Health inspection·June 23, 2025

F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure a copy of the notice of transfer/discharge was provided to the State Long-Term Care Ombudsman (assists with conflict resolution and protection of resident rights) prior to the planned discharge, for three of three sampled residents (Resident 1, 2, and 3). This failure had the potential to violate the resident's rights to appeal their discharge. Findings: On June 2, 2025, at 10:30 a.m., an unannounced visit was conducted at the facility to investigate a complaint on discharges. 1. A review of the admission Record, indicated Resident 1 was admitted to the facility on [DATE], with the diagnoses which included hemiplegia and hemiparesis following Cerebral Infarction (muscle weakness or paralysis to one side of the body), metabolic encephalopathy (brain disorder), and dementia (loss of memory, language, problem solving and thinking abilities). A review of Resident 1's Progress Notes, dated May 13, 2025, at 11:21 a.m., indicated, .spoke with (Resident 1's family member) requesting for resident to discharge home this coming friday . A review of Resident 1's Progress Notes, dated May 16, 2025, at 12:33 p.m., indicated, .DC (discharge) 5/16/25 (May 16, 2025) .to home .with all remaining medications . A review of Resident 1's Notice of Transfer/Discharge, dated May 13, 2025, indicated Resident 1 was provided notification of discharge on [DATE], and discharged from the facility on May 16, 2025. Further review of Resident 1's record indicated there was no documented evidence the Ombudsman's office was provided with the notice of transfer prior to discharge of Resident 1 on May 16, 2025. 2. A review of the admission Record, indicated Resident 2 was admitted to the facility on [DATE], with diagnosis of Acute osteomyelitis of left ankle and foot (an infection of the bone in that area caused by bacteria). A review of Resident 2's Progress Notes, dated May 14, 2025, at 7:09 p.m., indicated, .spoke with (name of family member) and resident discussed discharge ordered .informed writer that (family member) will pick up at 11 am (a.m.) on Friday (May 16, 2025) . (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: 555915 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 555915 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Springs Health and Rehabilitation Center 25924 Jackson Ave Murrieta, CA 92563 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)