Health inspection·October 31, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Based on observation, interview, and record review, the facility failed to ensure two of three sampled residents (Resident 1 and 3), had their preference for bedtime honored. This facility failure resulted in Residents 1 and 3 not having their rights supported when making their choice of when to go to bed for the evening. Findings: During a review of the facility's policy and procedure (P&P) titled, Self Determination, undated, the P&P indicated, Residents shall have the right to choose and participate in activities, schedules, and health care consistent with his/her interests, assessments, and plan(s) of care . Residents are encouraged to make choices about aspects of their life in Compass Health facilities that are significant to them. During an interview on 9/29/2023, at 4:20 p.m., with Resident 1, Resident 1 stated certified nursing assistant (CNA) [CNA1 name] and [CNA2 name] puts Resident 1 to bed too early at about 5:30 p.m., even after Resident 1 lets them know he would like to go to bed later. During a review of Resident 1's Minimum Data Set ((MDS) standardized tool used to communicate resident problems and strengths), dated 8/9/2023, the MDS indicated Resident 1's Brief Interview for Mental Status ((BIMS) screener that aids in detecting impaired thinking) score was 14 (cognitively intact). During a review of Resident 1's Care Plan ((CP) a plan for the action the staff should take to help a resident meet their goals), titled, Risk for Skin Breakdown, dated 11/19/2013, the CP indicated, Encourage OOB [out of bed] activity as appropriate. During a concurrent interview and observation on 9/29/2023, at 4:40 p.m., with CNA1 at a hallway kiosk (computer attached to the wall for the CNA to view and record resident information), CNA1 stated the opening page will show the needs of the resident. CNA1 pointed out where it indicates if assistance is needed to transfer (move from wheelchair to bed) and stated it does not indicate preferences for bedtime. During a concurrent interview and observation on 9/29/2023, at 5:20 p.m., with Resident 3 in their room, Resident 3 demonstrated with a hand brushing motion and stated [CNA1 name] brushes Resident 3 off or says, Go to bed [Resident 3 name]. During a review of Resident 3's MDS, dated 8/30/2023, the MDS indicated Resident 3's BIMS score was (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: 555371 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 555371 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/31/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bayside Care Center 1405 Teresa Drive Morro Bay, CA 93442 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)