Health inspection·July 24, 2024

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, observations and record review, the facility did not meet this requirement when it failed to provide evidence of incontinent (no ability to control one's bowels or bladder and requires staff to clean), care for two of 17 sampled residents (Resident 1 and 2). Residents Affected - Few This resulted in the potential for skin breakdown and a loss of dignity for both residents, who were dependent on staff for care. Findings: Resident 1 was admitted to the facility on [DATE] for conditions that included rhabdomyolysis (a breakdown of muscle), spondylosis (abnormal wear of the spinal cartilage), history of stroke and difficulty walking. A review of Resident 1 ' s Minimum Data Set (MDS, a standardized assessment tool that measures health and mental status in nursing home patients), dated 6/4/24 indicated that her ability to use the restroom, Toilet Hygiene, was rated at 2 or Substantial/Maximal Assist. During an interview and observation on 7/24/24 at 11:20 AM, Resident 1 ' s room smelled strongly of stale urine. Resident 1 was observed seated at the edge of her bed and in an interview, concurrently stated that she was waiting for assistance because she was wet. Resident 1 stated that she had pressed the call light at 11:00 AM and had been at the edge of the bed waiting for an unidentified CNA (Certified Nursing Assistant) who said they would return, I ' ve been waiting 20 minutes here, I looked at the clock. Resident 1 stated that she had also been left wet the night before: a CNA changed her at 10:10 PM, the next shift took over, and Resident 1 stated that the CNA from registry (a temporary help agency) who did not check on her the entire shift until it was time for the next shift to come on and changed her at 5:25 AM. She stated this happens all the time, and that it also happened on 7/15/24 when she was left wet for at least six hours. Resident 1 stated that on 7/22/24 and 7/23/24, her sheets were wet and she was not changed which made her uncomfortable. Resident 2 was admitted to the facility on [DATE] for conditions that included leg cellulitis (inflammation of the leg), diabetes, congestive heart failure, legal blindness, muscle weakness and unsteadiness on her feet. A review of Resident 2 ' s MDS dated [DATE], indicated that her ability to use the restroom, Toilet Hygiene, was rated at 1 or Dependent, Helper does all the work. In an interview and observation on 7/24/24 at 11:42 AM, Resident 2 stated, I'm getting left wet all night long. I can't tell you which CNA was here because I never saw her. I get changed before the evening shift leaves, and I don't see anyone until morning. Resident 2 had a large cast on her right foot and stated that she previously had a boot with bolts in it that seemed to intimidate the newer or registry CNAs who were not sure how to handle her. She stated, I think they avoided changing me (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 3 Event ID: 555682 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 555682 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Marysville Post-Acute 1617 Ramirez Street Marysville, CA 95901 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)