Health inspection·March 21, 2025

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure one of three residents sampled for patient rights (Resident 1) was treated with dignity and respect when the Marketing Director (MD) had spoken with Resident 1 on the phone with the hospice nurse (HN) available and stated, What the hell are you doing. We would've never brought you back if we knew you weren't going on hospice. Nobody wants you here, This resulted in Resident 1 becoming tearful and had the potential to result in psychosocial harm. Findings: A review of a facility policy titled, Resident Rights, with a revised date of [DATE], indicated, Our facility will make every effort to assist each resident in exercising his/her rights to assure that the resident is always treated with respect, kindness, and dignity. A review of the facility's records indicated Resident 1 was admitted to the facility on [DATE], with diagnoses that included morbid obesity (a disorder that involves having too much body fat, which increases the risk of health problems), obstructive sleep apnea (sleep disorder with recurrent episodes of complete or partial blockage of the upper airway during sleep, leading to reduced or absent breathing), other abnormalities of gait and mobility, generalized muscle weakness, acquired absence of right leg above knee, chronic pain syndrome, and unspecified depression (symptoms of depression). During an interview on [DATE] at 2:45 PM with Resident 1's power of attorney (POA), she stated the Marketing Director (MD) had spoken with Resident 1 on the phone with the hospice nurse (HN) available and stated, What the hell are you doing. We would've never brought you back if we knew you weren't going on hospice. Nobody wants you here, which caused Resident 1 to cry. POA stated that after speaking to Resident 1 he stated he did not have a POLST filled out but did not want to die, but did not want full Cardiopulmonary Resuscitation (CPR), so he had picked selective treatment. She stated that she requested for a POLST form and was met with comments that stated Resident 1 is supposed to go onto hospice, and he would not need a POLST. POA stated that once Resident 1 was sent to the hospital on [DATE] at 5:50 AM, the facility informed POA that Resident 1 had his POLST sent to the hospital with him; however, upon arrival to the hospital she found Resident 1 intubated and being transferred to the ICU. POA stated, How is it that days later they didn't have that signature on the POLST. During an interview on [DATE] at 2:30 PM with the hospice liaison (HL), she stated the MD was on the phone with Resident 1 and stated, The only reason I brought you back was because you said you were going to go on hospice, and further stated that the hospice staff took the phone away from Resident 1 because it was not okay to speak with him that way. HL stated after she spoke with Resident 1 he (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 4 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 03/21/2025 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)