Health inspection·March 13, 2025

F 0635 Provide doctor's orders for the resident's immediate care at the time the resident was admitted. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure the licensed staff verified Resident 1 ' s admission orders from the facility, by reviewing Resident 1 ' s medical history and general acute care hospital (GACH 1) discharge orders upon readmission to the facility on 3/12/2025, for one of two sampled residents (Resident 1), when it failed to: Residents Affected - Few As a result of this deficient practice, Resident 1 had the potential to not receive the care and services, and correct medications needed for the resident ' s diagnosis while in the facility. Findings: During a review of facility ' s admission Record indicated Resident 1 was initially admitted on [DATE] but readmitted back to the facility from GACH 1 on 3/12/2025, with diagnoses that included Schizophrenia (a disorder that affects a person ability to think, feel and behave clearly), Bipolar disorder (A disorder associated with episodes of mood swings ranging from depressive lows to manic highs). During a review of Resident 1 ' s History and Physical (H&P), dated 2/23/2025, indicated the resident 1 did not have the capacity to understand and make decisions. During a review of Resident 1 ' s GACH 1 Patient ' s Home Medication on Discharge dated 3/12/2025 indicated continue taking the following medications 1.Quetapine (a medication used for Schizophrenia) 150 milligrams oral tablet 1 tab orally 2 times a day During a review of Resident 1 ' s GACH 1 Telemetry-Clinical Summary Report dated 3/11/2025 indicated the following medication: 1. Quetiapine give 100 milligrams tablet oral at bedtime, the report indicated the status as active. During a review of a facility document titled Order Summary report dated March 13,2025, indicated an order for the following medication: 1. Seroquel (Quetiapine) oral tablet 100 milligrams, give 1 tablet by mouth at bedtime for Schizophrenia manifested by paranoid delusion thinking everyone is against him. (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: 555897 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 555897 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Monterey Healthcare & Wellness Centre, LP 1267 San Gabriel Blvd Rosemead, CA 91770 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)