Health check·August 10, 2023

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection. LPA met with Robert Kovacs, caregiver, and explained purpose of inspection. Caregiver indicated that Ombudsman was just at the facility to follow up on the same resident (R1). LPA spoke with Eva Nemethy, Administrator, by phone who stated she was currently at a medical appointment. LPA stated the reason for the inspection and discussed resident (R1). Both the caregiver and Administrator indicated resident (R1) has shown a decline in recent months, especially with his appetite, and has refused medical treatment on several occasions when 9-1-1 was called. Most recently, resident was vomiting a white mucous. LPA observed a note signed by resident on 8/4/23 refusing medical care. After speaking again with resident's primary care physician and nurse, 9-1-1 was called by the nurse this time, and resident agreed to be taken to the emergency room for a medical evaluation on 8/8/23. The facility has been in contact with the hospital staff and was informed resident has been diagnosed with a Urinary Tract Infection (UTI) and may return to the facility as early as tomorrow, 8/11/23. Caregiver stated that resident has received bed baths over the last couple of months but will also take a shower with assistance. Resident also wanted a walker to be nearby the bed when needed. LPA reviewed resident's file and observed a physician's report from 2019 when resident was admitted. Resident does not have a diagnosis of Dementia. LPA discussed with the Administrator how only the initial care plan was found in the file and how the care plan must be updated at least every 12 months, or when there is a change in condition, such as what she and caregiver have described with R1 over the past 6-7 months. Administrator agreed to submit an updated plan for R1 within 2 weeks. LPA reviewed resident files for the other (2) residents and found them to contain required paperwork. LPA toured the inside of the home and did not observe any health/safety risks and found the facility to be clean, odor-free and in good repair. Per California Code of Regulations, Title 22, Chapter 6, Division 6, the following (1) deficiency is cited on the 809-D page. Exit interview. Copy of report and appeal rights provided.