Health inspection·June 13, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. 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 follow their weight management policy for one of five residents (Resident 2), when Resident 2 was not weighed weekly after severe weight loss was noted on January 8, 2025. Residents Affected - Few This failure had the potential to lead to continued unmonitored weight loss which could negatively impact Resident 2's health condition. Findings: On April 29, 2025, at 8:45 a.m., an unannounced visit was conducted at the facility to investigate a quality care concern. A review of Resident 2's, admission Record, indicated the resident was admitted to the facility on [DATE], and re-admitted to the facility on [DATE], with diagnoses which included muscle wasting and atrophy (a breakdown of muscle tissue). A review of Resident 2 ' s, Weights and Vitals Summary, indicated the following: 12/10/2024 139 lbs., (pounds) 01/08/2025 122 lbs., (17 lbs. weight loss in a month); and 02/04/2025 109 lbs. (13 lbs. weight loss in a month). A review of eInteract SBAR summary for Providers, dated February 2, 2025, indicated, .The change in Condition .Food and/or fluid intake .Weight: W 122.0 lb. – 1/8/2025 . A review of the weight and vital summary did not indicate documentation of weekly weight monitoring after the resident had a weight loss of 17 lbs. on January 8, 2025, and 13 lbs. on February 4, 2025. On April 29, 2025, at 2 p.m., an interview was conducted with the Director of Nursing (DON). The DON stated that, per policy, Resident 2 should have been weighed, at least, weekly after the severe weight loss from December 2024-January 8, 20252025, was observed. A review of the facility ' s policy titled, Weight Assessment and Intervention, indicated, .The nursing staff will measure resident weights on admission, the next day, and weekly for two weeks Page 1 of 2 555017 555017 06/13/2025 Riverwalk Post Acute 4000 Harrison Street Riverside, CA 92503

F 0684 Level of Harm - Minimal harm or potential for actual harm thereafter. If no weight concerns are noted at this point, weights will be measured monthly thereafter .Any weight change of 5% or more since the last weight assessment will be retaken the next day for confirmation . Residents Affected - Few 555017 Page 2 of 2