Health inspection·January 24, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, medical record review, and facility document review, the facility failed to ensure the head and neck support for one of five sampled residents' (Resident 1) highbacked personalized wheelchair was in the correct position when Resident 1 left the facility for an outing with her family on 12/30/23. This failure resulted in Resident 1's head being tilted to one side and incorrectly aligned in her wheelchair, causing pain, and psychological distress, which had the potential to negatively impact the resident's well-being. Residents Affected - Few Findings Medical record review for Resident 1 was initiated on 1/16/24. Resident 1 was originally admitted to the facility on [DATE],and readmitted on [DATE]. Resident 1 had a diagnosis of MS. Review of Resident 1's H&P examination dated 10/3/23, showed Resident 1 had the capacity to understand and make medical decisions. Review of Residents 1's MDS dated [DATE], showed the resident was cognitively intact. Resident 1 required substantial assistance rolling side to side and was dependent on the staff for transfers from the bed to the chair. On 1/17/24 at 1541 hours,an interview was conducted with Resident 1's Family Member (Family Member 1). Family Member 1 stated a family gathering at the mall was planned for 12/30/23, because Resident 1 wanted to see the decorations. Family member 1 stated when Resident 1 arrived at the mall, it was visibly obvious that she was not in her chair correctly. Her head was just dangling off to one side, she was sliding down in her wheelchair, and she was in pain. Family Member 1 stated it took three people to adjust and reposition Resident 1. Family Member 1 added they had a very hard time adjusting Resident 1's head. On 1/18/24 at 1045 hours,an interview was conducted with Resident 1. Resident 1 stated she had been waiting for that day for months. Resident 1 stated before she left the facility, she had told the staff that she was turned sideways and needed to be readjusted. Resident 1 stated the staff told her that they could not adjust her because the bus was already there to pick her up. Resident 1 stated the bus ride was very bumpy, which caused her head to move side to side and all around because her head was not secured in the wheelchair head rest. Resident 1 stated she slid down in the wheelchair. Resident 1 stated it was very uncomfortable and scary. Resident 1 stated her neck had continued to hurt since that day. On 1/18/24 at 1530 hours,an interview and concurrent medical record review was conducted with the (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: 055671 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 055671 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Healthcare Center 1514 E. Lincoln Avenue Anaheim, CA 92805 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)