Health inspection·September 28, 2023

F 0550 Level of Harm - Potential for minimal harm Residents Affected - Some 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, medical record review, and facility document review, the facility failed to ensure one of two residents (Resident 1) was treated with respect and dignity. * A male staff member entered the shower room when a female resident (Resident 1) was present in the shower room. Resident 1 stated she felt a bit uncomfortable. This had the potential to negatively impact the Resident 1's well-being. Findings: Review of the facility's document titled Shower Schedule and Monitoring dated 7/9/04, showed to make sure the same gender staff are monitoring the shower rooms during the shower times. The document further gave an example: if it is the time for female showers, it must be a female staff that must be monitoring the shower room and if it is male shower time, it must be a male staff that must be monitoring. The document also showed the facility must coordinate to make sure the privacy of the residents is maintained. Medical record review for Resident 1 was initiated on 9/25/23. Resident 1 was admitted to the facility on [DATE]. Review of Resident 1's History and Physical Examination dated 12/9/22, showed Resident 1 didnot have the capacity to understand and make decisions. Review of the SOC 341 (a Report of Suspected Adult or Elder Abuse form) dated 9/14/23, showed a male staff member (CNA 1) entered the shower room while Resident 1 was in the shower room. On 9/25/23 at 1050 hours, an interview and concurrent document review was conducted with the Housekeeper. The Housekeeper was asked to discuss what had happened on 9/14/23, between CNA 1 and Resident 1. The Housekeeper stated on 9/14/23 around 0740 hours, she was standing by the janitordoor (across from the shower room) and saw CNA 1 holding towels while he was entering the shower room. The Housekeeperstated LVN 2 then borrowed the Housekeeper's key to open the shower room door. LVN 2 then walked in the shower room. The Housekeeper stated she then witnessed Resident 1 following LVN 2 out of the shower room. The Housekeeperstated CNA 1 was in the shower room for approximately less than fiveminutes. On 9/25/23 at 1142 hours, an interview was conducted with Resident 1. Resident 1 was asked to discuss what had happened on 9/14/23. Resident 1 stated after she finished taking a shower, CNA 1 came in Page 1 of 2 555211 555211 09/28/2023 Extended Care Hospital of Westminster 206 Hospital Circle Westminster, CA 92683

F 0550 Level of Harm - Potential for minimal harm Residents Affected - Some the shower room and stated he wanted to check onother male residents in the shower room. Resident 1 stated she felt a little uncomfortable. Resident 1 denied being scared and touched by CNA 1. On 9/26/23 at 1402 hours, a telephone interview and concurrent document review was conducted with LVN 2. LVN 2 stated in the morning of 9/14/23 around 0730 hours, Resident 1 was at the nurses' station holding a change of clothes and requesting to shower. LVN 2 stated she asked a female staff member (CNA 7) to open the shower room door for Resident 1. Resident 1 stated she wanted CNA 1 (male staff) to open the shower room for her. CNA 1 stated he would open the door for Resident 1. LVN 2 stated about20 minutes later, she walked to the shower room and saw the Housekeeperlooking scared while pointing her finger at the shower room door. LVN 2 stated she borrowed the shower room key from the Housekeeperand opened the shower room. LVN 2 stated she saw CNA 1 and Resident 1 standing a foot apart, both fully dressed. LVN 2 stated she asked both what was going on. CNA 1 stated they were looking at the towels. LVN 2 stated she then asked Resident 1 to follow her to the nurse's station. LVN 2 was asked if amale staff could open the shower room door for a female resident. LVN 2 stated only if no female staff were available, then a male staff couldopen the shower room for female residents. LVN 2 added the male staff were not supposed to go inside the shower room when a female staff was in the shower room. On 9/26/23 at 1219 hours, an interview and concurrent document review was conducted with the DON. The DON stated CNA 1 should not have entered the shower room while Resident 1 was in there. The DON stated CNA 1 should respect Resident 1's right and acknowledged CNA 1 had violated Resident 1's privacy. 555211 Page 2 of 2