Health inspection·May 9, 2025

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure the call light system was functioning properly for 2 residents (Resident 1 and Resident 2) residing in room [ROOM NUMBER]. Residents Affected - Few This failure had the potential to result in residents' needs not being met and prevent residents' communication for assistance when needed. Findings: During a review of Resident 1 ' s admission Record (AR), the AR indicated Resident 1 was admitted on [DATE] with diagnoses which included displaced comminuted fracture of left patella (kneecap was broken into multiple pieces and pieces were not properly aligned). During a review of Resident 1 ' s Minimum Data Set (MDS – a federally mandated resident assessment tool), the MDS indicated Resident 1 had moderate cognitive impairment. During a review of Resident 2 ' s AR, the AR indicated Resident 2 was admitted on [DATE] with diagnoses which included surgical aftercare following surgery on the digestive system. During a review of Resident 2 ' s MDS, the MDS indicated Resident 2 had moderate cognitive impairment. During a concurrent observation and interview on 5/9/25 at 10:57 a.m. with Resident 1 in room [ROOM NUMBER], Resident 1 ' s call light was activated but the light above the door did not turn on, and the call light panel at the nurse ' s station did not show the call. Resident 1 stated the call light had not worked since she was admitted and that she was not given a call bell. Resident 1 said she waited for someone to walk by her room and called out when she needed help. During an interview on 5/9/25 at 11:06 a.m. with Resident 2, Resident 2 stated she had experienced problems with her call light not working. Resident 2 stated that when she pushed the button, most of the time no one came, and sometimes she waited up to two hours for assistance. During a concurrent observation and interview on 5/9/25 at 11:11 a.m. with the Director of Nursing (DON), Resident 1 ' s call light was activated, but the light above the door did not turn on. DON confirmed that the call light was not working. During a concurrent observation and interview on 5/8/25 at 11:16 a.m. with Director of Staff Development (DSD) in room [ROOM NUMBER], DSD stated the button on the call light cord was not working. The (continued on next page) 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: 555333 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 555333 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lincoln Meadows Care Center 1550 Third Street Lincoln, CA 95648 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)