Health inspection·January 5, 2026

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure the Discharge Summary/Post Discharge Plan of Care was provided to the receiving Skilled Nursing Facility (SNF) for one of three sampled residents (Resident 1) when Resident 1 was transferred and/or discharged on 12/11/2025.This deficient practice resulted in the receiving facility obtaining incomplete medical records for Resident 1 and had the potential for Resident 1's discharge care instructions to be overlooked, which could delay the continuity of care at the receiving facility.Findings:During a review of Resident 1's admission Record (Face sheet), the Face sheet indicated Resident 1 was initially admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses including end stage renal disease ([ESRD] irreversible kidney failure), diabetes mellitus ([DM] a disorder characterized by difficulty in blood sugar control and poor wound healing), schizophrenia (a mental illness that is characterized by disturbances in thought), depression (a mood disorder causing persistent sadness and loss of interest in daily life), and anxiety disorder (a disorder of overwhelming feelings of fear, dread or unease that interferes with daily life).During a review of Resident 1's Minimum Data Set ([MDS] a resident assessment tool) dated 11/28/2025, the MDS indicated Resident 1 was unable to make decisions that were reasonable and consistent.During a review of Resident 1's History and Physical (H&P) dated 12/9/2025, the H&P indicated Resident1 did not have a capacity to understand and make medical decisions.During a review of Resident 1's Situation, Background, Assessment, Recommendation ([SBAR] a communication tool used by healthcare workers when there is a change of condition among the residents) Communication dated 11/28/2025 and timed at 3:41p.m., the SBAR indicated Resident 1 was banging her hands on the wall and attempting to grab the private parts of facility staff members. The SBAR indicated Resident 1 was unable to be redirected and reoriented by the facility staff and the facility's psychiatrist gave an order for Resident 1 to be transferred on 5150 (California's Welfare and Institutions Code that allows a peace officer or a designated professional to involuntarily confine someone for a 72-hour psychiatric hold if they are a danger to themselves or others) Hold to a General Acute Care Hospital (GACH) for further evaluation and treatment. Resident 1 was readmitted to the facility on [DATE].During a review of Resident 1's Interdisciplinary (IDT) Care Conference Note dated 12/8/2025, the IDT Note indicated Resident 1's plan of care was discussed with the Responsible Party (RP), which included discharge options to a more appropriate SNF who will be able to manage Resident 1's behavioral needs.During a review of Resident 1's Order Summary Report (Physician's Orders) dated 12/11/2025 and timed at 2:42 p.m., the Order Summary Report indicated an order was received to transfer Resident 1 to a SNF with all remaining medications on 12/11/2025 and a representative from the receiving facility would pick up Resident 1's medications, belongings and discharge paperwork.During a review of Nursing Progress Notes dated 12/11/2025 and timed at 2:45 p.m., the Nursing Progress Notes indicated Registered Nurse Supervisor (RNS) 1 could not reach a licensed staff (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: 056234 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 056234 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/05/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Marlora Post Acute Rehab Hosp 3801 E Anaheim St Long Beach, CA 90804 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)