Inspection·June 25, 2024

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure the call light was within reach for one of three sampled residents, (Resident 2). Residents Affected - Few This failure had the potential to result for Resident 2's needs being unmet, and the inability to call for help. Findings: On June 25, 2024, at 10:36 a.m., an unannounced visit to the facility was conducted to investigate a complaint regarding quality of care issue On June 25, 2024, at 12:59 p.m., observed Resident 2 lying in bed on his back, with eyes closed, respirations even and unlabored. Resident 2's call light was observed on the left side of his bed on the ground, not within resident's reach. On June 25, 2024, at 1:05 p.m., a concurrent observation and interview were conducted with the Certified Nursing Assistant (CNA). The CNA observed Resident 2's call light on the floor, on the left side of the bed. The CNA picked up the call light up and placed it on the left side of Resident 2's bed. The CNA stated that call lights should be within reach and Resident 2's call light was not within reach, when it was on the floor. A review of Resident 2's medical records indicated he was admitted to the facility on [DATE], with diagnoses of encounter for surgical aftercare following surgery on the genitourinary system, chronic kidney disease, stage four, (the kidneys are severely damaged and unable to filter waste), atrial fibrillation, (irregular heart beat), pressure ulcer of sacral region, stage 2, bilateral primary osteoarthritis, (a progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of bony spurs and cysts at the margins of the joints) of knee, Alzheimer's disease, (progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain), and vascular dementia, (a decline in thinking skills caused by conditions that block or reduce blood flow to various regions of the brain). Resident 2's History and Physical dated June 9, 2024, indicated he did not have the capacity to understand and make decisions. A review of Resident 2's Care Plan dated June 9, 2024, indicated Focus .has an alteration in musculoskeletal status r/t (related to) .OA, (osteoarthritis), of knees Be sure call light is within reach and respond promptly . (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 4 Event ID: 056214 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 056214 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ramona Rehabilitation and Post Acute Care Center 485 W. Johnston Avenue Hemet, CA 92543 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)