Inspection visit
Health inspection
3 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 3 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0727
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on
a full time basis.
Based on interview, facility document review, and facility policy review, the facility failed to ensure a
registered nurse (RN) was on duty daily for eight consecutive hours. This deficient practice had the potential
to affect all residents who resided in the facility.
Findings included:
A facility policy titled, RN Coverage Policy, last reviewed by the facility on 05/01/2024, revealed the section
titled, A. Minimum RN Coverage, included, 1. An RN will be on duty a minimum of 8 consecutive hours per
day, 7 days a week.
Facility nursing schedules for the timeframe from 10/01/2024 through 04/07/2025 revealed RN coverage
was provided Mondays through Fridays.
A facility nursing schedule for October 2024 indicated there were no RNs scheduled to work on 10/05/2024,
10/06/2024, 10/12/2024, 10/13/2024, 10/19/2024, 10/20/2024, 10/26/2024, and 10/27/2024.
A facility nursing schedule for November 2024 indicated there were no RNs scheduled to work on
11/02/2024, 11/03/2024, 11/09/2024, 11/10/2024, 11/16/2024, 11/17/2024, 11/23/2024, 11/24/2024, and
11/30/2024.
A facility nursing schedule for December 2024 indicated there were no RNs scheduled to work on
12/01/2024, 12/07/2024, 12/08/2024, 12/15/2024, 12/21/2024, 12/22/2024, 12/28/2024 and 12/29/2024.
A facility nursing schedule for January 2025 indicated there were no RN's scheduled to work on
01/01/2025, 01/04/2025, 01/05/2025, 01/11/2025, 01/12/2025, 01/18/2025, 01/19/2025, 01/25/2025 and
01/26/2025.
A facility nursing schedule for February 2025 indicated there were no RNs scheduled to work on
02/01/2025, 02/02/2025, 02/08/2025, 02/09/2025, 02/15/2025, 02/16/2025, 02/22/2025, and 02/23/2025.
A facility nursing schedule for March 2025 indicated there were no RNs scheduled to work on 03/01/2025,
03/02/2025, 03/08/2025, 03/09/2025, 03/15/2025, 03/16/2025, 03/22/2025, 03/23/2025, 03/29/2025, and
03/30/2025.
A facility nursing schedule for April 2025 indicated there were no RNs scheduled to work on 04/05/2025
and 04/06/2025.
(continued on next page)
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
Page 1 of 4
Event ID:
555539
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
555539
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
04/10/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Coalinga Regional Medical Ctr Dp/Snf
1191 Phelps Ave.
Coalinga, CA 93210
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0727
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
FORM CMS-2567 (02/99)
Previous Versions Obsolete
During an interview on 04/09/2025 at 9:46 AM, the Director of Nursing (DON) stated she knew the facility
was required to have RN coverage at least eight hours every day, and she revealed that from October 2024
to 04/09/2025 they had not had any RN coverage for the weekends.
During an interview on 04/09/2025 at 10:28 AM, the Administrator stated he thought the facility only had to
have a nurse scheduled, not necessarily an RN, and the facility did not have an RN scheduled for the
weekends.
Event ID:
Facility ID:
555539
If continuation sheet
Page 2 of 4
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
555539
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
04/10/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Coalinga Regional Medical Ctr Dp/Snf
1191 Phelps Ave.
Coalinga, CA 93210
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0732
Post nurse staffing information every day.
Level of Harm - Minimal harm
or potential for actual harm
Based on interview, facility document review, and facility policy review, the facility failed to ensure a
registered nurse (RN) was identified on the daily staff posting. This deficient practice had the potential to
affect all residents who resided in the facility.
Residents Affected - Many
Findings included:
A facility policy titled, Posting of Daily Hours per Patient Day (DHPPD), last reviewed by the facility on
05/01/2024, revealed, The posting shall include: Breakdown of RN, LVN [licensed vocational nurse]/LPN
[licensed practical nurse], and CNA [certified nursing assistant] hours
Facility nursing schedules for the timeframe from 10/01/2024 through 04/07/2025 revealed RN coverage
was provided Mondays through Fridays.
A facility document titled, Daily Census & NHPPD [Nursing Hours per Patient Day] for the timeframe from
10/01/2024 through 04/07/2025 revealed the daily posted staffing sheets did not identify RN coverage as
part of their nursing staff.
During an interview on 04/09/2025 at 4:05 PM, the Staffing Coordinator stated she did not count
(document) any RN hours on the daily staffing sheets.
During an interview on 04/10/2025 at 1:52 PM, The Director of Nursing (DON) stated she expected the staff
to make sure the daily staffing sheets were accurate.
During an interview on 04/10/2025 at 2:18 PM, the Administrator stated he expected the daily staffing
sheets to be accurate and show the staff who worked.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
555539
If continuation sheet
Page 3 of 4
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
555539
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
04/10/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Coalinga Regional Medical Ctr Dp/Snf
1191 Phelps Ave.
Coalinga, CA 93210
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0851
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and
other verifiable and auditable data.
Based on interview, facility document review, and facility policy review, the facility failed to electronically
submit the Payroll-Based Journal (PBJ) (staffing information for all employees in the nursing home based
on payroll data submitted on a quarterly schedule) to the Centers for Medicare and Medicaid Services
(CMS) for one quarter of the 2025 Fiscal Year for the facility.
Findings included:
A facility policy titled, Payroll-Based Journal (PBJ) Reporting Policy, revised 05/01/2024, revealed, [Facility
Name] will maintain an accurate and verifiable system for collecting, validating, and submitting staffing and
census data to CMS through the PBJ system on a quarterly basis, as required under 42 CFR [Code of
Federal Regulations] §[section]483.70(q). The policy revealed the section titled, 5. CMS Submission,
included, A confirmation of receipt and validation report will be reviewed and retained.
The facility's PBJ Staffing Data Report for quarter one of fiscal year 2025 revealed the facility did not submit
the PBJ report for the first quarter (October 1 - December 31) of fiscal year 2025.
During an interview on 04/10/2025 at 12:40 PM, the Staffing Coordinator stated that the previous Assistant
Administrator was responsible for the PBJ submission. The Staffing Coordinator stated she would be
trained to do the PBJ submission now because she was responsible for staffing and the hours per patient
day (HPPD) reporting.
During an interview on 04/10/2025 at 2:06 PM, the Director of Nursing (DON) stated the Assistant
Administrator left the position in late December 2024. The DON stated that when the Assistant
Administrator was at the facility, he had been responsible for submitting the PBJ data. The DON stated she
was not sure who submitted the PBJ data now. The DON stated she expected the PBJ data to be submitted
in a timely manner.
During an interview on 04/10/2025 at 2:31 PM, the Administrator stated he was not able to provide
evidence that the first quarter PBJ data was submitted. The Administrator stated it was his expectation that
facility staff follow all protocol, policy, and CMS regulations for PBJ data to be submitted timely, and the
facility staff should have been doing that.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
555539
If continuation sheet
Page 4 of 4
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Back to topCitations
3 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F727 - Except when waived under paragraph (f) or (g) of this section, the
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
F851 - Mandatory submission of staffing information based on payroll data in a
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
F732 - Nurse Staffing Information
Post nurse staffing information every day.
FAQ · About this visit
Common questions about this visit
What happened during the April 10, 2025 survey of COALINGA REGIONAL MEDICAL CTR DP/SNF?
This was a inspection survey of COALINGA REGIONAL MEDICAL CTR DP/SNF on April 10, 2025. The surveyor cited 3 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at COALINGA REGIONAL MEDICAL CTR DP/SNF on April 10, 2025?
Yes, 3 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full tim..."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.