Bridgeview Post Acute
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to report an abuse allegation for one of five sampled residents (Resident 4) when Resident 4 informed staff that they had been slapped in the face by another resident on 6/20/25. This failure had the potential to result in psychosocial and emotional harm for Resident 4 and had
the potential to place all the residents at risk for undetected/unreported elder neglect or abuse.Findings:During a review of the facility's policy titled, Abuse Investigation and Reporting, revised 7/2017, indicated that:1. All reports and findings of resident abuse shall be reported to local, state and federal agencies, and thoroughly investigated by facility management.2. All alleged violations involving abuse will be reported by the facility Administrator to the state licensing/certification agency responsible for surveying/licensing the facility. During a review of Residents 4's admission record, indicated Resident 4 was admitted on [DATE REDACTED] with diagnoses that included Parkinson's Disease (a progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movements), chronic obstructive pulmonary disease (COPD-a chronic lung disease causing difficulty in breathing), high blood pressure, and muscle weakness. During a review of Resident 4's most recent Minimum Data Set (MDS - an assessment and care screening tool), dated 6/19/25, the MDS indicated that Resident 4 had a brief interview for mental status (BIMS) score of 15 out of 15, indicating her cognition was not impaired. During a review of record titled progress Notes, dated 6/22/25, indicated that staff reported an incident between Resident 4 and Resident 5 where Resident 5 ran into Resident 4 with their wheelchair and then slapped Resident 4 on the face and chest. During a concurrent interview and record review on 8/12/25 at 12:30 pm with the Administrator (ADN), the record titled, Report of Suspected Dependent Adult/Elder Abuse, dated 6/20/25, indicated, that Resident 4 had been slapped on the face and chest by Resident 5 leaving Resident 4 with discoloration and scratches on the chest. ADN confirmed that the incident had occurred but was not reported to the state licensing/certification agency. ADN stated that it was their understanding that the facility was not required to report abuse if the perpetrator had a diagnosis of dementia. During an interview
on 8/12/25 at 1 pm with the Director of Nursing (DON), the DON confirmed that there had been an incident
on 6/20/25, where Resident 4 had been slapped by Resident 5. The DON stated that according to an All Facilities Letter (AFL) the facility was no longer required to report abuse that involved a perpetrator with a dementia diagnosis. The DON confirmed that the abuse incident had not been reported to the state licensing/certification agency.
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:
BRIDGEVIEW POST ACUTE in YUBA CITY, 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 YUBA CITY, 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 BRIDGEVIEW POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.