West Hills Health And Rehabilitation Center

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

with shingles and ordered Valtrex (an antiviral medication used for the treatment and suppression of infections such as shingles) 1000 milligrams (mg- unit of measure) every eight hours for seven days, Prednisone (a medication used with antiviral drugs for shingles to reduce inflammation [a localized physical condition in which part of the body becomes reddened, swollen, hot and often painful, especially as a reaction to injury or infection], speed healing, and lessen pain) 20 mg every eight hours for seven days and Protonix (a medication used for conditions caused by excessive stomach acid) 40 mg twice a day for seven days. During an interview on 11/24/2025 at 4:30 p.m. with Resident 1's RP, RP stated that the facility did not inform RP of Resident 1's diagnosis of shingles. During a concurrent interview and record review on 11/24/2025 at 5:00 p.m., with Registered Nurse 2 (RN 2), Resident 1's COC Assessment Form dated 11/22/2025, timed 7:48 a.m. was reviewed. RN 2 stated that Resident 1's RP was informed and made aware of Resident 1's change in condition on 11/22/2025 at 6:45 a.m. but was not notified that Resident 1 had been diagnosed with shingles. RN 2 further stated that there was no documented evidence that Resident 1's RP had been made aware of the shingles diagnosis. RN 2 stated that facility staff should have immediately informed Resident 1's RP of the new diagnosis, as the RP needs to be aware of any changes

in condition to make timely decisions regarding Resident 1's care. During an interview on 11/25/2025 at 12:30 p.m., with the Director of Nursing (DON), the DON stated that residents' representatives are to be contacted regarding any changes in a resident's condition so that they (residents' representatives) are informed of what is happening and can be prepared emotionally to support their loved ones. During a

review of the facility's policy and procedure (P&P) titled Change in a Resident's Condition or Status last reviewed on 1/8/2025, the P&P indicated our facility promptly notifies the resident, his or her attending physician, and the resident representative of changes in the residence and medical/mental condition and or status. Unless otherwise instructed by the resident, a nurse will notify the resident's representative when: b. there is a significant change in the resident's physical, mental, or psychosocial status.

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Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/25/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

West Hills Health and Rehabilitation Center

7940 Topanga Canyon Blvd.

Canoga Park, CA 91304

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)

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

towards the end of the shift by RN 3. RN 4 stated that he did not implement a room change to place Resident 1 under contact isolation. RN 4 stated he endorsed Resident 1's new diagnosis of shingles and

the need for room change to the oncoming shift's RN Supervisor, RN 5.During an interview on 11/25/2025 at 10:55 a.m. with RN 5, RN 5 stated that she was made aware of Resident 1's new diagnosis of shingles

on 11/22/2025 at around 11:00 p.m. RN 5 stated that she did not initiate Resident 1's room change for contact isolation because Resident 1's roommate was sleeping. RN 5 stated that the previous shifts should have implemented a room change to place the resident on contact isolation before RN 5's shift. RN 5 stated that she should have initiated Resident 1's room change to place Resident 1 on isolation but did not. RN 5 stated that she waited the following morning (11/23/2025) for the 7 a.m.-3 p.m. shift RN Supervisor to help her initiate a room change. RN 5 stated that Resident 1 was not placed on isolation until 16 hours following

the diagnosis of shingles. During an interview on 11/2/2025 at 12:30 p.m. with the Director of Nursing (DON), the DON stated that Resident 1 should have been isolated and transferred to another room as soon as the licensed nurse was informed by the physician of Resident 1's shingles diagnosis on 11/22/2025. The DON stated it was important to isolate Resident 1 to help contain the infection and decrease the spread of shingles. The facility's policy and procedure (P&P) titled Policies and Practices - Infection Control reviewed 1/8/2025, the P&P indicated this facility's infection control policies are practices are intended to facilitate maintaining a safe, sanitary and comfortable environment and to help prevent and manage transmission of diseases and infections. The objective of out infection control policies and practices are to: a. prevent, detect, investigate, and control infections in the facility; b. maintain a safe, sanitary, and comfortable environment for personnel, residents, visitors, and the general public; c. establish guidelines for implementing isolation precautions, including standard and transmission-based precautions.The facility's P&P titled Isolation- Categories of Transmission-Based Precautions reviewed 1/8/2025, the P&P indicated transmission-based precautions are initiated when a resident develops signs and symptoms of a transmissible infection. and is at risk of transmitting the infection to other residents. Contact precautions are implemented for residents known or suspected to be infected with microorganisms that can be transmitted by direct contact with the resident or indirect contact with environmental surfaces or resident-care items in

the resident's environment. The individual on contact precautions is placed in a private room if possible.

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