Westmont of La Mesa

1569.657(a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident's representative, if any, written notice of the rate increase within two business days after initially providing services... This requirement has not been met as evidenced by:Based on interviews and record review, the Licensee did not provide the resident’s responsible party with a notice of services at a new level of care . This posed a potential personal rights risk to R1.

Eviction notices; Reasons for Eviction Contents; Service: In addition to complying with other applicable regulations, the notice to quit shall include all required information listed on H&S 1569.683. This requirement was not met as evidenced by:Based on record review licensee did not issue a lawful 30 day notice for (R1) which posed a potential personal rights violation.

87465(a) – Incidental Medical and Dental Care(a) The licensee shall ensure that residents receive assistance in meeting their medical and dental needs… promptly notifying the physician of any significant change in a resident’s condition. Based on interviews and record review, the licensee did not seek timely medical care for a resident after staff observed a significant change in condition, which poses a potential health risk to persons in care.

Section 87625(b)(2) – Managed Incontinence…the licensee shall be responsible for the following: Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night. This requirement was not met as evidenced by: Based on records review, interviews with staff, and outside sources, the licensee did not provide incontinent care to meet R1’s needs. This posed a potential health, safety and personal risk to 1 of 122 residents in care.

87465 Incidental Medical and Dental Care (a)(4) The licensee shall assist residents with self-administered medications as needed. This requirement has not been met as evidenced by: Based on interviews, the Licensee did not ensure that staff correctly assisted residents with medication administration, which poses a potential health risk for 1 of 123 residents in care.

Reporting Requirements: Each licensee shall furnish to the licensing agency such reports as the Department may require...A written report shall be submitted to the licensing agency and to the person responsible for the resident within 7 days of the occurrence of..Death or any serious injury... This requirement is not met as evidenced by:Based on interview and records reviewed, the licensee did not report 1 out of 120 resident fall, hospitalization or death which poses a potential health, safety or personal rights risk to persons in care.

A plan for incidental medical care shall be developed by each facility. The plan shall encourage routine medical care and provide for assistance in obtaining such care by... The licensee shall arrange or assist in arranging for medical care appropriate to the conditions and needs or residents... This requirement was not met as evidenced by: Based on interviews and records review, the licensee delayed medical attention for 1 of 126 resident that expressed pain for 5 days which posed an immediate health, safety or personal risk to persons in care.

87468.1 Personal Rights of Residents in All Facilities (a) residents... shall have all of the following personal rights (3) to be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement has not been met as evidenced by: Based on interviews and records review, the Licensee did not ensure R1 was free from abuse resulting in bruising. This poses an immediate personal rights risk to 1 of 126 residents in care.

87465 Incident Medical and Dental Care (c)(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement has not been met as evidenced by: Based on interview and record review, the licensee did not ensure that R1's medication was administered as ordered by the physician. This poses a potential health risk to 1 of 92 residents in care.

The facility shall determine the amount of supervision necessary by assessing the mental status of the prospective resident to determine if the individual: (1)tends to wander; (2) is confused or forgetful (5) has a documented history of behaviors which may result in harm to self or others.This requirement was not met as evidenced by: Based on records reviews and interviews, the licensee did not ensure the amount of supervision determined necessary by assessments for one (1) Resident 1 [R1] in care which posed an immediate safety risk to residents in care.

87468.1 Personal Rights of Residents in All Facilities: “(a) Residents in all residential facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff…” This requirement was not met, as evidenced by: Based on records and interviews, licensee’s staff (S1) did not accord dignity to 1 of 121 residents (R1), which posed a potential personal rights risk to persons in care.

87468.1(a)(3) Personal Rights of Residents in All Facilities: “(a) Residents in all residential facilities for the elderly shall have all of the following personal rights: (3) To be free from…abuse…” This requirement was not met, as evidenced by: Based on records and interviews, licensee staff (S1) did not ensure 1 of 121 residents (R1) was free from abuse, which posed a potential personal rights risk to persons in care.

Personal Rights of Residents in All FacilitiesTo be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on observations, the licensee did not accord healthful accomodations in 138 of 138 persons in care which posed a potential health and personal rights risk to persons in care.

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement was not met as evidenced by: Based on evidence obtained from interviews and facility and medical records facility staff did not provide appropriate supervision to R1.Facility staff’s knowledge of R1’s falls prior to, and at the facility, demonstrates that R1 was at risk for falls, however staff neglected to implement fall safety and precaution plans to ensure their safety. This poses an immediate risk to resident’s in care safety.