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Complaint Investigation

Pavilion On Pico Healthcare & Wellness Centre, Lp

March 26, 2025 · Los Angeles, CA · 5916 W. Pico Boulevard
Citations 1
CMS Rating 3/5
Beds 59
Provider ID 055160
Healthcare Facility
Pavilion On Pico Healthcare & Wellness Centre, Lp
Los Angeles, CA  ·  View full profile →
Inspection Summary

PAVILION ON PICO HEALTHCARE & WELLNESS CENTRE, LP in LOS ANGELES, CA — inspection on March 26, 2025.

Found 1 citation. 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

FF745
Minimal harm or (Resident 1) interpersonal interactions, particularly with the staff at the skilled nursing facility where she Few current episodes of depression, and it is crucial to address her mood and emotional state, which influence affected

During a review of the Minimum Data Set (MDS - resident assessment tool) dated 2/7/2025, indicated Resident 1's cognitive (mental action or process of acquiring knowledge and understanding) skills for daily decisions were mildly impaired.

The MDS indicated Resident 1 required maximal assistance to total dependent from staff for activities of daily living (ADLs- routine tasks/activities such as bathing, dressing and toileting a person performs daily to care for themselves).

The MDS also indicated, Resident 1 experienced moderate depression in half or more of the days while in the facility.

During a review of Resident 1's History and Physical (H&P) dated 2/2/2025, the H&P indicated, Resident 1 can understand and make own medical decisions.

During a review of Resident 1's Care Plan (CP) for mood problem related to major depression, initiated on 2/10/2025, the CP indicated a goal of, Resident (1) will have improved mood state happier, calmer appearance, no signs and symptoms (s/sx) of depression.

During a review of Resident 1's Medical Record as of 3/26/2025, there was no CP develop regarding Resident 1's behavior of unrealistic demands and requests.

055160

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 055160 B.

Wing 03/26/2025

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

Pavilion on Pico Healthcare & Wellness Centre, LP 5916 W.

Pico Boulevard Los Angeles, CA 90035

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 LOS ANGELES, 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 PAVILION ON PICO HEALTHCARE & WELLNESS CENTRE, LP or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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