Health inspection·April 2, 2024

F 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. 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 implement interventions of turning and repositioning of dependent residents, for one of four residents (Resident 1), who had the potential for the development of a pressure injury/ulcer (injury to skin and underlying tissue resulting from prolonged pressure on the skin). Residents Affected - Few This failure placed the resident at an increased risk for developing and/or worsening of pressure injuries. Findings: On April 2, 2024, at 10:17 a.m., an unannounced visit was conducted at the facility for a quality-of-care complaint. On April 2, 2024, Resident 1's medical record was reviewed. Resident 1 was admitted to the facility on [DATE], with diagnoses which included acute and chronic respiratory failure (unable to breath without difficulty) post tracheostomy (an artificial opening in the trachea to allow oxygen to the lungs), quadriplegia (inability to move all four extremities), and intracranial hemorrhage (bleeding in the brain). The physician History and Physical indicated Resident 1 was nonverbal and noncommunicative. The records indicated Resident 1 was transferred to the general acute care hospital on January 21, 2024. Review of Resident 1's Care Plan dated February 23, 2023, indicated, .Focus .High risk for alteration in skin integrity .Resident's mother wants resident to be turned at 9pm, 12mn (midnight), 3am, and 6am .Interventions .During night shift turn resident at 9pm, 12mn, 3am, and 6am per family request .Turn and reposition at least every 2 hours and as needed for comfort and pressure relief . Review of the facility document untitled which included resident function and activity (turning and repositioning) for January 17-21, 2024, indicated: -January 17, at 2:17 p.m., .Assistance Needs .Total .Patient Position .Lying . -January 17, at 6:18 p.m., .Assistance Needs .Total .Patient Position .Supine . -January 18, at 1:06 p.m., .Assistance Needs .Total .Patient Position .Lying . There was no other documentation indicating Resident 1 was turned or repositioned. (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: 555390 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 555390 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/02/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Corona Regional Medical Center D/P Snf 730 Magnolia Avenue Corona, CA 92879 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)