Other·May 19, 2026

California Code, Health and Safety Code - HSC § 1418.21 (a) A skilled nursing facility that has been certified for purposes of Medicare or Medicaid shall post the overall facility rating information determined by the federal Centers for Medicare and Medicaid Services (CMS) in accordance with the following requirements: (1) The information shall be posted in at least the following locations?in the facility: (A) An area accessible and visible to members of the public. (B) An area used for employee breaks. (C) An area used by residents for communal functions, such as dining, resident council meetings, or activities. (2) The information shall be posted on white or light-colored paper that includes all of the following, in the following order: (C) The most recent overall star rating given by CMS to that facility, except that a facility shall have seven business days from the date when it receives a different rating from?CMS to include the updated rating in the posting. The star rating shall be aligned in the center of the page. The star rating shall be expressed as the number that reflects the number of stars given to the facility by?CMS. The number shall be in a clear and easily readable font of at least two inches print. (4) The requirements of this section shall be in addition to any other posting or inspection report availability requirements. (b) Violation of this section shall constitute a class B violation, as defined in?subdivision (e) of Section 1424?and, notwithstanding?Section 1290, shall not constitute a crime. Fines from a violation of this section shall be deposited into the State Health Facilities Citation Penalties Account, created pursuant to?Section 1417.2. On 4/10/2026, the California Department of Public Health (CDPH) conducted an unannounced visit to the facility to investigate a complaint. The facility failed to post its current Center for Medicare and Medicaid System (CMS- the federal agency that provides health coverage) star rating (CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas for which further inquiry. The Nursing Home Care Compare web site features a quality rating system that gives each nursing home a rating from one and five stars, with five-stars indicating much above average quality and nursing homes with one-star indicating much below average) signage on 4/10/2026. This failure had the potential to result in the dissemination of incorrect or outdated information to the public. During an observation on 4/10/2026, at 8:32 a.m., in the facility’s front lobby, a two-star rating was observed posted on the wall to the right of the receptionist desk. A review of the CMS website for star rating (dated 3/25/2026), on 4/10/2026 at 8:43 a.m., indicated the facility held a one-star rating. During a concurrent observation and interview on 4/10/2026, at 8:54 a.m., with Certified Nursing Assistant 1 (CNA 1), in the facility’s front lobby, CNA 1 stated a two-star rating posted on the wall to the right side of the receptionist desk. CNA 1 stated that the facility also had a star rating posted on the wall by the staff clock-in area (a designated location where employees officially record the start and end of their work shifts). During a concurrent observation and interview on 4/10/2026, at 8:55 a.m., with CNA 1, in the staff clock-in area, CNA 1 stated that no star ratings were posted. CNA 1 stated the facility also has a star rating posted in the residents` main dining room. During a concurrent observation and interview on 4/10/2026, at 8:56 a.m., with CNA 1, in the residents` main dining room, CNA 1 stated that no star ratings were posted. CNA 1 stated that the star rating should also be posted in the small dining room. During a concurrent observation and interview on 4/10/2026, at 8:57 a.m., with CNA 1, in the small dining room, CNA 1 stated that no star ratings were posted in the small dining room. During an interview on 4/10/2026, at 9:04 a.m., with Registered Nurse 1 (RN 1), RN 1 stated that the facility`s current star rating should be posted so residents and families are aware of the quality of care provided by the facility. RN 1 stated posting a two-star rating instead of one-star rating could mislead the residents and families and provide incorrect information. RN 1 stated that the star rating can influence a resident’s or family’s decision to remain at the facility. During a concurrent interview and record review on 4/10/2026, at 9:13 a.m., with the Administrator (ADM), the “All Facilities Letter (AFL- a communication from the California Department of Public Health to health facilities regarding changes or guidance affecting their operations)10-05, dated 2/26/2010, last updated on 10/6/2017, was reviewed. The AFL 10-05 indicated, “Effective 1/1/2011, Health and Safety Code (HSC - a set of regulations for maintaining public and workplace health and safety) Section 1418.21 requires that a skilled nursing facility that has been certified for purposes of Medicare or Medicaid post the overall facility rating information determined by the federal CMS in accordance with the following requirements: 1. The information shall be posted in at least the following locations in the facility: (A) An area accessible and visible to members of the public. (B) An area used for employee breaks. (C) An area used by residents for communal functions, such as dining, resident council meetings, or activities. 2. The information shall be posted on white or light-colored paper that includes all of the following, in the following order: … (C) The most recent overall star rating given by CMS to that facility, except that a facility shall have seven business days from the date when it receives a different rating from the CMS to include the updated rating in the posting… The star rating shall be expressed as the number that reflects the number of stars given to the facility by the CMS… Violation of this section shall constitute a class B violation (a violation of a regulation that has a direct relationship to the health, safety, or security of individuals), as defined in subdivision (e) of HSC Section 1424.” The ADM stated that the Minimum Data Set Nurse (MDSN) provides her (ADM) with the printed CMS rating monthly, and she (ADM) posts the star rating in the front lobby, and in the residents` activity and dining rooms. The ADM stated that she (ADM) is in charge of updating the facility`s star rating signage whenever CMS releases a new rating. The ADM further stated that she (ADM) was initially unsure of when to post the newly released star rating, but after reviewing the AFL 10-05 today (4/10/2026), the ADM stated that the facility should post the updated star rating within seven days of receipt. The ADM further stated that the importance of the star rating signage was to inform the public of quality-of-care reports. The ADM stated that the most recent CMS report released on 3/2026 indicated that the facility held a one-star rating. The ADM stated that more than seven days had passed since CMS released the new rating, and the facility had not yet updated the signage. The ADM stated that posting inaccurate star rating is considered false advertising. During a concurrent interview, and record review on 4/10/2026, at 9:345 a.m., with the MDSN, the facility’s star rating results were reviewed and were as follows: 1. 3/17/2026- one-star rating 2. 2/18/2026- one-star rating 3. 1/21/2026- two-stars rating The MDSN stated that the star rating signage was not updated for almost three months. The MDSN stated that the ADM was responsible for posting the correct and accurate star rating. The MDSN stated that the star rating indicates the quality of care provided by the facility to the residents. The MDSN stated that the star rating can influence a resident’s or family’s decision to remain at the facility. The MDSN stated that accurate star rating signage provides important information to the public. During an interview on 4/10/2026, at 10:14 a.m., with the ADM, the ADM stated the AFL 10-05 was not followed. The ADM stated that the facility does not have a policy and procedure (P&P) for star rating but follows the AFL 10-05. The facility failed to post its current CMS star rating signage on 4/10/2026. This failure had the potential to result in the dissemination of incorrect or outdated information to the public regarding its CMS rating. The above violation had a direct relationship with the health, safety, or security of the residents at the facility.