Inspection·November 15, 2024

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review, the facility failed to ensure a resident (Resident 3) who had a designated Advocate (AD 1) was invited to participate in the Interdisciplinary Team Meeting ([IDT] a team of health care professionals from different disciplines who work together to provide care for a resident) to discuss and participate in the revision of the care plan (a document that summarizes a resident ' s health conditions, care needs, current treatments, goals, and action plan) for one out of three sampled residents (Resident 3). This deficient practice resulted in Resident 1 ' s AD 1 not attending the IDT meeting and had the potential to result in a care plan that was not person-centered (designed specifically around the individual needs, preferences and goals of the resident receiving care) and would not meet Resident 3 ' s needs. Findings: During a review of Resident 3 ' s admission Record (Face Sheet), the Face Sheet indicated Resident 3 was originally admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses including diabetes mellitus (a disorder characterized by difficulty in blood sugar control and poor wound healing), generalized muscle weakness, abnormalities with gait (a person ' s manner of walking) and mobility (the ability to move freely or lack thereof), and Charcot ' s arthropathy (a rare disorder that causes the bones and joints in the foot and ankle to become unstable and deformed). During a review of Resident 3 ' s History and Physical (H&P) dated 1/15/2024, the H&P indicated Resident 3 had the capacity to understand and make medical decisions. During a review of Resident 3 ' s Interdisciplinary Team Conference Record dated 11/6/2024, the IDT Conference Record indicated an IDT meeting occurred on 11/6/2024 with Resident 3 in the presence of the Director of Nursing (DON) and Social Worker Representative (SWR) 1. The record indicated the care plan was reviewed with Resident 3 discussing medications, diet, and treatment. The record indicated AD 1 was not in attendance nor was there documentation indicating AD 1 was notified of the conference. During an interview on 11/15/2024 at 10:05 a.m. with Resident 3, Resident 3 stated several months ago she informed someone from the facility (does not remember who) she wanted AD 1 to be invited to and involved in all IDT meetings because she was forgetful. Resident 3 stated AD 1 was helping her handle her inaccurate care plan and other medical affairs. Resident 3 stated on 11/6/2024, the Social Worker Representative and the Director of Nursing had an unplanned rushed meeting with her regarding (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: 555114 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 555114 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/15/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Driftwood Healthcare Center 4109 Emerald St Torrance, CA 90503 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)