Inspection·November 25, 2025

F 0552 Ensure that residents are fully informed and understand their health status, care and treatments. 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 ensure the Responsible Party (RP), who was a Conservator (a person appointed by a court to manage the financial or personal affairs of someone who is unable to do so themselves due to illness, disability, or other incapacitation), appointed by the Los Angeles County Office of the Public Guardian, for one of four sampled residents (Resident 1) was informed of the risks and benefits of psychoactive medication (a drug that changes brain function and results in alterations in perception, mood, consciousness or behavior) and allowed to give their consent for Resident 1 to continue use of the medication, versus providing this information to Resident 1's FM and allowing her to give consent for Resident 1's use of the medication. This deficient practice resulted in Resident 1's Conservator being unaware of medications Resident 1 was prescribed and the inability to make decisions regarding Resident 1's care. Findings: During a review of Resident 1's admission Record (Face Sheet), the Face Sheet indicated Resident 1 was admitted to the facility on [DATE] with a diagnosis of schizophrenia (a mental illness that is characterized by disturbances in thought). During a review of Resident 1's Minimum Data Set ([MDS] a resident assessment tool) dated 9/12/2025, the MDS indicated Resident 1's cognition was severely impaired, and Resident 1 was dependent (helper does all of the effort) on facility staff to complete his activities of daily living ([ADLs] activities such as bathing, dressing and toileting a person performs daily). During a review of Resident 1's Letter of Conservatorship dated 6/27/2025, the Letter of Conservatorship indicated the Los Angeles County Office of the Public Guardian, appointed Conservator (a person appointed by a court to manage the financial or personal affairs of someone who is unable to do so themselves due to illness, disability, or other incapacitation) of the person and estate of the named Conservatee (a person who is deemed by a court to be unable to manage their own personal and/or financial affairs, and for whom a judge has appointed a conservator to make decisions on their behalf) , Resident 1, effective as of 6/11/2025. During a review of Resident 1's Physician Orders, the Physician's Orders indicated the following medication prescribed to Resident 1: 1. 9/5/2025 - Quetiapine Fumarate (antipsychotic medication used to treat schizophrenia) 25 mg one tablet by mouth every eight hours as needed for agitation. 2. 9/8/2025 - Aripiprazole (antipsychotic medication used to treat mental conditions such as schizophrenia) 20 milligrams ([mg] a unit of measurement) one tablet once a day for schizophrenia manifested by predominant negativity as evidenced by a blunted affect (reduced or diminished ability to show feelings)/lack of motivation to perform daily activities. During a review of Resident 1's Informed Consent (voluntary agreement to accept treatment and/or procedures after receiving education regarding the risks, benefits, and alternatives offered) dated 9/5/2025, the Informed Consent form indicated the signature allowing Resident 1 to use Quetiapine Fumarate was obtained from Resident 1's FM, not Resident 1's Conservator. During a review of Resident 1's Informed Consent dated 9/8/2025, the Informed Consent form indicated the signature allowing Resident 1 to use Aripiprazole was Residents Affected - Few (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 3 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 11/25/2025 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)