Health inspection·April 20, 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 observation, interview and record review, the facility failed to ensure the staff followed preferences for one of one resident (Resident 1) with dementia (memory disorder) when the staff cut Resident 1 ' s hair without permission from the resident ' s Responsible Party (RP). As a result, Resident 1 ' s right to have a preference was not respected. Findings: Resident 1 was admitted to the facility on [DATE] per the facility ' s Facesheet. A review of records was conducted. The Facesheet indicated Resident 1 ' s son as the Power of Attorney (POA) or the RP for the resident. The physician Progress Note dated 4/7/23 indicated Resident 1 had a diagnoses which included dementia. In addition, Resident 1 ' s Brief Interview for Mental Status (BIMS- a type of cognitive assessment) score was 6 indicating severe cognitive impairment. On 4/10/23 at 9:30 A.M., an interview with the Director of Nursing (DON) was conducted. The DON stated Certified Nurse Assistant (CNA) 1 cut Resident 1 ' s hair because Resident 1 had knots in her hair. The DON stated CNA 1 stated she knew Resident 1 had dementia. The DON stated, a resident or a RP ' s consent should be obtained before providing a haircut for any resident. On 4/10/23 at 9:43 A.M., an observation and interview of Resident 1 was conducted. Resident 1 ' s hair length was noted to be above the shoulder. Resident 1 stated she liked her hair long. On 4/10/23 at 9:49 A.M., an interview with Licensed Nurse (LN) 1 was conducted. LN 1 stated CNAs cannot cut a resident ' s hair. LN 1 stated CNA 1 should have asked Resident 1 ' s permission before providing a haircut to Resident 1. On 4/10/23 at 9:53 A.M., an interview with LN 2 was conducted. LN 2 stated LNs and CNAs were not allowed to cut hair and a haircut needed to be scheduled with a beautician. LN 2 also stated CNA 1 should have informed the Charge Nurse (CN) before and after she cut Resident 1 ' s hair. LN 2 stated Resident 1 ' s RP informed her Resident 1 preferred her hair long. LN 2 stated for any non-routine care, like a haircut, was going to be provided to a resident, the RP should have been informed first. On 4/10/23 at 10:19 A.M., an interview with CNA 2 was conducted. CNA 2 stated CNAs and LNs were not allowed to cut residents ' hair. CNA 2 stated if a resident ' s hair was matted, it should have been reported to the CN. Page 1 of 2 555216 555216 04/20/2023 Sharp Chula Vista Med Ctr Snf 751 Medical Center Court Chula Vista, CA 91911

F 0550 Level of Harm - Minimal harm or potential for actual harm On 4/10/23 at 10:41 A.M., an interview with CNA 1 was conducted. CNA 1 stated she cut Resident 1 ' s hair because it was tangled and she cut about three inches of hair above resident ' s shoulder. CNA 1 stated should not have cut Resident 1 ' s hair and should have asked the RP first. CNA 1 stated she should have informed the CN before and after she cut Resident 1 ' s hair. CNA 1 stated she knew Resident 1 had dementia. Residents Affected - Few On 4/10/23 at 11:08 A.M., an interview with LN 3 was conducted. LN 3 stated CNA 1 should have asked the resident ' s family and the CN what she should have done with Resident 1 ' s hair. On 4/10/23 at 11:18 A.M., an interview with LN 4 was conducted. LN 4 stated LNs and CNAs were not allowed to cut any resident ' s hair especially without the resident or RP ' s knowledge. Per the facility ' s Policy titled Patient Rights and Responsibilities, dated 01/12, .II. Care provided will be considerate, respectful and focused on the patient's individual needs . 555216 Page 2 of 2