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Complaint Investigation

Mayflower Care Center

August 1, 2024 · El Monte, CA · 5043 Peck Rd
Citations 2
CMS Rating 3/5
Beds 59
Provider ID 555374
Healthcare Facility
Mayflower Care Center
El Monte, CA  ·  View full profile →
Inspection Summary

MAYFLOWER CARE CENTER in EL MONTE, CA — inspection on August 1, 2024.

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

FF689
Minimal harm or Some hygiene, upper/lower body dressing, and toilet use. affected

During a review of Resident 1's Admission Record (AR), the AR indicated, the facility initially admitted Resident 1 to the facility on [DATE], and readmitted Resident 1 on 7/27/24, with diagnoses that included encephalopathy (a group of conditions that causes brain dysfunction which alters brain function or structure), dementia without behavioral, psychotic or mood disturbance and anxiety (a group of symptoms affecting memory, thinking and social abilities); schizoaffective disorder (a mental health problem where you experience psychosis as well as mood symptoms), history of falling, other abnormalities of gait (pattern of walking/running) and mobility (the ability to move joints and use muscles easily and comfortably), generalized muscle weakness (sudden difficulty moving your limbs, walking, standing, or sitting upright).

During a review of Resident 1's Minimum Data Set (MDS, a standardized resident assessment and care screening tool), dated 5/11/24, the MDS indicated, Resident 1 had moderately impaired cognition (ability to think and process information).

The MDS indicated, Resident 1 required partial/moderate assistance with bathing, oral/personal hygiene, and supervision or touching assistance with toilet use, and upper/lower body dressing.

2.

During a review of Resident 2's AR, the AR indicated, the facility initially admitted Resident 2 to the facility on [DATE], and readmitted Resident 2 on 5/4/24, with diagnoses that included urinary tract infection (an infection in any part of your urinary system: kidneys, bladder, ureters, and urethra), encephalopathy, dementia without behavioral, psychotic or mood disturbance and anxiety, schizoaffective disorder, history of falling, other abnormalities of gait and mobility, and generalized muscle weakness.

555374

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555374 B.

Wing 08/01/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Mayflower Care Center 5043 Peck Rd El Monte, CA 91732

During a review of Resident 1's Admission Record (AR), the AR indicated, the facility initially admitted Resident 1 to the facility on [DATE], and readmitted Resident 1 on 7/27/24, with diagnoses that included encephalopathy (a group of conditions that causes brain dysfunction which alters brain function or structure), dementia without behavioral, psychotic or mood disturbance and anxiety (a group of symptoms affecting memory, thinking and social abilities); schizoaffective disorder (a mental health problem where you experience psychosis as well as mood symptoms), history of falling, other abnormalities of gait (pattern of walking/running) and mobility (the ability to move joints and use muscles easily and comfortably), generalized muscle weakness (sudden difficulty moving your limbs, walking, standing, or sitting upright).

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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

555374

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 555374 B.

Wing 08/01/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Mayflower Care Center 5043 Peck Rd El Monte, CA 91732

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 EL MONTE, 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 MAYFLOWER CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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