Grancell Village Of The Jewish Homes For The Aging

During a review of Resident 46's Minimum Data Set (MDS- a resident assessment tool) dated 11/26/2024, the MDS indicated the resident`s cognitive skills (the brain's ability to think, read, learn, remember, reason, express thoughts, and make decisions) for daily decision making was severely impaired (never/rarely made decisions).

The MDS indicated that Resident 46 was dependent to staff (helper does all of the effort) for eating, oral hygiene, toileting hygiene, showering/bathing, and personal hygiene.

The MDS indicated that Resident 46 did not display any physical and verbal behavioral symptoms directed towards others (e.g., hitting, kicking, grabbing, screaming at others, and threatening others).

The MDS further indicated that Resident 46 was taking antidepressant (medication used to treat depression) and antipsychotic medications (medication that are used to treat mental disorders).

During a review of Resident 46`s Physician Order Report dated 9/11/2024, the order indicated to monitor the resident`s behavior of mood disorder manifested by agitation, constant loud blowing raspberry in the air (make a sound by putting your tongue out and blowing) during every shift.

This order was discontinued on 12/10/2024 at 2:47 p.m.

During a review of Resident 46`s Physician Order Report dated 11/16/2024, the order indicated to administer Seroquel 25 milligrams (mg-a unit of measure of mass) by mouth, twice a day for mood disorder manifested by agitation.

555137

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 555137 B.

Wing 01/16/2025

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

Grancell Village of the Jewish Homes for the Aging 7150 Tampa Ave Reseda, CA 91335