Shadelands Post Acute

Name: Shadelands Post Acute
Address: 2765 MITCHELL DR, Walnut Creek, CA, 94598, US
Telephone: 9252965547

2765 Mitchell Dr, Walnut Creek, CA 94598 · Contra Costa County · 59 certified beds · avg 59 residents/day · certified since Jul 29, 2022

Part of chain: PACS GROUP (274 facilities, chain avg rating 2.9★)

3/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

3.04

Nurse hours/resident/day (adjusted)

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

Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 4/5

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 (21)

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 14, 2026	E · Potential for harm, repeated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
May 14, 2026	E · Potential for harm, repeated	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 14, 2026	E · Potential for harm, repeated	The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective.
May 14, 2026	E · Potential for harm, repeated	The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations.
May 14, 2026	D · Potential for harm, one-off	The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand.
May 14, 2026	D · Potential for harm, one-off	The facility did not provide safe and appropriate pain management for a resident who needed it.
May 14, 2026	D · Potential for harm, one-off	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
May 14, 2026	D · Potential for harm, one-off	The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time.
May 14, 2026	D · Potential for harm, one-off	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 14, 2026	D · Potential for harm, one-off	The facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
May 14, 2026	D · Potential for harm, one-off	The facility did not properly inform residents or their representatives about arbitration agreements — contracts that give up the right to sue in court — including their right to refuse to sign.
May 14, 2026	D · Potential for harm, one-off	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
May 7, 2026	F · Potential for harm, facility-wide	The facility was not properly licensed, or did not operate in compliance with federal, state, and local laws, regulations, and accepted professional standards. · from a complaint
May 7, 2026	E · Potential for harm, repeated	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint
Aug 1, 2024	E · Potential for harm, repeated	The facility did not keep residents' personal and medical information private and confidential.
Aug 1, 2024	E · Potential for harm, repeated	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
Aug 1, 2024	E · Potential for harm, repeated	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.
Aug 1, 2024	D · Potential for harm, one-off	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits.
Aug 1, 2024	D · Potential for harm, one-off	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.
Oct 19, 2023	E · Potential for harm, repeated	The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. · from a complaint
Oct 19, 2023	E · Potential for harm, repeated	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. · from a complaint

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (5 → 12).

Year	Citations	Worst severity that year
2023	2	E
2024	5	E
2026	14	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)	3.04	4.31	3.95	bottom 1% in California; bottom 15% in the U.S.
Registered Nurse hours	0.39	0.61	0.69	bottom 29% in California; bottom 20% in the U.S.
Weekend total nurse staffing	2.66	3.90	3.50	bottom 1% in California; bottom 15% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.48	0.51	0.48	top 33% in California; top 35% in the U.S.
Total nursing staff turnover (%)	45.2	36.7	45.8	bottom 25% in California; bottom 49% in the U.S.
RN turnover (%)	33.3	38.1	42.9	top 40% in California; top 33% 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 4.31, RN 0.55, weekend 3.78. Staffing rating: 2/5.

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: 5/5 · long-stay residents: —/5 · short-stay residents: 5/5

Who owns this facility

For profit - Limited Liability company

Owner / manager	Type	Role	Stake	Since
Apt, Frederick	Individual	Corporate Officer	NOT APPLICABLE	11/05/2021
Bills, Craig	Individual	W-2 Managing Employee	NOT APPLICABLE	04/28/2022
Bills, Craig	Individual	Operational/Managerial Control	NOT APPLICABLE	04/28/2022
Hancock, Mark	Individual	Corporate Officer	NOT APPLICABLE	11/05/2021
Mitchell, John	Individual	Corporate Officer	NOT APPLICABLE	11/05/2021
Murray, Jason	Individual	Corporate Officer	NOT APPLICABLE	11/05/2021

Questions to ask on your visit

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

"What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"Who oversees antibiotic use here, and how do you decide when an antibiotic is really needed?"
"What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
"How do you explain health changes and treatment options to residents and their families?"
"How do you assess and manage residents' pain, especially for those who have trouble communicating?"
"How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
"What is your current medication error rate, and what have you changed to bring errors down?"
"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
Concord Post Acute	1.9 mi	Concord, CA	★★☆☆☆	2/5	abuse
La Casa via Transitional Care Center	2.1 mi	Walnut Creek, CA	★★★★★	4/5
Tampico Healthcare Center	2.1 mi	Walnut Creek, CA	★★★★☆	3/5
Pleasant Hill Post Acute	2.2 mi	Pleasant Hill, CA	★★★★☆	3/5
Diablo Valley Post Acute	2.7 mi	Concord, CA	★★☆☆☆	1/5	abuse
Rosewood Post Acute	2.7 mi	Pleasant Hill, CA	★★★★☆	4/5
Bayberry Skilled Nursing & Healthcare Center	3.4 mi	Concord, CA	★★★★☆	3/5
Willow Pass Healthcare Center	3.6 mi	Concord, CA	★★★☆☆	2/5
Stonebrook Post Acute	3.8 mi	Concord, CA	★★★★☆	4/5
Walnut Creek Skilled Nursing & Rehabilitation Cent	4.5 mi	Walnut Creek, CA	★★☆☆☆	2/5
Rossmoor Post Acute	4.5 mi	Walnut Creek, CA	★★★★★	4/5
Tice Valley Post Acute	4.6 mi	Walnut Creek, CA	★★★★★	4/5

Compare this facility with the 3 closest →

All facilities in Walnut Creek →

Facility data as of CMS processing date 2026-08-01. CCN 555926.

The Care File

Visit checklist — Shadelands Post Acute

2765 Mitchell Dr, Walnut Creek, CA 94598 · 9252965547

Health inspection rating 3/5 · CMS overall 4/5· Fines (3y): $0

Questions for the administrator:

☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "Who oversees antibiotic use here, and how do you decide when an antibiotic is really needed?"
☐ "What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
☐ "How do you explain health changes and treatment options to residents and their families?"
☐ "How do you assess and manage residents' pain, especially for those who have trouble communicating?"
☐ "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
☐ "What is your current medication error rate, and what have you changed to bring errors down?"
☐ "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 555926 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)