Oakmont of San Jose

§1569.657 Rate increase due to change in level of resident care; notice (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 at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. This was not met as evidenced by: Based on records review, the facility did not provide 2 day written notice about detailing the new rate for the charges for the new level of care.

Facility personnel sufficiency and competence

87411 Personnel Requirements – General(a)Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs ... This was not met as evidenced by: Based on records review & interviews, S6 administered medication that has already fallen on the floor, which poses an immediate health, safety or personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

87468.1 Personal Rights of Residents in All Facilities(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights:(2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This was not met as evidenced by: Based on records review, S2 was only wearing mask and no other PPEs while serving food to covid residents, S5 was not wearing mask while speaking to covid residents, which poses an immediate health, safety or personal rights risk to persons in care.

87506 Resident Records (c) All information and records obtained from or regarding residents shall be confidential.This was not met as evidenced by: Based on record reviews, RP was able to receive a covid report of another resident which poses an immediate health, safety or personal rights risk to persons in care.

Facility personnel sufficiency and competence

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care... This requirement is not met as evidenced by: Based on interview, record review and observation the licensee did not ensure the staff were sufficient in numbers to respond timely to the resident’s call buttons which poses an immediate health, safety and personal rights risk to persons in care.

87507 Admission Agreements (g)Admission agreements shall specify the following: (3) Payment provisions, including the following:(B) Rate for additional items and services, including: 1. A comprehensive description of and the corresponding fee schedule for all additional items and services not included in the fees for basic services shall be listed. This was not met as evidenced by:Facility did an intitial assessment after R1s move in which changed the agreed upon rate in the admission agreement.

87506 Resident Records (b) Each resident’s record shall contain at least the following information: (9) Name, address and telephone number of physician and dentist to be called in an emergency.This was not met as evidenced by: Based on records review, R1s PCP is not the correct physician in the face sheet, which poses an immediate health, safety or personal rights risk to persons in care.

87224 Eviction Procedures (d)The licensee shall set forth in the notice to quit the reasons relied upon for the eviction...(1)The notice to quit shall include the following information:This requirement was not met as evidenced by: Based on interviews & records review the facility gave the R1s responsible party an unlawful/invalid letter of eviction which poses an immediate health, safety or personal rights risk to persons in care.

Arrange appropriate medical and dental care

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to seek timely medication attention for resident (R1) resulting in hospitalization which poses an immediate health, safety, and personal rights risk to persons in care.

Regular observation and documentation of resident changes

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. Based on interview, record review and observation the licensee did not ensure to immediately inform resident (R1)'s physician of R1's change of condition on 12/26/2023 which poses an immediate health, safety, and personal rights risk to persons in care.

Right to sufficient care and qualified staff

(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure resident (R1) was provided a PRN medication within a timely manner and waited about 2 hours before it was dispensed which poses an immediate health, safety, and personal rights risk to persons in care

Facility personnel sufficiency and competence

87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care... This requirement is not met as evidenced by: Based on interviews, R1 needed more assistance with incontinence and there was not enough staff to be able to cater for the needs of R1 which poses an immediate health, safety or personal rights risk to persons in care.

87457 Pre-Admission Appraisal – General (a)Prior to admission, the prospective resident and his/her responsible person, if any, shall be interviewed by the licensee or the employee responsible for facility admissions. (2) The prospective resident's desires regarding admission, and his/her background, including any specific service needs, medical background and functional limitations shall be discussed. This requirement is not met as evidenced by:Based on interview, the licensee did not comply with the section cited above due to staff wasn't able to conduct skin check to determine if there is pressure injury on R1 prior to admission which poses an immediate health, safety or personal rights risk to persons in care.

87463 Reappraisals (a)The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate...Significant changes shall include but not be limited to: (3) Any illness, injury, trauma, or change in the health care needs of the resident that results in a circumstance or condition... This requirement is not met as evidenced by: Based on interview and records review, facility did not do a reappraisal based on the need of R1 for toileting due to a medication that causes her to urinate a large amount which poses an immediate health, safety or personal rights risk to persons in care.

Give PRN medication by physician order

87465 Incidental Medical and Dental Care (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly (2)Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on interview and records review, the instructions of the PRN medication prescribed by the physician was not followed. Medication was only applied on random days, not every change in diaper or bowel movement which poses an immediate health, safety or personal rights risk to persons in care.

Assist PRN administration when symptoms unclear

(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration provided all of the following requirements are met: This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to assist R1 with a prescribed PRN medication for constipation after it was noted that R1 had not had a BM for more than 3 days which poses an immediate health, safety, and personal rights risk to persons in care.

Regular observation and documentation of resident changes

The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure that staff documented and informed the resident's physician and family member of their observation of R1's last bowel movement being over 3 days which poses an immediate health, safety, and personal rights risk to persons in care.

Report suspected non-serious physical abuse within 24 hours

(c) Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1). This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to report suspected physical abuse of resident (R1) from staff (S1) on 12/02/2023 to the local law enforcement and to the licensing department within 24 hours which poses/posed an immediate health, safety, and personal rights risk to persons in care.

Document required significant condition changes

(b) The licensee shall immediately bring any such changes to the attention of the resident's physician and his family or responsible person. This requirement is not met as evidenced by: Based on interview, record review, and observation the licensee did not ensure to inform the resident's responsible party and physician after resident (R1) sustained a second fall on the same day which poses/posed an immediate health safety and personal rights risk to persons in care.

Update reappraisal at required intervals

(a) ... The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. Significant changes shall include but not be limited to: This requirement is not met as evidence by: Based on interview, record review, and observation the licensee did not ensure to re-assess resident (R1) after sustaining a fall in memory care which poses/posed an immediate health, safety, and personal rights risk to persons in care.

Facility personnel sufficiency and competence

87411 - Personnel Records - (a) 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 LPA observation and records review, facility staff did not responded to calls for assistence from resident call pendants and alarms. This poses a potential threat to the health and safety of residents in care.