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
14’23
32’24
6’25
18’26
70 shown
| Date | Severity | What inspectors found | Visit |
|---|---|---|---|
| Aug 26, 2026 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Aug 14, 2026 | E · potential | Provide and implement an infection prevention and control program. | Complaint |
| Jun 12, 2026 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Apr 29, 2026 | D · potential | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | Complaint |
| Feb 24, 2026 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Feb 20, 2026 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Feb 20, 2026 | E · potential | Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). | Routine |
| Feb 20, 2026 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Routine |
| Feb 20, 2026 | D · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Routine |
| Feb 20, 2026 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Routine |
| Feb 20, 2026 | E · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Feb 20, 2026 | D · 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 |
| Feb 20, 2026 | D · potential | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Routine |
| Feb 20, 2026 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Feb 20, 2026 | D · potential | Provide or get specialized rehabilitative services as required for a resident. | Routine |
| Feb 20, 2026 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Feb 20, 2026 | D · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Routine |
| Jan 28, 2026 | E · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Dec 12, 2025 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Dec 10, 2025 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| May 1, 2025 | D · potential | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | Complaint |
| Apr 23, 2025 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Apr 23, 2025 | E · potential | Provide and implement an infection prevention and control program. | Complaint |
| Feb 4, 2025 | D · 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. | Complaint |
| Nov 7, 2024 | D · potential | Keep residents' personal and medical records private and confidential. | Routine |
| Nov 7, 2024 | D · 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 |
| Nov 7, 2024 | D · potential | Ensure each resident receives an accurate assessment. | Routine |
| Nov 7, 2024 | D · 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 7, 2024 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Routine |
| Nov 7, 2024 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Routine |
| Nov 7, 2024 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Nov 7, 2024 | D · potential | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | Routine |
| Nov 7, 2024 | E · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Nov 7, 2024 | D · potential | Provide medically-related social services to help each resident achieve the highest possible quality of life. | Routine |
| Nov 7, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Nov 7, 2024 | D · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Nov 7, 2024 | D · 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 7, 2024 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Nov 7, 2024 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Routine |
| Nov 7, 2024 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Oct 10, 2024 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Aug 6, 2024 | D · 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. | Complaint |
| Apr 12, 2024 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Apr 4, 2024 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Mar 26, 2024 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Mar 22, 2024 | D · potential | Let each resident or the resident's legal representative access or purchase copies of all the resident's records. | Complaint |
| Mar 19, 2024 | E · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Complaint |
| Feb 22, 2024 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| Feb 16, 2024 | D · potential | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | Complaint |
| Feb 6, 2024 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Feb 1, 2024 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Jan 29, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jan 18, 2024 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Jan 18, 2024 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Jan 18, 2024 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Jan 2, 2024 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Dec 6, 2023 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Nov 30, 2023 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| Oct 16, 2023 | D · potential | Honor each resident's preferences, choices, values and beliefs. | Complaint |
| Oct 16, 2023 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Sep 14, 2023 | E · potential | Keep residents' personal and medical records private and confidential. | Routine |
| Sep 14, 2023 | D · potential | Ensure each resident receives an accurate assessment. | Routine |
| Sep 14, 2023 | D · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Routine |
| Sep 14, 2023 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Routine |
| Sep 14, 2023 | D · potential | Provide enough food/fluids to maintain a resident's health. | Routine |
| Sep 14, 2023 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Sep 14, 2023 | 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 |
| Sep 14, 2023 | E · potential | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | Routine |
| Sep 14, 2023 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Sep 14, 2023 | E · potential | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | 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
Capital Post Acute
6821 24th Street, Sacramento, CA 95822 · (916) 391-6011
Visit date: ____________ Spoke with: ______________________
Record on file
- Certification
- Medicare and Medi-Cal certified skilled nursing facility
- Medicare number (CCN)
- 555442
- Certified beds
- 121
- Legal owner
- Capital Post Acute, LLC
- Part of
- Spyglass Healthcare
Full profile on Medicare's Care Compare. Source: CMS, processed October 1, 2026.
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