Health inspection·December 13, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure one of three residents, (Resident 3), was assisted with his meal in a dignified manner when the Certified Nursing Assistant (CNA 2), stood over the resident. This failure caused Resident 3 to feel rushed and had the potential for compromised dignity. Findings: On November 29, 2023, at 11:48 a.m., an unannounced visit to the facility on a complaint investigation was initiated. On November 29, 2023, at 1:15 p.m., observed Resident 3 sitting in a wheelchair in the hallway. Resident 3's lunch tray was on the over-bed table in front of Resident 3. CNA 2 was standing beside Resident 3 as he was feeding Resident 3. On November 29, 2023, at 1:34 p.m., an interview was conducted with Resident 3. Resident 3 stated he needed assistance with eating his lunch. Resident 3 stated he felt rushed while CNA 2 was assisting him with lunch. On November 29, 2023, at 1:58 p.m., an interview was conducted with CNA 2. CNA 2 stated that he should have been seated while assisting Resident 3 with his lunch. A review of Resident 3's medical record indicated he was admitted on [DATE], with diagnoses of amyotrophic lateral sclerosis, (ALS - is also called Lou Gehrigsdisease. It's a neuromuscular disorder that causes muscle weakness), anxiety disorder, (a chronic condition characterized by an excessive and persistent sense of apprehension), and major depression, (a mood disorder that causes a persistent feeling of sadness and loss of interest). A review of Resident 3's History and Physical dated January 31, 2023, indicated he had the capacity to understand and make decisions. A review of Resident 3's Care Plan initiated May 23, 2023, indicated Focus . The resident has an ADL self-care performance deficit r/t Limited Mobility, Weakness secondary to left humerus fracture (history), Amyotrophic Lateral Sclerosis .Interventions . EATING: Extensive with one person assist . A review of a Nursing Times article titled Assisting Patients with Eating and Drinking to Prevent Page 1 of 3 055042 055042 12/13/2023 Alta Vista Healthcare & Wellness Centre 9020 Garfield Street Riverside, CA 92503

F 0550 Level of Harm - Minimal harm or potential for actual harm Malnutrition dated October 9, 2017, indicated .Assisting patients .Helping patients who cannot eat and drink independently takes time, understanding and patience. It must not be rushed and any nurse who is involved in this task should not be interrupted . 7. Sit down at the patient's eye level. This aids effective communication but also provides reassurance the patient that you have the time to help the patient to eat . Residents Affected - Few 055042 Page 2 of 3 055042 12/13/2023 Alta Vista Healthcare & Wellness Centre 9020 Garfield Street Riverside, CA 92503

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure basic accommodations of needs were met when one of three residents, (Resident 1) ' s call light was not within reach. Residents Affected - Few This failure had the potential for Resident 1 to have unmet needs and unable to call for assistance. Findings: On November 29, 2023, at 11:48 a.m., an unannounced visit to the facility on a complaint investigation was initiated. On November 29, 2023, at 12:54 p.m., observed Resident 1 sitting on the right side of his bed in a wheelchair. His over-bed table was in front of him, and his call light was on the left side of the bed on the floor, outside of Resident 1 ' s reach. On November 29, 2023, at 12:54 p.m., an interview was conducted with Resident 1. Resident 1 stated he used his call light to call for assistance. Resident 1 stated he would not be able to reach his call light and was concerned that he could not call for assistance. On November 29, 2023, at 1:19 p.m., an interview was conducted with the Certified Nursing Assistant, (CNA). The CNA stated she was taking care of Resident 1. The CNA stated the call light should always be within reach. The CNA stated Resident 1 ' s call light was not within his reach. A review of Resident 1 ' s medical records indicated he was admitted to the facility on [DATE], with diagnoses of stroke with hemiplegia, (paralysis of one side of the body), hemiparesis, (weakness of one side of the body), affecting right dominant side, aphasia, (affects a person's ability to express and understand written and spoken language), dysphagia, (difficulty swallowing), and anxiety disorder, (a chronic condition characterized by an excessive and persistent sense of apprehension). A review of Resident 1 ' s History and Physical dated September 29, 2023, indicated he had the capacity to understand and make decisions. A review of Resident 1 ' s Care Plan dated September 29, 2023, indicted Focus .The resident has an ADL, [activities of daily living], self-care performance deficit r/t, [related to], Limited Mobility, Weakness .Interventions .Encourage the resident to use bell to call for assistance . A review of the facility ' s policy and procedure titled Communication - Call System revised January 1, 2012, indicated .The Facility will provide a call system to enable residents to alert the nursing staff from their rooms . II. Call cords will be placed within the resident's reach in the resident's room. A. When the resident is out of bed, the call cord will be clipped to the bedspread in such a way as to be available to a wheelchair bound resident . 055042 Page 3 of 3