Health inspection·January 30, 2025

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on record review and interview, the facility failed to follow physician orders and adhere to its medication administration policy and procedures for one of two sampled residents (Resident 1) when: Residents Affected - Few 1. Staff did not seek physician clarification for a potential frequency change for a Lactulose (a medication which can be used to reduce the amount of ammonia in the blood of residents with liver disease) order when Resident 1 did not have four bowel movements in a day. 2. Staff did not notify Resident 1's physician of their continued inability to obtain an ordered medication of Rifaximin (An antibiotic that is used to treat and prevent complications in patients with cirrhosis). 3. Staff did not check Resident 1's blood pressure or heartrate prior to the administration of Propranolol (a medication used to treat high blood pressure). These failures had the potential to lead to negative outcomes for Resident 1. Findings: 1.During a review of Resident 1's admission Record undated, indicated in part, Resident 1 had diagnoses including cirrhosis of the liver (a chronic liver disease characterized by the formation of scar tissue that replaces healthy liver tissue), hepatic encephalopathy (a brain dysfunction that occurs when a damaged liver fails to filter toxins from the blood), ascites (a condition where excess fluid accumulates in the abdominal cavity), and hypertension (a condition where the blood vessels have consistently elevated blood pressure). During a concurrent record review and interview, on 1/24/25, starting at 2:12 p.m., with Certified Nursing Assistant (CNA 1) and the Director of Nursing (DON 1), Resident 1's medical record was reviewed. Resident 1 had a physician order for Lactulose Oral Solution 10 GM (grams)/15ML (milliliters) (Lactulose) give 30 ml by mouth every four hours for liver disease increase or decrease frequency toward goal of four bowel movements per day. The CNA 1 confirmed Resident 1 had two bowel movements on 12/22/24, two bowel movements on 12/23/24, and two bowel movements on 12/24/24. The DON 1 verbalized Resident 1's physician should have been notified on those dates when Resident 1 had less than 4 bowel movements a day to inquire if a frequency change in the order was needed. The DON 1 could not provide documentation indicting this was done. 2. During a concurrent record review and interview, on 1/24/25, with Licensed nurse (LN 1) and DON 1, Resident 1's Medication Administration Record (MAR) was reviewed. Resident 1's MAR indicated in (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: 056379 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 056379 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oxnard Manor Healthcare Center 1400 West Gonzales Road Oxnard, CA 93036 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)