Based on interview, and record review the facility failed to provide significant change in assessments for 1 of 13 sampled residents (Resident 1) with [MEDICAL CONDITION] disorder (episodes of uncontrolled electrical activity in the brain can cause changes in your behavior, movements or feelings, or level of consciousness) by failing to provide an accurate assessment and documentation after Resident 7 reported having a [MEDICAL CONDITION] on 7/2/19, 7/8/19, 7/10/19, 7/12/19 and 7/13/19. This failure resulted in Resident 7 complaining he had several (5) [MEDICAL CONDITION]. …
F637 citations in California
Assessment after a significant change · Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
California cites F637 less often than its own record predicts
0.90 times the national share — cited less often here than elsewhere.
Of every deficiency written in California in 2025, this is the portion that was F637.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What California surveyors wrote
F637 findings written in California, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on observation, interview, and record review the facility failed to complete a Minimum Data Set (MDS - a resident assessment tool) for Significant Change in Status Assessment (SCSA) to reflect one of five residents (Resident 11) current condition who experienced a significant change of having a cerebral infarction (happens when a blood clot blocks a vessel in the brain) in accordance with the facility's policy and procedure titled Change in Condition Using Triaged Trace. This failure had the potential to negatively affect the delivery of care and services by delaying the comprehensive reassessment of Resident 11's current condition and the development of appropriate interventions. …
Based on interview and medical record review, the facility failed to ensure the MDS assessment for significant change was completed timely for one of three residents (Resident 4) reviewed for closed records. * The facility failed to ensure the MDS assessment was completed in a timely manner when Resident 4 was admitted to the hospice services. This failure had the potential for the resident to not receive the necessary care and services based on the resident's assessment and needs.Findings: Review of CMS's Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual Version 1.19, showed a Significant Change in Status MDS is required to be performed when a resident enrolls in a hospice program. …
The short window
Recent years
| Year | Share of California citations | vs expected |
|---|---|---|
| 2023 | 0.31% | 1.01× |
| 2024 | 0.19% | 0.84× |
| 2025 | 0.22% | 0.90× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else California surveyors cite →
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