Health inspection·August 31, 2023

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to follow their policy and procedure to ensure the call lights were answered in a timely manner to provide care and services for two of three residents (Resident 1 and Resident 2). Residents Affected - Few This failure resulted in Resident 1 and Resident 2's care being prolonged and put them at risk for physical and psychosocial harm. Findings: 1.During a review of Resident 1's clinical record, the face sheet (contains demographic and medical information), indicated Resident 1 was admitted on [DATE], with diagnoses which included: joint replacement surgery, left artificial hip, left artificial knee and morbid obesity. During a review of the clinical record for Resident 1, the Brief Interview for Mental Status (BIMS- screening tool to identify and monitor cognitive decline), dated July 3, 2023, indicated, Resident 1's score was a 15, which indicated that there was no mental impairment. In an interview with Resident 1, on August 24, 2023, at 3:41 PM, Resident 1 stated, Call lights. It takes 45 minutes to answer the call lights. I am calling them for basic stuff, like drink refills, urinals, or a message out to the front desk (nurses' station) because they're not answering the call lights. I ' ll call the front desk (nurses' station) because they are not answering the call lights. 2.During a review of Resident 2's clinical record, the face sheet (contains demographic and medical information), indicated Resident 3 was admitted on [DATE], with diagnoses which includes: rheumatoid arthritis (painful swelling of the joints) and abnormalities of gait. During a review of the clinical record for Resident 2, the Brief Interview for Mental Status (BIMS- screening tool to identify and monitor cognitive decline), dated June 29, 2023, indicated, Resident 2's score was a 15, which indicated there was no mental impairment. In an interview with Resident 2 on August 24, 2023, at 4:09 PM, Resident 2 stated, I turn on my call light and it may take a while for them to come in. What they do is when they come into my room they say, I am going to tell the person that is listed as my certified nursing assistant. They then turn off the call light and the cna that is assigned to provide care doesn't come into my room. So, what I do is call again and then by the third call for help. I'm frustrated. I'm calling because I need to be changed or I'm ready for my patient care, fresh water. I try not to call. I call for my Page 1 of 2 555521 555521 08/31/2023 Rancho Mesa Care Center 9333 LA Mesa Dr Alta Loma, CA 91701

F 0684 medications. From beginning to end, it takes maybe a half an hour. Level of Harm - Minimal harm or potential for actual harm During a record review of the Resident Council Meeting Minutes, dated June 27, 2023, and July 27, the Resident Council Minutes indicated the Residents complained of staff not answering the call lights in a timely manner. The Resident Council Minutes did not indicate the call light complaints were resolved or addressed. Residents Affected - Few During a concurrent interview and record review of the resident council meeting minutes with the Director of Staff Development (DSD) on August 24. 2023, at 4:26 PM, DSD stated, I deal only with the resident council minutes if there are problems with the call lights or resident care. After the DSD reviewed the resident council minutes and searched for in-services related to call lights the DSD stated, There are no in-services for July or June for the call lights. DSD stated further, Call lights should be answered in 5 minutes. Why? To make sure the residents are not in immediate danger, an emergency, or not able to breathe. The facility was unable to provide documentation that stated the resident councils' concerns were addressed. During an interview with the Director of Nursing (DON) on August 24, 2023, at 4:42 PM, DON stated, Call lights. Everyone is to answer the call lights. It should be within 5 minutes. We answer the call lights to prevent falls, prevent any unusual occurrence and to answer their needs. DON was informed of the time residents stated that it takes staff to answer the call lights, 30 to 45 minutes. The DON stated further, That should not be happening because it is our duty to take care of the resident's needs. The facility policy and procedure titled, Answering the Call Light dated October 2010, indicated The purpose of this procedure is to respond to the resident's request and needs. General Guidelines .5. When the resident is in bed or confined to a chair be sure the call light is within easy reach of the resident .8. Answer the resident's call as soon as possible . 555521 Page 2 of 2