Below average — CMS composite of the measures below.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Jerold Phelps Comm Hosp Snf during CMS and state inspections, most recent first.
An allegation of financial abuse involving a resident with dementia and Parkinson's disease was not reported to the State Survey Agency within the required two-hour timeframe. Staff became aware of the alleged financial exploitation after the resident contacted her bank and became upset about debits from her account, and the abuse coordinator was notified shortly thereafter. However, the abuse coordinator later stated she did not know if the state agency had been called as required, and state records showed no timely voicemail report from the facility. The formal abuse report form was completed by the DON and faxed to the state several days after the facility first became aware of the allegation, resulting in noncompliance with federal reporting requirements.
The facility failed to ensure an RN worked at least 8 consecutive hours a day, seven days a week for a census of 8 residents. The DON reviewed staffing schedules and confirmed there were multiple days when no RN was scheduled, while an RN working at the hospital was only a float nurse available to assist if needed. The DON also stated there was no staffing policy and procedure, and QO H said the facility believed a float nurse was adequate based on the Facility Assessment.
The facility failed to keep its facility-wide assessment updated annually and did not include a staffing plan that ensured RN coverage for 8 consecutive hours per day, 7 days a week. The DON stated the assessment was last updated on 10/5/23, and staffing schedules showed multiple days with no RN scheduled. The DON and QO H also stated the facility did not have a policy and procedure addressing staffing or the Facility Assessment.
Insulin orders for two residents with DM lacked blood sugar parameters and instructions for when to hold insulin or notify the physician. One resident had an order for insulin glargine at bedtime, and another had an order for nightly insulin glargine with fluctuating blood glucose levels documented on flow sheets; the MAR also did not show the frequency of glucose monitoring. An LPN confirmed the orders did not include parameters, and both the pharmacist and physician stated insulin orders should include parameters or a sliding scale.
The facility failed to maintain MRR policy and procedures for scheduled medication reviews and medication administration oversight. The pharmacist stated he completed monthly MRRs and reported recommendations to the physician and DON, but he did not review residents receiving insulin or verify whether insulin parameters were ordered. He also stated there was no current MRR policy and procedure because he was still writing it.
Insulin pens in the med cart were found without opened dates for three residents. An LPN verified the pens were undated and stated insulin pens are used for 28 days once opened, and the PharmD stated the pens should be dated when opened. A medication safety reference reviewed by surveyors stated the open date should be written on the insulin label and that insulin expires 28 days after opening.
A resident with Failure to Thrive, Cachexia, and poor intake did not receive a timely initial RD nutritional assessment or reassessment, and the facility had no admission nutrition care plan documented for him. The resident’s MDS triggered Nutrition, the CDM noted intake remained less than 25%, and the first post-admission RD assessment was not documented until almost two months after admission, despite facility policy requiring an RD assessment within one week and reassessment within one week of consultation.
The facility's policies and procedures did not specify the required 2-hour timeframe for reporting abuse allegations or the 5-day deadline for submitting investigation summaries to CDPH. The DON confirmed these omissions after being informed by the Chief Quality Officer and a CDPH Surveyor, affecting a census of 8 residents.
A CNA shaved a resident's pubic hair without obtaining consent or consulting with licensed staff, despite the resident's severe cognitive impairment and lack of medical indication for the procedure. The incident was witnessed by another CNA and reported to nursing leadership, revealing a failure to respect the resident's rights and to follow facility protocols.
A resident with severe cognitive impairment and multiple health conditions was subjected to unauthorized shaving of pubic hair by a CNA, which was witnessed by another CNA and later observed by an LN. The incident was not reported to CDPH within the required 2-hour timeframe, and the facility did not submit an investigation summary within 5 business days. Facility policies lacked clear guidance on these reporting requirements, contributing to the deficiency.
The facility failed to develop baseline care plans for six residents within 48 hours of their admission. No baseline care plans signed by the residents or their representatives were found, and the facility's policies did not mention this requirement. Interviews with staff confirmed the lack of baseline care plans and documentation.
The facility failed to develop person-centered comprehensive care plans for five residents, impacting their quality of life and care. Residents with multiple diagnoses, including Dementia, Anxiety Disorder, Depression, and Diabetes, lacked care plans for psychotropic drug use and other critical areas. The facility did not adhere to its policy on resident care planning, leading to these deficiencies.
The Governing Body failed to appoint a California Licensed Nursing Home Administrator (NHA) responsible for the facility's management. The Chief Nursing Officer (CNO) confirmed through a phone call and a verification search that the Administrator did not possess an NHA license.
The facility failed to ensure that medication irregularities noted by the pharmacist during the drug regimen review for two residents were properly documented and communicated. The pharmacist's recommendations to taper Trazodone and lower the dose of Quetiapine were not followed up, and the attending physician did not document any review or action taken. This lack of documentation and communication had the potential to adversely affect the residents' health.
The facility failed to ensure that a resident was informed in advance about the use, risks, and benefits of the psychotropic medication Diazepam, as well as other medication options. The informed consent was obtained only after the medication was administered, contrary to the facility's policy and regulatory requirements.
The facility failed to complete a smoking assessment on admission for a resident to determine their functional capacity to safely smoke with or without assistance and the need for protective devices. The resident was observed smoking outside with a security staff member, and neither the resident nor the Licensed Nurse could confirm if a smoking assessment had been conducted. This failure had the potential to result in inappropriate care and supervision, as well as a fire hazard.
The facility failed to maintain a safe smoking environment and provide necessary protective equipment for a resident who smoked. The resident was not wearing a protective apron, and the blanket proposed for use was unsuitable. The designated smoking area was inconsistently defined, and the facility's smoking policy lacked provisions for smoking assessments and adaptive equipment.
Failure to Timely Report Allegation of Financial Abuse to State Agency
Penalty
Summary
The facility failed to ensure that an allegation of financial abuse was reported to the State Survey Agency within two hours of becoming aware of the allegation, as required by regulation and facility policy. The resident involved had dementia associated with Parkinson's disease and had been admitted with these diagnoses. The facility became aware of the alleged financial abuse on 2/19/26 at 3:30 p.m., when the resident called her bank to check her balance and became upset due to debits from her account. The abuse coordinator was notified at 3:49 p.m. that same day. The facility’s short-term care plan documented the resident’s upset related to the debits, and the facility’s policy stated it would promptly prevent, identify, and report suspected abuse, neglect, and exploitation. Despite this, the allegation was not reported to the California Department of Public Health (CDPH) within the required two-hour timeframe. The Chief Nursing Officer, who served as the abuse coordinator, stated she did not know if CDPH was called on 2/19/26 and acknowledged it was her expectation that staff report suspected abuse to CDPH within two hours and that it was her responsibility to verify timely reporting. CDPH records showed no voicemail messages from the facility between 2/19/26 and 2/24/26. CDPH ultimately received a faxed Report of Suspected Dependent Adult/Elder Abuse (SOC 341) on 2/23/26 at 4:49 p.m., which had been completed and dated 2/20/26 by the DON, confirming the resident as an alleged victim of financial abuse, demonstrating that the report was not made within the required reporting window.
RN Staffing Not Provided Daily
Penalty
Summary
The facility failed to ensure a Registered Nurse (RN) worked at least 8 consecutive hours a day, seven days a week for a census of 8 residents. During a concurrent interview and record review on 9/11/25 at 4:10 p.m., the DON reviewed the facility nurse staffing schedules for January 2025, February 2025, March 2025, and April 2025 and confirmed there was no RN scheduled on 1/25/25, 3/1/25, 3/9/25, 3/16/25, 3/23/25, 3/27/25, and 3/30/25. The DON stated an RN working at the hospital on those dates was assigned as a hospital float nurse and was not specifically designated to work as an RN at the facility; the float nurse was only available to assist if needed. During interviews on 9/12/25, the DON stated the facility did not have a policy and procedure addressing staffing, and QO H stated the facility was not aware staffing requirements were not met because they believed a float nurse was adequate. Review of the Facility Assessment dated updated 10/5/2023 indicated there was to be a Licensed Vocational Nurse on each shift and a Resource RN available 24 hours a day, 7 days a week on site.
Facility Assessment and RN Staffing Plan Not Updated
Penalty
Summary
The facility failed to ensure a comprehensive facility-wide assessment was updated annually and included a staffing plan that ensured RN coverage for 8 consecutive hours per day, seven days a week. During an interview on 9/11/25, the DON stated she did not have an updated facility assessment and provided a Facility Assessment Tool last updated on 10/5/23. The DON stated the facility was currently working on updating the facility assessment. During review of nurse staffing schedules for January, February, March, and April 2025, the DON confirmed there was no RN scheduled to work on 1/25/25, 3/1/25, 3/9/25, 3/16/25, 3/23/25, 3/27/25, and 3/30/25. The DON stated an RN working in the hospital down the hall could assist if needed, but was not specifically designated to work at the facility. The Facility Assessment Tool dated 10/5/23 stated there was an LVN on each shift and a Resource RN available 24 hours a day, 7 days a week on site. The DON and QO H also stated the facility did not have a policy and procedure addressing staffing or the Facility Assessment.
Insulin Orders Lacked Blood Sugar Parameters
Penalty
Summary
The facility failed to ensure professional standards of practice were followed for two residents with diabetes when insulin orders did not include blood sugar parameters or instructions for when to hold insulin and notify the physician. Resident 3, a female admitted with DM, had an order for insulin glargine 20 units subcutaneously at bedtime, but the physician order report did not include blood sugar parameters. Resident 9, a female admitted with DM, had an order for insulin glargine 80 units subcutaneously nightly, and the order also did not show documented evidence of insulin parameters or when to notify a physician if the insulin was to be held. Resident 9’s blood sugar flow sheets showed fluctuating glucose levels between 236 mg/dl and 91 mg/dl, and the MAR from 9/7/25 through 9/10/25 did not indicate the frequency of blood glucose monitoring. During interview and record review, Licensed Staff K confirmed the insulin orders for Residents 3 and 9 did not have parameters and stated glucose checks and insulin parameters had not been ordered consistently for residents. The pharmacist stated parameters for insulin should always be ordered and that the standard of practice is for insulin to have parameters or a sliding scale in the orders. The physician stated his standard of practice for insulin administration orders included parameters for managing high and low blood glucose levels and confirmed the orders were inconsistent.
Missing MRR Policy and Incomplete Medication Oversight
Penalty
Summary
The facility failed to ensure Medication Review (MRR) policy and procedures were developed and maintained for scheduled medication reviews and oversight of medication administration. During an interview, the facility pharmacist stated he completed monthly MRRs for each resident and reported findings to the physician and DON, and that he expected a physician response to recommendations within 48 hours. He also stated that standard practice for insulin administration included ordered parameters and blood sugar checks, and that parameters should be ordered depending on the type of insulin administered. However, he verified that he did not review the residents receiving insulin or whether parameters were ordered. When asked for the Policy and Procedures for the MRR process, he stated he was in the process of writing the policy and did not currently have a policy and procedure for the MRR.
Insulin Pens Stored Without Opened Dates
Penalty
Summary
The facility failed to ensure insulin pens stored in the medication cart were labeled with an opened date for three residents. During an observation of the medication cart with a licensed staff member, three insulin pens were found without an opened date: one Lantus pen for Resident 1, one Lantus pen for Resident 2, and one Humalog Kwik pen for Resident 3. The licensed staff member verified the pens did not have an opened date and stated that once opened, an insulin pen is used for 28 days. The facility pharmacist also stated that insulin pens should be dated with an opened date. A review of an Institute for Safe Medication Practices article stated that the date should be written on the insulin label when it is opened and that insulin expires 28 days after opening.
Delayed Nutritional Assessment and Missing Care Plan
Penalty
Summary
The facility did not complete timely nutritional assessments and reassessments for Resident 6, and it did not have documentation of an admission nutrition Nursing Care Plan for him. Resident 6 had been identified in a hospital Initial Nutritional Assessment as having low appetite, intake of less than 25%, and underweight status, with the RD documenting follow-up in 2-3 months. His hospital H&P listed diagnoses of Failure to Thrive, Cachexia, and Iron Deficiency Anemia and noted he was admitted for support with ADLs, physical therapy, and monitoring of nutrition. His initial MDS, dated 8/28/24, showed he was 69 inches tall, weighed 105 pounds, and triggered Nutrition, indicating a Nursing Care Plan was needed to address nutritional needs. The facility’s consulting RDs did not document the expected initial assessment within one week of admission or a timely reassessment despite the resident’s low weight and poor intake. The first documented post-admission RD nutritional assessment was on 10/9/24, almost two months after admission, and the CDM documented on 8/22/24 that the resident’s meal intake continued to be less than 25%, with no further documentation until 10/9/24. During interviews, the DON, DSD, and MDS nurse confirmed there was no nutritional care plan for Resident 6 prior to 6/15/25, and the RD stated she routinely completed initial assessments and reassessed high-risk residents every one to two months, while the other RD stated she would only assess if requested by the first RD.
Failure to Include Timely Abuse Reporting Requirements in Facility Policies
Penalty
Summary
The facility failed to ensure that its policies and procedures regarding resident abuse included the requirement to report allegations of abuse to the California Department of Public Health (CDPH) within 2 hours of awareness and to submit an investigation summary within 5 business days. A review of the facility's policies titled 'Abuse and Neglect Investigation' and 'Abuse Reporting Requirements' revealed that neither document specified these mandatory reporting timeframes. During an interview, the Director of Nursing (DON) acknowledged the omission of these requirements in the facility's policies and stated that she became aware of the 2-hour and 5-day reporting requirements only after being informed by the Chief Quality Officer and a CDPH Surveyor. These failures affected a census of 8 residents, as the facility's policies did not align with state reporting requirements for abuse allegations.
Resident Shaved Without Consent by CNA
Penalty
Summary
A Certified Nursing Assistant (CNA) shaved a resident's pubic hair without obtaining the resident's consent or consulting with licensed nursing staff. The resident involved had severe cognitive impairment, as indicated by a Brief Interview for Mental Status (BIMS) score of 5, and was dependent on staff for toileting hygiene. The resident also had diagnoses of dementia, Parkinson's disease, anxiety, and depression. The CNA used the resident's personal beard shaver to perform the shaving during incontinent care, despite the resident not requesting this care and not being scheduled for any procedure that would require shaving. Another CNA witnessed the incident and later reported it to a licensed nurse, who then informed the Director of Nursing (DON) and Human Resources (HR). Interviews with staff confirmed that the CNA did not provide a reason for shaving the resident and that the resident appeared agitated during the incident. The facility's policies and job descriptions require CNAs to act under the supervision of licensed nurses and to respect residents' rights to informed consent and dignified care. The incident was reported internally, and the CNA acknowledged understanding that a violation had occurred. The failure to obtain consent and to follow proper procedures resulted in the resident not being treated with respect and dignity, as required by facility policy and patient rights.
Failure to Timely Report and Investigate Suspected Abuse
Penalty
Summary
The facility failed to report an allegation of abuse involving a resident with severe cognitive impairment, dementia, Parkinson's disease, anxiety, and depression. A Certified Nursing Assistant (CNA) was observed by another CNA shaving the resident's pubic hair without medical reason or consent, using the resident's personal beard shaver. The resident appeared agitated during the incident, and the CNA who witnessed the event did not immediately report it. The incident was later observed by a Licensed Nurse (LN), who noticed the resident's pubic area was shaved in a sloppy manner and the skin was red. The LN submitted an incident report to Human Resources and informed the Director of Nursing (DON) the following day. Despite multiple staff members becoming aware of the incident, the facility did not report the suspected abuse to the California Department of Public Health (CDPH) within the required 2-hour timeframe from the time of awareness. The facility's policies and procedures did not specify the 2-hour reporting requirement, and staff interviews revealed a lack of clarity regarding the appropriate steps to take when abuse is suspected. The DON later acknowledged that staff are mandated reporters and should have reported the suspicion of abuse immediately or within 2 hours, but this was not reflected in the facility's written policies. Additionally, the facility failed to submit a summary of the investigation to CDPH within 5 business days, as required. The facility's policies did not include this 5-day reporting requirement, and the DON confirmed that a 5-day follow-up report was not provided. The lack of timely reporting and incomplete policy guidance contributed to the deficiency identified by surveyors.
Failure to Develop Baseline Care Plans Within 48 Hours of Admission
Penalty
Summary
The facility failed to develop a baseline care plan for six residents within 48 hours of their admission. This deficiency was identified during a review of records and interviews with facility staff. Specifically, no baseline care plans signed by the residents or their representatives were found among the facility documents. The Chief Nursing Officer (CNO) confirmed that there were no baseline care plans developed within the required timeframe and that there were no records of any care plans signed by new residents or their Resident Representatives (RR). The facility's policies on admission documentation and resident care planning did not mention the requirement to develop a baseline care plan within 48 hours of admission. During interviews, Licensed Nurse K stated that new residents signed documents in an admission packet but was unaware if a care plan was developed within 48 hours of admission. The CNO also consulted with Health Information Management (HIM), who were unable to find any documentation for the six residents indicating they received and signed for a baseline care plan. The regulatory Health and Safety Code S483.21 requires the facility to develop and implement a baseline care plan within 48 hours of a resident's admission, including initial goals, physician orders, dietary orders, therapy services, social services, and PASARR recommendations if applicable. The facility must also provide the resident and their representative with a summary of the baseline care plan, which was not done in these cases.
Failure to Develop Comprehensive Care Plans
Penalty
Summary
The facility failed to develop person-centered comprehensive care plans for five residents, which had the potential to negatively impact their quality of life and care. Resident 1, who was admitted with multiple diagnoses including Hypertension, Anxiety Disorder, Depression, Type 2 Diabetes, and Parkinson's Disease, did not have a care plan for the use of psychotropic drugs Sertraline and Trazodone. Similarly, Resident 3, diagnosed with Dementia, Anxiety Disorder, Depression, Bipolar Disorder, Diabetes, and Hyperlipidemia, lacked a care plan for the psychotropic drug Risperidone. Resident 5, admitted with Coronary Artery Disease, Hypertension, and Dementia, had no individualized care plans until they were developed on 2/29/24, after the issue was identified by the Chief Nursing Officer (CNO). Resident 4, admitted with conditions such as debility, cachexia, Dementia, malnutrition, and adult failure to thrive, had care areas like cognitive loss/dementia and psychotropic drug use triggered during the admission assessment, but no corresponding care plans were found. Additionally, Resident 57, who smokes after meals and was observed being administered Diazepam, did not have care plans for smoking or Diazepam use. The Health Information Manager (HIM) and the CNO acknowledged that the care plans provided for Resident 57 were completed the night before the surveyors' review. The facility's policy on resident care planning indicates that nurses gather data upon admission, input it into the electronic medical record (EMR) system, and complete weekly summaries to generate data for the Minimum Data Set (MDS). The MDS is supposed to auto-populate appropriate plans of care, which are then reviewed monthly by the Director of Nursing (DON). However, the facility failed to adhere to this policy, resulting in the absence of comprehensive care plans for the residents mentioned above.
Failure to Appoint Licensed Nursing Home Administrator
Penalty
Summary
The Governing Body failed to appoint a California Licensed Nursing Home Administrator (NHA) responsible for the management of the facility. During an interview, the Chief Nursing Officer (CNO) was unable to provide a copy of the Administrator's license and confirmed through a phone call with the Administrator that he did not possess an NHA license. The Administrator also confirmed in a separate interview that he did not have a license. A verification search through the California Department of Public Health (CDPH) confirmed the absence of an NHA license for the Administrator.
Failure to Document and Address Medication Irregularities
Penalty
Summary
The facility failed to ensure that irregularities noted by the pharmacist during the drug regimen review (DRR) for two residents were properly documented and communicated to the attending physician, medical director, and Director of Nursing (DON). Specifically, the pharmacist recommended tapering Trazodone for one resident and lowering the dose of Quetiapine for another resident. However, there was no documentation or follow-up on these recommendations, and the pharmacist did not provide a separate, written report of the irregularities as required by the facility's policies and procedures. Additionally, the attending physician did not document any review or action taken regarding the identified irregularities in the residents' medical records. During interviews, the Pharmacy Tech and Pharmacy Consultant confirmed the process of monthly DRR and acknowledged the need for improved documentation and communication. The pharmacist's recommendations were recorded in an Excel spreadsheet, but this method lacked the necessary detail and formal reporting required to ensure proper follow-up and action. The failure to document and address these medication irregularities had the potential to result in adverse effects on the residents' health and well-being.
Failure to Obtain Informed Consent for Psychotropic Medication
Penalty
Summary
The facility failed to ensure that Resident 57 was informed in advance by the physician or other practitioner about the use, risks, and benefits of the psychotropic medication Diazepam, as well as other medication options. This deficiency was observed during a medication administration on 2/29/24, when Licensed Nurse H administered a 5 mg tablet of Diazepam to Resident 57 without prior informed consent. The informed consent was only obtained later on the same day, as confirmed by the Chief Nursing Officer (CNO) during a record review and interview on 3/1/24. The facility's policy, dated 3/30/23, requires that informed consent be obtained and documented by the physician before initiating the administration of psychoactive drugs. Additionally, Title 22 CCR Section 72528(c) mandates that facility staff verify the presence of such documentation in the patient's health record prior to starting the therapy. The failure to adhere to these protocols deprived Resident 57 of her right to be fully informed about her medication and treatment options, which is essential for making an informed decision about her care.
Failure to Complete Smoking Assessment on Admission
Penalty
Summary
The facility failed to complete a smoking assessment on admission for one of six residents to determine the resident's functional capacity to safely smoke with or without assistance and the need for protective devices. This deficiency was identified during an observation and interview where the resident was seen smoking outside the facility with a security staff member. The resident had a portable ashtray positioned by the right side of her wheelchair and stated she smoked after meals outside the facility. When asked, the Licensed Nurse (LN) could not provide the smoking assessment and referred to the Health Information Management (HIM)/Information Technician (IT) to print out the document from the facility's electronic medical records. The resident herself could not confirm if she had undergone a smoking assessment for safety purposes. A review of the facility's policy on resident assessment indicated that a comprehensive assessment of the resident's needs should be made by the interdisciplinary team within fourteen or eight days of the resident's admission. This assessment is intended to describe the resident's capability to perform daily life functions and identify significant impairments in functional capacity. The information derived from the comprehensive assessment enables staff to plan care that allows the resident to reach their highest practicable level of functioning, including determining the resident's need for staff assistance and assistive devices or equipment to maintain or improve functional abilities. However, in this case, the facility failed to adhere to its policy, resulting in the potential for inappropriate care and supervision, as well as a fire hazard to both the resident and the facility.
Failure to Provide Safe Smoking Environment and Protective Equipment
Penalty
Summary
The facility failed to maintain an environment free from accident hazards and provide necessary assistive devices to a resident who smoked. During observations and interviews, it was noted that the resident smoked outside the facility with a portable ashtray positioned by her wheelchair. The resident's cigarettes and lighter were kept in a locked medication room, and she was accompanied by staff during smoke breaks. However, the resident was not wearing a protective apron during these breaks, and the staff could not provide a smoking assessment for the resident. Additionally, the blanket proposed as a protective apron was found to be unsuitable for preventing cigarette burns. The designated smoking area was observed to be inconsistently defined, with discrepancies in its distance from the building and emergency exit door. The facility's smoking policy required a written order for smoking and designated smoking areas but did not include the need for a smoking assessment or adaptive equipment. Interviews with staff and a customer service representative confirmed that the blanket intended for use as a protective apron was not appropriate for this purpose. The facility's failure to provide a safe smoking environment and necessary protective equipment posed a risk of cigarette burns and fire hazards.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Garberville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Fortuna Rehabilitation And Wellness Center, Lp | 38.4 mi | ★★★★★ | 48 | 0 |
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