Health inspection·June 7, 2023

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few a history of adjustment disorder with anxiety, currently not prescribed psychotropic medications. The Nurse Practitioner (NP) documented the resident had cognitive communication deficit with poor attention/concentration, insight/judgment, and poor memory capabilities. Review of Resident 1's care plan problems dated 3/4/2023 showed a problem to address an altercation with another resident. The interventions included monitoring every hour for her whereabouts. Additional problems dated 3/4/2023 showed a problem to address her small cut on the right side of her nose and a problem to address redness around her left eye. Review of Resident 1's Interdisciplinary Department Team (IDT) Altercation/Abuse/Incident Notes dated 3/6/2023 showed on 3/4/2023 at 12:45 p.m., a licensed nurse (LN) heard yelling and went to assess the situation in Resident 2's room. The LN documented she saw Resident 1 sitting in her wheelchair while trying to get access to Resident 2's draws. Resident 2 was standing in front of Resident 1 with a water bottle raised in her hand. She documented Resident 1 had redness around her left eye and a small four centimeter (cm) cut on the right side of her nose. Resident 1's bleeding was stopped with pressure, cleansed with normal saline, triple antibiotic ointment was applied to the cut and a dry dressing was applied. The Care Plan was completed and the preventive measures in place were to put the resident on every hour monitoring for her whereabouts. Review of Resident 1's Social Services Note dated 3/6/2023 at 12:52 showed day 1 of 72-hour monitoring, Resident 1 was unable to recall the incident on 3/4/2023 and the nursing department had implemented for both residents (Residents 1 and 2) to be under every hour monitoring for whereabouts. 2. Clinical record review for Resident 2 was conducted on 6/7/2023. Resident 2 was admitted to the facility with diagnoses including vascular dementia (changes to memory, thinking and behavior, decline in thinking skills), severe with other behavioral disturbances, major depressive disorder, and unspecified mood (affective) disorder. Review of Resident 2's hospital Discharge summary dated [DATE] showed Resident 2 had vascular dementia and was in the hospital for about five months prior to discharge on [DATE] back to a skilled nursing facility (SNF). The SNF was unable to handle her behavior and sent Resident 2 back to the emergency room for placement the very next day. The discharge instructions included to crush Resident 2's medications and give them with chocolate ice cream since this is the only way the resident takes her medication. Review of Resident 2's Doctor's Progress Note dated 9/15/2022 showed the resident was admitted to the SNF with diagnoses including vascular dementia. He documented on 3/12/2022, Resident 2 was sent to the emergency room due to being agitated, combative and throwing/smashing laptops, printers, and potted plants. An attempt was made to transfer her another SNF on 8/22/2022; however, the transfer was unsuccessful due to their inability to handle her behaviors and Resident 2 was sent back to the emergency room. The physician documented Resident 2 has been calm if the staff can give medications (needs to hide the medications in the foods that she likes). He documented Resident 2 does not have the capacity to make decisions and easily gets upset and agitated. Review of Resident 2's Psychiatry Diagnostic Interview note dated 11/18/2022 showed documentation Resident 2 was alert, angry and confused. The staff reported the resident displays angry outbursts which are often difficult to redirect. The NP documented the staff continue to monitor and document the resident's episodes of severe agitation, yelling and verbal abuse towards the staff. She documented the resident had aggressive, and verbal behaviors, was irritable, angry, poor impulse control, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 2 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0600 Level of Harm - Minimal harm or potential for actual harm insight/judgment. The plan and recommendations included monitoring for mood and behavior for verbal aggression and anger. Review of Resident 2's MDS dated [DATE], shows a BIMS score of 2 (severely impaired cognition) with inattention and disorganized thinking. Residents Affected - Few Review of Resident 2's Situation, Background, Assessment and Recommendations (SBAR) note dated 3/4/2023 at 12:45 p.m., showed no recommendations or monitoring. Review of Resident 2's IDT Altercation/Abuse/Incident Notes dated 3/6/2023 at 3:22 p.m., showed on 3/4/2023 at 12:45 p.m., a LN heard yelling and went to assess the situation in Resident 2's room. The LN documented she saw Resident 1 sitting in her wheelchair while trying to get access to Resident 2's draws. Resident 2 was standing in from of Resident 1 with a water bottle raised in her hand. Resident 1 was noted to have redness around her left eye and a small 4 cm cut on the right side of her nose. The nurse documented the staff would continue to monitor for emotional distress due to the incident. The Care Plan was completed and the Preventive Measures that were put in place to prevent re-occurrence were to put Resident 1 on every hour monitoring for her whereabouts and for Resident 2 to be monitored for emotional distress. The conclusion included to educate Resident 2 to call for assistance with the staff to help her redirect the other resident. On 6/7/2023 at 11:30 a.m., an interview was conducted with Certified Nursing Assistant (CNA) A. She stated Resident 1 was alert and oriented and able to make her needs known. CNA A stated Resident 1 has no behavior problems, and just stays in her wheelchair by the nurse's station. She stated she was unaware of Resident 1 entering another resident's room before the incident on 3/4/2023. Continued interview with CNA A regarding Resident 2. She stated Resident 2 had intermittent confusion and had no behavior problems. CNA A stated Resident 1 was happy all the time and ambulated independently. On 6/7/2023 at 11:40 a.m., an interview was conducted with CNA B. She stated Resident 1 was confused, sometimes able to make her needs known and had no behavioral problems. CNA B stated she was unaware of Resident 1 wandering into other residents' room, except with Resident 2. When she was asked about Resident 2, she stated Resident 2 was alert, and sometimes confused. CNA B stated Resident 2 yells and curses at staff and residents but was unaware of any physical altercations. On 6/7/2023 at 12:15 p.m., an interview was conducted with the Social Service Director (SSD). He stated Resident 1 was alert but not oriented and was able to make her needs known. The SSD stated he was unaware of Resident 1 wandering into other residents' room, she just sits outside her room in a wheelchair. He stated Resident 1 did not have any behavioral problems. When the SSD was asked about Resident 2's behaviors, he stated she was verbally abusive to the staff and was delusional. He stated Resident 2 is alert and oriented to her name only and ambulates independently in the hallways. The SSD stated he was unaware of Resident 2 having any physical behaviors. During an interview with the Assistant Director of Nurses (ADON) on 6/7/2023 at 1 p.m., she stated Resident 1's words do not make sense and she was unable to communicate. The ADON stated Resident 1 can self-propel herself in her wheelchair but was unaware of Resident 1 wandering into any other residents' rooms except Resident 2's room. She stated she was aware of the incident on 3/4/2023 when Resident 2 hit Resident 1 with a water bottle. The ADON stated the staff were monitoring Resident 1's behavior every hour to determine her whereabouts to keep her aware from Resident 2. When the ADON was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 3 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few interviewed about Resident 2, she stated Resident 2 was alert and oriented to name only and was able to make her needs known. She stated Resident 2's behaviors included angry outbursts and verbally abusing the staff, calling the staff idiots, useless, worthless and racial slurs. The ADON stated she was unaware of any physical aggressive behavior with Resident 2, except the incident on 3/4/2023. She stated the staff were monitoring Resident 2 for angry outbursts but was unable to locate any monitoring related to her physical aggressive behavior with Resident 1. On 6/7/2023 at 2:45 p.m., Resident 2 was observed lying in her bed, awake and alert. Multiple water bottles were visible on her bedside table. She was confused and unable to answer simple questions. On 6/7/2023 at 2:50 p.m., Resident 1 was observed sitting in her wheelchair in the hallway, two doors away from Resident 2. She was confused and unable to answer simple questions. A telephone interview was conducted on 6/7/2023 at 4:40 p.m., with Resident 1's responsible party (RP). He stated he was unaware of Resident 1 wandering into other residents' rooms. He stated she probably went into Resident 2's room because she thought Resident 2 had stolen something from her. Resident 1's RP stated Resident 1 is very happy there and feels she is safe there. A telephone interview was conducted on 6/7/2023 at 5:17 p.m., with Resident 2's RP. He stated he was aware of the incident on 3/4/2023. The RP stated in the past, Resident 2 had physical behaviors in the past due to a urinary tract infection but was unaware of any other recent behaviors. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 4 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to develop and implement individualized, resident-centered care plans for one of four sampled residents (Resident 2). Resident 2 had a history of physical aggression. On 3/4/3023, Resident 2 hit Resident 1 with a water bottle in her face. The facility failed to develop and implement a care plan to monitor Resident 2's physical aggression following the incident with Resident 1. This deficient practice has the potential for placing other residents at risk for injury and/or harm. Findings: Clinical record review for Resident 2 was conducted on 6/7/2023. Resident 2 was admitted to the facility with diagnoses including vascular dementia (changes to memory, thinking and behavior, decline in thinking skills), severe with other behavioral disturbances, major depressive disorder, and unspecified mood (affective) disorder. Review of Resident 2's hospital Discharge summary dated [DATE] showed Resident 2 had vascular dementia and was in the hospital for about five months prior to discharge on [DATE] back to a skilled nursing facility (SNF). The SNF was unable to handle her behavior and sent Resident 2 back to the emergency room for placement the very next day. Review of Resident 2's Doctor's Progress Note dated 9/15/2022 showed the resident was admitted to the SNF with diagnoses including vascular dementia. He documented on 3/12/2022, Resident 2 was sent to the emergency room due to being agitated, combative and throwing/smashing laptops, printers, and potted plants. An attempt was made to transfer her to another SNF on 8/22/2022; however, the transfer was unsuccessful due to their inability to handle her behaviors and Resident 2 was sent back to the emergency room. The physician documented Resident 2 had been calm if the staff can give medications (needs to hide the medications in the foods that she likes). He documented Resident 2 does not have the capacity to make decisions and easily gets upset and agitated. Review of Resident 2's Psychiatry Diagnostic Interview note dated 11/18/2022 showed Resident 2 was alert, angry and confused. The staff reported the resident displays angry outbursts which are often difficult to redirect. The NP documented the staff continued to monitor and document the resident's episodes of severe agitation, yelling and verbal abuse towards the staff. She documented the resident had aggressive, and verbal behaviors, was irritable, angry, with poor impulse control, insight/judgment. The plan and recommendations included monitoring for mood and behavior for verbal aggression and anger. Review of Resident 2's MDS dated [DATE], shows a BIMS score of 2 (severely impaired cognition) with inattention and disorganized thinking. Review of Resident 2's IDT Altercation/Abuse/Incident Notes dated 3/6/2023 at 3:22 p.m., showed on 3/4/2023 at 12:45 p.m., a LN heard yelling and went to assess the situation in Resident 2's room. The LN documented she saw Resident 1 sitting in her wheelchair while trying to get access to Resident 2's draws. Resident 2 was standing in front of Resident 1 with a water bottle raised in her hand. Resident 1 was noted to have redness around her left eye and a small 4 cm cut on the right side of her nose. The nurse documented the staff would continue to monitor for emotional distress due to the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 5 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0656 Level of Harm - Minimal harm or potential for actual harm incident. The Care Plan was completed and the Preventive Measures that were put in place to prevent re-occurrence were to put Resident 1 on every hour monitoring for her whereabouts and for Resident 2 to be monitored for emotional distress. The conclusion included to educate Resident 2 to call for assistance with the staff to help her redirect the other resident. Residents Affected - Few Review of Resident 2's Care Plan Problems showed: 1. a problem dated 12/28/2022 (revised date 4/20/2023)-potential to demonstrate physical behaviors related to dementia, cognitive impairment, history of throwing plants, laptops and refusing medications. The goal: will not harm self or others (initial date 12/28/2022, revised date 3/17/2023). Two interventions: monitor/document/report to the physician of danger to self and others and Psychiatric/Psychogeriatric consult as indicated. 2. a problem with an altercation with another resident (dated 3/4/2023, revised date 3/17/2023). The goal: will have no emotional distress from the incident. Interventions included: monitor every day for 72 hours whereabouts/activities of involved residents, educate to call for assistance with the staff to help her redirect the other resident. 3. a problem to address her vascular dementia with behavioral disturbances (initiated 9/15/2022, revised 2/7/2023). The goal: will be able to communicate needs daily. Interventions included: monitor for ability to chew and swallow, monitor communication skills. 4. a problem to address her impaired cognitive function/thought process (initiated 9/15/2022, revised 2/3/2023). The goal: will be able to communicate basic needs daily. 5. a problem to address the potential/actual demonstration of verbally abusive behaviors towards staff (initiated 12/28/2022, revised 1/13/2023). The goal: will have fewer than 3 episodes per shift of verbally abusing staff such as yelling or sudden outbursts of anger. Interventions: assess resident's understanding of the situation and allow time for her to express her feelings. 6. a problem to address her non-compliance/refusal to wear and identification band (initiated 9/15/2022, revised 9/15/2022). Interventions included: explain benefits of wearing the name band and risk and consequences of not wearing it. Review of the facility's Inservice Records showed: 1. On 1/18/2023: Dealing with residents with aggressive or catastrophic reactions and 2. On 3/20-24/2023, Alzheimer/Dementia was given; however, the Lesson Plans were titled Communicating Effectively with Dementia Residents and Recognizing Symptoms of Dementia and Calming Fears. The lesson plans did not address handling of aggressive behaviors after the incident on 3/4/2023. On 6/7/2023 at 1 p.m., an interview was conducted with the Assistant Director of Nurses (ADON). She stated Resident 2's behaviors included angry outbursts, and yelling and screaming at staff. When the ADON was asked was any attempt made to determine possible triggers that may affect Resident 2's outbursts and yelling, she did not know. The ADON confirmed Resident 2 should be monitored for aggressive behavior, but was unable to locate the monitoring or care plan problem. When the ADON was asked about Resident 2's care plan problems and if the goals and/or interventions were compatible with Resident 2's severely impaired cognition, she did not answer. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 6 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0656 Level of Harm - Minimal harm or potential for actual harm During an interview with the Director of Nurses (DON) on 6/7/2023 at 1:30 p.m., she stated Residents 1 and 2 were being monitored for their whereabouts. She was unable to explain the reason why Resident 2 was being monitored for her whereabouts when the incident on 3/4/2023 happened inside Resident 2's room. The DON confirmed no aggressive behavior monitoring was done for Resident 2 and no care plan to address her aggressive behavior. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 7 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0744 Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility failed to ensure a resident with a diagnosis of dementia (a memory disorder with impaired reasoning skills), received the appropriate treatment and services to attain or maintain his or her highest practicable, physical, mental and psychosocial well-being for one of four residents (Resident 2). Resident 2 had an episode of physical aggression with another resident. The facility failed to have a psychiatrist available at the facility to reevaluate and provide proper treatment. This deficient practice has the potential to negatively affect the delivery of services for all residents with a mental disorder. Residents Affected - Few Findings: Clinical record review for Resident 2 was conducted on 6/7/2023. Resident 2 was admitted to the facility with diagnoses including vascular dementia (changes to memory, thinking and behavior, decline in thinking skills), severe with other behavioral disturbances, major depressive disorder, and unspecified mood (affective) disorder. Review of Resident 2 physician's order dated 9/14/2022 showed an order to have Psychiatry and/or Psychology evaluation, treatment and follow up as needed. Review of Resident 2's Psychiatry Diagnostic Interview note dated 11/18/2022 showed Resident 2 was alert, angry and confused. The staff reported the resident displays angry outbursts which are often difficult to redirect. The NP documented the staff continued to monitor and document the resident's episodes of severe agitation, yelling and verbal abuse towards the staff. She documented the resident had aggressive, and verbal behaviors, was irritable, angry, poor impulse control, insight/judgment. The plan and recommendations included monitoring for mood and behavior for verbal aggression and anger. Review of Resident 2's Minimum Data Set (MDS-an assessment tool) dated 2/10/2023, shows a Brief Interview for Mental Status (BIMS) score of 2 (severely impaired cognition) with inattention and disorganized thinking. On 6/7/2023 at 12:15 p.m., an interview was conducted with the Social Service Director (SSD). When the SSD was asked about the facility's Psychiatrist, he stated the facility did not have any psychiatrist since the end of 2022, but a new psychiatrist just started in April 2023. The SSD stated the psychiatrist comes to the facility twice a month; however, she only came twice in April, once in May and currently once in June. When the SSD was asked if a referral for Resident 2 to be reevaluated by the psychiatrist after her physical aggressive behavior on 3/4/2023, he stated he did not get a referral from the staff to order one. An interview was conducted with the Administrator on 6/7/2023 at 12:10 p.m When he was asked about having a psychiatrist evaluation for Resident 2's aggressive behavior, he stated the facility did not have any available Psychiatrist since the end of 2022, but a new Psychiatrist started about 2 months ago. The Administrator stated today, a referral was made for Resident 2 to be evaluated by a psychiatrist. During an interview with the Director of Nurses (DON) on 6/7/2023 at 1:30 p.m., she stated Residents 1 and 2 were being monitored for their whereabouts. She was unable to explain the reason why (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 8 of 9 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 056212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Redwoods Post-Acute 1267 Meridian Avenue San Jose, CA 95125 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 0744 Level of Harm - Minimal harm or potential for actual harm Resident 2 was being monitored for her whereabouts when the incident on 3/4/2023 happened inside Resident 2's room. The DON confirmed no aggressive behavior monitoring was done for Resident 2 and no care plan to address her aggressive behavior. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056212 If continuation sheet Page 9 of 9