Health inspection·December 14, 2023

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 provide reasonable accommodation to meet the resident's need and preferences for one of three sampled residents (Resident 3), when a shower schedule was not provided and a shower was offered before bedtime, which was too late according to the resident's preferences. This failure resulted in Resident 3 missing her shower and feeling disappointed. Residents Affected - Few Findings: During a review of the facility policy titled Activities of Daily Living (ADLs), Supporting , revised 3/2018, the policy indicated: 1. Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene. 2. Interventions to improve or minimize a resident's functional abilities will be in accordance with the resident's assessed needs, preferences, stated goals and recognized standards of practice. During a review of Resident 3's clinical record, indicated that she was admitted to the facility on [DATE] with diagnoses which included pneumonia (an infection that affects one or both lungs), muscle weakness, and asthma (a disease that affects the lungs) with acute exacerbation (episodes of worsening asthma symptoms and lung function). Resident 3 was her own health care decision maker. During a review of Resident 3's Minimum Data Set (MDS - an assessment and care screening tool), dated 12/2/2023, the MDS indicated that Resident 3 had a brief interview for mental status (BIMS) score of 13, at section C Cognitive Patterns indicating that her cognition was intact. During a review of Resident 3's MDS at section GG - Functional Abilities and Goals, dated 12/2/2023, the MDS indicated that Resident 3 needed help for self-care which included Eating, Oral Hygiene, Toileting hygiene, Shower/Bath self, Upper body dressing . At the section of Self-care, indicated that Resident 3 was completely dependent and needed the helper to do all of the effort for Shower/Bath and lower body dressing, Resident 3 needed maximal assistance for upper body dressing. During a concurrent interview and review of the facility's shower schedule on 12/1/2023 at 1:33 pm with the Director of Staff Development (DSD), the DSD stated that the facility did not have shower-buddy, the Certified Nursing Assistants (CNAs) were expecting to provide shower service for the residents and informed the residents about their shower schedule. The shower schedule indicated that Resident 3 was scheduled to have a shower on every Monday and Thursday. (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 5 Event ID: 055092 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 055092 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Yuba City Post Acute 1220 Plumas St Yuba City, CA 95991 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)