Health inspection·April 27, 2023

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 call lights were within reach while in bed in accordance with their policy and procedure for two out of three sampled residents (Residents 1 and 2). Residents Affected - Few This failure has the potential to result into a delay in the provision of services and needs not being met for Residents 1 and 2. Findings: 1. During a review of Resident 1's medical record, the Resident Face Sheet (contains demographic and medical information), indicated Resident 1 was admitted to the facility on [DATE], with diagnoses which included cerebrovascular disease (a conditions that adversely affect blood flow to the brain, can cause lasting brain damage and long-term disability), chronic systolic congestive heart failure (disease in which heart cannot pump blood efficiently and makes it difficult to breathe), and hypertensive (elevated blood pressure). A review of Resident 1's Minimum Data Set (MDS- a standardized assessment and screening tool) dated January 30, 2023, indicated Resident 1 was assessed to be in need of extensive assistance (when Staff fully assists the person in accomplishing the task; person is unable to or minimally participates) with 1-person physical assistance with bed mobility, dressing, and personal hygiene. During an observation and concurrent interview, with Resident 1, on March 15, 2023, at 2:30 PM, Resident 1 was in her room, lying down in bed. Resident 1's call light was not within reach. When Resident 1 was asked to reach her call light, Resident 1 stated she was unable to reach her call light. During an observation and concurrent interview, with Certified Nurses Assistance 1 (CNA 1), on March 15, 2023, at 2:40 PM, in Resident 1's room, Resident 1's call light was not within reach of the resident. The resident's call light was clipped to the corner of pillowcase, close to the headboard of her bed, and was dangled down over the head bed frame to the floor. CNA 1 stated call light should be clipped within Resident 1's easy reach. 2. During a review of Resident 2's medical record, the Resident Face Sheet, indicated Resident 2 was admitted to the facility on [DATE], with diagnoses which included cerebrovascular disease,hypertensive, and hyperlipidemia (too many lipids (fats) in the blood). A review of Resident 2's MDS, dated [DATE], indicated Resident 2 has severely impaired cognitive skills for daily decision making. Further review indicated Resident 2 was assessed to be in need of Page 1 of 2 056444 056444 04/27/2023 Community Extended Care Hospital of Montclair 9620 Fremont Ave Montclair, CA 91763

F 0558 Level of Harm - Minimal harm or potential for actual harm extensive assistance with 1-person physical assistance with bed mobility, dressing, and personal hygiene. Furthermore, the MDS indicated Resident 2's upper and lower extremity had impairment on one side. A review of Resident 2's care plan, dated July 14, 2022, indicated .Problem: at risk for pain/discomfort r/t [related to] .medical condition . (R) [right] sided weakness . Residents Affected - Few During an observation, on March 15, 2023, at 3:00 PM, Resident 2 was in his room, lying down in bed. Resident 2's call light was not within his reach. When asked to reach for his call light. Resident 2 tried to reach it using his left hand (which was his strong side). Resident 2 was unable to reach the call light. During an observation and concurrent interview, with License Vocational Nurse (LVN 1), on March 15, 2023, at 3:10 PM, Resident 2's call light was wrapped up to the right side of Resident 2's bed grab bar (a device attached to the bed frame gives assistance in moving around and repositioning in bed), which was at Resident 2's weak side. The call light was dangled down to the floor. LVN 1 confirmed Resident 2's call light was not within the resident's reach. LVN 1 further stated Resident 2's call light should be clipped within Resident 2's left hand easy reach. During a concurrent interview and record review, on March 15, 2023, at 3:45 PM, with the Director of Nurses (DON), the DON reviewed the facility's policy and procedure (P&P) titled Call Lights revised January 2017, which indicated Policy: it is the policy of the facility to respond to the resident's requests and needs . Procedure: . When the resident is in bed or in the wheelchair or chair in the room staff should make sure that the call is within easy reach of the resident . The DON stated the facility did not follow the policy. 056444 Page 2 of 2