Health inspection·February 3, 2026

F 0656 Level of Harm - Potential for minimal harm Residents Affected - Some Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, medical record review, and facility P&P review, the facility failed to develop a care plan timely and implement care plan interventions for one of three sampled residents (Resident 1). * Resident 1 did not have a care plan for constipation. Additionally, Resident 1's care plan for diarrhea and loose stools was not developed in a timely manner. There was no monitoring for Resident1's signs and symptoms of dehydration as identified in the care plan. These failures had the potential risk of not providing appropriate, consistent, and individualized care to the resident.Findings: Review of the facility's P&P titled Comprehensive Care Plan dated October 2022 showed it is the policy of the facility to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that includes measurable objectives and time frames to meet a resident's medical, nursing and mental and psychological needs that are identified in the comprehensive assessment. Medical record review for Resident 1 was initiated on 2/3/26. Resident 1 was admitted to the facility on [DATE]. Review of Resident 1's H&P examination dated 3/29/25, showed Resident 1 had the capacity to understand and make decisions. Review of Resident 1's Nursing Progress Notes dated 4/2/25, showed Resident 1 had loose stools on 4/2/25. The Progress Notes further showed a physician's order to discontinue the docusate sodium (stool softener), to hold Geri-Kot tablet (laxative), and to give Lactobacillus (probiotics to maintain gut health). Review of Resident 1's Order Summary Report showed the following orders:- dated 4/5/25, discontinue docusate sodium oral tablet one tablet via GT in the morning for bowel movement, hold if loose stool; - dated 4/5/25, hold Geri-Kot tablet 8.6 mg one tablet via g-tube for bowel management, hold if loose stool ordered; and- dated 4/5/25, give Lactobacillus oral tablet one tablet via GT two times a day for supplement. Review of Resident 1's care plan for diarrhea and loose stools initiated on 4/9/26, showed interventions including to monitor, document and report as needed for signs and symptoms of dehydration (dry skin and mucous membranes, poor skin turgor, weight loss, anorexia, malaise, hypotension, increase heart rate, fever, abnormal electrolyte levels). Resident 1's care plan for the diarrhea and loose stools was initiated seven days after the first episode of diarrhea/ loose stools started (on 4/2/25). Review of Resident 1's medical record failed to show a care plan was developed for the resident's constipation, and failed to show the resident was monitored for signs and symptoms of dehydration. Review of Resident 1's Nursing Progress Notes dated 4/16/25, showed the resident's abdomen was non- tender, bowel sounds present, diarrhea noted and complaints of nausea. The physician was notified and an order was initiated for loperamide HCl (medication to treat diarrhea) two mg one tablet via GT every eight hours for loose stool or diarrhea. Review of Resident 1's Nursing Progress Notes dated 4/17/25, showed the resident was transferred to the acute care hospital for abnormal vital signs and was admitted to the ICU. On 1/3/26 at 0946 hours, an interview and concurrent medical record review for Resident 1 was conducted with the MDS Coordinator. The MDS Coordinator stated one of her (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: 555266 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 555266 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/03/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sun Mar Nursing Center 1720 West Orange Avenue Anaheim, CA 92804 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)