Health inspection·August 15, 2023

F 0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure two of three sampled Hospice (end of life care) residents (Residents 1 and 2), were free from unnecessary medications when: Residents Affected - Few 1. Resident 1 was ordered morphine sulfate (an opioid narcotic), without adequate indications of what level of pain (mild, moderate or severe), this medication was expected to treat. 2. Resident 2 was ordered Dilaudid (an opioid narcotic), without adequate indications of what level of pain the medication was expected to treat. This failure had the potential for Licensed Nursing (LN) to administer too much pain medication which could lead to over sedation and negative clinical outcomes, or give too little and subject the residents to uncontrolled pain, which could have a negative psychosocial and emotional impact on the quality of end of life care that Residents 1 and 2 received. Findings: 1. A review of the facility's policy and procedure titled, Medication Orders , revised 5/1/10, indicated, When recording PRN pain medication orders, specify: the type, route, dosage, frequency, strength, and reason for administration. A review of Resident 1's record indicated that she was admitted to the facility on [DATE] for Hospice care with the diagnosis of congestive heart failure, (heart does not pump blood as it should). Resident 1 was not capable of making her own health care decisions. During a review of Resident 1's Order Summary Report Active Orders, dated 8/15/23, the Order Summary Report Active Orders , indicated, Resident 1 had been ordered morphine sulfate (concentrate) oral solution 20MG/ML (unit of measure, MG, milligrams, ML, milliliters), give 0.25 ml by mouth every one hour as needed for pain and SOB [shortness of breath] , on 7/29/23. The order had not included if this dose was for mild, moderate or severe pain and indicated that there was only one dose for all levels of pain. During a concurrent interview and record review, on 8/15/23 at 9:52 am, with LN A, Resident 1's Orders were reviewed. LN A confirmed the Orders indicated that Resident 1 had been prescribed morphine sulfate 0.25 ml by mouth every one hour as needed for pain and SOB. LN A stated Resident 1 was on Hospice and the morphine order did not need to identify what level of pain it was expected to treat. 2. A review if Resident 2's records indicated admission to the facility 8/2/23 for Hospice care (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 2 Event ID: 056222 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 056222 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Marquis Care at Shasta 3550 Churn Creek Rd. Redding, CA 96002 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)