Health inspection·September 13, 2024

F 0626 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure one of three sampled residents (Resident 1) was readmitted to the facility after Resident 1 was transferred and treated at the General Acute Care Hospital (GACH). This deficient practice resulted in Resident 1 remaining at the GACH for two additional days after Resident 1 was deemed appropriate for discharge back to the facility but was denied readmission by the facility. Findings: A review of Resident 1 ' s admission Record, the admission record indicated Resident 1 was admitted to the facility on [DATE] with a diagnosis of right hemiplegia (a condition caused by a brain injury, that results in a varying degree of weakness, stiffness, and lack of control in one side of the body) and chronic kidney (disease gradual loss of kidney function. Kidneys are unable to filter wastes and excess fluids from blood). A review of Resident 1 ' s History and Physical (H&P), dated 8/26/2024, the H&P indicated Resident 1 did not have the capacity to understand and make decisions. A review of Resident 1 ' s Minimum Data Set (MDS, a standardized assessment and care planning tool), dated 9/1/2024, the MDS indicated that Resident 1 ' s cognitive skills (mental action or process of acquiring knowledge and understanding) for daily decision making was moderately impaired. During a review of Resident 1's Change of Condition (COC) dated 9/4/2024, the COC indicated Resident 1 was transferred to the GACH for symptoms of wheezing (a high-pitched, whistling sound that occurs during breathing when the airways in the lungs become narrowed or blocked) and shortness of breath. During a review of Resident 1's Nurse Progress Note dated 9/4/2024 and timed at 6:10 a.m., the Progress Note indicated Resident 1 was transferred to the GACH for further evaluation. During an interview on 9/13/2024 at 9:08 a.m. with Complainant 1, Complainant 1 stated the GACH called facility to request a bed for Resident 1 because she was medically cleared to return to the facility. Complainant 1 stated facility was informed Resident 1 had a history of multidrug-resistant organisms ([MDRO] Bacteria that resist treatment with more than one antibiotic) in 2021 and 2022. Complainant 1 stated the facility refused to accept Resident 1 because of history of MDRO. Complainant 1 (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: 555128 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 555128 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/13/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Downey Community Health Center 8425 Iowa Street Downey, CA 90241 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)