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Shasta Healthcare: Stage 4 Bedsore Patient Left Untreated - CA
Resident 1's family arrived at 11:00 a.m....
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Resident 1's family arrived at 11:00 a.m....
The incident at Infinity Care of East Los Angeles exposed gaps between the facility's written policies and actual practice when responding to potential falls....
Instead of her prescribed medications, the nurse provided blister packs containing drugs intended for two different patients....
Administrator V1 confirmed to inspectors on September 12 that no registered nurse worked in the facility on September 6....
The incident at Kennedy Care Center involved a cognitively impaired resident who requires maximum assistance with daily activities like bathing and dressing....
The facility's own policy required monthly notifications to the state ombudsman's office....
The facility operates with roughly half its required nursing staff, administrators admitted during a September complaint investigation....
Posted signs throughout the facility still displayed contact information for the former abuse coordinator, who had been terminated August 19....
The September inspection revealed far more than flying pests....
Resident 102 was admitted to the 98-bed facility on August 8, 2025, and discharged home on September 11 at their own request....
Hospital records from September 5th and 8th documented the facility's repeated denials....
The practice violated the facility's own policies and put vulnerable residents at risk....
The inspection revealed systemic problems with the facility's elopement prevention program....
The violation occurred on September 10 during what was otherwise a textbook demonstration of incontinence care at Carroll Healthcare Center....
The 112-bed facility's housekeeping schedules showed rooms had been serviced, but inspectors documented a pattern of neglect across multiple areas....
The facility had purchased new beds with assist bars designed to help residents with transfers and bed mobility....
The odor was first documented on September 8 at 8:48 AM when inspectors found the resident lying in bed....
When inspectors observed the resident on September 8, her fingernails extended approximately one inch or more beyond her fingertips....
The patient has severe cognitive impairment and "never or rarely" makes decisions independently....
Even worse, nurses were simply placing medication bottles on bedside tables and walking away, leaving pills unattended....