Health inspection·June 23, 2025

F 0573 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Let each resident or the resident's legal representative access or purchase copies of all the resident's records. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure a resident was able to exercise the right to access personal and medical records for one of two residents (Resident 1), when Resident 1 requested her medical records but were not provided within 48 hours of the request as per the facility's policy. This failure resulted in a violation of Resident 1's right to have access to medical records as requested by Resident 1. Findings: During a review of Resident 1 Face Sheet (contain resident demographic), the Face Sheet indicated, Resident 1 was admitted on [DATE], with diagnosis that included polyneuropathy (a condition where multiple peripheral nerves throughout the body are damaged). During a review of Resident 1 ' s Minimum Data Set (facility assessment tool), dated April 5, 2025, under Section C, it indicated her Brief Interview for Mental Status (BIMS) score was 14. (A BIMS score of 13 to 15 suggests the patient is cognitively intact.) During an interview on June 23, 2025, at 9:55 AM with Resident 1, Resident 1 presented emails that she had sent to the Medical Record (MR 1) and the Director of Nursing (DON 1). She indicated that she has not yet received her medical record and has not received any communication from them. She expressed her desire to arrange a meeting with them to discuss this matter. During a concurrent Record Review and Interview on June 23, 2025, at 10:15 AM, in the Medical Record office with Assistant Medical Record (AMR 1). Both incoming and outgoing emails were examined. The incoming emails revealed that on May 13, 2025, the Medical Record Department had received a request for psychiatric records from resident 1. On May 20, 2025, the Medical Record Department had received a request for a complete copy of medical records from resident 1. On May 29, 2025, the Medical Record Department had received a request for a medical release form from Resident 1. On May 30, 2025, the Medical Record Department had received an urgent follow-up email regarding the failure to provide medical records from Resident 1. On June 5, 2025, the Medical Record Department had received a request for a medical record release form from Resident 1. The outgoing emails indicated that an email was sent to Resident 1 on May 23, 2025. AMR 1 confirmed that only one response email was sent to Resident 1. During a concurrent interview on June 23, 2025, at 10:59 AM with Resident 1, the Assistant Medical Record (AMR 1), and the Administrator (Admin 1). Resident 1 indicated that the records department (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 2 Event ID: 555089 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 555089 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Meadows Ridge Care Center 1700 E Washington St Colton, CA 92324 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)