Health inspection·April 17, 2023

F 0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Level of Harm - Actual harm Residents Affected - Few Based on interview and record review, the facility failed to honor Resident 1's rights when a Licensed Nurse cut Resident 1's hair without permission. This failure decreased the facility's potential to ensure residents' rights and respect residents' different cultures. Findings: A review of Resident 1's admission record indicated admission to the facility on 5/7/20 with diagnosis which included left-sided weakness as a result of a stoke, lupus (an autoimmune disease which can affect tissue and organs), and depression. A review of a Minimum Data Set (MDS, an assessment tool), dated 2/15/23, indicated Resident 1 had mild memory problems. A review of a progress note dated 3/2/23 at 8 p.m., indicated, .Resident [1] is disappointed that his hair was cut without his consent . In an interview on 3/17/23 at 9:45 a.m., Resident 1 confirmed a nurse cut his hair without asking his permission. Resident 1 stated he felt the LN was disrespectful because he was Native American and hair was an important, sacred, and significant representation of his culture. Resident 1 stated he kept his braid and still had it in his personal possessions. In an interview on 3/17/23 at 10:15 a.m., the Administrator verified the LN should not have cut Resident 1's hair without his consent as it was against the facility policy and procedure for resident rights. In an interview on 3/17/23 at 10:30 a.m., the Director of Nurses (DON) stated Resident 1's rights were not respected. In an interview on 3/21/23 at 3:49 p.m., Certified Nurse Assistant C (CNA C) stated she witnessed Resident 1 tell the LN, No when she stated she was going to cut his hair. The CNA C also stated, [Resident 1] reached up to feel his hair and [the LN] said [it was] too late .[Resident 1] was upset .He was about to cry .[The LN] showed no regret .She asked me to lie and tell him to say it was OK. He was embarrassed and ashamed. After it happened, he pulled his hoodie up so no one could see his hair. A review of the facility's policy and procedure titled Resident Rights, revised 1/1/12, indicated, .Resident's [sic] have freedom of choice .about how they wish to live their everyday lives and (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 2 Event ID: 055208 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 055208 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/17/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Seaview Rehabilitation & Wellness Center, LP 6400 Purdue Drive Eureka, CA 95503 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)