F 0627
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for
a safe transfer/discharge.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to ensure the physician documented the clinical rationale for
the discharge for one of three sampled residents (Resident 1). This failure had the potential to result in an
inappropriate discharge without medical justification, compromising the resident's health, safety, and
continuity of care. Findings:On July 18, 2025, Resident 1's record was reviewed. Resident 1 was admitted
to the facility on [DATE], with diagnoses which included fusion of the spine and depression (more than just
feeling sad or having a bad day).A review of Resident 1's progress notes dated June 1, 2025, indicated,
.Assessment and Plan.Pt (Resident 1) is recommendedfor [sic] f/u (follow-up) imaging within one year due
to presence of polyp [small growth that can form on the lining of organs inside the body] .Pt (Resident 1)
increasing tolerance to ambulance and functionality.Pt (Resident 1) would benefit from continued care.A
review of Resident 1's Notice of Proposed Transfer/ Discharge, dated June 3, 2025, indicated, .Effective
Date.July 3, 2025.The documentation indicated Resident 1 required ongoing care; however, the facility
issued a Notice of Proposed Transfer/discharge on [DATE]. Further review of Resident 1's progress notes
dated June 26, 2025, indicated .The patient is very independent and cares for herself. The patient is getting
discharged , and the patient is cleared for discharge.The documentation did not provide clinical justification
that Resident 1 no longer required facility services or that discharge was in the best interest of the
resident's health and safety.On August 21, 2025, at 2:16 p.m., the Social Service Director (SSD) was
interviewed. She stated, discharge planning begins when the physician orders the discharge. The SSD
stated Resident 1 was under custodial care, and together with the IDT and the physician, it was decided the
resident required a lower level of care. The SSD stated, Resident 1 received a written notice of discharge
on [DATE].On August 22, 2025, at 1:19 p.m., a concurrent interview and review of Resident 1's progress
notes with the Nurse Practitioner (NP) was conducted. The NP stated assessments are performed prior to
discharge and should be documented in the resident's medical record. The NP stated that on June 1, 2025,
she documented Resident 1 would benefit from continued care. The NP stated the determination to
discharge the resident was not reflected in the record.On August 22, 2025, at 2:30 p.m., the Director of
Nursing (DON) was interviewed during a record review of Resident 1. The DON stated, Resident 1 was
provided notice of transfer/discharge on [DATE]. The DON stated, the NP's documentation did not support
discharge readiness. The DON stated, Resident 1 should not have issued a notice of proposed
transfer/discharge without physician documentation of the rationale.A review of the facility policy and
procedure titled Transfer or Discharge Documentation, dated December 2016, indicated, .When a resident
is transferred or discharged , details of the transfer or discharge will be documented in the medical record
and appropriate information to the receiving healthcare facility or provider.Should the resident be
transferred or discharged for any of the following reasons, the basis for the transfer or discharge will be
document in the resident's clinical
(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:
555566
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
555566
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
08/22/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Corona Post Acute Center
2600 South Main Street
Corona, CA 92882
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)
F 0627
records by the resident's Attending Physician.
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
555566
If continuation sheet
Page 2 of 2