Health inspection·October 10, 2024

F 0697 Provide safe, appropriate pain management for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review, the facility failed to ensure pain was assessed every shift, as ordered, for one of three sampled residents (Resident 1). Residents Affected - Few This deficient practice had the potential to cause avoidable discomfort and distress due to unidentified and untreated pain for Resident 1. Findings: During a review of Resident 1's admission Record, the admisssion record indicated the facility originally admitted Resident 1 on 1/14/2016, and most recently re-admitted Resident 1 on 10/6/2024. Resident 1's diagnoses included broken left hip bone, abnormalities of gait and mobility, generalized muscle weakness, age-related osteoporosis (weak and brittle bones due to lack of calcium and Vitamin D), contracture (a stiffening/shortening at any joint, that reduces the joint's range of motion) of the right hip, and unspecified dementia (a progressive state of decline in mental abilities). During a review of Resident 1's Minimum Data Set (MDS, a federally mandated resident assessment tool), dated 9/7/2024, the MDS indicated Resident 1 had severely impaired cognitive skills for daily decision making (Problems with a person's ability to think, learn, remember, use judgement, and make decisions). The MDS indicated Resident 1 was dependent on staff for activities of daily living (ADLS, routine tasks/activities such as bathing, dressing and toileting a person performs daily to care for themselves) and mobility while in and out of bed. During a review of Resident 1's physician orders, dated 10/6/2024, the physician orders indicated staff were supposed to assess Resident 1 for pain every shift. During a concurrent interview and record review on 10/10/2024 at 2:40 PM, with Licensed Vocational Nurse (LVN) 1, Resident 1's Medication Administration Record (MAR) dated 10/2024 was reviewed. LVN 1 stated Resident 1's MAR indicated staff did not assess Resident 1's pain on 10/9/2024 during the 3:00 PM to 11:00 PM shift. During a concurrent interview and record review on 10/10/2024 at 4:25 PM, with the Director of Nursing (DON), Resident 1's MAR dated 10/2024 and active physician orders were reviewed. The DON stated the physician orders indicated staff were supposed to assess Resident 1's pain every shift, and the MAR indicated staff did not assess Resident 1's pain on 10/9/2024 during the 3:00 PM to 11:00 PM shift. The DON stated the LVNs were responsible for conducting the pain assessments if ordered by the physician. The DON stated that if staff did not assess for pain, especially in residents who might not be able to express themselves due to cognitive deficits, it put the resident at risk for unidentified pain that could go untreated. Page 1 of 2 055045 055045 10/10/2024 Riviera Healthcare Center 8203 Telegraph Rd Pico Rivera, CA 90660

F 0697 Level of Harm - Minimal harm or potential for actual harm During a review of the facility's policy and procedure (P&P) titled Pain - Clinical Protocol, revised January 2024, the P&P indicated the facility physicians and staff were supposed to identify individuals who had pain or who were at risk for having pain. The P&P indicated staff were supposed to assess pain using a consistent approach and standardized pain assessment. Residents Affected - Few 055045 Page 2 of 2