Based on record review and interview, it was determined that the facility failed to complete Quarterly Minimum Data Set (MDS) assessments within 14 days after the assessment reference date. This was evident for one (Resident #185) out of three residents reviewed for resident assessments.The findings include:The Minimum Data Set (MDS) is a mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive and accurate assessment of each resident's functional capacity and health status to assist nursing home staff in identifying health problems. …
F638 citations in Maryland
Resident Assessment and Care Planning Deficiencies
Assure that each resident’s assessment is updated at least once every 3 months.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Maryland cites F638 more often than its own record predicts
1.15 times the share F638 takes of citations nationally.
Of every deficiency written in Maryland in 2025, this is the portion that was F638.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Maryland surveyors wrote
F638 findings written in Maryland, 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 medical record review and staff interview, it was determined the facility failed to ensure Resident #6 had a Minimum Data Set (MDS) assessment review completed in a timely manner. This was evident for 1 of 7 residents reviewed for timeliness of MDS reports during the survey. The findings include: The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. A facility is required to assess current residents at least every 3 months. …
The short window
Recent years
| Year | Share of Maryland citations | vs expected |
|---|---|---|
| 2023 | 0.25% | 1.13× |
| 2024 | 0.16% | 0.92× |
| 2025 | 0.13% | 1.15× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Maryland surveyors cite →
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