Long Beach Healthcare Center

In the surveyor’s words

From the most serious findings on record at Long Beach Healthcare Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Sep 2, 2022

  Based on interview and record review, the facility failed to provide supervision and adhere to its policy and procedure for one of three sampled residents (Resident 1) to ensure the resident did not elope (leave without notice or authorization) from the facility. Resident 1 was assessed as a high risk for elopement and had a history of elopement from the facility on 6/17/2022. Resident 1 eloped from the facility for the second time on 8/28/2022 at 6:00 a.m. The facility failed to: 1. Ensure the facility had a system in place to monitor front entrance door from 10 p.m. to 7 a.m. daily to prevent residents with impaired cognitive status to elope from the facility. 3. […]

• Actual harm, isolatedF689Mar 16, 2026

  Based on interview, and record review, the facility failed to ensure one of three sampled residents (Resident 1), who required a two-person assist with transfers from a sitting to standing position and from a chair to bed, was assisted by Certified Nursing Assistant (CNA 1) and another staff member conducting a full body lift to transfer Resident 1 from a chair to her bed. This deficient practice resulted in Resident 1 standing up and attempting to transfer from a chair to her bed without assistance and falling to the floor. Resident 1 was transferred to a General Acute Care Hospital (GACH) where she was diagnosed with bilateral (both sides) acute distal fibular fractures (a sudden traumatic break in the lower end of the calf bone) of both ankles. […]

• Actual harm, isolatedF692May 23, 2025

  Based on interview, and record review, the facility failed to prevent unplanned weight loss (a weight loss greater than 5 % in one month) of 29 pounds ([lbs.] 18.59 % percent [%] in 6 months) from 1/2025 to 5/25 for one of three sampled residents (Resident 116). The facility failed to: 1. Ensure Registered Dietician's (RD- expert on diet and nutrition) recommendations for Resident 116's weekly weights, protein supplement ( boost protein [ nutrients body needed] intake ), double portions for breakfast, appetite stimulant (medication that stimulates appetite) and to have a blood test done for a complete metabolic panel (CMP- blood test that measures 14 different substances in the blood) and a prealbumin (blood test used to indicate nutritional deficiencies) were carried out. 2. […]

• Actual harm, isolatedF580May 15, 2025

  Based on observation, interview, and record review, the facility failed to notify the physician of a change of condition (COC) for one of three sampled residents (Resident 2). The facility failed to: 1. Notify Resident 2's physician when Resident 2, who was receiving Aspirin [ASA] used as a blood thinner to prevent a stroke) and Clopidogrel Bisulfate ([Plavix] a medication used to prevent blood clots [blood cells that clump together and could obstruct the flow of blood]), sustained a head injury on 5/4/2025, that resulted in an abrasion, (a scrape of the top layer of the skin), a laceration (a cut with a jagged or torn wound that is caused by a sharp object), a small bump with substantial (large in size, number, or amount) bleeding to his head. 2. […]

• Actual harm, isolatedF600Jan 24, 2025

  Based on interview, and record review the facility failed to protect the residents right to be free from physical abuse for one of two sampled residents (Resident 1). The facility failed to: 1. Ensure Certified Nursing Assistant (CNA) 1 did not leave the room when on [DATE] Resident 1 and Resident 2 had verbal argument to prevent physical altercation (punched Resident 1 in the head 10 times) between both residents. 2. Ensure facility investigated CNA 2's grievance dated [DATE] about witnessing Resident 1 being upset towards Resident 2 and had an argument. The facility to develop preventative measure to safeguard both residents from possible physical altercation. 3. […]