Health inspection·May 20, 2025

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, medical record review, and facility P&P review, the facility failed to ensure the complete medical record was maintained for one of three sampled residents (Resident 1). * Resident 1's Elopement Evaluation was not completely filled out. * Resident 1's medical record failed to show documentation the resident was monitored for a change in condition on 5/3/25, for the 0700-1500 hours shift. Findings: Review of the facility P&P titled Charting and Documentation revised 7/2017 showed documentation in the medical record will be objective (not opinionated or speculative), complete, and accurate. Closed medical record review for Resident 1 was initiated on 5/20/25. Resident 1 was admitted to the facility on [DATE], and discharged on 5/5/25. a. Review of Resident 1's Elopement Evaluation dated 5/2/25, showed the following areas were left blank: - Is the wandering behavior a pattern, goal-oriented (i.e. specific destination in mind, going home etc.); - Is the Resident's wandering behavior likely to affect the safety or well being of self/others; - Is the Resident's wandering behavior likely to affect the privacy of others; - Risk for wandering/elopement identified, focus, goal, and interventions; - Clinical suggestions. b. Review of Resident 1's eINTERACT Version 4.0 Tool dated 5/2/25, showed Resident 1 had a change of condition for agitation, physical aggression, striking out at staff, and attempting to leave the facility. Further review showed the resident was a danger to self or others. Review of Resident 1's closed medical record did not show documentation the resident was monitored for the change of condition on 5/3/25, between 0700-1500 hours. Page 1 of 2 055671 055671 05/20/2025 Parkview Healthcare Center 1514 E. Lincoln Avenue Anaheim, CA 92805

F 0842 Level of Harm - Minimal harm or potential for actual harm On 5/20/25 at 1602 hours, an interview and concurrent closedmedical record review was conducted for Resident 1 with the DON. When asked if the Elopement Evaluation dated 5/2/25, should be filled out completely, the DON stated yes. The DON verified on 5/3/25, for the 0700-1500 hours shift, the change of condition monitoring progress note was not documented. Residents Affected - Few On 5/21/25 at 1504 hours, the Administrator acknowledged the above findings. 055671 Page 2 of 2