Living Center West

In the surveyor’s words

From the most serious findings on record at Living Center West, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Jul 29, 2024

  Based on observation, clinical record review, policy review, and staff and resident interviews, the facility failed to prevent sexual exploitation for 1 of 1 resident reviewed for abuse (Resident #10). After a staff member observed Staff A, Activities Director, and Resident #10 kissing in the activity room, they left the room leaving the two of them alone in the room. No one reported the witnessed event to members of administration until several weeks later and the facility didn't terminate Staff A until 6/17/24. In addition, the facility learned on 2/29/24 that Resident #10 stated he and Staff A kissed and she locked the door of the activity room so they could be alone. […]

• Immediate jeopardy, isolatedF609Jul 29, 2024

  Based on observation, clinical record review, policy review, staff, and resident interviews, the facility failed to report an allegation of sexual exploitation for 1 of 1 resident reviewed for abuse (Resident #10). On 5/7/24 a staff member observed Staff A, Activities Director, and Resident #10 kissing in the activity room. No one reported the witnessed event to members of administration until 6/10/24. The facility suspended Staff A on 6/10/24 and terminated her on 6/17/24. The deficient practice resulted in an Immediate Jeopardy to the health and safety of residents who resided at the facility. The facility reported a census of 74 residents. The State Agency informed the facility of the Immediate Jeopardy (IJ) on 7/25/24 at 9:30 AM The IJ began on 2/29/24. […]

• Immediate jeopardy, isolatedF610Jul 29, 2024

  Based on observation, clinical record review, policy review, staff, and resident interviews, the facility failed to investigate an allegation of sexual exploitation and separate an alleged perpetrator of sexual exploitation from other residents for 1 of 1 resident reviewed for abuse (Resident #10). When a staff member observed Staff A, Activities Director, and Resident #10 kissing in the activity room. No one reported the witnessed event to members of administration until several weeks later. At that time, the facility suspended Staff A and then terminated her employment on 6/17/24. In addition, the facility learned Resident #10 reported on 2/29/24 he and Staff A kissed and she locked the door of the activity room so they could be alone. […]

• Actual harm, isolatedF689Jun 8, 2026

  Based on observation, record review, resident and staff interview, and facility policy review the facility failed to provide a call light within reach of a resident, which resulted in a fall with a bruise to the hip for 1 of 1 resident reviewed with a fall (Resident #1). The facility identified a census of 74 residents. On March 6, 2026, the facility staff self-reported the incident to the Department of Inspections, Appeals, & Licensing. The facility staff fully corrected the deficient practice on March 17, 2026, by taking the following steps: -Head to toe assessment of Resident #1 completed on 3/06/26. […]

• Actual harm, isolatedF686May 8, 2024

  Based on clinical record review, staff and resident interviews, observations, and facility policy review, the facility failed to identify impaired skin for residents at high risk to develop pressure sores for 2 of 6 resident's reviewed (Residents #5 and #6). The facility reported a census of 85 residents. Findings include: 1. According to the Minimum Data Set (MDS) dated [DATE], Resident #5 had diagnoses which included Non-traumatic brain dysfunction, heart failure, diabetes, and dementia. The MDS revealed the resident required extensive assistance for personal hygiene and had total dependence on staff for toileting, moving about the facility via wheelchair, did not ambulate, and had incontinence of bowel and bladder. […]