Health inspection·September 26, 2023

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 observation, interview, and record review, the facility failed to ensure one of three sampled residents (Resident 1) received necessary care to maintain good grooming and personal hygiene when Resident 1 had long, sharp fingernails with brownish yellow matter underneath on both hands. Residents Affected - Few This failure resulted in Resident 1 feeling helpless and placed her at risk for infections and hurting themselves with long fingernails. Findings: During a review of Resident 1's admission Record , printed on 9/26/23, the admission Record indicated Resident 1 was originally admitted to the facility on admitted to the facility on [DATE]. The admission records also indicated that Resident 1 had a medical diagnosis including spastic hemiplegia (a condition that that results in the muscles on one side of the body being in a constant state of contraction and weakness of one side of the body). During a record review of Resident 1's Minimum Data Set (MDS, a resident assessment tool used to guide care), dated 8/27/23, the MDS assessment section G indicated Resident 1 was totally dependent on staff for showers and needed staff's total assistance to maintain personal hygiene and grooming. The MDS assessment section C indicated Resident 1's Brief Interview of Mental Status (BIMS- an assessment for cognition status) score was 12 out of 15 which indicates intact mental status. During a concurrent observation and interview on 9/26/23, at 10:38 a.m., with Resident 1, Resident 1 had long sharp fingernails with brownish yellow matter underneath the nails on both hands. Resident 1 stated the nails in her left contracted (shortening of muscles and tendons causing a deformity) hand are digging into the palm of her hand and hurting her. Resident 1 stated no one helped to trim her fingernails and that made her feel helpless . During a concurrent observation and interview on 9/26/23, at 10:55 am., with Licensed Vocational Nurse (LVN) 1, Resident 1's fingernails were observed. LVN 1 stated Resident 1's fingernails were long and digging into her left contracted hand and needed to be trimmed. LVN 1 also stated Resident 1 could injure herself and cause infection due to fingernails digging into her palms. During an interview on 9/26/23, at 1:10 p.m., with the Director of Nursing (DON), the DON stated staff was expected to assist Resident 1 to perform ADL (Activities of daily living) care and provide routine nail care. DON also stated when nail care is not provided it could result in skin injury from scratching, can promote bacterial growth, and cause wound and infection. Page 1 of 2 055876 055876 09/26/2023 Princeton Manor Healthcare Center, LLC 2124 57th Avenue Oakland, CA 94621

F 0677 Level of Harm - Minimal harm or potential for actual harm During a review of the facility's Policy and procedure(P&P) titled, Grooming Care of the Fingernails and Toenails , revised 10/21/2021, the P&P indicated, Purpose- Nail care is given to clean the nailbed and keep the nails trimmed . Policy 1. Fingernails are trimmed by Certified Nursing assistants (CNAs), except for Residents with diabetes or circulatory impairments, this includes all toenails except for high-risk Residents. NOTE: A Licensed Nurse will trim those Residents' nails. Residents Affected - Few 055876 Page 2 of 2