Health inspection·July 22, 2022

F 0758 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Based on interview and record review, the facility failed to ensure one of 16 sampled residents (Resident 45) was not prescribed a PRN (as needed) psychotropic medication (drugs used to treat mental illness) past 14 days, without a rationale for continuation for its use. This failure placed Resident 45 at risk for receiving an unnecessary psychotropic medication. Findings: During a review of Resident 45's Order Details, dated 4/25/22 and 6/2/22, the Order Details indicated in part, .Ativan (medication for anxiety) tab 0.5 milligrams (MG), PRN every 12 hours for anxiety manifested by agitation. Start date 4/25/2022. End date indefinite. No new orders noted until 6/2/22. The Order Details further indicated, in part . Lorazepam Tablet (medication for anxiety) 0.5 MG by mouth every 8 hours as needed for Anxiety manifested by agitation hitting staff. Start date 6-02-2022. End date indefinite During an interview on 7/22/22, at 9:28 a.m., with the Director of Nursing (DON), the DON acknowledged, there was no 14 day expiration date documented. DON stated, Yes, I acknowledge that is not there. During a concurrent interview, and record review, on 7/22/22, at 10:33 a.m., with the DON, Resident 45's Progress Notes by Nurse Practitioner (NP), dated 5/05/22 and by Physician, dated 6/15/22, were reviewed. The Progress Notes by NP, indicated in part . On Risperdone (medication for mental illness) currently with ativan prn which helps. The Progress Notes by physician, indicated, no information about rationale to continue the Ativan. DON confirmed, there was not appropriate documentation for rationale to continue the Ativan PRN, with a nod of her head. Facility was unable to provide a policy for PRN Psychotropic medications. 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 3 Event ID: 055684 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 055684 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/22/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Californian 2225 DE LA Vina Street Santa Barbara, CA 93105 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)