Whittier Hills Health Care Ctr
WHITTIER HILLS HEALTH CARE CTR in WHITTIER, CA — inspection on January 10, 2025.
Found 22 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 an interview on 1/9/2025 at 4:28 PM with the Director of Nurses (DON), the DON stated, she expected her staffs to close the curtain to provide privacy any time they do care.
The DON stated, it was important to provide privacy because no resident would want any stranger to see their body.
The DON stated, Resident 100 could have been upset, and got stressed out about the incident.
During a review of the facility's policy and procedure (P&P) titled, Resident Rights - Dignity and Privacy, dated 11/2021, indicated it is the policy of the facility that all residents be treated with kindness, dignity, and respect.
Residents shall be examined and treated in a manner that maintains the privacy of their bodies. A closed door or drawn curtain shields the Resident from passers-by.
- During a review of Resident 18's admission Record indicated the resident was admitted to the
facility on [DATE] with diagnoses that included rhabdomyolysis (the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood), metabolic encephalopathy (disorder that affects brain function that can cause confusion, memory loss, and loss of consciousness), and abnormalities of gait and mobility.
During a review of Resident 18's Minimum Data Set (MDS, a resident assessment tool) dated 10/28/2025, indicated resident ' s cognition (mental action or process of acquiring knowledge and understanding through thought, experience and the senses) was intact.
During a review of Resident 18's Orders dated 12/23/2024 indicated a physician order for indwelling catheter #16/10 milliliters (size of indwelling catheter- 16 inch long 10 milliliter wide) to close drainage system (A closed urinary drainage system consists of a catheter inserted into the urinary bladder and connected via tubing to a drainage bag.) for obstructive uropathy (a condition in which the flow of urine is blocked).
During an observation in Resident 18's room on 1/6/2025 at 9:56 AM, Resident 18 was observed sleeping in bed.
Observed Resident 18 ' s foley catheter drainage bag hanging on resident's bed frame without a dignity cover bag.
During a concurrent observation and interview in Resident 18's room om 1/6/2025 at 10:19 AM, the Assistant Director of Nursing (ADON) verified there was no dignity bag to cover resident's foley drainage bag.
The ADON stated residents only need a dignity bag when they are out of their room.
During an interview with the Director of Nursing (DON) on 1/10/2025 at 11:02 AM, the DON stated resident's foley drainage bag should be covered with a dignity cover at all times for privacy.
During a review of the facility's policy and procedure (P&P) titled Dignity and Privacy, dated 11/2021 indicated all residents will be treated with kindness, dignity, and respect.
The P&P indicated privacy of a resident's body shall be maintained during toileting, bathing, and other activities of personal hygiene, except when staff assistance is needed for the Resident's safety.
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Whittier Hills Health Care Ctr 10426 Bogardus Ave Whittier, CA 90603
stated, we want residents to have access to their amenities, but we didn't fix this quickly enough. I'll
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During a group interview on 1/7/2025 at 3:35 PM with twelve facility residents during the facility's Resident Council meeting, six residents indicated they were not aware of who and how to contact the Ombudsman's office.
All six residents indicated it would be helpful to be aware of the role and how to contact the Ombudsman for questions or unresolved issues in the facility.
During an interview on 1/9/2025 at 12:10 PM with the Activity Director (AD), the AD stated, Resident Council meeting was held monthly, and she did not have any documented evidence that she explained to the residents about the Ombudsman's role and provided the residents with the Ombudsman's contact phone number.
During an interview on 1/9/2025 at 12:30 PM with the admission Assistant (AMA) 1, AMA 1 stated, there was no documented evidence that the facility explained to the residents about the Ombudsman's role and provided them with the Ombudsman's contact phone number upon admission.
During an interview on 1/9/2025 at 4:30 PM with the Director of Nurses (DON), the DON stated, it was important for the residents to know the Ombudsman's contact phone number because it was one of the Resident Rights.
The DON stated, if the residents were aware of the Ombudsman's contact phone number, the residents could make sure their voice was heard and had choices if they did not feel comfortable talking to the facility.
During a review of the facility's policy and procedure titled, Resident Rights, undated, indicated the facility's residents have the right to have access to the names, addresses (mailing and email), and telephone numbers of all pertinent State agencies and advocacy groups, such as the State Survey Agency, the State licensure office, adult protective services where state law provides for jurisdiction in long-term care facilities, the Office of the State Long-Term Care Ombudsman program, the protection and advocacy network, home and community based service programs.
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During a group interview on 1/7/2025 at 3:35 PM with twelve facility's residents when the facility's Resident Council meeting was held, six residents stated they were not aware of where to find the facility's Annual Recertification Survey with Plan of Correction (POC) from the previous survey results.
All six residents indicated it would be helpful to be aware of where to find the facility's previous survey results and able to know the deficiencies were corrected.
During an interview on 1/9/2025 at 12:10 PM with the Activity Director (AD), the AD stated, Resident Council meeting was held monthly, and she did not have documented evidence that she informed or reminded the residents where to find the facility's previous Survey results.
During an interview on 1/9/2025 at 12:30 PM with the admission Assistant (AMA) 1, AMA 1 stated, there was no documented evidence that they included the information for where to find the facility's previous survey results when explaining Resident rights to the residents upon admission.
During an interview on 1/9/2025 at 4:30 PM with the Director of Nurses (DON), the DON stated, it was important for the residents to know where the facility's previous survey results binder was and examine the results because it was one of the resident rights.
During a review of the facility's policy and procedure titled, Resident Rights, undated, indicated the facility's residents have the right to examine the results of the most recent survey of the facility conducted by Federal or State surveyors and any plan of correction in effect with respect to the facility.
During a review of Resident 3's Face Sheet (front page of the chart that contains a summary of basic information about the resident) indicated a readmission to the facility on [DATE] with diagnoses that included of metabolic encephalopathy (a problem in the brain caused by a chemical imbalance), chronic obstructive pulmonary disease ( a diseases that blocks airflow and make it hard to breathe.
During a review of Resident 3's History and Physical (H&P) dated 12/24/2024, the H&P indicated the resident has the capacity to understand and make decisions.
During a review of Resident 3's Physician Orders for Life Sustaining Treatment (POLST) dated 10/28/2024, the POLST indicated the resident had an Advance Directive dated 3/13/2022.
During an interview and concurrent record review on 1/08/2025 at 9:08 AM of Resident 3's chart with Social Service Assistant (SSA), SSA stated Resident 3's POLST indicated Resident 3 had an Advance Directive but could not locate the Advance Directive in Resident 3's chart. SSA stated it might have been placed somewhere else in between Resident 3's last transfer to the Hospital and readmission to the facility.
During an interview on 1/10/2025 at 2:25 PM with Director of Nursing (DON), DON stated if a Resident has an advance directive the copy should be kept in the Resident's chart.
The DON stated it is important for the facility to keep a paper copy in the chart in case of any emergency, all staff and emergency medical services have access to the Resident's Advance Directive.
During a review of the facility's policy and procedure (P&P) titled Advanced Directives and Associated Documentation dated revised on 12/2023 indicated It is the policy of this facility to inform and provide written information to all adult residents concerning the right to obtain a copy of the Advanced Directive and conservatorship/guardianship documents and place in residents health record.
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indicated the Long-Term Care Facility Resident Assessment Instrument 3.0 User ' s Manual Version
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During an interview on 1/8/2025 at 4:04 PM with the MDSN, the MDSN stated, she had been late with MDS assessment and submission and was trying to catch up.
During an interview on 1/9/2025 at 4:28 PM with the Director of Nursing (DON), the DON stated the MDSN was in charge for updating and transmitting the MDS quarterly and annually, and the MDS assessment should be done on time.
The DON stated it was important to complete and transmit MDS timely to make sure the resident ' s status was accurate and most up to date so that the care plan could be revised or initiated based on the resident's conditions timely.
During a review of the CMS Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual, Version 1.17.1, dated October 2019, indicated for the quarterly non-comprehensive MDS assessment, the MDS completion date must be no later than 14 calendar days following the ARD.
During a review of the facility's policy and procedure (P&P) titled, Job Description-Minimum Data Set (MDS Coordinator-RN), dated 12/17/2021, indicated the position's responsibility is to conduct and coordinate the development and completion of the Resident Assessment Instrument (RAI), that is, the Minimum Data Set (MDS), Care Area Assessments (CAAs) and Care Plan in accordance with State and Federal requirements.
During a review of the facility's P&P titled, Resident Assessment Instrument (RAI), dated 10/1/2023, indicated the Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual Version 1.17.1 October 2019 will be the source guidance for the RAI Process.
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During an interview with the Director of Nursing (DON) on 1/10/2025 at 10:54 AM, the DON stated it was important to develop a care plan for residents at risk for elopement so there are interventions to prevent elopement from happening.
The DON stated the care plan should have been created as soon as facility knew resident was at risk.
The DON stated if there was no care plan there was a possibility the resident could elope.
The DON stated she expects the staff to review the elopement assessment and to create a care plan.
The DON stated if there were any instances of eloping it should be documented in the progress notes.
During an interview with the Medical Records Director (MRD) on 1/10/2025 at 12:20 PM, MRD stated she could not find elopement/wandering risk documented in Resident 29's Interdisciplinary Team's (IDT) record for care planning.
During a review of the facility's policy and procedure (P&P) titled Comprehensive Resident Centered Care Plan revised on 12/2023 indicated the IDT shall develop a comprehensive person-centered care plan for each resident that includes measurable objectives and timeframes to meet a resident ' s medical, nursing, mental and psychosocial needs that are identified in the comprehensive assessment.
The P&P indicated the IDT will also develop and implement a baseline care plan for each resident, within 48 hours of admission, that includes minimum healthcare information necessary to properly care for each resident and instructions needed to provide effective and person-centered care that meet professional standards of quality care.
The P&P indicated the resident's comprehensive plan of care will be reviewed and/or revised by the IDT after each assessment, including both the comprehensive and quarterly review assessments.
During a review of the facility's policy and procedure (P&P) titled Elopement/Unsafe Wandering revised on 12/2023 indicated residents with high risk factors will be identified as At Risk and will have an individualized care plan developed that includes measurable objectives and time frames.
The P&P indicated care plan interventions will consider the elements of the evaluation or behavior observations that identified the resident at risk.
The P&P also indicated interventions will address the individualized level of supervision needed to prevent elopement/unsafe wandering.
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During a review of the facility's policy and procedure titled, Physician visits, revised June 2019, indicated during the initial visit, the physician shall complete a thorough assessment, develop plan of care and writes or verifies admitting orders for the resident.
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sugar.
it is the policy of the facility to provide resident ' s care, treatment, response to care, guidance to the
care provided to the resident; and assistance in the development of a Plan of Care for each resident.
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cannot provide the intended support and may lead to discomfort or even harm. It's essential that these
a properly sized replacement.
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During an interview with the Director of Nursing (DON) on 1/10/2025 at 10:54 AM, the DON stated it was important to develop a care plan for residents at risk for elopement so there are interventions to prevent elopement from happening.
The DON stated the care plan should have been created as soon as facility knew resident was at risk.
The DON stated if there was no care plan there was a possibility the resident could elope.
The DON stated she expects the staff to review the elopement assessment and to create a care plan.
The DON stated if there were any instances of eloping it should be documented in the progress notes.
During an interview with the Medical Records Director (MRD) on 1/10/2025 at 12:20 PM, MRD stated she could not find elopement/wandering risk documented in Resident 29's Interdisciplinary Team's (IDT) record for care planning.
During a review of the facility's policy and procedure (P&P) titled Elopement/Unsafe Wandering revised on 12/2023 indicated the facility will provide a safe environment as free of accidents as possible for all residents through appropriate assessment, interventions, and adequate supervision to prevent accidents related to unsafe wandering or elopement while maintaining the least restrictive manner for those at risk for elopement.
The P&P indicated residents with high risk factors will be identified as At Risk and will have an individualized care plan developed that includes measurable objectives and time frames.
The P&P indicated care plan interventions will consider the elements of the evaluation or behavior observations that identified the resident at risk.
The P&P also indicated interventions will address the individualized level of supervision needed to prevent elopement/unsafe wandering.
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During a concurrent observation and interview on 1/8/2025 at 12:50 PM, with Registered Nurse 1 (RN
requested it from the kitchen after the oversight was identified. RN 1 stated, she shouldn ' t skip the shake, as it ' s essential for addressing her recent weight loss.
During an interview on 1/9/2025 at 4:06 PM with Dietary Supervisor (DS), stated Resident 136 does have a physician order to receive the health shake with her meals three times a day. It must have been missed accidentally. DS stated the shakes are essential for residents with weight loss to maintain proper nutrition and prevent further health complications.
During an interview on 1/10/2025 at 12:45 PM with the Director of Nursing (DON), DON stated, it was important to ensure the residents receive prescribed dietary supplements, follow the physician ' s diet orders for the residents to maintain the nutritional health, especially for those with weight loss concerns.
Nutritional supplements like health shakes are a key component of their care plan and must be provided as ordered to prevent further decline.
During a review of the facility's policy and procedure (P&P) titled, Diet Orders, revised 2023, indicated that Diet orders as prescribed by the Physician will be provided by the Food & Nutrition Services Department.
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identifiable fashion.
The P&P indicated the tubing should be kept off the floor.
The P&P also indicated
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Whittier Hills Health Care Ctr 10426 Bogardus Ave Whittier, CA 90603
During a review of Resident 48's Progress Notes, dated 12/30/2024, indicted skilled nurse
During an interview and concurrent observation on 1/8/2025 at 2:48 PM of Medication room [ROOM NUMBER] with Registered Nurse (RN)1, One IM e-kit was observed opened with no zip tie (a fastener consisting of a thin flexible nylon strap). RN 1 stated the IM e-kit was missing the Furosemide (a medication used to reduce water retention). RN 1 stated she did not know why she did not know why and for how long the IM e-kit was not resealed with the orange zip ties when the medication was taken out to prevent unauthorized access to the e-kit and to let the pharmacy know the e-kit had been opened and needed to be replaced.
During a telephone interview on 1/9/2025 at 10:17 AM, with the Pharmacist.
The Pharmacist stated the facility started to implement the use of CUBEX (an automated unit dose system for storage and retrieval of unit doses of drugs for administration to patients) for emergency supply of medications on 12/20/2024 and the facility was expected not to use the e-kits anymore.
The pharmacist stated the pharmacy staff went to pick up all the physical e-kit boxes from the facility on 1/4/2025, but the facility did not turn in the IM e-kit on that day.
The pharmacist stated they were not aware that the facility still had the e-kit and was still using it, so they did not replace the e-kit.
During an interview on 1/9/2025 at 1:50 PM, with the Director of Nursing (DON), the DON stated if the nurse opened the e-kit and used medication from the e-kit, the nurse should reseal the e-kit with the orange zip ties, so that no one else could get the access to the e-kit and remove medications from it without authorization and alert other staff a replacement of the e-kit was needed.
The DON stated it was important to have emergency supply of medications available to ensure the patient received the medication when needed.
The DON stated after 12/20/2024, the facility started to use CUBEX for the emergency supply of medications and did not need to use the e-kit anymore, but she did not know why the staff still opened the e-kit and removed medication from it for a patient on 12/30/2024.
During a review of the undated facility's policy and procedure (P&P) titled, Emergency Pharmacy Service and Emergency Kits, indicated an emergency supply of medications, .are supplied by the provider pharmacy in limited quantities in portable, sealed containers, . and When an emergency or starter dose of a medication is needed, the nurse unlocks the container/cabinet, .As soon as possible, the nurse seals the E kit with a color-coded lock to indicate need for replacement of the E kit.
The P&P also indicated opened kit are replaced 72 hours of opening.
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During initial kitchen tour with the Dietary Director (DD) on 1/6/2025 8:30 AM, observed that the refrigerator temperature logs located in the kitchen in a binder were incomplete. No temperature entries were documented for 1/4/2025 for AM and PM shift for Freezer #1.
During a concurrent interview and record review on 1/7/2025 at 8:35 AM with the DD, the Refrigeration and Freezer Temperature Log for January 2025 was reviewed.
The log had missing entries were noted for the AM and PM shift on 1/4/2025.
The DD stated she should have followed up the completion of the log.
During an interview on 1/7/2025 at 8:35 AM with the DS stated, Staff are expected to record refrigerator Temperatures are checked twice a day as part of our food safety protocols.
Without these logs, we have no way of knowing if food has been stored at safe temperatures, which could lead to food spoilage or bacterial growth. If residents consume spoiled food, they could develop foodborne illnesses.
During a review of the facility's policy and procedure (P&P) titled, Cold Storage temperature monitoring and record keeping , indicated, Food and Nutrition staff shall review and record temperatures of all refrigerators and freezers to ensure at the correct temperature for food storage and handling.
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During an interview on 1/9/2025 at 4:30 PM with the Director of Nurses (DON), the DON stated, the facility did not have a policy and procedure guide for the RNs to follow when admitting a resident to the facility.
The DON stated, they did not have a list of hospital records that they expected the RN to review upon resident's admission.
The DON stated, she trusted her RNs to know what hospital records to review and to request when some records were not sent with the resident.
During a review of the facility's policy and procedures titled, Quality Assurance and Performance Improvement, revised January 2022, indicated the facility will establish and implement a Quality Assessment and Assurance Committee, develop a written Quality Assurance and Performance Improvement Plan, which will be used to continually assess the facility's performance using a systematic, interdisciplinary, comprehensive, and data-driven approach to maintaining and improving safety and quality. QAPI Plan Components will include the design and scope to include clinical care, address all systems of care and management practices.
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During a review of the facility's contact precautions signage dated 8/2021 indicated STOP, see nurse before entering room; clean hands-on room entry, wear a gown on room entry, wear gloves on room entry and clean hands when exiting.
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During a concurrent interview and record review of the facility's Maintenance Repair Request Logs for 1/2025 from Nursing Stations 1 and 2 on 1/7/2025 at 1:24 PM, MS confirmed there was no request to fix patio door. MS stated he will fix the door now. MS stated he did not have any other log for routine inspections, he would fix things based on his visual observations and what was reported in the Maintenance Repair Request Log, nothing else.
During an interview with the Administrator (ADM) on 1/7/2024 at 4:20 PM, the ADM stated the Registered Nurse Supervisor (RNS) and receptionist locks the facility doors after visiting hours which was 8 PM. ADM stated he trusts his staff and knows that the doors are always locked.
The ADM stated they could use a log to make sure the doors are functional and locked, but don't have log currently.
The ADM stated he will follow up with MS regarding the patio door and will have a correction tomorrow.
During a concurrent interview and observation of patio door with MS and ADM on 1/8/2025 at 9 AM, observed patio door function and able to latch and close completely. MS stated the latch was fixed yesterday and the door is now able to be kept closed. MS stated the door closer located at the top of the door was also fixed to be able to lock the door from outside so that no one can enter facility.
During a concurrent interview and observation of fence door with MS and ADM on 1/8/2025 at 9:03 AM, observed a black pad lock on latch. MS stated there are only 2 people has key access to open fence door pad lock. MS stated only himself and his assistant have key and will lock the fence door pad lock after their shift. ADM stated the fence door will remain locked for residents' safety.
During an interview with the Director of Nursing (DON) on 1/10/2025 at 11:08 AM, the DON stated the doors in the facility should remained closed and locked to ensure no one comes in the facility.
The DON stated the function of the patio door should have been reported and that anyone could have reported it was broken.
During a review of the facility's policy & procedure (P&P) titled Safety, Resident revised on 9/2019 indicated the facility would create a safe environment for the resident.
The P&P indicated to report all faulty equipment immediately and do not use.
During a review of the facility's P&P titled Physical Environment revised on 5/2022 indicated the facility would establish procedures for routine and non-routine care equipment and to ensure that it remains in good working order for resident and staff safety.
The P&P indicated routine inspections, and maintenance will be recorded in the Preventive Maintenance Log.
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During an interview on 1/10/2025 at 10:51 AM with Director of Nursing (DON), DON stated some of the complications that can be caused by secondhand smoke could be cancer or other health conditions for some people. DON stated the facility had implemented steps such as posting the signage on the door across from Resident 97's door to remind everyone to keep the door closed during smoke breaks to prevent cigarette smoke from entering the facility and going into Resident 97's room but was not aware the door latch was not working until 1/7/2025.
During a review of the facility's policy and procedure (P&P) titled Smoking Policy dated with a revised date of 12/2016 indicated It is the facility policy to provide to it's residents a smoke free environment .
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During a review of Resident 301's GACH 1's Admission History and Physical, dated 12/10/2024, indicated Resident 301 had a past medical history that included type 2 DM.
During a review of Resident 301's Admission Report Check List (a communication form where the facility's Registered Nurse (RN) receives information from GACH 1's RN regarding a resident that would be admitted to the facility, undated, indicated Resident 301 had a history of DM.
The form did not have a prefilled area with questions to remind the RNs to ask for the results of the last vital signs including blood sugar check and if insulin was given.
During a review of Resident 301's Nursing Progress Notes, dated 1/8/2025, indicated per GACH 1's record, The note indicated, Resident 301's blood sugar check was around 151-154 milligrams (mg, unit of weight) per deciliter (dL, unit of volume) (a normal blood sugar level is between 70 and 100 mg/dL) while she was in GACH 1.
The note indicated, Resident 301's blood sugar was checked, and the result was at 118 mg/dL.
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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 055430 B.
Wing 01/10/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Whittier Hills Health Care Ctr 10426 Bogardus Ave Whittier, CA 90603
During a review of Resident 301 ' s GACH 1 Admission History and Physical, dated 12/10/2024, indicated Resident 301 had a past medical history that included type 2 DM.
During a review of Resident 301 ' s Medication Administration Record (MAR), from GACH 1, indicated Resident 301 was given insulin Lispro (treatment medication for high blood sugar levels) on 12/10/2024 at 9:20 PM; 12/11/2024 at 5:57 PM and 8:38 PM; 12/12/2024 at 5:58 PM and 10:20 PM; 12/13/2024 at 9:02 AM, 12:08 PM, and 5:45 PM; 12/15/2024 at 9:59 AM; 12/16/2024 at 12:24 PM and 5:24 PM; 12/17/2024 at 1:49 PM; 12/18/2024 at 8:36 AM, 12:15 PM, 5:04 PM and 9:21 PM; 12/19/2024 at 10:44 AM, 1:39 PM; 12/20/2024 at 6:24 PM; 12/21/2024 at 6:11 PM; and 12/28/2024 at 6:32 AM.
During a review of Resident 301 ' s Admission Report Check List (ARCL, a communication form completed by the facility ' s Registered Nurse (RN) when receiving information from the GACH regarding a resident prior to admission to the facility), undated, indicated Resident 301 had a history of DM.
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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 055430 B.
Wing 01/10/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Whittier Hills Health Care Ctr 10426 Bogardus Ave Whittier, CA 90603
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.