Health inspection·July 26, 2024

F 0740 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident must receive and the facility must provide necessary behavioral health care and services. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to provide the necessary behavioral health service to maintain the highest practicable mental and psychosocial well-being in accordance with the comprehensive assessment to two of three sampled residents (1 and 2) when their psychiatric services were not being followed up. This failure had a potential to affect maintaining Resident 1 and 2's highest practicable mental and psychosocial well-being. Findings: Review of Resident 1's face sheet indicated she admitted to the facility on [DATE] and her diagnoses including Obsessive -compulsive personality disorder (is a mental health condition that cause an extensive preoccupation with perfectionism, organization and control), bipolar disorder(is a mental health condition that affects your moods, which can swing from 1 extreme to another) and major depressive disorder(is a common and serious medical illness that negatively affects how you feel, the way you think and how you act). Review of Resident 1's Psychiatric Visit Progress Report dated 6/22/23, indicated psychiatrist evaluated and reviewed Resident 1's medications and management with stating a follow-up should be done within two to four weeks or as needed (PRN) while in the facility. Further review indicated no follow-up psychiatric services were provided. Review of Resident 2's face sheet indicated he readmitted to the facility on [DATE] and his diagnoses including dementia (is a term used to describe a group of symptoms affecting memory, thinking and social abilities). Review of Resident 2's care plan, dated 11/21/23, indicated he had a plan of care to address not sleeping at night. Review of Resident 2's Psychiatric Visit Progress Report dated 4/7/22, indicated it was an initial eval for Resident 2 and would need to have follow-up within two to four weeks or as needed (PRN) while in the facility. Further review indicated no follow-up psychiatric services were provided. During an interview and record review on 7/9/24, at 11:30 a.m., with the social service assistant (SSA), she reviewed Resident 1 and 2's clinical records with stating that Resident 1 and 2 should have followed up with psychiatric services as per their planning of psychiatric visit progress report. During an interview on 7/9/24, at 12:30 p.m., with the assistant director of nursing (ADON), she Page 1 of 2 055318 055318 07/26/2024 Skyline Healthcare Center - San Jose 2065 Forest Avenue San Jose, CA 95128

F 0740 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few confirmed both Residents 1 and 2 should have continued receiving psychiatric services; and that, the facility nursing staff missed following-up. Review of the facility's undated policy and procedure (P&P) titled, Psychosocial Wellbeing-Behavioral Health Services, the P&P indicated, The company will provide, and residents will receive behavioral health services as needed to attain or maintain the highest practicable physical, mental, and psychosocial well-being in accordance with the comprehensive assessment and plan of care. 055318 Page 2 of 2