Health inspection·October 3, 2024

F 0644 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Based on record review and interview, the facility failed to notify the appropriate state-designated authority after a resident was diagnosed with a new mental illness for 1 (Resident #59) of 2 sampled residents reviewed for preadmission screening and resident review (PASARR) requirements. Findings included: An admission Record revealed the facility admitted Resident #59 on 12/15/2023. According to the admission Record, the resident had a medical history that included diagnoses of psychosis (onset 12/15/2023) and major depressive disorder (onset 12/15/2023). The admission Record revealed the resident received a diagnosis of schizophrenia on 12/29/2023. An quarterly Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 09/22/2024, revealed Resident #59 had a Brief Interview for Mental Status (BIMS) score of 15, which indicated the resident had intact cognition. The MDS indicated the resident had active diagnoses to include psychotic disorder and schizophrenia. Resident #59's care plan included a focus area initiated 12/25/2023, that indicated the resident had a mood problem related to admission to the facility, depression, psychosis, and a history of schizophrenia. Interventions directed staff to schedule behavioral health consultations as needed (initiated 12/25/2023), administer medications as ordered (initiated 12/25/2023), and report to the physician any signs or symptoms of depression, anxiety, or sad moods (initiated 12/25/2023). The care plan also indicated a focus area initiated 04/04/2024, that indicated the resident was at risk for increased confusion and disordered thought, secondary to schizophrenia. The care plan indicated the schizophrenia diagnosis was given by a psychiatrist on 12/29/2023. Interventions directed staff to provide psychiatry and psychology consultations as needed (initiated 04/04/2024). The care plan also revealed a focus area initiated 06/25/2024, that indicated the resident had psychosis behavior manifested by auditory hallucinations. Resident #59's medical record revealed no evidence that indicated a referral was made to the appropriate state-designated authority following the resident's new diagnosis of schizophrenia on 12/29/2023. During an interview on 10/02/2024 at 1:25 PM, Social Services (SS) #7 stated she was not necessarily responsible for PASARR screenings. She stated the Level I screenings were usually done at the hospital prior to the resident's admission, and once it was received, a resident could be admitted . SS #7 stated if a resident had a change in condition, whether physical or mental, the facility would do a review and if needed, a new Level I screening would be completed. SS #7 stated Resident #59's (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 6 Event ID: 055474 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055474 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/03/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Woodcrest Post Acute & Rehabilitation 8133 Magnolia Avenue Riverside, CA 92504 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)