Health inspection·December 11, 2025

F 0635 Provide doctor's orders for the resident's immediate care at the time the resident was admitted. 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 follow their policy on having a Physician order in place upon admission related to self-catheterization for one of three residents (Resident 1) reviewed for intermittent catheterization. (a technique where a thin tube is inserted into the bladder through the urethra to drain urine). This failure had the potential to cause harm to Resident 1's health. Findings.A review of the facility's admission Record indicated Resident 1 was admitted on [DATE] with diagnoses which included Flaccid Neuropathic Bladder (a condition where the bladder's nerves are damaged causing losing the ability to empty properly) and Fracture of the Thoracic Vertebra (vertebrae in the middle of the vertebral column). On 12/11/2025 at 11 A.M., an interview and record review with Licensed Nurse (LN) 1 was conducted. LN 1 stated according to Resident 1's daughter, Resident 1 had done intermittent catheterization at home. LN 1 stated there was no Physician order to have Resident 1 perform an intermittent catheterization of herself in Resident 1's medical record. LN 1 stated it was important to have a Physician order in place to provide proper care and treatment to Resident 1, as the Physician order acted as a guide and helped to prevent complications in Resident 1's plan of care and treatment. A record review of Resident 1's Minimum Data Set (MDS- a federally mandated assessment tool) dated 11/19/25 indicated Resident 1's brief interview for mental status (BIMS) score was 05 which indicated Resident 1 had impaired cognition (thought process). A record review of Resident 1's MDS section H -bladder and bowel dated 11/19/25 indicated H0100-dintermittent catheterization On 12/11/25 at 11:55 A.M., an interview and record review with the Assistant Director of Nursing (ADON) was conducted. The ADON stated Resident 1 did not have a Physician order to intermittently do self-catheterization. The ADON stated it was always important to have a Physician order in all of the residents records in the facility including Resident 1 to guide nursing staff in the plan of care of the residents leading to better health outcomes and preventing complications. On 12/11/25 at 4 P.M., an interview with LN 2 was conducted. LN 2 stated Resident 1 did intermittent catheterization a couple of times per shift when LN 2 was assigned to Resident 1. LN 2 stated a Physician order was important to provide safety for Resident 1 and a guide for Resident 1's plan of care. A review of the facility's undated policy , titled Physicians Orders, indicated 2. A Physician's order in needed for all diets, therapies, and other treatments. Residents Affected - Few 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: 555323 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 555323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/11/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aviara Healthcare Center 944 Regal Road Encinitas, CA 92024 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)