Health inspection·April 2, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm During a review of Resident 1's MD (medical doctor) Progress note dated 1/23/25, note indicated, Pt [patient] admitted for fall at home.Assessment/Plan.10. OSA (obstructive sleep apnea) G47.33 [diagnosis code] Continue home CPAP. Residents Affected - Few During a review of Resident 1's Order Summary Report dated 3/25/25 at 10:40 am, current orders indicated, no active orders for the use of a CPAP machine. During a review of Resident 1's Medication Administration Record (MAR) dated 1/21/25-2/28/25, MAR indicated no administrations charted for the use of a CPAP machine for any day. During an observation on 3/25/25, at 10:40 a.m., in Resident 1's room, no CPAP machine was observed in the room. During a review of Resident 1's Facesheet, dated 3/25/25, facesheet indicated Resident 1 had a diagnosis listed for Obstructive Sleep Apnea (Adult).onset date 12/20/24. During an interview on 3/25/25 at 11:59 a.m., with Licensed Vocational Nurse (LVN) A. LVN A stated, she was assigned nurse to Resident 1 and took care of Patient 1 multiple times. LVN A stated, Resident 1 had a complaint that he did not have a CPAP machine to use at night and trying to get him the CPAP. LVN A stated, she knows Resident 1 had a CPAP machine when he was here at the facility but he had no CPAP during this current admission. During a review of Resident 1's Progress Note dated 2/28/25, note indicated, Received call from [MD B-medical doctor B] .states he feels resident was having cognitive issues perhaps related to CPAP not using at bedtime. [MD C & NP D-Nurse Practitioner D] notified to obtain CPAP order. Signed by LVN A. During a review of Resident 1's Progress Note dated 3/13/25, note indicated, [MD B] contacted nurse.Asked about getting a CPAP machine for the pt [patient-Resident 1]. During an interview on 3/25/25, at 12:55 p.m., with Director of Nursing (DON), DON stated, the MD should have put an order (for CPAP) for the resident (Resident 1). They (MD/NP) are responsible for putting their orders in. During an interview on 3/25/25 at 3:09 p.m., with MD C, MD C stated, he was not sure the protocol for getting the CPAP machine once it was recommended to use. MD C stated the Director of Nursing would know. Page 1 of 2 056048 056048 04/02/2025 Pacific Coast Manor 1935 Wharf Road Capitola, CA 95010

F 0684 Level of Harm - Minimal harm or potential for actual harm During an interview on 3/26/25, at 10:43 a.m., with MD B, MD B stated, he sees Resident 1 outside the facility for outpatient visits. MD B stated, he had some concerns about Resident 1's change in behavior, Resident 1 had severe sleep apnea, and the facility was not using the CPAP machine. MD B stated, he notified the facility multiple times Resident 1 needs to use the CPAP machine but Resident 1 did not have a CPAP machine. Residents Affected - Few 056048 Page 2 of 2