Health inspection·July 16, 2024

F 0626 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to permit Resident 1 to return back to Skilled Nursing Facility 1 (SNF 1) from a general acute care hospital (GACH) for one of three sampled residents (Resident 1). As a resulted, GACH transferred Resident 1 to SNF 2 which was not the resident's preference. Findings: A review of Resident 1's admission record indicated Resident 1 was admitted to SNF 1 on 6/7/2024, with a diagnosis but not limited to anxiety disorder (a condition in which a person has excessive worry and feelings of fear, dread, and uneasiness), unspecified asthma (chronic lung disease that causes the bronchial airways in the lungs to narrow and swell, making it difficult to breathe). A review of Resident 1's History and Physical dated 6/10/2024, indicate Resident 1 had the capacity to make medical decisions. A review of Resident 1's Minimum Data Set (MDS- a standardized assessment and care screening tool) dated 6/11/2024, indicated Resident 1 had moderately impaired cognitive (mental ability to make decisions) skills for daily living. During an interview on 7-16-2024 at 8:54 am, the Admissions Director (AD) stated AD never told SNF 1 Administrator or the Director of Nursing (DON) that AD spoke with the Case Manager at the GACH regarding Resident 1 not wanting to return back to SNF 1. The AD stated AD never received a call from any of the GACH's Case Managers or Discharge Planners regarding readmitting Resident 1 back to SNF 1. The AD stated the administrator told AD the resident did not want to return back to SNF 1. During an interview on 7-16-2024 at 10:10 am, the Administrator stated there was no documentation in the nurse's progress notes, Situation Background Assessment Recommendation (SBAR), Change of Condition (COC) or transfer sheet indicating that Resident 1 stated he did not want to return back to the facility. During a concurrent record review with the Administrator of the facility census a new Resident 4 was admitted to the facility on [DATE] and placed in Resident 1's room and bed. The Administrator stated she never heard Resident 1 say that the resident did not want to return to SNF 1. The Administrator stated SNF1's AD spoke with a Case Manager (unable to recall the name) at the GACH that the case manager informed the AD that Resident 1 did not want to return back to SNF 1. The Administrator stated the AD told the Administrator that Resident 1 did not want to return back to SNF 1. The Administrator stated she should have discussed with Resident 1 regarding the resident's wishes to (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: 555786 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 555786 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ocean Park Healthcare 2828 Pico Boulevard Santa Monica, CA 90405 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)