Four Seasons Healthcare & Wellness Center, Lp
FOUR SEASONS HEALTHCARE & WELLNESS CENTER, LP in NORTH HOLLYWOOD, CA — inspection on April 25, 2025.
Found 4 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.
Inspection Findings
During a review of Resident 130's Minimum Data Set (MDS - resident assessment tool), dated 1/27/2025, the MDS indicated the resident was able to understand others and was able to make himself understood.
The MDS further indicated the resident required set up assistance from staff for eating and was dependent on staff for toileting, bathing, and dressing.
During a review of Resident 130's History and Physical (H&P), dated 7/15/2024, the H&P indicated the resident had the capacity to understand and make decisions.
During a review of Resident 130's Physician Psychiatric Consultation Note, dated 1/8/2025, the Physician Psychiatric Consultation Note indicated the resident had a diagnosis of anxiety (a mental health condition that may result in restlessness, irritability, feelings of nervousness, panic, and fear) with an overall stable mood but anxious feeling at times.
During a review of Resident 130's Order Summary Report, the report indicated orders for the following:
- On 3/23/2025, and clarified on 3/25/2025, Lorazepam oral tablet 0.5 milligrams (mg - a unit of measure) give one tablet by mouth every 24 hours as needed for anxiety verbalized by aggression towards staff.
055932
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 055932 B.
Wing 04/25/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Four Seasons Healthcare & Wellness Center, LP 5335 Laurel Canyon Blvd.
North Hollywood, CA 91607
During a concurrent interview and record review, on [DATE], at 2:32 p.m., with the Director of Nursing (DON), Resident 90's MAR, for [DATE], was reviewed.
The DON stated insulin Lispro Kwikpen for Resident 90 was expired and needed to be removed from Medication Cart Station 2 Cart A and replaced with a new pen from pharmacy.
The DON acknowledged that several LVN's failed to remove the expired insulin Lispro Kiwkpen for Resident 90 from the medication cart, and according to the MAR, Resident 90 was administered four (4) doses of expired insulin between [DATE] and [DATE], resulting in significant medication errors.
The DON stated administering expired insulin to Resident 90 will not be effective in controlling the blood sugar levels and can harm the resident by causing high blood sugar levels, leading to DKA ([DKA] - a condition that develops when the body doesn't have enough insulin resulting in the buildup of acid in the blood to levels that can be life threatening), and hospitalization .
During an interview, on [DATE], at 2:32 p.m., with the DON, the DON stated the artificial tears eye drop bottle for Resident 68 was not labeled with a date indicating when use began.
The DON stated eye drop bottles are multi-dose (containing more than one [1] dose) containers and are usually good for 28 days once it is opened.
The DON stated opened eye drops should be dated with an open date to know when they should be disposed of, otherwise they are considered expired.
The DON stated that using expired eye artificial tears will not be effective in treating eye dryness due to decreased potency and lead to possible infections due to decreased sterility.
During a review of facility's policy and procedures (P&P) titled, Storage of Medications, last reviewed on [DATE], the P&P indicated Medications and biologicals are stored safely, and properly, following manufacturer's recommendations or those of the supplier.
M.
Outdated, contaminated, or deteriorated medications .are immediately removed from stock, disposed of according to procedures for medication disposal, and reordered from the pharmacy if a current order exists.
055932
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 055932 B.
Wing 04/25/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Four Seasons Healthcare & Wellness Center, LP 5335 Laurel Canyon Blvd.
North Hollywood, CA 91607
During a review of Resident 52's Admission Record (a document containing demographic and diagnostic information,) the Admission Record indicated the facility admitted the resident on [DATE], and readmitted the resident on [DATE], with diagnoses including type 2 diabetes mellitus ([DM2] - a disorder characterized by difficulty in blood sugar control and poor wound healing), long term use of insulin, and metabolic encephalopathy (a change in how your brain works due to an underlying condition).
During a review of Resident 52's History and Physical (H&P), dated [DATE], the H&P indicated the resident was unable to make decisions.
During a review of Resident 52's Minimum Data Set ([MDS] - a resident assessment tool), dated [DATE], the MDS indicated the resident had the ability to make self-understood and understand others and had moderate cognitive impairment (more pronounced deficits emerge, interfering with daily activities).
The MDS indicated the resident was on a high-risk drug class hypoglycemic (agents that lower glucose levels in the blood) medication.
055932
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 055932 B.
Wing 04/25/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Four Seasons Healthcare & Wellness Center, LP 5335 Laurel Canyon Blvd.
North Hollywood, CA 91607
During a review of Resident 173's Admission Record, the Admission Record indicated the facility initially admitted Resident 173 on 1/9/2025 and readmitted the resident on 2/17/2025 with diagnoses that included type two (2) diabetes mellitus (DM, a disorder characterized by difficulty in blood sugar control and poor wound healing), end stage renal disease (ESRD, irreversible kidney failure), and hypertensive heart and chronic kidney disease (heart and kidney problems that occur because of high blood pressure that is present over a long time).
During a review of Resident 173's Minimum Data Sheet (MDS - a resident assessment tool) dated 3/18/2025, the MDS indicated Resident 173 understood others and made self understood.
The MDS indicated the resident required supervision and touching assistance (helper provides verbal cues and/or touching /steadying and or contact guard assistance as resident completes the activity) when eating.
During a review of Resident 173's Physician Orders dated 3/30/2025, the Physician Orders indicated to provide CCHO, standard portion diet, mechanical soft texture (diet with soft, and chopped meats), regular, thin consistency.
During an interview on 4/22/2025 at 11:42 a.m. with Resident 173, Resident 173 stated the food at the facility was terrible as it was sometimes cold when it arrives. Resident 173 stated the food should be 165 F and wants steam coming from the food. Resident 173 stated he notified the facility staff as it was their responsibility to serve hot food. Resident 173 stated the facility used warmers, but it was not hot; hence, the food comes out cold. Resident 173 stated he has lost weight and did not want to eat in the facility.
055932
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 055932 B.
Wing 04/25/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Four Seasons Healthcare & Wellness Center, LP 5335 Laurel Canyon Blvd.
North Hollywood, CA 91607