F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
Based on observation, interview, and record review the facility failed to ensure three of the five sampled
staff (Receptionist 1, Certified Nurse Assistant 1, and Maintenance 1) wore an identification badge as
indicated in the facility ' s policy.
This deficient practice did not promote a culture of safety and transparency and violated residents ' right to
know who was providing care and to be treated with respect.
Findings:
During an observation and interview on 5/16/2025 at 10:08 a.m., with Receptionist 1, Receptionist 1was not
wearing a name badge and Receptionist 1 stated she was new, and she was still waiting for her name
badge to be issued.
During an observation and interview on 5/16/2025 at 10:10 a.m., with Certified Nurse Assistant 1 (CNA 1),
CNA 1 was not wearing a name badge and CNA 1 stated she forgot to wear her name badge today.
During an observation and interview on 5/16/2025 at 10:20 a.m., with Maintenance 1, Maintenance 1was
not wearing a name badge and Maintenance 1 stated he was not wearing his name badge right now while
doing rounds in residents ' rooms.
During an interview on 5/16/2025 at 12:47 p.m. with the Assistant Director of Nursing ADON), the ADON
stated all staff need to always wear a name badge so residents can identify facility staff.
During a review of the facility's policy and procedure (P&P) titled, Identification Badge Policy, updated
1/2021, the P&P indicated:
1) The purpose of the policy was to establish a process for the issuance of approved identification badges
and designate the responsibilities associated with maintaining compliance for ALL employees.
2) An identification badge, including; employees 1) full name (in at least 18 p An identification badge,
including; employees 1) full name (in at least 18-point font), 2) position/ title and 3) current professional
picture, must be worn by all staff members, always while on the facility premises. This is an important
aspect of both security and resident rights.
3) All staff were responsible for:
a. Wearing the company always issued picture identification badge while at work, on facility
(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 3
Event ID:
056283
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
056283
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/16/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Bixby Towers Post-Acute Rehab
3747 Atlantic Avenue
Long Beach, CA 90807
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 0550
premises and not outside the premises unless on official business;
Level of Harm - Minimal harm
or potential for actual harm
b. Wearing the identification badge above waist level and fully visible with face and name side facing
outwards:
Residents Affected - Some
c. Ensuring that identification badges are easily read and not obscured by clothing, stickers or anything else
that could inhibit a patient or visitor from seeing/reading the badge.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
056283
If continuation sheet
Page 2 of 3
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
056283
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/16/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Bixby Towers Post-Acute Rehab
3747 Atlantic Avenue
Long Beach, CA 90807
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 0919
Make sure that a working call system is available in each resident's bathroom and bathing area.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure one of four sampled resident ' s
(Residents 3) call light (device that allows residents to request assistance from nursing staff) was within
reach.
Residents Affected - Few
This deficient practice resulted in a delay of care and services.
Findings:
During a review of Resident 3 ' s admission Record, the admission Record indicated Resident 3 was
originally admitted to the facility on [DATE] with diagnoses including metabolic encephalopathy (brain
disorder) and muscle weakness.
During a review of Resident 3's Minimum data Set (MDS), a resident assessment tool, dated 2/20/2025, the
MDS indicated Resident 3 ' s cognition was intact. The MDS indicated Resident 3 needed setup assistance
with eating, oral hygiene, personal hygiene, and partial assist (helper does less than half the effort) with
showering.
During an interview and observation 5/16/2025 at 10:30 a.m. with licensed vocational nurse 2 (LVN2),
Resident 3's called light was not in reach. LVN 2 stated Resident 3 ' s call light should be within reach so he
can call for help.
During an interview on 5/16/2025 at 12:47 p.m. with the Assistant Director of Nursing ADON), the ADON
stated call lights should always be in reach so residents can call for assistance when needed.
During a review of the facility's policy and procedure (P&P) titled, Call Light Answering, revised 12/2023,
the P&P indicated the facility will provide the residents a means of communication with the nursing staff.
The P&P indicated the call light need to be within the residents ' reach before the staff leaves the room.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
056283
If continuation sheet
Page 3 of 3
