B to be in violation of the Code of Conduct and the Abuse, Neglect, Exploitation, and Misappropriation of Resident Property, Prohibition Policy and has brought us to the conclusion of termination of employment. During a follow up interview with LN C on 8/14/25 at 8:04 am, LN C stated, I did wound care on another resident and immediately came back to check on [Resident 2], the Certified Nurse Assistant (CNA) J saw the door was shut, but did not know who had shut it. CNA J caught [Resident 2] trying to climb out of bed. [Resident 2] had no apparent injury, and the door remained opened the rest of

the shift.

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📋 Inspection Summary

OROVILLE HOSPITAL POST-ACUTE CENTER in OROVILLE, 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 OROVILLE, 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 OROVILLE HOSPITAL POST-ACUTE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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