Health inspection·December 27, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to protect the dignity of one resident (1). As a result, a Certified Nursing Assistant (CNA 1) took an unauthorized picture of Resident 1 sleeping, and shared it via text message group chat. Findings: On 12/12/23, the facility reported to the Department, former CNA had shared a picture of (Resident 1) as he was sleeping in their group chat . On 12/19/23 an unannounced visit of the facility was conducted. On 12/19/23 at 10:40 A.M., the Director of Nursing was interviewed. The DON stated CNA 1 sent a picture of Resident 1 sleeping to friends via a text message group chat. The DON stated in the picture Resident 1 ' s dentures were partially out of his mouth. The DON stated the facility did not allow staff to take pictures of residents. The DON stated Resident 1 was cognitively impaired and not aware of the picture being taken. The DON stated the family was notified and concerned about Resident 1 ' s dignity. CNA 1 was not available for interview. The DON stated the picture was taken July 2023, and CNA 1 resigned from the facility November of 2023. On 12/19/23, at 11:15 A.M., the Director of Social Services (DSS) was interviewed. The DSS stated no picture taking was allowed in the facility. The DSS stated Resident 1 was not alert/aware of the situation and support was offered to the family. On 12/19/23 at 11:25 A.M., the Director of Staff Development (DSD) was interviewed. The DSD stated part of abuse training included focus on privacy and dignity. On 12/20/23, the clinical record was reviewed. Resident 1 was admitted to the facility on [DATE], with diagnoses which included Parkinson ' s Disease (a progressive disorder of the nervous system) and Neurocognitive Disorder (dementia), according to the facility Face Sheet. The Brief Interview for Mental Status (BIMS) was 3 out of 15, which indicated severe cognitive impairment. The picture provided by the DON was of Resident 1 on his right side in bed. His eyes were closed, and mouth was open with dentures partially out of his mouth. The heading of the picture indicated, Bestie Chat and had comments about the picture from two different phone numbers. Page 1 of 3 555134 555134 12/27/2023 Mount Miguel Covenant Village 325 Kempton St. Spring Valley, CA 91977

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Per facility policy Dignity, reviewed 9/18/23, Residents are treated with dignity at all times. Per facility policy Resident Rights, Revised 2/21, .These rights include the resident ' s right to: .a dignified existence; .be treated with respect, kindness, and dignity . The unauthorized release, access, or disclosure of resident information is prohibited. Per facility policy Videotaping, Photographing, and Other Imaging of Residents, Revised 4/17, Staff may not take or release images or recordings of any resident without explicit written consent . Any image or recording taken that may be construed as humiliating or demeaning to a resident or residents is considered resident abuse . 555134 Page 2 of 3 555134 12/27/2023 Mount Miguel Covenant Village 325 Kempton St. Spring Valley, CA 91977

F 0583 Keep residents' personal and medical records private and confidential. 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 protect the privacy of one resident (1). As a result, a Certified Nursing Assistant (CNA 1) shared an unauthorized picture of Resident 1 via text message group chat. Residents Affected - Few Findings: On 12/12/23, the facility reported to the Department, former CNA had shared a picture of (Resident 1) as he was sleeping in their group chat . On 12/19/23 an unannounced visit of the facility was conducted. On 12/19/23 at 10:40 A.M., the Director of Nursing was interviewed. The DON stated on 12/11/23, it was reported CNA 1 had sent a picture of Resident 1 in a text message group chat back in July 2023. The DON stated the facility did not allow staff to take pictures of residents. CNA 1 was not available for interview. The DON stated CNA 1 resigned from the facility November of 2023. On 12/19/23, at 11:15 A.M., the Director of Social Services (DSS) was interviewed. The DSS stated no picture taking was allowed in the facility. On 12/19/23 at 11:25 A.M., the Director of Staff Development (DSD) was interviewed. The DSD stated part of abuse training included focus on privacy and dignity. On 12/20/23, the clinical record was reviewed. Resident 1 was admitted to the facility on [DATE], with diagnoses which included Parkinson ' s Disease (a progressive disorder of the nervous system) and Neurocognitive Disorder (dementia), according to the facility Face Sheet. The Brief Interview for Mental Status (BIMS) was 3 out of 15, which indicated severe cognitive impairment. The picture provided by the DON was of Resident 1 on his right side in bed. His eyes were closed, and mouth was open with dentures partially out of his mouth. The heading of the picture indicated, Bestie Chat and had comments about the picture from two different phone numbers. Per facility policy Videotaping, Photographing, and Other Imaging of Residents, Revised 4/17, Residents will be protected from invasion of privacy and/or abuse that might occur from photographs, videotapes, digital images, and recordings during resident care or other facility activities . Staff may not take or release images or recordings of any resident without explicit written consent .Transmitting unauthorized images of any resident through email, internet or social media is considered a violation of resident rights . 555134 Page 3 of 3