Inspection·November 26, 2024

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, medical record review, and facility P&P review, the facility failed to treat one of three sampled residents (Resident 2) with dignity when the staff removed her indwelling urinary Foley catheter. * The facility failed to get permission from Resident 2 for multiple staff to be present during the Foley catheter removal. This failure had the potential to negatively affect Resident 2's well-being. Findings: Review of the facility's P&P titled Resident Rights revised 10/2009 showed the Federal and state laws guarantee certain basic rights to all residents of this facility which includes to choose a physician and treatment, and participate in decisions and care planning. Our facility will make every effort to exercise his/her rights to assure the resident is always treated with respect, kindness, and dignity. Review of the facility's P&P Titled Quality of Life-Dignity revised 10/2009 showed the staff members shall promote, maintain, and protect the residents' privacy, including bodily privacy during assistance with personal care and during treatment procedures. Medical record review for Resident 2 was initiated on 11/19/24. Resident 2 was admitted to the facility on [DATE]. On 11/19/24 at 1032 hours, an interview was conducted with Resident 2. Resident 2 stated on 11/16/24, two male and one female staff came into her room to remove her indwelling urinary foley catheter. Resident 2 stated she felt it did not take three people to remove the indwelling urinary Foley catheter, and the staff were treating her like a body and not as a person. On 11/19/24 at 1401 hours, a follow-up interview was conducted with Resident 2. Resident 2 stated when the staff came to remove her indwelling urinary Foley catheter, the staff did not ask her permission, and it was more like an announcement. Resident 2 further stated the staff did not ask her permission for the other staff to be present when removing her indwelling urinary Foley catheter. Resident 2 stated she felt upset, embarrassed, violated, and caused her to cry afterwards. On 11/19/24 at 1508 hours, an interview was conducted with LVN 2. LVN 2 stated she went in Resident 2's room to help LVN 4 and CNA 4 remove the indwelling urinary Foley catheter. LVN 2 stated Resident 2 requested for LVN 2 to remove it since the morning nurse was a male staff. When asked who was (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 6 Event ID: 555027 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 555027 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Beachside Nursing Center 7781 Garfield Avenue Huntington Beach, CA 92648 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)