Dept of State Hospitals - Napa D/P SNF

Name: Dept of State Hospitals - Napa D/P SNF
Address: 2100 NAPA-VALLEJO HIGHWAY, Napa, CA, 94558, US
Telephone: 7072535000

2100 Napa-Vallejo Highway, Napa, CA 94558 · Napa County · 36 certified beds · avg 23 residents/day · certified since Jun 14, 1984

2/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

9.93

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 3/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (25)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
May 15, 2026	F · Potential for harm, facility-wide	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
May 15, 2026	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
May 15, 2026	F · Potential for harm, facility-wide	The facility did not conduct and document a facility-wide assessment of what staff, supplies, and resources it needs to care for its residents properly — during everyday operations, nights, weekends, and emergencies.
May 15, 2026	F · Potential for harm, facility-wide	The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them.
May 15, 2026	F · Potential for harm, facility-wide	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
May 15, 2026	F · Potential for harm, facility-wide	The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors.
May 15, 2026	E · Potential for harm, repeated	The facility did not enter each resident's assessment information into the required format and send it to the state within 7 days of completing the assessment, as the rules require.
May 15, 2026	E · Potential for harm, repeated	The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services.
May 15, 2026	D · Potential for harm, one-off	The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights.
May 15, 2026	D · Potential for harm, one-off	The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups.
May 15, 2026	D · Potential for harm, one-off	The facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment.
May 15, 2026	D · Potential for harm, one-off	The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · from a complaint
May 15, 2026	D · Potential for harm, one-off	The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
May 15, 2026	D · Potential for harm, one-off	The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident.
May 15, 2026	D · Potential for harm, one-off	The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature.
Apr 2, 2026	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint
Sep 8, 2025	D · Potential for harm, one-off	The facility did not train its staff on dementia care and on recognizing and reporting abuse, neglect, and exploitation. · from a complaint
May 22, 2025	F · Potential for harm, facility-wide	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
May 22, 2025	D · Potential for harm, one-off	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Dec 30, 2024	F · Potential for harm, facility-wide	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · from a complaint
May 16, 2024	E · Potential for harm, repeated	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
May 16, 2024	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
May 16, 2024	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Dec 18, 2023	E · Potential for harm, repeated	The facility did not have an agreement with an approved laboratory to provide lab services, even though it doesn't offer lab services on site. · from a complaint
Dec 18, 2023	E · Potential for harm, repeated	The facility did not designate a physician to serve as medical director — the doctor responsible for overseeing resident care policies and coordinating medical care across the facility. · from a complaint

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (2 → 15).

Year	Citations	Worst severity that year
2023	2	E
2024	4	F
2025	3	F
2026	16	F

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	California avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	9.93	4.31	3.95	top 1% in California; top 1% in the U.S.
Registered Nurse hours	5.62	0.61	0.69	top 1% in California; top 1% in the U.S.
Weekend total nurse staffing	9.52	3.90	3.50	top 1% in California; top 1% in the U.S.
Weekend RN hours (not acuity-adjusted)	5.72	0.51	0.48	top 1% in California; top 1% in the U.S.
Total nursing staff turnover (%)	31.3	36.7	45.8	top 34% in California; top 17% in the U.S.
RN turnover (%)	25.9	38.1	42.9	top 30% in California; top 23% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 10.32, RN 5.84, weekend 9.89. Staffing rating: 5/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: —/5

Who owns this facility

Government - State

Owner / manager	Type	Role	Stake	Since
		Ownership Data Not Available

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Who completes resident assessments here, and how do you check them for accuracy?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"How do you decide you have enough staff and resources for your resident population, including nights and weekends?"
"How does your quality improvement program work, and can you share a recent example of a problem you found and fixed?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"Can we tour the whole building today, including resident bathrooms and common areas, not just the lobby?"
"How do you make sure resident assessments are completed and submitted to the state on time?"
"How do you screen new residents for mental health and disability-related needs, and how do you provide the specialized services they require?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
The Meadows of Napa Valley	1.7 mi	Napa, CA	★★★★★	5/5
Napa Community Health Center	3.5 mi	Napa, CA	★☆☆☆☆	1/5
Napa Valley Care Center	3.8 mi	Napa, CA	★★★☆☆	2/5
Napa Post Acute	3.9 mi	Napa, CA	★☆☆☆☆	1/5
Solano Post Acute	9.8 mi	Vallejo, CA	★★☆☆☆	1/5
Veterans Home of California - Yountville - SNF	9.9 mi	Yountville, CA	★★★★★	4/5
Broadway Villa Post Acute	10.3 mi	Sonoma, CA	★★★★★	3/5
Sonoma Post Acute	10.4 mi	Sonoma, CA	★★★★☆	3/5
Valley of the Moon Post Acute	10.9 mi	Sonoma, CA	★★★☆☆	2/5	abuse
Springs Road Healthcare	11.5 mi	Vallejo, CA	★★★★★	4/5

Compare this facility with the 3 closest →

All facilities in Napa →

Facility data as of CMS processing date 2026-08-01. CCN 05A357.

The Care File

Visit checklist — Dept of State Hospitals - Napa D/P SNF

2100 Napa-Vallejo Highway, Napa, CA 94558 · 7072535000

Health inspection rating 2/5 · CMS overall 3/5· Fines (3y): $0

Questions for the administrator:

☐ "Who completes resident assessments here, and how do you check them for accuracy?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "How do you decide you have enough staff and resources for your resident population, including nights and weekends?"
☐ "How does your quality improvement program work, and can you share a recent example of a problem you found and fixed?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "Can we tour the whole building today, including resident bathrooms and common areas, not just the lobby?"
☐ "How do you make sure resident assessments are completed and submitted to the state on time?"
☐ "How do you screen new residents for mental health and disability-related needs, and how do you provide the specialized services they require?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 05A357 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)