Health inspection·June 20, 2025

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Based on observation, interview, and record review, the facility failed to provide care in a manner that promoted dignity and respect for one of four sampled residents (Resident 1) when Resident 1 was observed spitting in hallways and was reported to open his bowels on the facility patio. This failure had the potential to minimize Resident 1's self esteem and to negatively impact the psychosocial well-being for other residents in the facility. Findings: During a review of Resident 1's clinical record, the record indicated Resident 1 was admitted in early 2023 with multiple diagnoses including Dementia (a decline in mental ability severe enough to interfere with daily life). A review of Resident 1's Minimum Data Set (MDS- a federally mandated assessment tool), Cognitive Patterns, dated 3/21/25, indicated Resident 1 had a Brief Interview for Mental Status (BIMS- tool to assess cognition) score of 3 out of 15 that indicated Resident 1 had severe cognitive impairment. During an interview on 6/18/25 at 12:36 p.m. with Certified Nurse Assistant (CNA 1), CNA 1 stated Resident 1 has been observed having bowel movements on the outside patio. During an interview on 6/18/25 at 12:49 p.m. with Licensed Nurse 1 (LN 1), LN 1 stated Resident 2 had bowel movements outside often and acknowledged it could be stressful for other residents to see. During an interview on 6/18/25 at 1:08 p.m. with Licensed Nurse 3 (LN 3), LN 3 stated that Resident 1 goes to the bathroom outside often and spits on the floor throughout the facility. LN 3 further confirmed Resident 1 was involved in an altercation with another resident who saw him with his pants down in the patio. During an observation on 6/18/25 at 3:51 p.m. Resident 1 was observed walking independently in the hallway while spitting on the floor. During a concurrent interview and record review on 6/18/25 at 3:09 p.m. with Director of Nursing (DON), the DON reviewed Resident 1's clinical record and stated there was no care plan or interventions related to Resident 1 having bowel movements outside and spitting on the facility floors. The DON further confirmed Resident 1 was involved in a physical altercation as a result of another resident seeing Resident 1 with his pants down in the patio. (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: 055858 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 055858 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rancho Seco Care Center 144 F Street Galt, CA 95632 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)