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Complaint Investigation

Skyline Healthcare Center - La

April 14, 2025 · Los Angeles, CA · 3032 Rowena Ave
Citations 2
CMS Rating 1/5
Beds 99
Provider ID 555117
Healthcare Facility
Skyline Healthcare Center - La
Los Angeles, CA  ·  View full profile →
Inspection Summary

SKYLINE HEALTHCARE CENTER - LA in LOS ANGELES, CA — inspection on April 14, 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

FF580
Minimal harm or Few interview, Resident 1 stated, I need pain medication. It takes hours to get my pain medications. My legs and affected

During a review of the Minimum Data sheet (MDS - resident assessment tool), dated 2/27/25, the MDS indicated Resident 1 had intact cognition (the ability to think, learn, and remember).

The MDS indicated Resident 1 had frequent pain of 9 (pain that is very hard to tolerate) out of 10 using the numerical pain rating scale (a common scale where individuals choose a number between 0 and 10 to represent their pain, with 0 being no pain and 10 being the worst pain imaginable).

The MDS indicated Resident 1 was dependent (helper does all the effort) on toileting hygiene, shower/bathe self, lower body dressing, personal hygiene, and tub/shower transfer.

During a review of Resident 1's Order Summary Report, dated 2/5/2025, the Order Summary Report indicated an order for acetaminophen (a medication that treats minor pain and lowers fever) tablet 325 milligrams (mg - unit of measurement) to give 2 tablets by mouth every six hours as needed for mild pain 1 to 4 out of 10 using the numeric rating pain scale (2 tablets is equal to 650 mg).

During a review of Resident 1's physician order, dated 2/19/2025, the physician order indicated an order for Oxycodone-HCI (a narcotic drug used to relieve pain severe enough when other pain medicines did not work well enough) oral capsule 5 mg to give 1 tablet by mouth every four hours as needed for moderate pain, 5 to 7 out of 10 using the numeric pain rating scale and give 2 tablets by mouth every 4 hours as needed for severe pain 8 to 9 out of 10 using the pain scale (2 tablets is equal to10 mg).

During a review of Resident 1's care plan on risk for pain related to pain due to orthopedic device and right hip artificial joint, initiated on 2/6/2025, the care plan indicated with the goal of Resident 1 reporting satisfactory pain control. Resident 1's care plan indicated interventions that included to administer pain medications as ordered (if non medication interventions are ineffective), determine resident's satisfactory level, evaluate effectiveness of pain-relieving interventions (non-medication and medication), evaluate resident's pain, monitor for factors/activities that precipitate or aggravate pain, and monitor participation in therapies for decline and refusal.

555117

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 555117 B.

Wing 04/14/2025

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

Skyline Healthcare Center - LA 3032 Rowena Ave Los Angeles, CA 90039

During a review of the Minimum Data sheet (MDS - resident assessment tool), dated 2/27/25, the MDS indicated Resident 1 had intact cognition (the ability to think, learn, and remember).

The MDS indicated Resident 1 had frequent pain of 9 (pain that is very hard to tolerate) out of 10 using the numerical pain rating scale (a common scale where individuals choose a number between 0 and 10 to represent their pain, with 0 being no pain and 10 being the worst pain imaginable).

The MDS indicated Resident 1 was dependent (helper does all the effort) on toileting hygiene, shower/bathe self, lower body dressing, personal hygiene, and tub/shower transfer.

During a review of Resident 1's Order Summary Report, dated 2/5/2025, the Order Summary Report indicated an order for acetaminophen (a medication that treats minor pain and lowers fever) tablet 325 milligrams (mg - unit of measurement) to give 2 tablets by mouth every six hours as needed for mild pain 1 to 4 out of 10 using the numeric rating pain scale (2 tablets is equal to 650 mg).

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

555117

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 555117 B.

Wing 04/14/2025

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

Skyline Healthcare Center - LA 3032 Rowena Ave Los Angeles, CA 90039

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 SKYLINE HEALTHCARE CENTER - LA or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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