The level of harm was cited as minimal harm or potential for actual harm, and the deficiency affected a small number of residents.
Nursing Home News — Page 348
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The finding emerged from a complaint inspection completed October 21, 2025.
The incident unfolded when CNA #2 asked CNA #1 to help transfer a resident identified in inspection records only as Resident #1.
The citation, issued October 28 during a complaint inspection, covered how the facility procures, stores, prepares, distributes, and serves food.
The resident is identified in inspection documents only as Resident 3.
The violation was serious enough that inspectors determined it carried potential for more than minimal harm, even if no one had been documented as hurt yet.
Inspectors cited Mission Valley Nursing and Transitional Care following a complaint investigation completed October 29, 2025.
The inspection record does not describe a near-miss.
Inspectors found the problems affected more than one resident.
Federal health inspectors conducted a complaint investigation at the Neptune City nursing home on October 24, 2025.
Inspectors identified one resident, referred to in records as Resident R1, among six reviewed whose fall resulted in a confirmed injury.
The nurse had stepped into the dining room, out of sight, as residents and staff filed past on their way to the noon meal.