Inspection·August 8, 2024

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few had been rough and hurt the resident during perineal care. CNA #3 stated the resident informed her on 08/04/2024, during morning rounds. CNA #3 stated she had not reported the allegations to the charge nurse or the Administrator. She stated she did inform CNA #4 about Resident #55's allegations. During an interview on 08/05/2024 at 2:07 PM, CNA #4 stated CNA #3 had informed her that Resident #55 had reported that an aide was rough and had hurt the resident. She stated she did not report the allegation to the charge nurse or the Administrator. During an interview on 08/07/2024 at 10:55 AM, the Social Service Director (SSD) stated he had received a report after surveyor inquiry that an aide had been rough with Resident #55. He stated he began the investigation and Resident #55 was interviewed. The SSD stated the resident stated they felt safe and there had not been any physical signs of abuse. The SSD stated Resident #55 reported they felt safe at the facility. During a follow up interview on 08/07/2024 at 2:38 PM, Resident #55 stated they felt safe and was not fearful of the staff. An interview with the Administrator on 08/08/2024 at 10:43 AM revealed he expected the facility staff to report any allegations of staff members being rough or hurting any of the residents. The Administrator stated the aide should have reported the allegation to the supervisors and the Abuse Coordinator immediately. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055410 If continuation sheet Page 2 of 7 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 055410 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Post Acute 361 E. Grangeville Blvd Hanford, CA 93230 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)

F 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm Based on observation, record review, interview, and facility policy review, the facility failed to ensure the medication error rate was not greater than 5 percent (%). The facility had 2 medication errors out of 27 total opportunities, resulting in a medication error rate of 7.41%, affecting 2 (Resident #78 and Resident #43) of 5 residents observed during medication administration. Residents Affected - Few Findings included: A facility policy titled, Medication Administration General Guidelines, dated 01/2021, revealed the section titled Medication Preparation: included 3. Prior to administration, review and confirm medication orders for each individual resident on the Medication Administration Record [MAR]. Compare the medication and dosage schedule on the resident's MAR with the medication label. If the label and MAR are different, and the container is not flagged indicating a change in directions, or if there is any other reason to question the dosage or directions, the prescriber's orders are checked for the correct dosage schedule. Apply a 'direction change' sticker to label if directions have changed from the current label. The policy further specified, Medication Administration: 1. Medications are administered in accordance with written orders of the prescriber. If a dose seems excessive considering the resident's age and condition, or a medication order seems to be unrelated to the resident's current diagnosis or condition, the nurse calls the provider pharmacy for clarification prior to the administration of the medication. If necessary, the nurse contacts the prescriber for clarification. This interaction with the pharmacy and the resulting order clarification are documented in the nursing notes and elsewhere in the medical record as appropriate. 1. An admission Record indicated the facility admitted Resident #78 on 06/26/2024. According to the admission Record, the resident had a medical history that included a diagnosis of generalized muscle weakness. Resident #78's Order Summary Report with active orders as of 08/06/2024, contained an order dated 06/26/2024 for a multiple vitamin tablet to be given one time per day as a supplement. During an observation of medication pass on 08/06/2024 at 8:21 AM, Licensed Vocational Nurse (LVN) #1 administered one multivitamin with minerals tablet to Resident #78. During an interview on 08/06/2024 at 12:38 PM, LVN #1 stated Resident #78's order did not say the multivitamin tablet should contain minerals. She stated the order was for a multivitamin tablet without minerals. LVN #1 stated that before she gave the tablet, she should have called the doctor to verify that she could give the multivitamin with minerals. LVN #1 stated she should have triple checked that it was the correct medication to give by reading the label again before she gave it. She stated she gave the wrong medication. 2. An admission Record indicated the facility admitted Resident #43 on 10/25/2017. According to the admission Record, the resident had a medical history that included diagnoses of unspecified dementia and diabetes mellitus type 2. Resident #43's Order Summary Report with active orders as of 08/06/2024, contained an order dated 07/15/2022 and reordered on 08/06/2024 for a multiple vitamin tablet to be given one time per day as a supplement. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055410 If continuation sheet Page 3 of 7 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 055410 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Post Acute 361 E. Grangeville Blvd Hanford, CA 93230 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)

F 0759 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an observation of medication pass on 08/06/2024 at 8:43 AM, Licensed Vocational Nurse (LVN) #2 administered one multivitamin with minerals tablet to Resident #43. During an interview on 08/06/2024 at 12:42 PM, LVN #2 stated the bottle in the cart of multivitamins with minerals was not the same medication as the order for multivitamins. She stated she should not have given Resident #43 the multivitamins with minerals, because it was not ordered, and she should have checked for a bottle of multivitamins without minerals or clarified the order before giving it. During an interview on 08/07/2024 at 10:24 AM, the Director of Nursing (DON) stated that during medication administration, she expected the nurses to match the physician's order with the label on the medication bottle to avoid errors. She stated the nurses should not have given the multivitamins with minerals until they clarified the order. During an interview on 08/07/2024 at 10:26 AM, the Administrator stated he expected the nurses to double check the medication label before giving a medication, and then give the medication according to the order. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055410 If continuation sheet Page 4 of 7 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 055410 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Post Acute 361 E. Grangeville Blvd Hanford, CA 93230 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)

F 0912 Level of Harm - Potential for minimal harm Residents Affected - Some Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure resident rooms measured at least 80 square (sq.) feet (ft.) per resident in 26 (Rooms 100, 102, 104, 106, 108, 110, 112, 200, 204, 206, 208, 210, 212, 214, 300, 301, 302, 303, 304, 305, 404, 406, 408, 410, 412, and 414) of 40 resident rooms in the facility. Findings included: A Client Accommodation Analysis, undated, revealed documentation of room sizes indicated the following resident rooms and corresponding square footage (sq. ft.): - In room [ROOM NUMBER], the total floor area measured 212 sq. ft. and three beds occupied the room, which provided 70.7 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 213.9 sq. ft. and three beds occupied the room, which provided 71.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 200.5 sq. ft. and three beds occupied the room, which provided 66.8 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 214.5 sq. ft. and three beds occupied the room, which provided 71.5 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 224.6 sq. ft. and three beds occupied the room, which provided 74.9 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 210.9 sq. ft. and three beds occupied the room, which provided 70.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 292.5 sq. ft. and four beds occupied the room, which provided 73.1 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 222.6 sq. ft. and three beds occupied the room, which provided 74.2 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 220 sq. ft. and three beds occupied the room, which provided 73.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 222 sq. ft. and three beds occupied the room, which provided 74 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 224 sq. ft. and three beds occupied the room, which provided 74.7 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 222 sq. ft. and three beds occupied the room, which provided 74 sq. ft. of space per resident. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055410 If continuation sheet Page 5 of 7 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 055410 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Post Acute 361 E. Grangeville Blvd Hanford, CA 93230 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)

F 0912 Level of Harm - Potential for minimal harm - In room [ROOM NUMBER], the total floor area measured 224 sq. ft. and three beds occupied the room, which provided 74.7 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 224 sq. ft. and three beds occupied the room, which provided 74.7 sq. ft. of space per resident. Residents Affected - Some - In room [ROOM NUMBER], the total floor area measured 209 sq. ft. and three beds occupied the room, which provided 69.7 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 214 sq. ft. and three beds occupied the room, which provided 71.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 220 sq. ft. and three beds occupied the room, which provided 73.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 224 sq. ft. and three beds occupied the room, which provided 74.7 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 220 sq. ft. and three beds occupied the room, which provided 73.3 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 297.6 sq. ft. and four beds occupied the room, which provided 74.4 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 236.3 sq. ft. and three beds occupied the room, which provided 78.8 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 234.3 sq. ft. and three beds occupied the room, which provided 78.1 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 234.3 sq. ft. and three beds occupied the room, which provided 78.1 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 234.3 sq. ft. and three beds occupied the room, which provided 78.1 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 234.3 sq. ft. and three beds occupied the room, which provided 78.1 sq. ft. of space per resident. - In room [ROOM NUMBER], the total floor area measured 236.4 sq. ft. and three beds occupied the room, which provided 78.8 sq. ft. of space per resident. During the initial pool process on 08/05/2024, 24 residents were interviewed. No residents expressed concerns with room size. During an interview on 08/07/2024 at 11:41 AM, the Maintenance Director stated there had not been any concerns voiced about the rooms not being large enough. The Maintenance Director confirmed the measurements provided were accurate for the room sizes. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055410 If continuation sheet Page 6 of 7 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 055410 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Post Acute 361 E. Grangeville Blvd Hanford, CA 93230 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)

F 0912 Level of Harm - Potential for minimal harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete During an interview on 08/08/2024 at 10:45 AM, the Director of Nursing (DON) stated that the facility had a waiver for the rooms that did not meet the required 80 sq. ft. per resident. The DON stated her expectation was that resident care was provided in those rooms in a safe manner while maintaining resident privacy. The DON stated she was not aware of there being any issues providing care due to the size of the rooms. During an interview on 08/08/2024 at 11:04 AM, the Administrator stated there was no policy for room size. The Administrator stated his expectation was that there should not be any difference in care for those residents residing in the smaller rooms. The Administrator stated the current room sizes allowed for care and privacy. The Administrator stated he had never received any complaints of staff not being able to provide care due to the room size. Event ID: Facility ID: 055410 If continuation sheet Page 7 of 7