Health inspection·October 15, 2024

F 0568 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. Based on interviews and record review, the facility failed to provide account statement of residents ' spending, including transaction receipts, timely information on account access and available account balances for 4 out of 4 residents when facility did not notify residents or their conservators of the amount of funds in their personal accounts, track spending or submit quarterly report statements on time. This failure undermined Residents ' Rights to have informed and easy access to their funds for personal purchases they wish to make. Findings: During a review of Resident 1 ' s, admission Record, printed 10/15/24, the record indicated Resident 1 was admitted to the facility in July 2023 with multiple diagnosis including Malignant neoplasm (cancer) of bladder neck. A review of the Resident 1 ' s Minimum Data Set (MDS, a resident assessment instrument used to identify resident care problems to be addressed in an individualized care plan.) MDS, reveals Resident had a BIMS score of 7 which indicated moderately impaired cognitive status. Brief Interview for Mental Status (BIMS, is a scoring system used to determine the resident ' s cognitive status regarding attention, orientation, and ability to register and recall information. A BIMS score of thirteen to fifteen is an indication of intact cognitive status). During an interview on 10/22/24 at 10:17 a.m. with Resident 1 ' s Conservator 1, Conservator 1 stated that they send the facility $50.00 every month for Resident 1 to use for personal item expenses. Conservator 1 did not know how much money Resident 1 has in her account or what the funds have been used for. Conservator 1 also stated they have not received the quarterly statement or any itemized receipts from the facility. During a review of Resident 2 ' s, admission Record, printed 10/15/24, the record indicated Resident 2 was admitted to the facility in September 2021 with multiple diagnosis including Schizophrenia (A mental illness that is characterized by disturbances in thought). A review of Resident 2 ' s MDS section C indicated Resident 2 had a BIMS score of 14 indicating Resident 2 was cognitively intact. During an interview on 10/15/24 at 11:50 a.m. with Resident 2, Resident 2 stated they did know they have money available to them in their personal account to purchase items and they have no knowledge of quarterly reports of fund. Page 1 of 3 555254 555254 10/15/2024 Medical Hill Healthcare Center 475 29th Street Oakland, CA 94609

F 0568 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During a review of Resident 3 ' s, admission Record, printed 10/15/24, the record indicated Resident 3 was admitted to the facility in June 2021 with multiple diagnosis including Multiple Sclerosis, MS (A chronic, progressive disease involving damage to the nerve cells in the brain and spinal cord). A review of Resident 3 ' s MDS revealed Resident 3 had a BIMS score of 15 indicating Resident 3 was cognitively intact. During an interview on 10/15/24 at 12:00 p.m. with Resident 3, Resident 3 stated they last made purchases around nine months ago when resident requested clothing and received 2 pantsuits. Resident 3 stated that they did not know how much the pantsuits cost and were not given an itemized receipt after the purchase. Resident 3 also stated they have not received a quarterly report of the balance in their personal account and is unaware of how much money they have. During an interview on 10/21/24 at 4:05 p.m. with Resident 3 ' s Conservator (3), Conservator 3 stated she does not receive itemized receipts of Resident ' s purchases and has not received a quarterly report for Resident 3. During a review of Resident 4 ' s, admission Record, printed 10/15/24, the record indicated Resident 4 was admitted to the facility in November 2021 with multiple diagnosis including Schizoaffective Disorder (A mental illness that can affect thoughts, mood and behavior,) and Parkinson ' s Disease (A progressive disease of the nervous system, marked by tremor, muscular rigidity, and slow, and precise movements).A concurrent review of Resident 4 ' s MDS revealed, Resident 4 had a BIMS score of 6 indicating severe cognitive impairment. During an interview on 10/15/24 at 12:10 p.m. with resident 4, Resident 4 stated they are unaware how much money is in their personal account and they have no recollection of receiving a quarterly report of the spending and subsequent balance in their account. During an interview on 10/16/24 at 12:20 p.m. with Resident 4 ' s Conservator (4), Conservator 4 stated the facility had not sent her a quarterly report in a long time and cannot recall when the last quarterly report was received. Conservator stated that Resident 4 has money to purchase items but does not know or has receipt of what has been purchased. During an interview on 10/15/24 at 12:05 p.m. with Social Worker (SW), SW stated when Resident ' s request an item, the SW will check with the Business Office Manager (BOM) of how much money Resident has in their account and purchases the item. SW stated typically, this is done without Resident ' s feedback and in some cases, for Residents who want designer items, they will get Resident ' s permission before purchasing. Once purchase is completed, the SW will give item purchased to Resident and receipt of purchase to Business Office Manager (BOM). During an interview on 10/15/24 at 1:15 p.m. with Director of Nursing (DON), DON stated some residents have a conservator who manages Residents personal finances. DON stated they provided an itemized list of resident ' s balance of funds for the conserved residents to the conservator. During an interview on 10/15/24 at 1:45 p.m. with Administrator (ADM), ADM stated the Business Office Manager (BOM) handles accounting of Resident ' s personal financial accounts and trusts. Administrators had no knowledge of quarterly reports being issued out to Residents or Resident ' s Conservator. During an interview on 10/21/24 at 3:00 p.m. with BOM, BOM stated that the SW will provide a 555254 Page 2 of 3 555254 10/15/2024 Medical Hill Healthcare Center 475 29th Street Oakland, CA 94609

F 0568 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few receipt of purchase and that it will be itemized in resident ' s account. BOM does not provide the receipt to Resident or Conservator. BOM stated that they are behind in sending out the quarterly reports to Conservators and sends the reports by postal mail and not email. BOM was unable to provide receipt of when the Conservator receives quarterly reports and stated the facility does not give the reports or receipts of items purchased to the residents. BOM stated the SW will show them weekly how much they have in their account digitally. A review of the Policy & Procedure titled Management of Resident ' s Funds indicated . Policy Interpretation and Implementation .3. Should the facility manage the resident ' s funds, the facility acts a fiduciary of the resident funds and holds, safeguards, manages and accounts for the personal funds of the Resident . 3. Should our facility be appointed the resident's representative payee, and directly receive monthly benefits to which the Resident is entitled, such funds are managed in accordance with established policies and Federal/State requirements .5. Copies of financial transactions are managed by the business office. 555254 Page 3 of 3