Inspection·August 12, 2025

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, and record review, the facility failed to make reasonable accommodations to meet the needs and preferences of two residents (Residents A and B) who required Hoyer lift (a mechanical device used to transfer residents who cannot bear weight) for transfers. This failure resulted in delays, missed activities, and disruption of established daily routines for two of three sampled residents (Residents A and B).Findings:On July 22, 2025, at 12:14 p.m., during an interview with Resident A, he stated everybody is fighting over two Hoyer lifts. Resident A stated, two Hoyer lifts were not enough to service more than 100 residents.1.A review of Resident A's admission Record indicated Resident A was admitted to the facility May 26, 2019, with diagnoses which included morbid obesity (extremely overweight), and chronic pain syndrome (persistent pain lasting longer than 3 months, often significantly impacting daily life and potentially leading to disability).On July 22, 2025, at 1:53 p.m., during an interview with Certified Nurse Assistant (CNA) 1, CNA 1 stated at least ten residents in the East station require a Hoyer lift for transfers. CNA 1 stated the facility needs four or five Hoyer lifts at that station to accommodate smokers who want to smoke at the same time.On July 22, 2025, at 1:58 p.m. during an interview with the Maintenance Supervisor (MS), the MS stated there were three functioning Hoyer lifts in the facility, one was disabled, and no replacement parts were available. On July 22, 2025, at 4:33 p.m. during another interview with Resident A, he stated it is hard for us to wait to be transferred and it screws up our daily routines. Resident A stated his routine is to be up at 10 a.m. daily and back to bed at 11:30 a.m. Resident A stated, this has happened more than once and sometimes he was told there was no available Hoyer lift and had to wait until other residents were finished. A review of Resident A's care plan dated February 18, 2025, indicated .Focus : Self Care Deficit at risk for poor hygiene R/T (related to) DX (diagnosis) - chronic pain syndrome.Needs total with 2 persons assistance with transfer .Intervention.CNA May sit up resident in wheelchair with Hoyer lift for transfer every day shift .On July 23, 2025, at 11:54 a.m., during an interview with CNA 2, CNA 2 stated she was regularly assigned to Resident A. CNA 2 stated it was facility practice to accommodate resident preferences. CNA 2 stated Resident A required the Hoyer lift for transfers and preferred to be up by 10 a.m., and 30 minutes earlier on shower days. CNA 2 stated, it often took longer than that to transfer him because there was no available Hoyer lift, requiring her to wait until other CNAs were finished. 2. A review of Resident B's admission Record, indicated Resident B was admitted to the facility on [DATE], with diagnoses which included hemiplegia (one sided paralysis) and hemiparesis (muscle weakness restricted to one side) following cerebral infarction (disrupted blood flow to the brain).A review of Resident B's care plan dated February 7, 2025, with target date of August 6, 2025, indicated Focus : ADL (activity of daily living)/Mobility: Resident has actual ADL/Mobility decline and requires assistance related to Dx of (L)left sided weakness s/p (status post) CVA (cerebrovascular accident -stroke) Intervention.Transfer.Use EZ (another brand) lift during transfer for safety every 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 2 Event ID: 555309 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 555309 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/12/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sundance Creek Post Acute 5800 West Wilson Street Banning, CA 92220 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)