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Complaint Investigation

Hayward Post Acute

Inspection Date: December 22, 2025
Total Violations 1
Facility ID 555398
Location HAYWARD, CA
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Inspection Findings

F-Tag F0585

Resident Rights Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

interview and record review, the facility failed to follow up on Resident 1's grievance.This failure led to Resident 1 feeling angry and sad. Findings:During a review of Resident 1's admission Record, dated 9/10/25, it indicated Resident 1 was admitted to the facility on [DATE REDACTED] with diagnoses that included anxiety disorder.During an interview on 9/10/25 at 11:50 a.m., with Resident 1, the resident stated Resident 2 resided in the room across Resident 1's room and he could hear him yelling and screaming at the staff.

Also stated Resident 2 had a behavior of pounding on and off on overbed table. Further stated that Resident 2's behavior made him angry and sad. Stated he had brought his concern to the staff on multiple occasions, but nothing was done about it.During a review of Resident 1's Minimum Data Set (an assessment tool) dated 6/25/25, it indicated he had a brief interview for mental status or BIMS of 15 (score of 15 indicates a cognitively intact status, meaning the resident shows no significant or minimal cognitive impairment). During an interview on 9/10/25 at 2:31p.m., with Certified Nursing Assistant (CNA) 1, CNA1 stated Resident 2 had a behavior of screaming, banging on bedside tables, throwing whatever he could get

a hold of from his bedside to the staff. Further stated Resident 1 was complaining he could not sleep because of the noise.During an interview on 9/10/25 at 1:23 p.m., with Licensed Vocational Nurse (LVN) 1, LVN 1 stated that Resident 1 had been complaining of Resident 2's behavior of screaming and banging whatever items he could grab on his table for the past year.During an interview on 9/10/25 at 2:20 p.m., with Registered nurse (RN) 1, RN 1 stated Resident 2 had a behavior of banging on his bedside table and Resident 1 complained about Resident 2's behavior. RN 1 stated the management was aware of Resident 1's complaints.During an interview on 9/10/25 at 2:44 p.m., with the Assistant Director of Nursing (ADON), ADON stated she was not aware of Resident 1's grievance and the nursing staff should tell the management if residents have grievances.During an interview on 9/10/25 at 3:11 p.m., with the Director of Nursing (DON), DON stated she was not aware of Resident 1's grievance and the nursing staff should tell

the management if residents have concerns or grievances. Stated she should be informed of the grievances, so interventions were done to resolve Resident 1's concerns. During a review of the facility's undated policy and procedure (P&P) titled, Resident Grievance/Complaint Procedures, the P&P indicated, Any resident, family member, or appointed resident representative may file a grievance or complaint concerning care, treatment, behavior of other residents, staff members.

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

Event ID:

📋 Inspection Summary

Hayward Post Acute in HAYWARD, CA inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in HAYWARD, CA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Hayward Post Acute or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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