Health inspection·March 5, 2024

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, facility failed to ensure a baseline care plan for one of three sampled residents (Resident 1). Resident 1 did not have a baseline care plan that identified that Resident 1 refused and Resident 1 ' s family member (FM) refused to attend the Integrated Discharge Disciplinary Team (IDT the Residents health care team made up of various specialties). This deficient practice had the potential for Resident 1 to not receive appropriate care and treatment specific to her needs. Findings: During a review of Resident 1 ' s admission Record the admission Record indicated the facility admitted Resident 1 o the facility on 12/31/2022 and readmitted her on 1/25/2024 with diagnoses of essential (primary) hypertension (high blood pressure, pulmonary fibrosis, unspecified (a disease where there is scarring of the lungs making it hard to breath) and rheumatoid arthritis , unspecified (a chronic progressive disease-causing inflammation in the joints). During a review of Resident 1 ' s history and physical (H&P) report dated 12/30/2022, the H&P indicated resident 1 had the ability to understand and make decisions. During a review of the Resident 1 ' s Minimum Data Set (MDS- a comprehensive assessment and care planning tool) dated 1/30/2024, the MDS indicated Resident 1 is dependent (helper does all of the effort. Resident puts forth none of the effort to complete the activity, or the assistance of 2 or more helpers is required for the resident to complete the activity) with showering, upper and lower body dressing. During a record review of Resident 1 ' s progress notes a late entry entered and dated 1/30/2024 indicated Resident 1 and Resident 1 ' s daughter had declined to attend IDT meetings. During a review of Residents 1 ' s medical record, the medical record indicated the last IDT meeting was on 10/11/2023. During an interview on 3/5/2024 at 1:16 p.m., with the Social Worker (SW), the SW stated facility staff had an ITD meeting with Resident 1 and Resident 1 ' s daughter on 10/11/ 2023. The SW stated this is when Resident 1 and her daughter stated they did not want to attend future IDT meetings. The SW also stated that she I did not explain the risks and benefits of IDT meetings to the Resident 1 or her daughter. The SW stated when the resident and/or the resident ' s representative do not attend Page 1 of 2 056104 056104 03/05/2024 Rose Villa Health Care Center 9028 Rose Street Bellflower, CA 90706

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few IDT meetings, the Residents needs and concerns may not be met. The SW stated there was not a care plan initiated for Resident 1 and her daughter ' s refusal to attending IDT meetings. The SW stated importance of initiating a care plan is to address all resident needs. During an interview on 3/5/2024 at 2:52 p.m., with the Director of Nursing (DON), the DON stated IDT meetings are held upon admission and quarterly (every three months). The DON stated Resident 1 was readmitted on [DATE] and staff had 14 days to complete an IDT meeting with the Resident. The DON also verified the last IDT meeting was on 10/11/2024. The DON stated the Resident and the daughter refused to have any further IDT meetings. The [NAME] stated when the Resident and family refuses to attend IDT meetings the staff is responsible for having an IDT meeting and the family ' s refusal should be care planned. The DON stated it is important to have IDT meetings and to care plan residents ' refusal to attend. She stated we need to address all concerns of the residents and meet their needs. During a review of the facility ' s policy and procedure (P/P) titled Policy/Procedure-Nursing Administration Care Planning Revised 5/2019, the P/P indicated it is the policy of this facility and the interdisciplinary team (IDT) shall develop a comprehensive care plan for each resident. Scheduling and preparation of the care plan meeting calendar is completed by the MDS Coordinator and / or Social Services Designee. 056104 Page 2 of 2