Health inspection·February 12, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure three of five sampled residents (Resident 3, Resident 4, and Resident 5) were provided a safe and homelike environment. The facility failed to: 1. Ensure the facility temperature was between 71 degrees Fahrenheit (°F, unit of measurement for temperature) to 81°F as indicated in the facility's policy and procedure (PnP). 2. Ensure safe and clean shower rooms were provided for the residents. These deficient practices had the potential to cause serious medical problems and altered comfort level. In addition, based on the Reasonable Person Concept (refers to a tool to assist the survey team's assessment of the severity level of negative, or potentially negative, psychosocial outcome the deficiency may have had on a reasonable person in the resident's position), due to Residents 3, 4, and 5's impaired cognition (refers to conscious mental activities including thinking, reasoning, understanding, learning, and remembering) and medical condition, a homelike environment that were not provided may have psychological (mental or emotional) effects including feelings of hopelessness (a feeling or state of despair or lack of hope) and helplessness (the belief that there is nothing that anyone can do to improve a bad situation). Findings: During a record review of Resident 3's admission Record, the admission Record indicated the facility admitted the resident on 3/30/2022 with diagnoses including metabolic encephalopathy (an alteration in consciousness due to brain dysfunction), adult failure to thrive (an older person experiences a significant decline in their overall health), and unspecified dementia (impaired ability to remember, think, or make decisions that interferes with doing everyday activities). During a record review of Resident 3's Care Plan on self-care, last revised on 4/9/2024, the Care Plan indicated Resident 3 had self-care deficit and was dependent on facility staff on activities of daily living (ADLs - basic tasks that must be accomplished every day for an individual to thrive). The Care Plan Interventions included to assist Resident 3 with ADLs as needed and to provide a safe environment. During a record review of Resident 3's History and Physical (H and P), dated 12/5/2024, the H and P indicated the resident had no capacity to understand and make decisions. During a record review of Resident 3's Minimum Data Set (MDS - a resident assessment tool), dated Page 1 of 4 555686 555686 02/12/2025 Studio City Rehabilitation Center 11429 Ventura Blvd Studio City, CA 91604

F 0584 1/6/2025, the MDS indicated the resident's cognitive skills was severely impaired. Level of Harm - Minimal harm or potential for actual harm During a record review of Resident 4's admission Record, the admission Record indicated the facility admitted the resident on 3/15/2023 with diagnoses including adult failure to thrive, and unspecified dementia, and bipolar disorder (mental illness that causes unusual shifts in a person's mood, energy, activity levels, and concentration) Residents Affected - Some During a record review of Resident 4's H and P, dated 6/13/2024, the H and P indicated the resident had no capacity to understand and make decisions. During a record review of Resident 4's MDS, dated [DATE], the MDS indicated the resident's cognitive skills was severely impaired. The MDS indicated Resident 4 had functional limitation in range of motion (ROM extent of movement of a joint) on both sides of both the upper extremity (shoulder, elbow, wrist, and hand) and the lower extremity (hip, knee, ankle, and foot). During a record review of Resident 4's Care Plan on self-care, last revised on 12/24/2024, the Care Plan indicated Resident 4 had self-care deficit and required maximal assistance (helper lifts or holds trunk or limbs and provides more than half the effort) on the ADLs. The Care Plan Interventions included to assist Resident 4 with ADLs as needed and to provide a safe environment. During a record review of Resident 5's admission Record, the admission Record indicated the facility admitted the resident on 10/17/2019 with diagnoses including type 2 diabetes mellitus (a chronic condition that affects the way the body processes blood sugar [glucose]), unspecified dementia, and seizures (a sudden, uncontrolled burst of electrical activity in the brain) During a record review of Resident 5's H and P, dated 10/24/2023, the H and P indicated the resident had no capacity to understand and make decisions. During a record review of Resident 5's Care Plan on self-care, last revised on 4/29/2024, the Care Plan indicated Resident 5 had self-care deficit and dependent on facility staff on ADLs. The Care Plan Interventions included to assist Resident 5 with ADLs as needed and to provide a safe environment. During a record review of Resident 5's MDS, dated [DATE], the MDS indicated the resident's cognitive skills was severely impaired. During a concurrent observation and interview on 2/12/2025 with the Maintenance Assistant (MA), MA was observed checking the facility temperature using a temperature gun (a hand-held device that measures the temperature of something without touching it) and the following readings were observed: a. At 6:59 a.m., the temperature in the dining room was 70.7°F. b. At 7:01 a.m., the temperature inside Resident room [ROOM NUMBER] (RR 1) was 70.8°F. c. At 7:03 a.m., the temperature at subacute nurse station was 69.8°F. d. At 7:04 a.m., the temperature inside RR 3 was 70.7°F and the temperature inside RR 4 was 69.5°F. 555686 Page 2 of 4 555686 02/12/2025 Studio City Rehabilitation Center 11429 Ventura Blvd Studio City, CA 91604

F 0584 Level of Harm - Minimal harm or potential for actual harm e. At 7:07 a.m., the temperature inside RR 5 was 68.1°F. The hallway in front of RR 5 had a temperature of 63.5°F. RR 6 had a temperature on 60°F. Observed RR 6's window was open. MA stated the windows in the facility should be closed to keep the warm air inside the facility. f. At 7:12 a.m., the temperature inside RR 7 was 61.5°F. Residents Affected - Some g. At 7:19 a.m., the temperature inside RR 8 was 68.8°F. During a follow up interview on 2/12/2025 at 7:33 a.m. with MA, MA stated the facility temperature was cold. MA stated on 2/6/2025, station 2's heater that supplied warm air on RR 6 and RR 7 was not working. MA stated the facility hired an outside company and had the heater fixed on 2/6/2025. During a concurrent observation and interview on 2/12/2025 with Maintenance Supervisor (MS), MS was observed checking the facility temperature using a temperature gun and the following readings were observed: a. At 9:57 a.m., the temperature inside RR 10 was 69°F. b. At 10:03 a.m., the temperature inside RR 6 was 65°F and the temperature in the hallway was 65.5°F. c. At 10:05 a.m., the temperature in station 2 dining room was 64.5°F d. At 10:15 a.m., the temperature at the subacute nurse station was 69.4°F and the temperature in the hallway was 66°F. e. At 10:16 a.m., the temperature inside RR 4 was 67°F and the temperature inside RR 3 was 65.3°F. f. At 10:17 a.m., the temperature inside RR 1 was 67.8°F. g. At 10:18 a.m., the temperature inside RR 2 was 70.8°F. During a follow up interview on 2/12/2025 at 10:19 a.m. with MS, MS stated the facility temperature taken did not meet the required facility temperature of 71°F to 81°F. During an interview on 2/12/2025 at 10:51 a.m. with the Director of Nursing (DON), the DON stated the facility temperature was not within the regulation of 71°F to 81°F. The DON stated facility temperature that were not between 71°F to 81°F had the potential to cause the residents' discomfort. The DON stated the facility failed to ensure the facility temperature was within 71°F to 81°F per the facility's PnP. During a record review of the facility's policy and procedure (PnP) titled, Homelike Environment, last reviewed on 4/17/2024, the PnP indicated residents were provided with a safe, clean, comfortable, and homelike environment and encouraged to use their personal belongings to the extent possible. The PnP indicated the facility staff and management maximizes, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting that included a. clean, sanitary, and orderly environment and h. comfortable and safe temperatures (71°F to 81°F). 555686 Page 3 of 4 555686 02/12/2025 Studio City Rehabilitation Center 11429 Ventura Blvd Studio City, CA 91604

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 2. During a concurrent observation and interview on 2/12/2025 at 7:14 a.m. with Licensed Vocational Nurse 2 (LVN 2), observed towels and a box of gloves on the floor inside shower room [ROOM NUMBER]. Observed one of three shower chairs inside shower room [ROOM NUMBER] with smudges of feces on the shower chair seat. LVN 2 stated shower chairs and equipments used for residents should be cleaned and disinfected after each resident use. LVN 2 stated feces left on the shower chair and towels on the shower room floor was unsanitary and had the potential to cause infection to the residents. LVN 2 stated residents were not provided a home like environment. During a concurrent observation and interview on 2/12/2025 at 7:23 a.m. with MA, observed shower room [ROOM NUMBER] with a disposable brief on the glove box holder. Observed a pack of unused razors on top of the sharp container. MA stated disposable briefs, and the razors should not be left inside the resident shower rooms unattended. MA stated there were bins for designated for sharps, linens and trash. During an interview on 2/12/2025 at 10:51 a.m. with the DON, the DON stated the facility staff did not clean the equipments and the residents' shower rooms after providing resident care. The DON stated shower rooms and equipments not cleaned and disinfected after use meant the facility did not provide a clean and homelike environment for the residents. During a record review of the facility's policy and procedure (PnP) titled, Homelike Environment, last reviewed on 4/17/2024, the PnP indicated residents were provided with a safe, clean, comfortable, and homelike environment and encouraged to use their personal belongings to the extent possible. The PnP indicated the facility staff and management maximizes, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting that included a. clean, sanitary, and orderly environment and h. comfortable and safe temperatures (71°F to 81°F). 555686 Page 4 of 4