Health inspection·July 30, 2025

F 0552 Ensure that residents are fully informed and understand their health status, care and treatments. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review, the facility failed to ensure appropriate notification was provided for one of four sampled residents (Resident 1) when, Resident 1's responsible party (RP, health care decision maker) was not informed of Resident 1's allegation of abuse.This failure had the potential to affect the ability of the RP to be informed of and participate in Resident 1's plan of care.Findings:A review of Resident 1's admission RECORD, indicated, she was admitted to the facility with diagnoses which included schizophrenia (a serious mental illness that affects how a person thinks, feels, and behaves).A review of Resident 1's clinical document titled, Progress Notes, dated 7/21/25, at 1:43 PM, indicated, .DON [director of nurses] NOTE.Report received that resident claimed she was hit on the head early this morning. Resident stated that around 2 AM, a tall man hit him with a stick.stated I have lumps and bumps up here on my head.A review of Resident 1' s clinical document titled, Care Plan Report, initiated 7/21/25, indicated, .The resident has a potential psychosocial well-being problem r/t [related to] claim of someone hitting my head.Goal .The resident will have no psychosocial well being problem.Interventions.Increase communication between resident/family/caregivers.During a concurrent interview and record review on 7/30/25, at 2:31 PM, with the DON, the DON confirmed there was no documentation in Resident 1's clinical record to indicate the RP had been informed of the allegation of abuse and there should have been. The DON stated it was important to inform the RP and to keep them updated on what was happening with the resident.A review of a facility policy titled, Abuse, Neglect, Exploitation or Misappropriation-Reporting and Investigating, dated 9/22, indicated, .All reports of resident abuse.are reported.and thoroughly investigated.The administrator or the individual making the allegation immediately reports his or her suspicion to.The resident's representative.the resident and/or representative are notified of the outcome immediately upon conclusion of the investigation. Residents Affected - Few Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 055011 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055011 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE River View Post Acute 1611 Scenic Drive Modesto, CA 95355 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)