Woodcrest Post Acute & Rehabilitation
Inspection Findings
F-Tag F0684
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
transfer her to the hospital.On August 12, 2025, at 5:30 p.m., a concurrent interview and record review of Resident 5's record was conducted with the Director of Nursing (DON). The DON stated when they notice a change of condition, the CNA should report it to the charge nurse. The DON stated if there is a change of condition from day shift it should be endorsed to the following shift. The DON stated Resident 5 had a decrease in meal intake or meal percentage on July 19, 2025, starting at breakfast meal at 50% and 25%, respectively for breakfast and lunch.the DON stated Resident 5 was dependent in eating, started on July 18, 2025, which was a decline when she was initially admitted on [DATE REDACTED]. The DON stated the decrease in Resident 5's food intake and decline in ADL need in eating would be considered a change of condition and
the doctor should have been notified.On August 18, 2025, at 12:32 p.m., during a phone interview conducted with Licensed Vocational Nurse (LVN) 1, LVN 1 stated she was the Licensed Nurse (LN) assigned to Resident 5 on July 19, 2025, from 3 p.m. to 11 p.m. LVN 1 stated there was no endorsement from the morning shift LN of any changes with Resident 5. LVN 1 stated when she was passing the medications and reached Resident 5's room, the resident was observed to be lethargic. LVN 1 stated the vital signs were stable, but Resident 5 was not able to answer questions. LVN 1 stated she verified with the family member present at bedside if that was normal for the resident, and the family member stated that was not normal for the resident. LVN 1 stated she was not sure of the time she was able to send out Resident 5 to the acute hospital. LVN 1 stated the physician should have been notified when Resident 5 had a decrease in meal intake as this was a change of condition. On August 18, 2025, at 4:55 p.m., during
a phone interview with LVN 2, LVN 2 stated she was the LN assigned to the resident the morning shift of July 19, 2025. LVN 2 stated she did not recall the CAN notifying her of Resident 5's decrease in food intake.
LVN 2 stated she did not recall Resident 5's family member reporting to her that Resident 5 was not her usual self. LVN 2 stated the physician should have been notified if the resident had a poor food intake or a decrease from previous meals. A review of the facility's policy and procedure titled, Acute Condition Changes- Clinical Protocol, revised date March 2023, indicated, .Direct care staff .including nursing assistants .recognizing subtle .significant changes .decrease in food intake .how to communicate .to the nurse . and, before contacting a physician .with an acute change of condition .nursing staff .collect pertinent details .to report to the physician .
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WOODCREST POST ACUTE & REHABILITATION in RIVERSIDE, 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 RIVERSIDE, 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 WOODCREST POST ACUTE & REHABILITATION or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.