Failure to Complete Timely Quarterly MDS Assessment
Penalty
No penalty information released
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 ensure that a quarterly Minimum Data Set (MDS) assessment was completed every three months for one of four residents reviewed for MDS assessments. Specifically, for one resident, the quarterly MDS assessment had an assessment reference date (ARD) of 11/14/25 but was not signed by the RN for completion and was completed 14 days after the ARD. During an interview, the MDS Coordinator confirmed that the assessment was not completed on time. This resulted in the resident's assessment being outdated at the time of review.