Health inspection·June 17, 2025

F 0563 Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to permit residents to receive visitors according to the facility ' s policy and procedures (P&P) titled, Visitation and Resident Rights, for one of four sampled residents, Resident 1. Residents Affected - Few This deficient practice violated residents ' rights regarding visitation. Cross Reference F656. Findings: During a review of the admission Record indicated Resident 1 was originally admitted to the facility on [DATE] and readmitted on [DATE] with diagnosis including respiratory tuberculosis (a contagious bacterial infection that involves the lungs), pneumonia (lung infection that inflames air sacs with fluid or pus) and depression (a mood disorder that causes persistent feeling of sadness and loss of interest). During a review of the Minimum Data Set (MDS – resident assessment tool) dated 3/23/2025, indicated Resident 1 ' s cognitive (mental action or process of acquiring knowledge and understanding) skills for daily decisions were severely impaired. The MDS indicated Resident 1 required moderate assistance from staff for activities of daily living (ADLs- routine tasks/activities such as bathing, dressing and toileting a person performs daily to care for themselves). The same MDS also indicated, Resident 1 experienced feeling down, depressed, or hopeless, and have little interest or pleasure in doing things in 2-6 days (several days) a week. During a review of Resident 1 ' s Interdisciplinary Team (IDT - a group of dedicated healthcare professionals who work to bring knowledge together to help residents receive the care they need) Notes, dated 3/12/2025, the IDT notes indicated, Resident 1 ' s Family Member 2 (FM 2) and Family Member 3 (FM 3) are not allowed to visit unless they are accompanied by Resident ' s Family Member 1 (FM 1). During a review of Resident 1 ' s Progress Notes dated 3/13/2025, the Progress Notes indicated, the Ombudsman (an advocate for residents of nursing homes, board and care centers, and assisted living facilities) notified the facility that according to the regulation, the facility cannot restrict visitation and Resident 1 ' s FM 1 cannot [NAME] visitors if Resident 1 would like to have them . FM 1 can restrict visitors only if the visitor put Resident 1 in immediate risk of threat or neglect. During a review of Resident 1 ' s Progress Notes dated 6/3/2025, the Progress Notes indicated, Two (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 4 Event ID: 055748 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 055748 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sunset Park Healthcare 2250 29th Street Santa Monica, CA 90405 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)