Health inspection·January 23, 2026

F 0553 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Allow resident to participate in the development and implementation of his or her person-centered plan of care. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to implement the facility's policy and procedure (P&P) titled, Care Plan Conference, to develop the plan of care based on resident's comprehensive assessment and notify and inform residents and its legal representative for three of four sampled residents, (Resident 1, Resident 3 and Resident 4). This deficient practice violated the resident and legal representative the right to participate in the planning process and establish expected goals and outcomes of care.1.During a review of Resident 1's Face Sheet (FS), the FS indicated Resident 1 was admitted to the facility on [DATE] with diagnoses including atrial fibrillation (afib- an irregular and very rapid heart rhythm that and can lead blood clots in the heart), peripheral vascular disease (PVD - a circulatory condition in which narrowed blood vessels reduce blood flow to the limbs) and anxiety disorder (a mental health disorder characterized by feelings of worry, anxiety or fear that are strong enough to interfere with one's daily activities). During a review of the Minimum Data Set (MDS -a resident assessment tool) dated 12/30/2025, the MDS indicated Resident 1's cognitive (mental action or process of acquiring knowledge and understanding) skills for daily decisions was intact. The MDS also indicated Resident 1 required moderate assistance from staff for activities of daily living (ADLs- routine tasks/activities such as bathing, dressing and toileting a person performs daily to care for themselves). During a review of Resident 1's Medical Record as of 1/23/2026, there was no Interdisciplinary Team (IDT - a group of dedicated healthcare professionals who work to bring knowledge together to help residents receive the care they need) meeting and care plan conference upon Resident 1's admission. During an interview with Resident 1's Care Coordinator (CC 1) on 1/23/2026 at 8:36 a.m., CC1 stated, she visited Resident 1 in the facility and tried to inquire about Resident 1's plan of care and goals during her stay in the facility and no staff was able to provide her with the care plan and documentation. CC 1 stated, she contacted facility's staff in the social services department and no one had contacted her back and no staff was able to answer her questions. During a concurrent interview and record reviews with Director of Staff and Development (DSD) on 1/23/2026 at 12:04 p.m., DSD stated, Resident 1's CC 1 came to the facility and inquire about Resident 1's plan of care but she was unable to provide her with any information regarding Resident 1. SSD stated that she notified social services department regarding CC 1's inquiries. SSD stated, upon admission, an IDT meeting must be held to discuss resident's plan of care during the stay in the facility, and the resident and/or resident's representative (RR) should be included in the care conference meeting. SSD reviewed Resident 1's medical record and stated and confirmed, there was no IDT meeting documentation and no meeting was completed that discussed Resident 1's plan of care. During an interview with Social Services Director Interim (SSDI) on 1/23/2026 at 12:19 p.m., SSDI stated, she had just started as a SSDI and works part time. SSDI stated, she is still getting acquainted with her role and has not seen all the residents in the facility. SSDI stated, upon admission, an IDT meeting must be (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 2 Event ID: 055540 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 055540 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/23/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Santa Monica Health Care Center 1320 20th Street Santa Monica, CA 90404 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)