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F0636
D

Failure to Complete Required Annual MDS Assessment

San Jose, California Survey Completed on 06-27-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to complete an annual Minimum Data Set (MDS) assessment for one resident as required. Review of the resident's medical record showed that while an annual MDS assessment was completed in May of the previous year, there was no evidence of a completed annual MDS assessment for the following year. During an interview and concurrent record review, the MDS Coordinator confirmed that the annual assessment had not been completed within the required timeframe. According to the CMS RAI Manual, the annual MDS assessment must be completed at least every 366 days, and this requirement was not met for the resident in question.

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