Health inspection·May 22, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Actual harm **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 provide the necessary care and services to ensure one of three sampled residents (Resident 1) attained and maintained the highest practicable physical well-being. Residents Affected - Few * The facility failed to ensure Resident 1's colostomy bag was emptied according to the standards of practice when CNA 1 poured hot water in the colostomy bag. While the hot water was being poured, the colostomy bag touched the resident's skin, resulting in Resident 1 sustaining a burn on the left thigh and requiring pain medication administration and wound treatment. This failure had caused the burn to the resident's skin and the resident to experience pain and need wound treatment. Findings: Review of facility's P&P titled Ostomy Care - Colostomy, Urostomy, and Ileostomy revised 12/19/22, showed it is the policy of the facility to ensure that residents who require colostomy, urostomy, or ileostomy services receive care consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goal and preference. Review of the facility's lesson plan titled Emptying an Ostomy bag (undated) showed 1. When applicable, direct care staff will empty the ostomy bag if bowel or air is noted. Supplies must be gathered prior to performing the task such as: wipes, toilet tissue, disposable bag, 2. Once supplies are obtained, direct care staff will wash hands and apply gloves. Then, place the disposable bag over the clamp at the bottom of the ostomy bag. This will ensure all of the contents in the ostomy bag are captured inside the disposable bag. Direct care staff will then, unclamp the clip and begin pushing the bowel or air down towards the opening with your gloved finger slowly, preventing any potential damage to the bag. Once all air or bowel is removed, wipe the ends of the opening and apply clamp. Ensure the clamp is closed. 4. Dispose of the disposable bag. Remove gloves and wash hands. 5. Direct care staff members will notify direct supervisor if resident asks for changing of the pouch or cleaning the inside of the pouch or any other care that direct care staff is not obligated to perform. 6. It is never appropriate for direct care staff to perform such tasks that are not within their scope. These may include, but are not limited to: (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 6 Event ID: 055984 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 055984 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/22/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Anaheim Healthcare Center, LLC 501 South Beach Blvd. Anaheim, CA 92804 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)