West Hills Health & Rehabilitation

In the surveyor’s words

From the most serious findings on record at West Hills Health & Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF760Dec 18, 2023

  Based on interview and record review it was determined the facility failed to administer medication as ordered for 1 of 6 sampled residents (#485) reviewed for medication administration. This failure resulted in an increased potassium level and required Resident 485's hospitalization . Findings include: On 6/14/23, the Past Noncompliance was corrected when the facility completed a root cause analysis of the incident and staff were trained on steps to take if a medication was thought to be missing which included: -Performing a thorough search of all med carts and the med room including the refrigerator to find the missing medication. -Placing notes on or in the med cart to advise oncoming workers of a medication's location. […]

• Actual harm, isolatedF689Nov 10, 2022

  Based on observation, interview and record review it was determined the facility failed to provide properly maintained assistive devices to prevent falls and implement the resident care plan for 2 of 3 sampled residents (#s 100 and 105) reviewed for accidents. As a result of staff not following care planned interventions, Resident 100 fell , fractured her/his right hip, sustained a [CONDITION(S)], required hospitalization and surgery. Findings include: 1. Resident 100 admitted to the facility in 2/2021 with diagnoses including [CONDITION(S)] and malnutrition. Resident 100's most recent MDS dated [DATE] revealed a BIMS score of 15, indicating no cognitive impairment. […]

• No harm, potential for more than minimal, widespreadF812Apr 25, 2025

  Based on observation, interview, and record review it was determined the facility failed to ensure proper personal hygiene practices and safe food storage handling techniques for 1 of 1 facility kitchen and 2 of 2 facility ice machines reviewed for kitchen sanitation. This placed residents at risk for cross contamination and foodborne illnesses. Findings include: On 4/21/25 at 9:50 AM, Staff 29 (Cook) was observed to have head and facial hair exposed with no facial and head hair restraints. Staff 30 (Cook) was observed to have with facial hair exposed and no facial hair covering. Staff 29 and Staff 30 were actively prepping the lunch meal. On 4/21/25 at 10:20 AM, Staff 8 (AM Dining Services Director) acknowledged hair and beard nets were to be worn at all times when working in the kitchen. […]

• No harm, potential for more than minimal, widespreadF802May 9, 2024

  Based on interview and record review it was determined the facility failed to ensure sufficient dietary staff were available to ensure food service was delivered in a timely manner for 1 or 1 kitchens reviewed. This placed residents at risk for unmet nutritional needs. Findings include: A public complaint was made to the state agency on 10/9/23 which alleged all meals were served late daily and timeliness had been an issue for several months. Witness 2 (Complainant) stated meals were served hours after the posted times and residents complained to staff their meals were late. […]

• No harm, potential for more than minimal, widespreadF880Dec 18, 2023

  Based on interview and record review, it was determined the facility failed to develop and implement a water management program and conduct a risk analysis assessment for potential areas of growth and spread of waterborne pathogens for 1 of 1 facility reviewed for infection control. This placed all residents at risk for exposure to waterborne pathogens. Findings include: On 12/14/23 at 9:53 AM Staff 20 (Maintenance Director) confirmed he was in charge of the facility's legionella program and reported he did not receive any training on how to protect the facility from waterborne pathogens such as legionella. He also stated was not aware of the need to complete a thorough analysis of the facility's water systems to identify and address the risk of waterborne pathogens such as legionella. […]