Health inspection·April 5, 2023

F 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During a telephone interview on 6/13/2022 at 3:17 p.m., Resident 41 was asked about his transfer to the hospital on 5/18/2022. Resident 41 stated the Administrator told him he was sent to the hospital for, an evaluation. When asked about signing his discharge documents (from the facility) while in the hospital, Resident 41 stated LN C told him to sign the documents; he stated she did not ask him to sign them. During a telephone interview on 6/13/2022 at 10:50 a.m., Resident 41 ' s RP stated Resident 41 had been deemed to have no capacity to make his own medical decisions prior to his arrival at the facility (approximately two years prior). The RP stated he was not Resident 41 ' s legal DPOA (durable power of attorney for healthcare) but he was his representative, and the facility contacted him for medical care issues. The RP stated the facility did not inform him of the potential need to transfer Resident to another facility due to his past behaviors and stated the transfer to Hospital 1, came out of the blue. The RP stated the Administrator had not spoken to him and he was in the dark about next steps with Resident 41. Review of Resident 41 ' s facility medical record revealed an active (current) physician order, dated 12/04/2019, that indicated, Patient does not have decision making capacity. DPOA (Durable Power of Attorney-someone to act as an attorney-in-fact agent on behalf of another person) pending SW (social worker) consult/conservatorship. During an interview on 6/14/2022 at 3:02 p.m., Licensed Nurse C (LN C) stated she had been working in social services for approximately seven to eight months. LN C stated Resident 41 was challenging and had been verbally aggressive with residents and staff in the past. LN C stated Resident 41 was, not all there. When asked if she meant he had dementia (impaired ability to remember, think, or make decisions that interferes with doing everyday activities), LN C stated, exactly. LN C stated she brought Resident 41 ' s discharge paperwork to him at the hospital. When asked why Resident 41 signed the documentation (versus his RP), LN C stated she had emailed the RP but was unable to, get ahold of him. LN C stated she called an unidentified conservator about conserving (process where a judge appoints a responsible person -called a conservator- to care for another adult who cannot care for themself) Resident 41, but the conservator did not get back to her. LN C stated she normally sent discharge paperwork to the family or RP (for their signature), but this was an unplanned discharge. LN C stated she had Resident 41 sign the documentation to show she had reviewed it with him. When asked who told her to go to the hospital and obtain Resident 41 ' s signature, LN C stated Lawyer E (facility attorney) instructed her to do so. LN C stated legal questions went to Lawyer E. LN C stated Resident 41 had dementia, so family needed to sign the paperwork as well, but she did not have Resident 41 ' s RP sign as she was unable to get ahold of him. LN C stated she returned to the hospital with the discharge pack (of documents) a few days later (approximately 6/3/2022) but she was not allowed into the hospital. Review of Resident 41 medical record revealed a progress note written by LN C (dated 5/20/2022 at 10:27 a.m., approximately two days after his hospital transfer) that indicated, Attempted to reach (RP ' s name), residents (sic) responsible party. SS (social service) left VM (voicemail) informing him that (Resident 41 ' s) belongings are packed up and ready for pick up. Left message on home and alternative # (number) requesting call back. Review of Resident 41 ' s medical record from Hospital 1, dated 5/19/2022 at 3:07 p.m., revealed a physician progress note documented by Physician D. Under the subtitle, Assessment, Physician D documented, .Per my assessment, patient lacks capacity to make his medical decisions .A surrogate decision maker can be considered for this patient . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 2 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Review of facility document (containing the facility name in the letterhead position) titled, Notice of Proposed Transfer/Discharge (dated 6/1/2022) indicated LN C and Resident 41 had both signed the document on 6/1/2022. The document was not signed by Resident 41 ' s RP. Review of facility document titled, Discharge Packet indicated, Resident ' s Name: (Resident 41), discharge date : [DATE], Discharge time: 11 am (sic) . The document indicated, .I acknowledge that I have received this Discharge Packet in its entirety and have had the discharge information explained to me to my satisfaction . The document was signed by both Resident 41 and LN C on 6/1/2022. The document was not signed by Resident 41 ' s RP. During a telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked about LN C going to Hospital 1 to have Resident 41 sign his discharge paperwork. The Administrator stated the facility had Resident 41 sign the discharge paperwork to acknowledge and show the information was given to him. When asked who directed LN C to visit the hospital and obtain Resident 41 ' s signature, the Administrator stated, a group of staff made the decision. When asked who the group consisted of, the Administrator stated he, the Director of Nursing and LN C comprised the group. When asked if Lawyer E was involved in the decision, the Administrator stated, perhaps and stated the event was six months ago. When asked who specifically directed LN C to go to Hospital 1, the Administrator stated, I can ' t recall and stated we thought it was the best way to keep the resident informed of his rights and follow the discharge process. During the same telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked what the normal process was for signing discharge paperwork in the event a resident was not competent to make their own medical decisions. The Administrator stated, I don ' t know and stated the facility would ensure the family knows. When asked if the facility would have a family member sign the paperwork, the Administrator stated, I will double-check. When asked why LN C returned to Hospital 1 a second time, the Administrator stated, I don ' t recall. When informed that Hospital 1 ' s Quality Director had stated it was not appropriate to have Resident 41 sign documents as he was deemed not competent to make his own medical decisions, the Administrator stated, It was totally appropriate (to have Resident 41 sign his discharge paperwork). When informed Hospital 1 ' s Quality Director had stated LN C was refused admittance on her second visit, the Administrator stated he was not aware LN C had returned to Hospital 1 a second time. The Administrator stated it was, silly that Hospital 1 would not allow facility staff to connect with patients. During the same telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked if he was aware Resident 41 ' s physician had deemed him incapable of making his own medical decisions (in 2019). The Administrator stated, I don ' t recall. When asked why the facility did not have Resident 41 ' s RP sign the discharge paperwork, the Administrator stated, I don ' t recall. When asked to confirm that the facility policy titled, Resident Rights, subtitled, Information and Communication (dated 10/4/2016) did not contain information about a resident ' s Responsible Party, the Administrator stated, I (would) have to look at it. Review of facility document titled, Resident Rights, subtitled, Information and Communication (dated 10/4/2016) indicated residents had the right to, .be immediately informed when there is: .a significant change in your physical, mental, or psychosocial status . a decision to transfer or discharge you from the facility. The document did not include information that the resident has the right to be represented by another person (RP), in the event the resident is unable to represent themselves. Review of facility document titled, Resident Rights, subtitled Resident Rights and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 3 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0623 Responsibilities, Notice of, further subtitled, Procedure (dated 03/2019) indicated, 3. Should a resident be found incompetent by a court of law, the resident ' s representative shall act in behalf of the resident . Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 4 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0624 Prepare residents for a safe transfer or discharge from the nursing home. 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 ensure a safe and orderly discharge of one of two sample residents (Resident 41) from the facility. when facility leadership directed facility Social Service Staff (LN C) to visit Resident 1 while he was admitted at a local hospital (Hospital 1) and obtain his signature on discharge documentation (from the facility); Resident 1 subsequently signed the discharge documentation presented to him by LN C. A physician at the facility had deemed Resident 1 incompetent to make his own medical decisions prior to his hospital transfer; Physician D (a hospital doctor) additionally deemed Resident 1 unable to make his own medical decisions. Residents Affected - Few This failure prevented Resident 1 ' s responsible party (RP, person designated to represent a resident who is unable to make their own medical decisions) from being notified timely of Resident 1 ' s discharge to a local hospital and prevented Resident 1 ' s RP from advocating on his behalf while he was temporarily out of the facility. Findings: Review of Resident 41 ' s medical record revealed he was a [AGE] year-old male with diagnosis including cerebral infarction (stroke), dementia (loss of cognitive functioning including thinking, remembering, and reasoning that interferes with a person's daily life and activities) with behavioral disturbance (behavioral abnormalities; common and prominent characteristics of dementia), Hemiplegia (one-sided paralysis; affects either the right or left side of the body) and Hemiparesis (weakness or inability to move one side of the body) due to his stroke. Resident 41 ' s medical record revealed on 4/19/2022, he had a BIMS score (Brief Interview for Mental Status, assessment tool) of 13 (indicating he was cognitively intact). During an interview on 6/1/2022 at 12:15 p.m., the Administrator stated Resident 41 had been residing in the facility approximately two years. Review of Resident 41 ' s medical record revealed a nurse progress note dated 5/18/2022 at 2:26 p.m. that indicated, . Pt (patient) .noted to be engaged in a physical altercation outside in the back patio with (Resident 3) that caused Resident 3 to fall and sustain an injury. Review of Resident 41 ' s hospital medical record revealed a note by Physician F (an emergency room doctor), dated 5/19/22 at 1:31 a.m. Under subtitle, Initial Assessment/Plan, Physician F ' s note indicated Resident 41 presented to the hospital ' s emergency room from the facility after reportedly assaulting other patients. Physician F ' s note further indicated, Patient (Resident 41) arrives to emergency department stating the facility wanted to ' get rid of him ' . During an interview on 6/1/2022 at 1:10 p.m., Resident 3 was outside on the patio and described the incident (on 5/18/2022) between her and Resident 41. Resident 3 stated she and Resident 41 normally chit-chatted (while out on the patio) but on the day in question, Resident 41 had spun her wheelchair around and pushed her until her wheels went off the pavement and she fell over. Resident 3 stated she (currently) was not frightened of Resident 41 as, they (facility staff) assure me he ' s not coming back. During an interview on 6/1/2022 at 3:20 p.m. the ADON (Assistant Director of Nursing) stated Resident 3 had wanted to file a police report about the incident and the ADON told her to think about it (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 5 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0624 because, he (Resident 41) was not coming back. Level of Harm - Minimal harm or potential for actual harm During an interview on 6/1/2022 at 4:00 p.m., the Administrator and the ADON were asked when it was determined Resident 41 was not returning to the facility. The ADON stated, the day after (the incident, 5/19/2022). The Administrator stated Resident 41 could return to the facility, but the facility did not want him back. Residents Affected - Few During an interview with the Administrator, ADON and Staff E on 6/1/2022 at 4:15 p.m., the Administrator stated Resident 41 was a potential harm to others so the facility sent him to a local hospital. During a telephone interview on 6/13/2022 at 3:17 p.m., Resident 41 was asked about his transfer to the hospital on 5/18/2022. Resident 41 stated the Administrator told him he was sent to the hospital for, an evaluation. When asked about signing his discharge documents (from the facility) while in the hospital, Resident 41 stated LN C told him to sign the documents; he stated she did not ask him to sign them. During a telephone interview on 6/13/2022 at 10:50 a.m., Resident 41 ' s RP stated Resident 41 had been deemed to have no capacity to make his own medical decisions prior to his arrival at the facility (approximately two years prior). The RP stated he was not Resident 41 ' s legal DPOA (durable power of attorney for healthcare) but he was his representative, and the facility contacted him for medical care issues. The RP stated the facility did not inform him of the potential need to transfer Resident to another facility due to his past behaviors and stated the transfer to Hospital 1, came out of the blue. The RP stated the Administrator had not spoken to him and he was in the dark about next steps with Resident 41. Review of Resident 41 ' s facility medical record revealed an active (current) physician order, dated 12/04/2019, that indicated, Patient does not have decision making capacity. DPOA (Durable Power of Attorney-someone to act as an attorney-in-fact agent on behalf of another person) pending SW (social worker) consult/conservatorship. During an interview on 6/14/2022 at 3:02 p.m., Licensed Nurse C (LN C) stated she had been working in social services for approximately seven to eight months. LN C stated Resident 41 was challenging and had been verbally aggressive with residents and staff in the past. LN C stated Resident 41 was, not all there. When asked if she meant he had dementia (impaired ability to remember, think, or make decisions that interferes with doing everyday activities), LN C stated, exactly. LN C stated she brought Resident 41 ' s discharge paperwork to him at the hospital. When asked why Resident 41 signed the documentation (versus his RP), LN C stated she had emailed the RP but was unable to, get ahold of him. LN C stated she called an unidentified conservator about conserving (process where a judge appoints a responsible person -called a conservator- to care for another adult who cannot care for themself) Resident 41, but the conservator did not get back to her. LN C stated she normally sent discharge paperwork to the family or RP (for their signature), but this was an unplanned discharge. LN C stated she had Resident 41 sign the documentation to show she had reviewed it with him. When asked who told her to go to the hospital and obtain Resident 41 ' s signature, LN C stated Lawyer E (facility attorney) instructed her to do so. LN C stated legal questions went to Lawyer E. LN C stated Resident 41 had dementia, so family needed to sign the paperwork as well, but she did not have Resident 41 ' s RP sign as she was unable to get ahold of him. LN C stated she returned to the hospital with the discharge pack (of documents) a few days later (approximately 6/3/2022) but she was not allowed into the hospital. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 6 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0624 Level of Harm - Minimal harm or potential for actual harm Review of Resident 41 medical record revealed a progress note written by LN C (dated 5/20/2022 at 10:27 a.m., approximately two days after his hospital transfer) that indicated, Attempted to reach (RP ' s name), residents (sic) responsible party. SS (social service) left VM (voicemail) informing him that (Resident 41 ' s) belongings are packed up and ready for pick up. Left message on home and alternative # (number) requesting call back. Residents Affected - Few During a telephone interview on 6/15/2022 at 2:37 p.m., Hospital 1 ' s Director of Quality (DQ) was asked about Resident 41 ' s stay at the hospital (beginning 5/18/2022). DQ stated Resident 41 had come to the Hospital ' s Emergency Department (ED) on an emergent basis due to an altercation at the facility. DQ stated Resident 41 was kept in the ED from 5/18/2022 through 5/20/2022 (two days) because the hospital thought he would be returning to the facility. DQ stated Resident 41 wanted to return to the facility, but the facility refused, to take him back from day one. During the same interview on 6/15/2022 at 2:37 p.m., DQ stated during utilization management rounds (process that evaluates the efficiency, appropriateness, and medical necessity of the treatments, services, procedures, and facilities provided to patients) at the hospital, staff notified her that Resident 41 was confused but the facility had come to the hospital and had him sign discharge forms on 6/1/2022. DQ stated Resident 41 had dementia and did not have capacity (to make his own medical decisions) and stated she was, shocked facility staff had him sign (legal documents) when he had no capacity. DQ stated one document signed was a Notice of Proposed Transfer but there were no witnesses present when the signing occurred. DQ stated the facility did not call and coordinate their visit (as was customary with visits from skilled nursing staff at the hospital) and stated, we would not have allowed it (had they known) and stated it was, very disturbing. DQ stated the hospital ' s Skilled Nursing Coordinator called the facility and told them that having Resident 41 sign documents was, not okay. DQ stated a facility staff member returned on 6/3/022 (despite the hospital informing them he did not have capacity) to deliver a pack of paper but the hospital did not allow them entrance. Review of Resident 41 ' s medical record from Hospital 1, dated 5/19/2022 at 3:07 p.m., revealed a physician progress note documented by Physician D. Under the subtitle, Assessment, Physician D documented, .Per my assessment, patient lacks capacity to make his medical decisions .A surrogate decision maker can be considered for this patient . Review of facility document (containing the facility name in the letterhead position) titled, Notice of Proposed Transfer/Discharge (dated 6/1/2022) indicated LN C and Resident 41 had both signed the document on 6/1/2022. The document was not signed by Resident 41 ' s RP. Review of facility document titled, Discharge Packet indicated, Resident ' s Name: (Resident 41), discharge date : [DATE], Discharge time: 11 am (sic) . The document indicated, .I acknowledge that I have received this Discharge Packet in its entirety and have had the discharge information explained to me to my satisfaction . The document was signed by both Resident 41 and LN C on 6/1/2022. The document was not signed by Resident 41 ' s RP. During a telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked about LN C going to Hospital 1 to have Resident 41 sign his discharge paperwork. The Administrator stated the facility had Resident 41 sign the discharge paperwork to acknowledge and show the information was given to him. When asked who directed LN C to visit the hospital and obtain Resident 41 ' s signature, the Administrator stated, a group of staff made the decision. When asked who the group consisted of, the Administrator stated he, the Director of Nursing and LN C comprised the group. When asked if Lawyer E was involved in the decision, the Administrator stated, perhaps and stated the event was six (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 7 of 8 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 056411 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Park View Post Acute 3751 Montgomery Dr Santa Rosa, CA 95405 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 0624 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few months ago. When asked who specifically directed LN C to go to Hospital 1, the Administrator stated, I can ' t recall and stated we thought it was the best way to keep the resident informed of his rights and follow the discharge process. During the same telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked what the normal process was for signing discharge paperwork in the event a resident was not competent to make their own medical decisions. The Administrator stated, I don ' t know and stated the facility would ensure the family knows. When asked if the facility would have a family member sign the paperwork, the Administrator stated, I will double-check. When asked why LN C returned to Hospital 1 a second time, the Administrator stated, I don ' t recall. When informed that Hospital 1 ' s Quality Director had stated it was not appropriate to have Resident 41 sign documents as he was deemed not competent to make his own medical decisions, the Administrator stated, It was totally appropriate (to have Resident 41 sign his discharge paperwork). When informed Hospital 1 ' s Quality Director had stated LN C was refused admittance on her second visit, the Administrator stated he was not aware LN C had returned to Hospital 1 a second time. The Administrator stated it was, silly that Hospital 1 would not allow facility staff to connect with patients. During the same telephone interview on 12/1/2022 at 10:12 a.m., the Administrator was asked if he was aware Resident 41 ' s physician had deemed him incapable of making his own medical decisions (in 2019). The Administrator stated, I don ' t recall. When asked why the facility did not have Resident 41 ' s RP sign the discharge paperwork, the Administrator stated, I don ' t recall. When asked to confirm that the facility policy titled, Resident Rights, subtitled, Information and Communication (dated 10/4/2016) did not contain information about a resident ' s Responsible Party, the Administrator stated, I (would) have to look at it. Review of facility document titled, Resident Rights, subtitled, Information and Communication (dated 10/4/2016) indicated residents had the right to, .be immediately informed when there is: .a significant change in your physical, mental, or psychosocial status . a decision to transfer or discharge you from the facility. The document did not include information that the resident has the right to be represented by another person (RP), in the event the resident is unable to represent themselves. Review of facility document titled, Resident Rights, subtitled Resident Rights and Responsibilities, Notice of, further subtitled, Procedure (dated 03/2019) indicated, 3. Should a resident be found incompetent by a court of law, the resident ' s representative shall act in behalf of the resident . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 056411 If continuation sheet Page 8 of 8