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Complaint Investigation

Coventry Court Health Center

August 26, 2025 · Anaheim, CA · 2040 S. Euclid Avenue
Citations 2
CMS Rating 4/5
Beds 97
Provider ID 055983
Healthcare Facility
Coventry Court Health Center
Anaheim, CA  ·  View full profile →
Inspection Summary

COVENTRY COURT HEALTH CENTER in ANAHEIM, CA — inspection on August 26, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0657
Resident Assessment and Care Planning Deficiencies
Potential for Minimal Harm

minimal harm

at 1242 hours, an interview and concurrent closed medical record review was conducted with MDS Nurse

  • MDS Nurse 1 verified the above findings. MDS Nurse 1 stated Resident 1's plan of care interventions
  • should have been updated to reflect Resident 1's refusal of the medication as ordered, ongoing monitoring of resident's glucose level and risks associated with medication refusal for the treatment and management of diabetes. On 8/26/25 at 1605 hours, an interview and concurrent closed medical record review was conducted with the DON.

The DON acknowledged and verified the above findings.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/26/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Coventry Court Health Center

2040 S.

Euclid Avenue Anaheim, CA 92802

SUMMARY STATEMENT OF DEFICIENCIES

Review of the facility P&P titled Administration of Medication (undated) showed medications must be administered in accordance with the written orders of the attending physician.

Should a drug be withheld, refused or given other than at the scheduled time, the staff administering must indicate the reason on the MAR.

For those utilizing eMARs, the appropriate code must be entered with follow up documentation as appropriate for the situation.

Closed medical record review for Resident 1 was initiated on 8/22/25. Resident 1 was readmitted to the facility on [DATE].

Review of Resident 1's H&P examination dated 4/14/25, showed Resident 1 was admitted to the facility with diagnoses including Type 2 diabetes and had the capacity to understand and make medical decisions.

Review of Resident 1's Order Summary Report showed a physician's order dated 4/15/25, for Resident 1 to receive insulin Glargine Solution (antidiabetic) 100 units/ml 12 units subcutaneously at bedtime for diabetes.

Hold for blood sugar less than 90.

Review of Resident 1's MAR from April to June 2025 showed the following nursing documentation with the designated chart code 1: refusal, 10: hospitalized and 14: no insulin required:- dated 4/15/25, BS of 136 mg/dl, chart code 1 - dated 4/16/25, BS of 133 mg/dl, chart code 1- dated 4/17/25, BS of 151 mg/dl, chart code 1- dated 4/18/25, BS of 146 mg/dl, chart code 1- dated 4/21/25, BS of 134 mg/dl, chart code 1- dated 4/27/25, BS of 127 mg/dl, chart code 1- dated 4/29/25, BS of 144 mg/dl, chart code 1- dated 5/1/25, BS of 116 mg/dl, chart code 1- dated 5/2/25, BS of 185 mg/dl, chart code 1- dated 5/3/25, BS of 166 mg/dl, chart code 1- dated 5/4/25, BS of 136 mg/dl, chart code 1- dated 5/8/25, BS of 178 mg/dl, chart code 1- dated 5/10/25, BS of 114 mg/dl, chart code 1- dated 5/11/25, BS of 148 mg/dl, chart code 1- dated 5/15/25, BS of 128 mg/dl, chart code 1- dated 5/17/25, BS of 116 mg/dl, chart code 1- dated 5/18/25, BS of 127 mg/dl, chart code 1- dated 5/22/25, BS of 173 mg/dl, chart code 1dated 5/23/25-5/28/25, BS not available, chart code 1- dated 5/29/25, BS of 150 mg/dl, chart code 1- dated 5/30/25, BS of 90 mg/dl, chart code 14- dated 6/1/25, BS of 150 mg/dl, chart code 1- dated 6/2 to 6/4/25, BS not available, chart code 1Further review of Resident 1's medical record failed to show documented evidence the physician was notified of the resident's consistent refusal of insulin. On 8/26/25 at 1242 hours, an interview and concurrent closed medical record review was conducted with MDS Nurse 1. MDS Nurse 1 verified the above findings. MDS Nurse 1 stated there should have been documentation to show the physician was informed regarding refusal of medication or treatment as ordered. On 8/26/25 at 1605 hours, an interview and concurrent closed medical record review was conducted with the DON.

The DON acknowledged and verified the above findings.

Facility ID:

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in ANAHEIM, CA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from COVENTRY COURT HEALTH CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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