Health inspection·August 12, 2025

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 observation, interview, medical record review, and facility P&P review, the facility failed to ensure the necessary care and services were provided to promote the healing of a pressure injury for one of three sampled residents (Resident 3). * The facility failed to provide a LAL mattress for Resident 3 who had a Stage 3 pressure injury (characterized by full-thickness skin loss, where the damage extends into the subcutaneous tissue (fat). While adipose tissue (fat) is visible, bone, tendon, or muscle are not exposed. The wound may have a crater-like appearance, and slough (dead tissue) or eschar (a scab) may be present, but they do not obscure the depth of the wound. Undermining and tunneling (where the wound extends under the skin's surface) can also occur). This failure had the potential to cause and delay the healing of resident's pressure injury. Findings: Review of the facility's P&P titled Pressure Injury Prevention and Management revised 9/12/23, showed in part, this facility is committed to the prevention of avoidable pressure injuries, unless clinically unavoidable, and to provide treatment and services to heal the pressure injury, prevent infection and the development of additional pressure injury. Under Policy Explanation and Compliance Guidelines: the facility shall establish and utilize a systematic approach for pressure injury prevention and management, including prompt assessment and treatment, intervening to stabilize, reduce or remove underlying risk factors; monitoring the impact of the interventions; and modifying the interventions as appropriate. Interventions will be documented in the care plan and communicated to all relevant staff. According to the NPIAP guidelines for pressure injury dated 2/2025, the goal of this international collaboration is to develop evidenced-based recommendations for the prevention and treatment of pressure injuries that can be used by health professionals throughout the world. The NPIAP staging system is a widely used classification for pressure injuries, which are skin damage caused by prolonged pressure. The NPIAP defines the Stage 3 pressure injury - as full thickness skin loss exposing subcutaneous tissue (deepest layer of the skin primarily consist of fat tissues, connective tissue blood vessels and nerves). On 8/7/25 at 1520 hours, an observation was conducted of Resident 3's wound care treatment with LVN 1. Resident 3's bed did not have a LAL mattress. On 8/7/25 at 1600 hours, an observation and concurrent interview was conducted with LVN 3 for Resident 3. LVN 3 stated Resident 3 was using a regular mattress and verified there was no LAL mattress on her bed. LVN 3 further stated Resident 3 should have a LAL mattress because she had a Stage 3 pressure injury. LVN 3 stated a LAL mattress would help relieve pressure on Resident 3's wound and promote healing. Medical record review for Resident 3 was initiated on 8/7/25. Resident 3 was admitted to the facility on [DATE], with diagnoses including a Stage 3 pressure injury measuring 3 cm (length) x 2 cm (width) x 0 cm (depth). Review of Resident 3's physician orders failed to show an order for a LAL mattress when she was admitted to facility. Review of Resident 3's care plan for the Stage 3 sacrococcyx (fused area at the spine and tailbone) pressure injury initiated 7/30/25, showed an intervention to have low air loss mattress for wound management. On 8/7/25 at 1610 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: 555536 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 555536 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/12/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park Regency Care Center 1770 W. LA Habra Blvd. LA Habra, CA 90631 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)