Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Panorama City Conv & Rehab Ctr during CMS and state inspections, most recent first.
Failure to monitor braces and splints caused pressure injuries for two residents. One resident developed pressure injuries to both heels and the left calf after wearing an ill-fitting E-Z boot and shoe inserts, with no orders or care plan entry for the device. Another resident had a left ankle brace and finger splint in use, but there were no orders or Kardex/care plan entries for wear times or skin checks, and a red area was noted under the finger splint.
Dishwasher temperatures were not maintained within required wash and rinse ranges, and the temperature log also had missing entries. The FSDM confirmed the required settings and stated staff should have reported out-of-range readings, but said no such reports were made and staff would not know whether dishes had been adequately cleaned.
Failure to Monitor Antibiotic Use: The facility did not consistently apply its antibiotic stewardship process for three residents. One resident received Cipro despite a urine culture below the facility’s UTI threshold and no genitourinary symptoms, another had a low-count urine result with blank infection tracking before later receiving an antibiotic, and a third had an antibiotic ordered by an outside provider without a urinalysis or completed infection assessment. For all three residents, there was no documented antibiotic time out or rationale for continued use.
The facility failed to properly monitor and document psychotropic use for one resident receiving trazodone for insomnia, with no side effect or target behavior monitoring found in the EHR. For another resident receiving duloxetine for neuropathy pain, the record did not contain adequate documentation supporting a failed GDR; the decision was based mainly on the resident’s report of increased pain at a care conference and the provider’s agreement to restore the prior dose.
Failure to manage bowel meds and loose stools: A resident with dementia and adult failure to thrive reported being given stool-softening medicine without explanation and said they had daily loose stools and did not want it. The EHR showed frequent soft/loose stools, repeated refusals of bowel meds on the MAR, and no documentation that the meds were held or that the provider was notified, despite orders to hold senna for loose stools and notify the provider.
Two residents with cognitive impairment and dependence on staff experienced incidents involving unexplained injuries and allegations of sexual abuse. In both cases, the facility did not report the allegations to the State Agency within the required 24-hour timeframe, as confirmed by the DON.
Two residents with cognitive impairments experienced either unexplained injuries or alleged verbal abuse, but the facility did not complete thorough investigations. The investigations lacked interviews with the affected residents, staff, or other residents, and in one case, the investigation documentation was left blank. The DON acknowledged that interviews should have been conducted.
A resident with Alzheimer's disease and impaired mobility, who required two-person assistance and a gait belt for transfers, was transferred by a single nursing assistant without a gait belt, contrary to the care plan. This resulted in a fall in the bathroom, causing a head laceration that required staples and multiple bruises. Staff interviews confirmed the resident's need for two-person assistance and the use of a gait belt during transfers.
A facility failed to accurately assess a resident's health status by not documenting a pressure ulcer (PU) on the Minimum Data Set (MDS) upon admission. Despite hospital discharge notes and a skin evaluation form indicating the presence of a PU, the MDS was incorrectly coded. Staff acknowledged the error and the need for correction.
A facility failed to update a care plan for a resident who developed a pressure ulcer (PU) after admission with a hip fracture. The care plan initially noted fragile skin but was not revised to reflect the PU, despite ongoing assessments confirming its presence. The DON acknowledged that interventions were not specific to PUs, and the care plan did not accurately reflect the resident's condition.
The facility failed to ensure person-centered side effect and target behavior monitoring for psychotropic medications for several residents, leading to a risk of unnecessary medication use. Residents lacked proper documentation and assessment, with discrepancies in care plans and treatment records, hindering effective evaluation of medication use.
The facility failed to label and date food products, maintain required dishwasher sanitization temperatures, and ensure proper hand hygiene and glove use during meal preparation. Undated food was found in a refrigerator, and the dishwasher's rinse cycle temperatures were below the required 180°F on several occasions. Staff F, a Dietary Aide, repeatedly touched food with gloves on without changing them or performing hand hygiene, despite acknowledging this was not acceptable.
A facility failed to follow physician orders and notify the provider when medications were held for a resident. Nurses administered Metoprolol outside of ordered parameters, and both Metoprolol and Imdur were held multiple times without notifying the provider, as required.
A facility failed to properly assess, maintain, and monitor IV access devices for a resident requiring IV therapy. The resident's care plan lacked documentation for IV site maintenance, and staff did not perform routine monitoring, dressing changes, or necessary measurements. Observations revealed an unchanged IV bandage with dried blood, and staff interviews confirmed the absence of required documentation and procedures.
Inadequate hand hygiene practices were observed in a facility, where a CNA failed to perform hand hygiene after assisting a resident during dining tray pass, and another CNA did not perform hand hygiene between glove changes while providing care under transmission-based precautions. The Director of Nursing and Unit Manager confirmed the need for proper hand hygiene after resident contact and glove changes.
A resident with multiple sclerosis and hemiplegia was injured during a transfer when a nursing assistant failed to follow the care plan, which required a Hoyer lift and two-person assistance. Instead, a sit-to-stand lift was improperly used, resulting in a fracture and hospitalization.
A deficiency was identified in medication administration practices at the facility, where medications for three residents were prepared by one LPN but administered by another staff member without proper verification. This practice, which occurred due to short-staffing, was against the facility's policy and placed residents at risk for medication errors.
Failure to Monitor Braces and Splints Caused Pressure Injuries
Penalty
Summary
The facility failed to monitor medical devices to prevent pressure-related injuries for 2 of 4 residents reviewed for pressure injuries. Resident 3 was admitted with a diagnosis of left hip fracture and was able to make needs known. The record showed the resident was at risk for pressure injury and initially had no current pressure injuries, but later developed pressure injuries to both heels and the left lower leg/calf. A progress note stated the resident was wearing their own shoes with sole inserts that felt too tight and put pressure on the heels, and that the resident had also been wearing E-Z boots in bed that fit poorly and had been found to be put on improperly at times. The record further showed a medical device-related pressure injury to the left lower leg that was later documented as involving eschar, then slough and drainage. The care plan included pressure injury interventions for the heel and lower leg, but there was no care plan entry for the E-Z boots. Provider orders reviewed on 01/22/2026 showed no orders in place to monitor and manage the E-Z boot. During interview and observation, Resident 3 stated the boot on the left ankle did not fit well, and staff observed the hard plastic E-Z boot on the bedside table. A CNA stated the resident had been wearing the E-Z boot that morning and removed it, and that the boot should have been on the Kardex, but it was not. Resident 7 was admitted with severe malnutrition and was able to make needs known. During interview and observation, the resident was seen sitting in a wheelchair with a left ankle brace and right finger splint, and stated they wore the ankle brace to walk and the finger brace to help straighten the finger. When the finger brace was removed, a red area was noted on the knuckle. The EHR showed no care plan or Kardex entry for the ankle brace or finger splint and no provider orders for when to apply or remove them or to check the skin under them. Staff interviews confirmed the braces and splints should have been included in the care plan/Kardex and should have had orders for wear times and skin monitoring.
Dishwasher Temperatures Not Maintained or Documented
Penalty
Summary
The facility failed to ensure the dishwasher was cleaning dishes at the required temperatures for 1 of 1 kitchen dishwashers reviewed during a kitchen task. Review of the Food Services Department Daily Dish Machine Temperature Log on 01/26/2026 showed the wash cycle was required to reach 150-160 degrees Fahrenheit and the rinse cycle was required to reach no less than 180 degrees Fahrenheit, but multiple entries were documented outside those ranges, including wash at 145 degrees and 142 degrees and rinse temperatures of 179 degrees, 172 degrees, and 145 degrees on several dates. The log also had missing entries for 01/23/2026 PM, 01/24/2026 PM, and 01/25/2026 AM. Staff D, Food Service Manager, confirmed the required temperatures and stated staff should have notified a supervisor when temperatures were out of range, but said they had not been notified of any out-of-range temperatures and that staff should have notified them. When asked how staff would know whether dishes had been adequately cleaned, Staff D stated they would not know.
Failure to Monitor Antibiotic Use
Penalty
Summary
The facility failed to implement an effective Antibiotic Stewardship Program for 3 of 3 residents reviewed for antibiotic stewardship. The facility policy stated staff were to use McGeer constitutional infection criteria to determine whether antibiotics were necessary and to notify the provider of diagnostic results, including whether an antibiotic should be continued, discontinued, or changed. The facility’s UTI criteria required a urine culture with at least 100,000 CFU of no more than two organisms plus localizing genitourinary signs and symptoms, but the infection tracking and record review did not show that these criteria were consistently applied. Resident 3 had pelvic pain and was prescribed Cipro for a UTI, but the urine culture showed 10-25 thousand CFU of bacteria and 25-50 thousand CFU of yeast, and the infection tracking noted the resident had no genitourinary symptoms. Resident 5 had a urine lab report showing 10 to 20 thousand CFU of an organism, with the provider noting it was likely not a UTI, yet the infection tracking was blank and the resident was later prescribed an antibiotic after reporting pelvic pain and increased agitation. Resident 130 had Bactrim ordered, infection tracking later showed the resident did not meet criteria for antibiotic use, and an outside provider phoned in another antibiotic order without a urinalysis being done; for all three residents, the record showed no documentation of an antibiotic time out or rationale for continued use of the antibiotic.
Psychotropic Medication Monitoring and GDR Documentation Deficiencies
Penalty
Summary
The facility failed to ensure psychotropic medications were regularly monitored and documented, and failed to ensure there was adequate indication for noncompletion of a gradual dose reduction for two residents reviewed for unnecessary medication use. One resident, who was severely cognitively impaired, had orders for trazodone for insomnia, including an increase in dose, but the electronic health record contained no documentation of side effect monitoring or target behavior monitoring for the medication. Staff reviewed the January medication and treatment records and confirmed the medication had been given and increased, but could not find the required monitoring documentation. A second resident, who was cognitively intact, had duloxetine ordered for pain related to polyneuropathy and also received PRN acetaminophen for pain. A pharmacy consultant noted the resident’s reduced creatinine clearance and recommended tapering duloxetine because of the risk of accumulation, but the provider declined and cited a prior failed GDR. The record showed a prior dose reduction from 60 mg to 40 mg had been ordered because of poor kidney function, with alert charting initiated to monitor the resident’s response. Review of the record showed PRN acetaminophen use before and after the dose reduction, but nurses’ notes and provider notes did not document increased or poorly controlled pain, or that PRN acetaminophen was ineffective, during the period after the GDR. The facility later documented the GDR as failed based on the resident’s statement during a care conference that neuropathy pain had increased at night and a request to restore the prior duloxetine dose, and the provider agreed to reinstate the higher dose. Staff stated that this was enough to show the GDR had failed.
Failure to Manage Bowel Medications and Loose Stools
Penalty
Summary
Care and services were not provided in accordance with professional standards for a resident with dementia and adult failure to thrive who was able to make needs known. The resident reported being given medicine to soften stools without being told what it was, and stated they had been having loose stools every day and did not want the medication. The record showed 14 soft stools and 8 loose stools over the prior 24 days, including two extra-large loose stools on 01/17/2026. The provider’s orders included loperamide as needed for loose stools, magnesium oxide daily, and senna twice daily for constipation with instructions to hold it for loose stools and notify the provider. The January 2026 MAR showed the resident refused the evening dose 18 times and the morning dose twice in the last 24 days. The EHR contained no documentation that the provider was notified of the loose stools or medication refusals, and no documentation that the medications were held. Staff interviews stated bowel medications should be held and the provider notified when a resident has loose stools or refuses medication consistently.
Failure to Timely Report Allegations of Abuse and Injuries of Unknown Origin
Penalty
Summary
The facility failed to report allegations of abuse and injuries of unknown origin to the State Agency within the required timeframe for two residents. One resident, who had a history of cerebral vascular accident and neurological disorder with moderate cognitive impairment and dependence on staff for some activities of daily living, was found during a physician's examination to have healing fractures of multiple ribs. There was no identified source of injury in the progress notes, and the facility's investigation documentation was left blank. The allegation was not reported to the State Agency until six days after the injury was discovered. Another resident, diagnosed with Parkinson's disease and also with moderate cognitive impairment and dependence on staff, reported an allegation of sexual abuse by a staff member. The incident was documented in the progress notes, but the report to the State Agency was not made until the day after the investigation was completed, rather than within the required 24-hour period. The Director of Nursing confirmed that both incidents were not reported in a timely manner as mandated.
Failure to Conduct Thorough Investigations into Alleged Abuse and Injuries of Unknown Origin
Penalty
Summary
The facility failed to conduct thorough investigations into alleged abuse or injuries of unknown origin for two residents. One resident, with a history of stroke and neurological disorder and moderate cognitive impairment, was found to have a right shoulder dislocation requiring surgery, as well as healing fractures of multiple right ribs. In both instances, the facility's investigations did not identify the source of the injuries, lacked interviews with the resident, staff who provided care, or other residents, and did not include a summary of the timeline of the injuries. One of the investigations was left blank, and there was no documentation of efforts to determine how the injuries occurred. Another resident, who had dementia and mood disturbances with moderate cognitive impairment, reported that a staff member made inappropriate comments about their body. The facility's investigation into this allegation did not include interviews with a sample of residents who had received care from the named staff member. The Director of Nursing acknowledged that staff and resident interviews should have been conducted as part of the investigations.
Failure to Follow Care Plan for Safe Resident Transfers
Penalty
Summary
A deficiency occurred when staff failed to follow the care plan for a resident with Alzheimer's disease and kidney disease, who was dependent on staff for all activities of daily living and required two-person assistance with a gait belt for transfers. The care directive specified the use of a sit-to-stand device with two staff in the morning and two staff with a gait belt for all other transfers. Despite these requirements, a nursing assistant transferred the resident without a second staff member and did not use a gait belt, contrary to the established care plan. As a result of this failure, the resident fell in the bathroom, sustaining a head laceration that required eight staples and multiple bruises. The facility's investigation confirmed that the root cause of the fall was the staff member's noncompliance with the care plan, specifically the lack of a second staff person and the absence of a gait belt during the transfer. Staff interviews corroborated the resident's need for two-person assistance and the use of a gait belt, and it was noted that the resident could be resistive during transfers, further emphasizing the importance of following the care plan.
Inaccurate Resident Assessment for Pressure Ulcer
Penalty
Summary
The facility failed to ensure that resident assessments accurately reflected their health status and care needs, specifically for one resident who was admitted with a pressure ulcer (PU). The resident was admitted to the facility with a left hip fracture, and the admission Minimum Data Set (MDS) incorrectly indicated that the resident did not have a PU. However, hospital discharge notes and a skin evaluation form both documented the presence of a PU on the resident's hip. Staff C, a licensed practical nurse and MDS coordinator, acknowledged the coding error on the MDS and expressed uncertainty as to why the PU was not recorded, despite clear documentation. Staff B, the Director of Nursing, confirmed that the MDS should accurately reflect the resident's status.
Failure to Update Care Plan for Resident with Pressure Ulcer
Penalty
Summary
The facility failed to review, revise, and implement a comprehensive care plan for a resident who was admitted with a left hip fracture and later developed a pressure ulcer (PU) on the hip. The admission Minimum Data Set (MDS) indicated the resident was dependent on staff for some activities of daily living. A Skin Evaluation form initially documented fragile skin with redness but no open areas. Subsequent evaluations confirmed the presence of a PU, yet the care plan was not updated to reflect this change in the resident's condition. The Director of Nursing acknowledged that while some interventions were in place to prevent skin breakdown, they were not specific to residents with PUs, and the care plan did not accurately reflect the resident's skin status or include appropriate interventions for the PU.
Deficiency in Psychotropic Medication Monitoring
Penalty
Summary
The facility failed to ensure person-centered side effect and target behavior monitoring for psychotropic medications for four out of five sampled residents. This deficiency was identified through interviews and record reviews, revealing that residents were at risk of receiving unnecessary medications without proper monitoring. The facility's policy required specific behaviors to be identified for each resident, with side effects documented daily and care plans developed around current behaviors. However, these requirements were not met for the residents reviewed. Resident 74, who was cognitively intact and prescribed an anti-depressant, did not have person-centered side effect or target behavior monitoring documented in their electronic health record. Staff interviews confirmed the absence of necessary monitoring and assessments before administering psychotropic medication. Similarly, Resident 42, with severe cognitive impairment and prescribed both an antidepressant and an antipsychotic, lacked specific daily tracking of behaviors, which was expected by the facility's Director of Nursing Services. Resident 46, also cognitively intact and prescribed an anti-depressant, did not have person-centered target behavior monitoring documented. Resident 3, with moderate cognitive impairment and receiving antipsychotic medication, had discrepancies between care plan and treatment administration record regarding targeted behaviors for medication use. The lack of consistent and specific behavior monitoring hindered the ability to evaluate the effectiveness of the medication and the need for its continued use.
Deficiencies in Food Safety and Hygiene Practices
Penalty
Summary
The facility failed to ensure proper labeling and dating of food products, as observed in the 100-hall oxygen room refrigerator, where four undated and unlabeled containers filled with a red gelatin-like substance were found. This lack of labeling violates the facility's policy that requires food prepared by the facility to be labeled with the date it was prepared or a use-by date, as confirmed by Staff O, the Dietary Manager. Additionally, the facility did not maintain the required sanitization temperatures for their high-temperature dishwasher. The dishwasher's rinse cycle temperatures were recorded below the minimum required 180 degrees Fahrenheit on multiple occasions, including specific dates in October 2024. Staff P, from the dietary department, acknowledged that these temperatures were not reported to a supervisor as required, and no documentation was provided to show that any corrective action was taken. Furthermore, there were multiple instances of improper hand hygiene and glove use by Staff F, a Dietary Aide, during meal preparation and service. Staff F was observed repeatedly touching food with gloves on, then touching various surfaces without changing gloves, and failing to perform hand hygiene when changing gloves. Despite acknowledging that touching food with gloves was not acceptable, Staff F continued this practice, indicating a lack of adherence to proper food handling protocols.
Failure to Follow Physician Orders and Notify Provider of Held Medications
Penalty
Summary
The facility failed to ensure that services provided met professional standards of practice by not adhering to physician orders and failing to notify the provider when medications were held for a resident. Specifically, the facility's nurses administered Metoprolol to a resident outside of the physician's ordered parameters on multiple occasions, despite instructions to hold the medication if the resident's systolic blood pressure (SBP) was less than 110 or pulse was less than 60. Instances of non-compliance included administering the medication when the resident's pulse was as low as 50 and when the SBP was 109. Additionally, the facility's records showed that the resident's Metoprolol and Imdur were held on eight occasions each in September 2024 due to low SBP or pulse, yet there was no documentation indicating that the provider was informed of these held medications. The Unit Manager confirmed that it was expected for nurses to notify the provider when medications were held, but no further documentation was provided to show that this communication occurred.
Failure in IV Therapy Monitoring and Maintenance
Penalty
Summary
The facility failed to ensure proper assessment, maintenance, and monitoring of intravenous (IV) access devices for a resident requiring IV therapy. The deficiency was identified when it was observed that the IV orders did not include routine monitoring of IV insertion sites, weekly changes of IV dressings and needleless injection caps, and initial and weekly measurements of IV catheters' external length and the resident's arm circumferences. This oversight was noted for a resident who was cognitively intact and required IV antibiotics due to an infection. The resident reported that the IV bandage had not been changed since insertion, and observation confirmed the presence of dried blood at the insertion site and along the IV tubing under the transparent dressing. The facility's policy required sterile dressing changes upon admission and at least weekly, with specific measurements to be taken as part of the initial assessment. However, the resident's care plan lacked documentation regarding the maintenance and monitoring of the IV access site. Staff interviews revealed that the expected procedures, such as monitoring the insertion site for infection signs, performing weekly dressing changes, and measuring the external length of the tubing, were not documented or followed. The Director of Nursing Services confirmed the absence of documentation for external measurements and needleless injection cap changes, acknowledging that the bandage should have been changed if its integrity was compromised.
Inadequate Hand Hygiene Practices Observed
Penalty
Summary
The facility failed to ensure appropriate hand hygiene practices during the dining tray pass and while providing care under transmission-based precautions. On October 9, 2024, a Certified Nursing Assistant (CNA), identified as Staff H, was observed passing a food tray to a resident in a sampled room. Staff H placed a shirt saver on the resident, touching their clothing, but did not perform hand hygiene after this contact before proceeding to the next resident. Staff H admitted to washing hands only at the beginning of the tray pass or when getting a resident out of bed, but not when setting up trays. The Director of Nursing Services, Staff B, confirmed that staff should perform hand hygiene after touching residents or their food. On October 16, 2024, another CNA, Staff G, was observed providing care to a resident under transmission-based precautions. Staff G changed gloves multiple times during care without performing hand hygiene between glove changes. The Unit Manager, Staff D, stated that staff should perform hand hygiene after removing soiled gloves and before putting on clean ones. These observations indicate a failure to adhere to proper infection prevention and control practices, placing residents at risk for healthcare-associated infections.
Improper Transfer Leads to Resident Injury
Penalty
Summary
The facility failed to ensure that Resident 1 was free from avoidable accidents during a transfer, resulting in harm. Resident 1, who had multiple sclerosis, hemiplegia, and hemiparesis, required two-person assistance with a Hoyer lift for all transfers as per their care plan. However, on the day of the incident, a nursing assistant, Staff C, attempted to use a sit-to-stand lift, which was inappropriate for Resident 1's condition as they could not bear weight or grip the handles. This improper use of equipment led to Resident 1 experiencing pain and subsequently being transferred to the hospital, where an acute fracture of the left humeral neck was diagnosed. The incident occurred when Staff C, without following the care plan, attempted to transfer Resident 1 to the toilet using a sit-to-stand lift and later manually lifted the resident without a gait belt. This was against the care plan's directive, which specified the use of a Hoyer lift with two staff members for all transfers. The Director of Nursing confirmed that the correct procedure was not followed, leading to Resident 1's injury and hospitalization. The facility's policy on mechanical lift usage was not adhered to, resulting in a deficiency in providing adequate supervision and safety during resident transfers.
Medication Administration Deficiency
Penalty
Summary
The facility failed to adhere to professional standards of practice during medication administration for three residents, leading to a risk of medication errors and adverse outcomes. The facility's policy required that medications be listed on the Medication Administration Record (MAR) and that the licensed nurse initial the MAR after administering the medication. However, it was found that medications for Residents 5, 6, and 7 were prepared and signed off by one LPN, Staff F, but were administered by another staff member, Staff D, without proper verification of the five rights of medication administration. Resident 5, who had an infection related to an orthopedic prosthetic and arthritis, had multiple medications prepared and signed by Staff F but administered by Staff D. Similarly, Resident 6, with diagnoses including diabetes, hypertension, and narcolepsy, and Resident 7, with diabetes and anemia, also had their medications prepared by Staff F and administered by Staff D. This practice was not in line with the facility's policy, which required the same nurse to prepare and administer the medication to ensure accuracy and safety. Interviews with various staff members, including LPNs and unit managers, revealed that this practice was a regular occurrence, especially when the facility was short-staffed. Staff D admitted to administering medications prepared by other nurses, including Staff F, without verifying the right resident, drug, dose, time, and route. The Director of Nursing, Staff B, acknowledged awareness of this practice and had sent an email to all licensed nurses to cease this practice, although no formal policy was provided to support this directive.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Lacey
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Woodard Creek Health & Rehabilitation | 1.4 mi | ★★★★★ | 45 | 1 |
| Olympia Transitional Care And Rehabilitation | 1.6 mi | ★★★★★ | 19 | 0 |
| Crystal Cove Post Acute | 1.9 mi | — | 43 | 0 |
| Lacey Post Acute & Rehabilitation | 2.1 mi | ★★★★★ | 11 | 0 |
| Regency Olympia Rehabilitation And Nursing Center | 2.4 mi | ★★★★★ | 15 | 0 |
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