Health inspection·May 15, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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 sound levels in the facility were at adequate levels to ensure two of five sampled Residents (4 and 5) were not disturbed by loud music or television levels. This deficient practice had the potential for the inability of residents to rest or sleep. Findings: During a tour of the subacute unit, on 5/15/2023 at 10:50 am, loud music was heard in the hallway coming from Resident 1 & Resident 2's room. Resident 1 was in the restroom, sitting on a motorized wheelchair, grooming himself. Resident 2 was in bed, non-verbal, in no apparent distress. The music could be heard across the hallway, all the way to the back of Resident 3's room. Resident 3 was awake, in bed, non-verbal, in no apparent distress. During an interview, on 5/15/2023 at 11:05 am, Resident 1 stated the following. The music does not bother Resident 2. There have been times when other Resident's family or visitors have asked him to lower down the music and he complies. During an interview, on 5/15/2023 at 11:25 am, a visitor (Visitor 1) stated the following. Visitor 1 visits Resident 4 almost every day. Visitor 1 arrives to the facility at 7 am and leaves at 2 pm. There are times when the music could be heard in Resident 4's room. Sometimes the music is too loud and Visitor 1 has asked Resident 1 to lower the music and Resident 1 complies. At times, the music is so loud that it can be heard by Resident 4 family members when on Facetime (a video call) through the iPad (a tablet). She (Visitor 1) feels bed for other residents who cannot speak for themselves and must endure the loud music. During a tour of the facility, on 5/15/2023 at 11:50 am, the following was observed in Resident 5, 6, and 7's room. Resident 5's bed was empty. Resident 6 was sleeping in bed, the television (TV) was on, and the call light was next to Resident 6's next to his ear. The sound of the TV was coming from the speaker on the Resident 6's call light. The sound was low but could be heard at the doorway and in the rest of the room, including Resident 5's and Resident 7's area. During an observation and interview, on 5/15/2023 at 11:53 am, with Resident 7, Resident 7 was awake, in bed, and non-verbal. Resident 7 was able to answer questions in Spanish by nodding or shaking his head and using hand gestures with his left hand. Resident 7 was asked if he could hear the TV, Resident 7 nodded his head, indicating yes. Resident 7 was asked if the TV was on all day, Resident 7 Page 1 of 3 555848 555848 05/15/2023 Providence Little Comp of Mary Subacute Care Ctr 1322 West Sixth Street San Pedro, CA 90732

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few nodded his head, indicating yes. Resident 7 was asked if the TV was loud at night, Resident 7 nodded his head, indicating yes. Resident 7 was asked if the sound bothered him, Resident 1 nodded his head, indicating no. During an observation and interview, on 5/15/2023 at 12:01 pm, Resident 5 was sitting on a wheelchair in the hallway and looking at an iPad. Resident 5 was non-verbal but able to answer questions in Spanish, by nodding or shaking his head. Resident 5 was asked of the TV in his room was on all day, Resident 5 nodded his head, indicating yes. Resident 5 was asked if the TV was still on at midnight, Resident 1 nodded his head, indicating yes. Resident 5 was asked if the TV was still on at 1 am, Resident 5 shook his head, indicating no. Resident 5 was asked if the volume was too loud at night, Resident 5 nodded his head, indicating yes. Resident 5 was asked if he was able to sleep at night while the TV was on, Resident 5 shook his head, indicating no. During an interview, on 5/15/2023 at 12:06 pm, the Nurse Director (ND) and the Nurse Manager (NM) stated the facility did not have a policy or procedure for loud levels. The ND and NM stated they would try to lower down the volume of the TV at night to ensure the sound was at comfortable levels for everyone. During an interview, on 5/15/2023 at 1 pm, the social worker (SW) stated the following. He (SW) had received complaints that Resident 5 was not able to sleep at night because Resident 6's TV was too loud. Resident 6 liked to watch a show on TV starting at 11:30 pm and ending at 12:30 am. The TV was turned off at 12:30 am. The SW was in the process of trying to resolve the issue and was waiting for family for Resident 6 to provide headphones. The SW stated he would follow up with Resident 6's family regarding the headphones. The SW stated Residents should be considerate towards others. A review of Resident 1's medical record indicated Resident 1 was admitted to the facility on [DATE] with an admitting diagnosis of acute and chronic respiratory failure (a serious condition that makes it difficult to breath on your own) and status post tracheostomy (a surgical opening through the neck into the windpipe to allow air to fill the lungs). A review of Resident 1's Minimum Data Set (MDS, a resident assessment tool) indicated Resident 1's BIMS (Brief Interview for Mental Status) score was 15, indicating Resident 1 was interviewable. A review of Resident 4's medical record indicated Resident 4 was admitted to the facility on [DATE] for respiratory failure and had a tracheostomy in place. A review of Resident 4's MDS, indicated Resident 4 was rarely or never able to understand or make himself understood. A review of Resident 5 medical record indicated Resident 5 was admitted to the facility on [DATE] with an admitting diagnosis of sepsis (the body's overwhelming and life-threatening response to an infection that can lead to tissue damage, organ failure, or death). Resident 5 had a tracheostomy in place. A review of Resident 5's dated 4/27/2023, indicated Resident 1 was sometimes able to make himself understood and sometimes able to understand others. A review of Resident 7's medical record indicated Resident 7 was admitted to the facility on [DATE] for respiratory failure. Resident 7 had a tracheostomy in place. 555848 Page 2 of 3 555848 05/15/2023 Providence Little Comp of Mary Subacute Care Ctr 1322 West Sixth Street San Pedro, CA 90732

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few A review of Resident 7's MDS, dated [DATE], indicated Resident 7 was able to sometimes understand and sometimes understood others. A review of the facility's policy and procedure titled, Resident Rights, dated 9/2023, indicated Resident Rights shall include, but are not limited to ensure that each resident's quality of life is maintained or improved by treating them with respect and dignity, and providing care that takes into account their unique characteristics. 555848 Page 3 of 3