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Encino Hospital Medical Center D/P SNF

16237 Ventura Blvd, Encino, CA 91436 · For profit - Corporation · 28 certified beds · (818) 995-5141 Medicare & Medicaid certified

Call the home — (818) 995-5141 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse-prevention, restraint, or reporting citations — no harm found (F0609, F0610) — most recent Dec 2024
Insights

On the public record, this home looks stronger than most — but visit before you decide.

In its favor
  • a strong health-inspection score (5/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
  • no federal fines or payment denials on record
  • a high payroll-based staffing rating (4/5)
  • lower-than-typical staff turnover (33% vs 45% nationally) — better care continuity
Worth asking about
  • it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609, F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • a high number of inspection citations overall (24) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags

One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.

A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.

5/5
CMS overall
5 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 5 of 5
StaffingFrom payroll records (PBJ) 4 of 5
Quality measuresSelf-reported by the facility 5 of 5

Location & what’s nearby

Hospital
★★★ 3/5 CMS
Urgent care / clinic
16311 Ventura Blvd · (818) 579-7410 · Call to confirm hours
Pharmacy
16311 Ventura Blvd · (818) 783-0422 · Call to confirm hours
Grocery
Ralphs<0.1 mi
16325 Ventura Blvd · (818) 728-4515 · Call to confirm hours
Park
4967 Libbit Ave · (818) 756-7667 · Typically dawn to dusk
Place of worship
4915 Hayvenhurst Ave · (818) 784-9986

Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Overall quality measures 5 of 5
Long-stay residentspeople who live here 5 of 5

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 2 to 4 stars. From monthly CMS archive snapshots.

Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.

Overall rating4★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents who lose too much weight1.0%4.0%5.4%better
Long-stay residents with a catheter left in their bladder12.5%0.8%0.9%worse
Long-stay residents with a urinary tract infection7.3%1.2%2.0%worse
Long-stay residents with depressive symptoms0.0%7.3%6.5%check this — see note marked star below the table
Long-stay residents who were physically restrained0.0%0.4%0.1%better than state — see note marked double-dagger below the table
Long-stay residents with falls causing major injury0.0%1.6%3.3%check this — see note marked star below the table
Long-stay residents on antianxiety or hypnotic medication17.7%13.7%18.9%typical
Long-stay residents given the seasonal flu vaccine100.0%98.2%95.3%typical
Long-stay residents with pressure ulcers3.2%4.3%4.7%better
Long-stay residents with worsening bladder/bowel control2.6%10.2%21.2%better than state — see note marked double-dagger below the table
Long-stay residents who got an antipsychotic medication — see the note below the table1.5%12.0%17.1%better

* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.

On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.

§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.

CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

0.06U.S. median 0.31
Therapy hours / resident / day
0.03hours / resident / day
Physical therapy
0.02hours / resident / day
Occupational therapy
0.01hours / resident / day
Speech therapy

Therapy staffing: this home’s payroll records show 0.06 therapist hours per resident per day in 2026Q1 — more than 3% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 15% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNFnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNFnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at dischargenot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at dischargenot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at dischargenot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identifiednot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care settingnot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final dischargenot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF staynot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsenednot reported — The data for this measure is missing or was not submitted. Call the facility to discuss this quality measure.
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalizationnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFsnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.

Staffing

2.18
RN hours/ resident / day
2.06
LPN hours/ resident / day
3.39
Aide hours/ resident / day
7.62
Total nurse hours/ resident / day
2.49
RN hoursweekends
32.7%
Total nursing turnover
7.7%
RN turnover

How full it usually is: this home is certified for 28 beds and averages 23.9 residents a day — about 85% occupied, or roughly 4 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 7.62 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 2.18 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 3.39 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 7.03 hrs/resident/day on weekends vs 7.87 on weekdays — 11% thinner on weekends. RN hours go from 2.05 to 2.49 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 33% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

4
deficiencies at the latest standard inspection (2025-12-04)
5
at the previous standard inspection (2024-12-04)

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

ABCDEFGHIJKL

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

24 citations, most serious first. The 10 most serious are shown; the remaining 14 are one tap away and print in full.

  • Potential for harm · Ecited before2025-12-04 · tag F0812 — failed to store, cook, and serve food safely — pattern
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review, the facility failed to ensure safe and sanitary food storage and food preparation practices in the kitchen when: a. A plastic scoop was left in a food bin, in the dry storage area, during the initial kitchen tour. b. The facility failed to ensure food was labeled with a date, stored correctly and disposed of upon expiration. These failures had the potential to result in harmful bacteria growth and cross contamination (a transfer of harmful bacteria from one place to another or one object to another) that could lead to foodborne illness (illness caused by food contaminated with bacteria, viruses, and other toxins) in three of three medically compromised residents who received food from the kitchen. Findings: a. During an initial kitchen tour observation on 12/1/2025 at 9:16 am in the dry storage area, a plastic scoop was left in a large bin labeled flour. The bin contained white powdery material, and the scoop was covered in that white powdery material. During a concurrent observation and interview on 12/1/2025 at 9:19 am with the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-12-04 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review the facility failed to ensure residents who were incontinent (lacks voluntary control over urination) of bladder (organ in the pelvis that stores urine) received appropriate treatment and services to prevent urinary tract infections (UTI, common infections that happen when bacteria infect the urinary tract) by failing to ensure the urinary catheter (a thin flexible tube that is inserted into the bladder to help drain urine) collection bag tubing was not looped or coiled to allow the urine to flow freely into the collection bag for two of two residents (Resident 1 and Resident 12) reviewed under the urinary catheter care area.This failure had the potential to result in the backflow of urine into the residents' bladders, which can cause urinary tract infections (UTI- an infection in the bladder/urinary tract). Findings: a. During a review of Resident 12's admission Record, the admission Record indicated, the facility initially admitted Resident 12 to the facility on 6/1/2008 and readmitted the resident on 9/30/2025. The admission…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-12-04 · tag F0693 — failed to provide proper feeding-tube care — isolated
    Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to provide appropriate treatment and services to prevent complications of enteral feeding (EF - a form of nutrition that is delivered through a tube in the stomach) by failing to indicate with a label, the date and time the enteral feeding tubing was started for one of one sampled resident (Resident 18) investigated under the tube feeding care area. This deficient practice had the potential for administering expired enteral feeding which could place Resident 18 at risk for complications such as diarrhea (loose, watery stool) or vomiting leading to dehydration (loss or removal of water). Findings: During a review of Resident 18's Admission/Registration Record printed on [DATE], the Admission/Registration Record indicated the facility admitted Resident 18 on [DATE]. During a review of Resident 18's History and Physical (H&P) dated [DATE], the H&P indicated Resident 18's diagnoses included hypoxic brain injury (damage to the brain from not…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-12-04 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure the facility's kitchen ice machine Daily Scoop Sanitizer log was completed daily to indicate the ice scooper was sanitized daily. This failure had the potential to result in cross contamination (the process by which bacteria or other microorganisms are unintentionally transferred from one substance or object to another) of harmful bacteria that could contaminate the ice and cause foodborne illness (an illness caused by food contaminated with bacteria, viruses, and other toxins) in three of three medically compromised and vulnerable residents who received food from the kitchen. Findings: During a concurrent interview and record review on 12/3/2025 at 11:00 AM with the Director of Food and Nutrition (DFN), the facility kitchen ice machine Daily Scoop Sanitizer Log, dated 12/2025, was reviewed. The log indicated, the sanitization of the ice machine scoop was not documented on 12/2/2025 and on 9/7/2025. The DFN stated the log is to be completed daily at the end of the day by the night shift. The DFN stated the night…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-20 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to report an alleged incident of physical abuse involving one of one sampled resident (Resident 1) to the long-term care ombudsman (a person who investigates, reports on, and helps settle complaints) office, the local law enforcement agency, and the Department of Health Services in accordance with State law and the facility ' s policy and procedures, within but not later than two hours of the alleged involved incident. This deficient practice resulted in the California Department of Public Health (CDPH) being unaware of this alleged abuse incident and potential injury to Resident 1, which could then had the potential for a delay in CDPH ' s investigation and other abuse allegations to go unreported at the same facility. Findings: During a review of Resident 1 ' s admission Record (known as Face Sheet) dated 01/01/2024, the face sheet indicated that Resident 1 was admitted to the facility on [DATE] with a diagnose of respiratory failure (a serious medical…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-12-20 · tag F0610 — failed to investigate and act on abuse reports — isolated
    Respond appropriately to all alleged violations.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to conduct a timely and thorough investigation for one of one sampled residents (Resident 1) when a Certified Nurse Assistant 1 (CNA) allegedly pulled Resident 1 ' s wheelchair from Resident 1 therefore causing Resident 1 ' s to suffer a fall from the wheelchair on 10/14/2024 at 9:00 p.m. On 10/15/2024, Resident 1 was noted to have a purple bruise on her left buttock and Resident 1 reported body pain 3/10. This deficient practice had the potential to result in unidentified abuse affecting Resident 1 and therefore, the facility failure to conduct a thoroughly investigation of the alleged violation. Findings: During a review of Resident 1 ' s admission Record (Face Sheet), dated 01/01/2024, the face sheet indicated that Resident 1 was admitted to the facility on [DATE] with a diagnose of respiratory failure (a serious medical condition that makes it difficult to breath on your own). The admission records also indicated that Resident 1 is receiving services…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-04 · tag F0550 — failed to protect resident dignity and rights — isolated
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review, the facility failed to: 1. Ensure Certified Nursing Assistant 2 (CNA 2) was not standing over a resident while feeding the resident for one (Resident 9) out of two sampled residents investigated for the care area of dignity. This deficient practice violated the resident`s rights to be treated with respect and dignity which had the potential to affect the resident`s sense of self-worth and self-esteem. 2. Based on interview and record review, the facility failed to ensure a facility staff knocked and asked permission prior to entering a resident`s room for one of one resident (Resident 19) investigated under Resident Rights. This deficient practice violated the resident`s rights to be treated with respect and dignity which had the potential to affect the resident`s sense of self-worth and self-esteem. Findings: 1. During a review of Resident 9's Face Sheet, the Face Sheet indicated the facility admitted the resident on 2/5/2016 with diagnoses including multiple cerebrovascular accidents (CVA - stroke, loss of blood flow to a part of…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-04 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to implement its abuse prohibition policy by failing to report immediately, but no later than two hours after the allegation was made, an allegation of staff to resident abuse (the willful infliction of injury with resulting physical harm, pain, or mental anguish) to the State Survey Agency (California Department of Public Health), ombudsman, and local law enforcement for one of three sampled residents (Resident 8). This deficient practice had the potential to result in a delay of an onsite investigation of abuse. Findings: During a review of Resident 8's History and Physical (H&P), dated 1/1/2024, the H&P indicated Resident 8 was admitted to the facility in December 2008 with diagnoses including but not limited to encephalitis (inflammation of the brain), cerebrovascular accident (CVA-stroke, loss of blood flow to a part of the brain), and ventilator (a medical device to help support or replace breathing) dependent respiratory failure. During a review of Resident 8's Minimum Data Set (MDS - a resident assessment tool), the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-12-04 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure Certified Nursing Assistant 1 (CNA 1) did not transfer a resident from the wheelchair to the bed using a mechanical lift (a device used to assist with transfers and movement) without assistance from another staff for one of one sampled resident investigated under the accident care area (Resident 14). This deficient practice had the potential for the resident to sustain a serious injury in the event of a fall incident. Findings: During a review of Resident 14's Face Sheet, the Face Sheet indicated that the facility admitted the resident on 9/09/2024 with diagnoses that included encephalopathy (a general term for a brain disorder or disease that can be caused by a number of things, including injury, disease, drugs, or chemicals) and respiratory failure (a serious condition that occurs when the lungs have difficulty getting enough oxygen into the blood, or when there is too much carbon dioxide in the blood). During a review of Resident 14's Minimum Data Set (MDS - a federally mandated resident assessment…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-04 · tag F0812 — failed to store, cook, and serve food safely — isolated
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to follow safe food handling practices by failing to ensure: 1. Food stored in the resident unit refrigerator was labeled with the resident`s name, room number, date of preparation and discarded after two days. 2. The refrigerator in the resident's unit has a thermometer. These deficient practices had placed two of two residents (Resident 9 and 21) at risk for foodborne illnesses (an infection or irritation of the gastrointestinal tract [including the stomach and intestines] caused by food or beverages that contain harmful bacteria/germs, chemicals, or other organisms) with common symptoms such as nausea, vomiting, stomach cramps, and diarrhea. Findings: 1. During a review of Resident 9's History and Physical (H&P), the H&P indicated the facility admitted the resident on 2/5/2016 with history of respiratory failure and cerebrovacular accident (CVA-medical conditon that occurs when blood flow to the brain is suddenly interrupted). During a…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
Show the remaining 14 citations
  • Potential for harm · Dcited before2024-12-04 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review, the facility failed to ensure Certified Nursing Assistant 1 (CNA 1) performed hand hygiene (the practice of cleaning your hands to prevent the spread of disease and infection) after doffing (to take off) her gown, touching a soiled linen cart, and leaving a resident's room for one (Resident 9) out of six sampled residents investigated under the care area of infection control. This deficient practice had the potential to place residents at increased risk of contracting an infection. Findings: During a review of Resident 9's Face Sheet (front page of the chart that contains a summary of basic information about the resident), the Face Sheet indicated the facility admitted the resident on 2/5/2016 with diagnoses including multiple cerebrovascular accidents (CVA - stroke, loss of blood flow to a part of the brain), bilateral (both sides) lower extremity paraplegia (loss of movement and/or sensation, to some degree, of the legs), and right upper extremity paralysis (loss of muscle function). During a review of Resident 9's Minimum Data…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-10-11 · tag F0583 — failed to protect personal privacy — isolated
    Keep residents' personal and medical records private and confidential.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure staff protect and maintain residents privacy and confidentiality for one of two sampled residents (Resident 2) when a Charge Nurse (CN) 2 released Resident 2's medical information to Resident 1's family member (FM 1). This deficient practice resulted in Resident 2's medical information released to other people who do not have the rights to know about. Findings: During a review of Resident 2's History and Physical (H&P, a formal and complete assessment of the patient and the problem), dated 1/1/2024, the H&P indicated, Resident 2 was admitted to the facility with diagnoses including but not limited to chronic respiratory failure (condition in which not enough oxygen passes from the lungs into the blood), ventilator dependent (a medical device to help support or replace breathing), dysphagia (difficulty swallowing), and status post gastrotomy (an artificial external opening into the stomach for nutritional and medication administration) tube…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-03-19 · tag F0573 — isolated
    Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to support one resident's (Resident 1) right to access personal and medical records (all records maintained for the purposes of patient treatment, including reports, notes, orders, diagnoses, treatments, test results, photographs, medical images, and more); failed to provide Resident 1's and/or Resident 1's representative (RR, an individual who is authorized either by a patient or a State law, to make health care treatment decisions for the patient when the patient is unable to do so) access to the personal and medical records within 24 hours of a written request; failed to follow up and mail to the requestor (Resident 1's representative) a written statement explaining the delay and setting forth the date by which the facility will provide records or a response. This deficient practice had the potential to violate Resident 1's rights to obtain copies of the protected health information as per federal regulation and the facility's policy and procedure.…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-03-19 · tag F0585 — failed to handle grievances — isolated
    Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to make information available on how to file a grievance (an official statement of a complaint over something believed to be wrong or unfair) for one resident (Resident 1) and/or resident's representative (s) (RR). This failure resulted in violation of Resident 1's and/or Resident 1's representative to receive information on how to file a complaint in accordance with the Patient Rights and Responsibilities and the facility's policy and procedure. Findings: During a review of Resident 1's History and Physical ( H&P, a through medical examination conducted upon admission to the facility), dated 4/29/2023, the H&P indicated, Resident 1 was admitted on [DATE] with past medical history (PMH, a record of information about a person's health) of hypertension (HTN, when the pressure in the blood vessels is above defined normal parameters) and traumatic brain injury (TBI) with right (R) subdural hematoma (SDH, a type of bleeding near your brain that…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-01-30 · tag F0551 — isolated
    Give the resident's representative the ability to exercise the resident's rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interviews and record review, the facility failed to ensure residents' rights were honored when the facility limited Resident 1's legal representative's visitation to one hour a day. This failure had violated Resident 1's visitation rights by not honoring exercising the resident's rights to designate visitors of his/her choosing. Findings: During a review of Resident 1's History and Physical (H&P), dated 09/26/2019, the H&P indicated, Resident 1 was admitted to the facility for continued tracheostomy (a surgically created hole in the windpipe (trachea) that provides an alternative airway for breathing) care, anti-aspiration ( to avoid food or fluids getting into the airway) measures, and pulmonary toilet ( exercises and procedures that help to clear the airways of mucus and other secretions). During a review of Resident 1's physician's progress note (PPN), dated 1/29/2024, the PPN indicated, Resident 1 had past medical history including, but not limited to. respiratory failure (a condition when blood does not have enough oxygen or too much carbon dioxide), severe…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2024-01-07 · tag F0761 — failed to label and store drugs safely — pattern
    Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
    What the surveyor found here — an excerpt from the official record, may be distressing

    3. A review of Resident 1's Admission/Registration Record, dated 1/1/2024, indicated the facility admitted the resident with a diagnosis of respiratory failure (a serious condition that occurs when the lungs cannot get enough oxygen). A review of Resident 1's Minimum Data Set (MDS- as assessment and care screening tool) dated 12/8/2024, indicated the facility admitted the resident on 7/13/2000. The MDS indicated the resident was in a persistent vegetative state (a chronic condition with absence of responsiveness and awareness due to overwhelming dysfunction of the brain) with no discernible consciousness (no evidence of awareness of self or environment). The MDS indicated the resident was dependent on staff for dressing, eating, toilet use, and personal hygiene. A review of Resident 1's Care Plan titled, At Risk for Injury Due to Seizure Disorder, initiated 12/29/2023, indicated interventions of medication as ordered and monitor drug levels as ordered. A review of Resident 1's Physician Orders indicated an order to decrease Dilantin (phenytoin) to 150 milligrams (mg, a unit of…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2024-01-07 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY 3. A review of Resident 18's Admission/Registration form, dated 1/1/2024, indicated the facility admitted the resident with a diagnosis of respiratory failure. A review of Resident 18's MDS dated [DATE], indicated the facility admitted the resident on 8/21/2018. The MDS indicated the resident sometimes had the ability to understand others and was rarely/never understood. The MDS indicated the resident was totally dependent on staff for bed mobility, dressing, toilet use, and personal hygiene. A review of Resident 18's Physician Orders, dated 9/25/2023, indicated an order for contact isolation for multidrug-resistant organisms (MDRO, bacteria that have become resistant to certain antibiotics) and carbapenem resistant pseudomonas aeruginosa (CRPA, a group of bacteria that have developed resistance to antibiotics and are a serious cause of healthcare associated infections) of sputum (type of thick mucus produced by the lungs). During an observation on 1/6/2024 at 10:15 a.m., observed Resident 18 lying in bed with a…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-01-07 · tag F0550 — failed to protect resident dignity and rights — isolated
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to ensure residents' right to a dignified existence by failing to: 1. Ensure an indwelling urinary catheter (a flexible tube inserted into the bladder and left in place to continuously drain urine) collection bag (attached to the catheter tube for the purpose of collecting urine) was covered with a privacy bag (dignity bag- a bag that conceals urine in the collection bag) for one of two sampled residents (Resident 3) investigated under the Dignity care area. This deficient practice had the potential to affect Resident 3's dignity and privacy. 2. Ensure Licensed Vocational Nurse 2 (LVN 2) knocked on a resident's door before entering the room for one of two sampled residents (Resident 25) investigated for dignity. This deficient practice had the potential to affect the resident's sense of self-worth and self-esteem. Findings: 1. A review of Resident 3's Admission/Registration form, dated 1/1/2024, indicated the facility admitted with the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-01-07 · tag F0552 — isolated
    Ensure that residents are fully informed and understand their health status, care and treatments.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to promote the resident's right to be informed of and participate in their treatment for one of two sampled residents (Resident 5) by failing to obtain consent and inform the resident or responsible party in advance of the risks and benefits of the psychoactive (affecting the mind or behavior) medication sertraline (used to treat certain mental/mood disorders such as depression [(mood disorder that causes a persistent feeling of sadness and loss of interest]). This deficient practice violated Resident 5's and/or their responsible party's right to make an informed decision regarding the use of a psychoactive medication. Findings: A review of Resident 5's Admission/Registration form, dated 1/1/2024, indicated the facility admitted with the resident with a diagnosis of respiratory failure (a serious condition that occurs when the lungs cannot get enough oxygen). A review of Resident 5's Minimum Data Set (MDS- as assessment and care screening tool) dated 10/26/23, indicated the facility admitted the resident on 9/3/2004. The MDS…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-01-07 · tag F0684 — failed to provide proper treatment and quality of care — isolated
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review the facility failed to provide professional standards of care to residents receiving care for deep vein thrombosis (DVT, a blood clot [gel-like clump of blood] that develops in one of the large veins in the body) prophylaxis (prevention) for one of six sampled residents (Resident 7) investigated for Position/Mobility by failing to clarify the physician's order for sequential compression device (SCDs, a machine that intermittently pumps air into sleeves wrapped around the lower legs in order to increase blood flow and prevent DVTs) and apply the SCDs. This deficient practice had the potential to result in a DVT for Resident 7. Findings: A review of Resident 7's Admission/Registration Record dated 1/1/2024, indicated the facility admitted the resident with a diagnosis of respiratory failure (a serious condition that occurs when the lungs cannot get enough oxygen). A review of Resident 7's Minimum Data Set (MDS- as assessment and care screening tool) dated 11/15/2023, indicated the facility admitted the resident on 1/23/2007. The MDS…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-01-07 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure licensed nursing staff completed documentation indicating reconciliation (a system of recordkeeping that ensures an accurate inventory of medications by accounting for controlled medications that have been received, dispensed, and administered) of controlled medications (substances that have an accepted medical use, have a potential for abuse, and may also lead to physical or psychological [related to the mental and emotional state of a person] dependence) for two of 37 shift opportunities investigated during the Medication Storage task. This deficient practice had the potential for inaccurate reconciliation of controlled medications and placed the facility at potential for inability to readily identify loss and drug diversion (illegal distribution of abuse of prescription drugs or their use for unintended purposes) of controlled medications. Findings: During an inspection of Medication Cart 1 and concurrent interview and record review on 1/7/2024 at 8:11 a.m., with Registered Nurse 2 (RN 2), reviewed the Narcotic…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-01-07 · tag F0812 — failed to store, cook, and serve food safely — isolated
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review, the facility failed to follow proper food handling practices by failing to ensure frozen poultry was dated while thawing in the refrigerator. This deficient practice had the potential to place two out of 27 residents living in the facility at risk for foodborne illnesses (refers to illness caused by the ingestion of contaminated food or beverages). Findings: During an observation of the facility's kitchen and concurrent interview on 1/6/2024 at 8:45 a.m., with the Dietary Clerk (DC), observed in Refrigerator 3 a transparent Ziploc (a brand of reusable, re-sealable sliding channel storage bags) bag containing four pieces of chicken breast placed in the bottom rack. Upon closer inspection, the DC confirmed by stating that there was no date on the bag to indicate when the poultry was placed in the refrigerator to be thawed. The DC stated that there should be a date labeled when any meat item is taken out from the freezer to be thawed in the refrigerator. The DC stated that the thawing date was important to guide the staff to know when…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-01-07 · tag F0883 — failed to offer flu and pneumonia vaccines — isolated
    Develop and implement policies and procedures for flu and pneumonia vaccinations.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure there was documented evidence that the pneumococcal vaccines (medications used to prevent lung infections caused by streptococcus pneumoniae [a type of bacteria]) was offered and residents and/or their representatives were educated about the risk and benefits of the vaccines for two of five sampled residents (Resident 3 and 7). This deficient practice placed Resident 3 and 7 at a higher risk of acquiring and developing complications from pneumonia. Findings: a. A review of Resident 3's Admission/Registration Record, dated 1/1/2024, indicated the facility admitted the resident with a diagnosis of respiratory failure (a serious condition that occurs when the lungs cannot get enough oxygen). A review of Resident 3's Minimum Data Set (MDS- as assessment and care screening tool) dated 8/15/2023, indicated the facility admitted the resident on 9/14/2004. The MDS indicated the resident was in a persistent vegetative state (a chronic condition with…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-09-29 · tag F0551 — isolated
    Give the resident's representative the ability to exercise the resident's rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to protect and promote the interest and safety for one of one sampled resident (Resident 1). This failure resulted in a violation of Resident 1's rights and had the potential to negatively affect Resident 1's health outcomes and wellbeing. Findings: During a review of Resident 1's History and Physical (H&P), dated 09/26/2019, the H&P indicated, Resident 1 was admitted to the facility for continued tracheostomy (a surgically created hole in the windpipe (trachea) that provides an alternative airway for breathing) care, anti-aspiration (to avoid food or fluids getting into the airway) measures, and pulmonary toilet (exercises and procedures that help to clear the airways of mucus and other secretions). During a review of Resident 1's progress note (PN), dated 09/10/2023, the PN indicated, Resident 1 had past medical history including but not limited to respiratory failure (a condition when blood does not have enough oxygen or too much carbon dioxide),…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
  • Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
  • State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to PRIME HEALTHCARE — 6 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

RatingThis homeChain avg
Overall 5 of 53.5+1.5 vs chain
Health inspection 5 of 53.5+1.5 vs chain
Staffing 4 of 53.0+1.0 vs chain
Quality measures 5 of 54.0+1.0 vs chain
The other 5 homes this chain runs (chain average 3.5★, per CMS)

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

Owner / managerTypeRoleShareSince
PRIME HEALTHCARE SERVICES - ENCINO LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST100%since 06/01/2008
PRIME HEALTHCARE FOUNDATION INCOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST100%since 01/01/2010
GARCIA, EMIndividualW-2 MANAGING EMPLOYEE; CORPORATE DIRECTOR; CORPORATE OFFICERsince 01/01/2013
BHATIA, SUNDEEPIndividualCORPORATE DIRECTORsince 01/01/2013
DOAN, CHRISTOPHERIndividualCORPORATE OFFICERsince 11/01/2019

CMS files one row per role, so the 7 rows in the source record cover these 5 parties — each is shown once here with every role it holds. Nothing is omitted.

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

What families pay in CA

Paying with Medicaid

This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the California Medicaid page.

Typical monthly cost in California
$12,167/mo
Nursing home (semi-private)
$15,178/mo
Nursing home (private)
$7,000/mo
Assisted living

Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.

Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 555380. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-12-04, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →

Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →

Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.

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