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Inspection visit

Health inspection

BEAR VALLEY COMMUNITY HOSPITALCMS #5554681 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.

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. Based on observation, interview, and record review, the facility failed to ensure resident was treated with respect and dignity for one resident (Resident 1) when the facility staff spoke to Resident 1 using language and tone as if one might address a child and refused Resident 1 to receive a shower at his preferred time.This failure resulted in Resident 1 feeling put down and embarrassed which could potentially affect his care from his lack of trust or doubt with the facility staff to participate in treatment plan.Findings:During a review of a Medical Doctor (MD) Progress Note, dated August 27, 2024, the MD progress note indicated Resident 1 has history of congestive heart failure (a serious condition in which the heart doesn't pump blood through the body as efficiently as it should), seizure disorder (a sudden burst of electrical activity in the brain and can cause changes in behavior, movements, feelings and levels of consciousness), stroke (a serious medical emergency that happens when blood flow to the brain is interrupted, either by a blockage or a rupture of a blood vessel), hypothyroidism (when the thyroid gland isn't producing enough thyroid hormones and many bodily functions slow down), and hypertension (when the force of the blood pushing on the blood vessel walls is too high and the heart has to pump harder). During a review of the facility's document title, Report of Suspected Dependent Adult/Elder Abuse (SOC 341-a form that the facility is required to report suspected abuse), dated June 11, 2025, the SOC 341 indicated that there was potential for verbal abuse from a Certified Nurse Assistant (CNA1) towards Resident 1. The SOC 341 also indicated that a CNA spoke to a resident in a belittling and demeaning manner, using language and tone comparable to how one might address a child. This occurred after the resident requested a shower in the evening, having declined one earlier in the day.During an interview on June 20, 2025, at 10:51 AM, with Resident 1, Resident 1 stated I wanted a shower, and [CNA1] was Snooty. [CNA1] said I tried to get you to the shower earlier and I said I'm sorry. I just didn't want to shower in am and would rather know what I did for [CNA1] to yell at me like that. [CNA1] came down like a cat out hell. She was mean and vulgar. Resident 1 stated that CNA1 yelled at him in front of the facility staff and other residents which made him feel not too good.During an interview on June 20, 2025, at 11:52 AM, with RN1, RN1 stated Resident 1 did not want to shower at the scheduled time and CNA1 responded in a very unprofessional tone and was brazen with him.During an interview on June 20, 2025, at 12:17 PM, with the Director of Nursing (DON), the DON stated that Resident 1 live here, and CNA1 was rude and didn't need to be.During an interview on July 7, 2025, at 11:22 AM, with CNA2, CNA2 stated Resident 1 asked about a shower and CNA1 scolded [Resident 1] like a child because he was asking for a shower and CNA1 asked 'why are you asking me now, it's late.' CNA2 further stated It was disturbing. It didn't sit right. CNA2 added, He was aware of her behavior, and he asked, 'why are you talking to me like that'. CNA2 stated, He was completely silent after that. I think he got embarrassed and left [the area]. It was embarrassing to him because other people were around. I wouldn't want to be treated like putting me down with others around.During a concurrent interview and record review (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: 555468 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 555468 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bear Valley Community Hospital 41870 Garstin Rd Big Bear Lake, CA 92315 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)
F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete on July 7, 2025, at 11:42 AM, with the Assistant Director of Nursing (ADON) and DON, the facility's policy and procedure (P&P) titled, Resident Rights, undated, was reviewed. The P&P indicated, POLICY: [The facility] will assure that all residents are treated with respect and dignity in a manner and environment that promotes their quality of life while promoting their right to self-determination whereby their care choices are respected . PROCEDURE: .3. The right to be assisted by all staff in maintaining and enhancing their self-esteem and self-worth .15.The right to choose their own schedule and have their needs accommodated in relation to: .15.3. Their bathing times and schedule . The ADON and DON acknowledged that the right to be treated with dignity and respect as well as the right to make his own schedule was not followed. Event ID: Facility ID: 555468 If continuation sheet Page 2 of 2

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Citations

1 citation recorded*CMS

What do CMS severity letters mean?

Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.

General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.

Each letter combines severity with scope: how many residents the deficiency affected.

  • 0550GeneralS&S Dpotential for harm

    F550 - Resident Rights

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

FAQ · About this visit

Common questions about this visit

What happened during the July 7, 2025 survey of BEAR VALLEY COMMUNITY HOSPITAL?

This was a inspection survey of BEAR VALLEY COMMUNITY HOSPITAL on July 7, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at BEAR VALLEY COMMUNITY HOSPITAL on July 7, 2025?

Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her right..."

What type of survey was this?

This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.

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Next steps

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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.