Health inspection·March 10, 2025

F 0880 Provide and implement an infection prevention and control program. 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 report an Influenza A (a contagious respiratory illness caused by the influenza virus, commonly known as the flu, that infects the nose, throat and lungs) outbreak (the occurrence of cases of disease in excess of what would normally be expected) to the California Department of Public Health (CDPH) immediately for two of 10 sampled residents (Resident ' s 9 and 10). Residents Affected - Some This deficient practice resulted in CDPH not being aware of the Influenza A outbreak until 2/24/2025 (three days after Resident 10 tested positive for Influenza A) and the inability to investigate the outbreak. These deficient practices had the potential for pertinent information to be lost and/or forgotten, and more resident ' s who tested positive to go unreported. Findings: a. During a review of Resident 9's admission Record (Face Sheet), the Face Sheet indicated Resident 9 was originally admitted to the facility on [DATE] and re-admitted on [DATE] with diagnoses including chronic obstructive pulmonary disease (COPD - a chronic lung disease causing difficulty in breathing) and bronchitis (when the airways in the lungs become inflamed). During a review of Resident 9's History and Physical (H&P), dated 2/24/2025, the H&P indicated Resident 9 had the capacity to understand and make decisions. During a review of Resident 9's Minimum Data Set (MDS - a resident assessment tool), dated 3/1/2025, the MDS indicated Resident 9 had the ability to be understood and the ability to understand others. The MDS indicated Resident 9 ' s cognition (thinking) was moderately impaired. During a review of the facility's Resident Influenza Outbreak Report Form (Line List - a structured table used to organize and summarize information about individuals associated with an outbreak, with each row representing a case and each column representing a variable like demographics, clinical details, or potential exposure), dated 2/24/2025, the Line List indicated Resident 9 was tested for influenza A on 2/15/2025 due to having flu-like symptoms (include fever, chills, cough, body aches and headache). During a review of Resident 9 ' s General Acute Care Hospital (GACH) Lab Results dated 2/15/2025, the Lab Results indicated Resident 9 tested positive for influenza A (a contagious respiratory illness caused by the influenza virus, commonly known as the flu, that infects the nose, throat and lungs) on 2/15/2025. (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: 056283 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 056283 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bixby Towers Post-Acute Rehab 3747 Atlantic Avenue Long Beach, CA 90807 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)