Health inspection·January 6, 2026

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few review of Resident 1's RADIOLOGY [medical field using imaging technologies] SERVICES PATIENT REPORT [RSPR], dated 12/29/25, the RSPR indicated, RIGHT KNEE. IMPRESSIONS: A periprosthetic fracture [a broken bone around a joint replacement] of the distal femur. The age of the fracture is indeterminate [uncertain about when the event occurred].During a concurrent interview and record review on 1/6/26 at 2:38 p.m. with DON, Resident 1's Nurses Note [NN], dated 12/31/25 was reviewed. NN indicated, Resident stated 9/10 bilateral knees and right hip pain. Observed redness on right outer thigh and swelling on right knee. MD notified and given order to Send to [acute] Hospital for CT [computed tomography scan used to take detailed images of the body] scan. DON stated on 12/29/25, Resident 1 had an x-ray (medical imaging that uses radiation to take pictures of the inside of the body) done indicating an age-indeterminate fracture. DON stated on 12/29/25, Resident 1 had no swelling on her right knee and had no pain, but on 12/31/25, Resident 1 had swelling on her right knee and complained of pain. DON stated Resident 1 was sent to the hospital on [DATE] for a CT.During a review of Resident 1's ED [Emergency Department] Physician Notes [Acute hospital records], dated 12/31/25, the ED Physician Notes indicated, pt [patient] sent from [facility] for possible CT. pt fell when trying to get out of bed on 12/29 and pt now c/o [complained of] bilateral knee pain. CT Knee Rt [right]. There is periprosthetic fracture of the distal femoral metaphysis [the flared, widened area of the thigh bone just above the knee joint] with 1 cm [centimeter metric unit of length] impaction [the broken ends of a bone are forcefully driven into each other]. Fracture site extends to the patellofemoral compartment [compartment in the front of the knee between the knee cap and thigh bone].During a review of Resident 1's Operation/Procedure Report [OPR] [Acute hospital records], dated 1/3/26, the OPR indicated, DIAGNOSIS: Right distal femur fracture. PROCEDURES. Application of retrograde intramedullary nailing [surgery where a metal rod is inserted backward into the hollow center of a long bone to stabilize a fracture], right femur.During an interview on 1/7/26 at 1:16 p.m. with Licensed Vocational Nurse (LVN) 1, LVN 1 stated she was the nurse assigned to Resident 1 when Resident 1 fell on [DATE]. LVN 1 stated on 12/29/25 around 5:15 a.m., she was passing medications when CNA 1 called her to Resident 1's room. LVN 1 stated Resident 1 had most of her hip on the bed and Resident 1's legs were hanging off the bed. LVN 1 stated she assessed Resident 1. LVN 1 stated Resident 1 did not have injuries and did not complain of pain.During an interview on 1/12/26 at 11:43 a.m. with CNA 1, CNA 1 stated she was the CNA assigned to Resident 1 when Resident 1 fell on [DATE]. CNA 1 stated on 12/29/25 at around 5:15 a.m., when she passed by Resident 1's room, CNA 1 saw Resident 1 holding the bed rail and her left leg was bent on the floor mat. CNA 1 stated Resident 1 stated she was trying to go to the bathroom to pee. CNA 1 stated she checked Resident 1's brief, and it was wet and had bowel movement. CNA 1 stated she went to see Resident 1 on 12/29/25 at 3:30 a.m. and she saw Resident 1's brief indicator color had changed from yellow to blue, indicating Resident 1's brief was wet. CNA 1 stated she offered to change Resident 1 ‘s brief but she refused. CNA 1 stated she did not notify LVN 1 when Resident 1 refused to be changed. CNA 1 stated she did not ask help from another CNA to change Resident 1. CNA 1 stated she did not come back to ask Resident 1 to change her brief until she passed by Resident 1's room around 5:15 a.m. and saw Resident 1 falling off her bed. CNA 1 stated during her shift on 12/29/25 night shift (10 p.m. to 6:30 a.m.), she only changed Resident 1 once right after the fall at around 5:15 a.m. CNA 1 stated she did not check and change Resident 1's brief every two hours because Resident 1 would usually refuse at night, CNA 1 stated she was supposed to offer to check and change Resident 1 every two hours to prevent falls and skin breakdown. CNA 1 stated when Resident 1 refused to be changed, she should have notified LVN 1 and asked for help from the other CNAs to help her change Resident 1.During a review of the facility P&P titled, Fall Management (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055601 If continuation sheet Page 2 of 3 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 055601 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/06/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Julian Healthcare Center 1801 Julian Avenue Bakersfield, CA 93304 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)

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Program, dated November 2017, the P&P indicated, Purpose To prevent resident falls and minimize complications associated with falls through the development of a Fall Management Program. Policy It is the policy of this facility to provide the highest quality care in the safest environment for the residents residing in the facility. Assist patient with toileting as appropriate.During a review of the facility's P&P titled, Refusal of Treatment, dated 11/1/17, the P&P indicated, When a resident refuses or discontinues treatment, the Charge Nurse or Director of Nursing Services (DNS) interviews the resident to determine what and why the resident is refusing or discontinue treatment. The Charge Nurse or DNS will attempt to address the resident's concerns and explain the consequences of the refusal or discontinuance of treatment.During a review of the facility's P&P titled, Continence Management Guideline, dated November 2017, the P&P indicated, incontinence care i. Pad/brief change every 2-4 hours. Event ID: Facility ID: 055601 If continuation sheet Page 3 of 3