Medicare flags this nursing home for abuse. Medicare adds this flag when a home was cited for abuse that harmed a resident, or for potential abuse more than once. Ask the home what changed.
Inspection citations
16’22
4’24
25’25
17’26
62 shown
| Date | Severity | What inspectors found | Visit |
|---|---|---|---|
| Aug 6, 2026 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jun 26, 2026 | D · potential | Ensure that residents are fully informed and understand their health status, care and treatments. | Routine |
| Jun 26, 2026 | D · potential | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Routine |
| Jun 26, 2026 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Jun 26, 2026 | E · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Routine |
| Jun 26, 2026 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jun 26, 2026 | F · potential | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Routine |
| Jun 26, 2026 | F · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Jun 26, 2026 | F · potential | Dispose of garbage and refuse properly. | Routine |
| Jun 26, 2026 | D · potential | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | Routine |
| Jun 26, 2026 | F · potential | Provide and implement an infection prevention and control program. | Routine |
| May 21, 2026 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Mar 6, 2026 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Feb 26, 2026 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Jan 29, 2026 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Jan 29, 2026 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Jan 23, 2026 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| Dec 23, 2025 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Nov 24, 2025 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Nov 13, 2025 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Nov 13, 2025 | D · potential | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | Routine |
| Nov 13, 2025 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Nov 13, 2025 | E · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Nov 13, 2025 | E · potential | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Routine |
| Nov 13, 2025 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Nov 13, 2025 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Nov 13, 2025 | D · potential | Provide enough food/fluids to maintain a resident's health. | Routine |
| Nov 13, 2025 | F · potential | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Routine |
| Nov 13, 2025 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Nov 13, 2025 | E · potential | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | Routine |
| Nov 13, 2025 | E · potential | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Routine |
| Nov 13, 2025 | D · potential | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Routine |
| Nov 13, 2025 | D · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Nov 13, 2025 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Nov 13, 2025 | D · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Routine |
| Nov 13, 2025 | E · potential | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Routine |
| May 7, 2025 | E · potential | PASARR screening for Mental disorders or Intellectual Disabilities | Complaint |
| May 7, 2025 | E · potential | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Complaint |
| Apr 10, 2025 | E · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Feb 20, 2025 | E · potential | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | Complaint |
| Jan 8, 2025 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Jan 8, 2025 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Nov 21, 2024 | D · potential | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Complaint |
| Aug 15, 2024 | G · harm | Provide care and assistance to perform activities of daily living for any resident who is unable. | Complaint |
| Aug 15, 2024 | G · harm | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Feb 15, 2024 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Jul 27, 2022 | E · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Routine |
| Jul 27, 2022 | E · potential | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Routine |
| Jul 27, 2022 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Routine |
| Jul 27, 2022 | E · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Routine |
| Jul 27, 2022 | H · harm | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Jul 27, 2022 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Routine |
| Jul 27, 2022 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Routine |
| Jul 27, 2022 | E · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Jul 27, 2022 | F · potential | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | Routine |
| Jul 27, 2022 | F · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Routine |
| Jul 27, 2022 | E · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Jul 27, 2022 | G · harm | Ensure that residents are free from significant medication errors. | Routine |
| Jul 27, 2022 | F · potential | Provide and implement an infection prevention and control program. | Routine |
| Jul 27, 2022 | E · potential | Implement a program that monitors antibiotic use. | Routine |
| Jul 27, 2022 | E · potential | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Routine |
| Jul 27, 2022 | E · potential | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | Routine |
Medicare's severity letters: A–C minimal harm, D–F potential for more than minimal harm, G–L actual harm or immediate danger. Source: CMS health deficiencies file, processed October 1, 2026.
Questions to ask on a visit
Fortuna Rehabilitation and Wellness Center, LP
2321 Newburg Road, Fortuna, CA 95540 · (707) 725-4467
Visit date: ____________ Spoke with: ______________________
Record on file
- Certification
- Medicare and Medi-Cal certified skilled nursing facility
- Medicare number (CCN)
- 056361
- Certified beds
- 104
- Legal owner
- Fortuna Rehabilitation & Wellness Center, LP
- Part of
- Corporate Interface Services
Full profile on Medicare's Care Compare. Source: CMS, processed October 1, 2026.
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