Health inspection·January 21, 2025

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide safety rails in a bathroom that was used by two of four residents (Resident 7 and Resident 11) who had access to the bathroom. This failure had the potential for accidents related to toilet use. Findings: Per the facility's admission Record, Resident 7 (R7) was admitted on [DATE] for Respite Care (short-term relief for primary caregivers, giving them time to rest, travel, or spend time with other family and friends). R7 had diagnoses which included Malignant Neoplasm (a cancerous tumor, which is an abnormal growth of cells that have the potential to spread to other parts of the body) of bladder, Surgery of the Genitourinary (the urinary and genital organs) System, Chronic Respiratory Failure (a long-term condition that prevents the lungs from exchanging enough oxygen and carbon dioxide with the body). Record review of Minimum Data Set (MDS-standardized assessment tool used to comprehensively evaluate the health status of nursing home residents) Section GG-Functional Abilities-Admission for R7 was conducted. Record review indicated R7 was assessed for the category F, Toilet Transfer: The ability to get on and off commode as . Substantial/ maximal assistance-Helper does MORE THAN HALF the effort. Helper holds trunk or limbs but provides more than half the effort. Per admission Record, Resident 11 (R11) was admitted on [DATE] with diagnoses which included abnormalities of gait (a person's manner of walking) and mobility, muscle weakness, Cerebral Infarction (medical condition that occurs when blood flow to the brain is disrupted, depriving brain cells of oxygen and nutrients), and Falls. Record review of MDS Section GG-Functional Abilities-Admission for R11 was conducted. Record review indicated R11 was assessed for the category F, Toilet Transfer: The ability to get on and off commode as .Supervision or touching assistance-Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity . On 12/31/24 at 9:27 A.M., an interview was conducted with Complainant 1 (C1). C1 stated that her husband, R7 had a bathroom with no safety rails near the toilet or anywhere in the bathroom. On 12/31/24 at 12:29 P.M., an observation of the bathroom that connected room [ROOM NUMBER] and room [ROOM NUMBER] was conducted. There were no safety rails by the toilet or anywhere in the bathroom. (continued on next page) 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 3 Event ID: 055067 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 055067 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Palomar Vista Healthcare Center 201 N Fig Street Escondido, CA 92025 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)