Health inspection·August 9, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure a comfortable, safe temperature level was maintained in the range of 71 to 81 degrees Fahrenheit (a unit of measurement of temperature) in the facility hallway, and three resident rooms (room [ROOM NUMBER], 2, and 3). This failure had the potential for the residents to have an uncomfortable environment. Findings: Review of Resident 1's face sheet (a document that gives a resident's information at a quick glance) indicated Resident 1 admitted to facility on 7/12/2023 with diagnoses right tibia fracture (a broken right lower leg bone), left femur fracture (a broken left thigh bone), congestive heart failure (a chronic condition in which the heart does not not pump blood as well as it should), asthma (a condition in which airways narrow, swell, and may produce extra mucus, which makes it difficult to breathe), and diabetes type 2 (a chronic condition that affects the way the body processes blood sugar). Resident's minimum data set (MDS, a clinical assessment tool) dated 7/18/2023 indicated Resident 1's brief interview for mental status (BIMS) score of 15 of 15 (13-15 score means a intact cognition). During observation and interview with Resident 1 on 7/24/2023 at 10:25 a.m., Resident 1 stated she was feeling hot in room [ROOM NUMBER] and started upon admission to the facility. Resident 1 also stated room [ROOM NUMBER] was getting hotter by noon every day from last one week or so. Resident 1 further stated no cool air coming into room [ROOM NUMBER] and the facility provided a small electric fan to her but the fan was not able to keep up the cool air in the room [ROOM NUMBER]. Review of Resident 2's face sheet indicated Resident 2 admitted to facility on 2/20/2018 with diagnoses including atrial fibrillation (an irregular, often rapid heart rate that commonly causes poor blood flow), hypertension (a condition in which the force of the blood against the artery walls is too high), and dementia (loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life). Resident 2 had a resposible party 1 (RP 1- person acting on behalf of the resident for day-to-day decision making for resident) for decision making. Resident 2's MDS assessment dated [DATE] indicated Resident 2's BIMS score of 3 of 15 (0-7: severely impaired cognition). During an interview with Resident 2's RP (RP 1) on 7/24/2023 at 1:10 p.m., RP 1 stated room [ROOM NUMBER] feels hot every time when he was visiting Resident 1. RP 1 also stated he was sweating in the room [ROOM NUMBER] during his visits, and he was concerned for Resident 2 for the high temperature in the room [ROOM NUMBER]. (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 3 Event ID: 056058 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 056058 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Almaden Health and Rehabilitation Center 2065 Los Gatos-Almaden Road San Jose, CA 95124 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)