Health inspection·May 21, 2025

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 provide the services necessary to maintain good grooming for three residents (Resident 1, Resident 2, and Resident 3) of three sampled residents when all three had long, jagged (rough, uneven shape, with some sharp points), and dirty fingernails. This failure decreased the facility's potential to prevent skin infections if the residents' scratched their skin with dirty jagged nails. Residents Affected - Some Findings: A review of Resident 1 ' s admission record indicated admission to the facility on 4/4/25 with diagnoses including generalized muscle weakness and the need for assistance with personal care. A review of Resident 2 ' s admission record indicated admission to the facility on [DATE] with diagnoses including generalized muscle weakness and the need for assistance with personal care. A review of Resident 3 ' s admission record indicated admission to the facility on 6/4/24 with diagnoses including generalized muscle weakness and the need for assistance with personal care. During a concurrent observation and interview on 5/19/25 at 4:32 p.m., Certified Nursing Assistant A (CNA A) confirmed Resident 1 had many scratches on her forearm caused by scratching herself. During a concurrent observation and interview on 5/21/25 at 1:37 p.m., the Director of Nursing (DON) confirmed Resident 1 needed nail care, and it was obvious she had not received nail care, as her fingernails were excessively long, dirty, and some were jagged. The DON called Licensed Nurse B (LN B) and CNA C into Resident 1 ' s room and told them staff were expected to conduct a bedside assessment of each resident and identify resident care needs. During an observation on 5/21/25 at 4:10 p.m., Resident 2 had long fingernails with some of them jagged and had brown debris underneath them. During an observation on 5/21/25 at 4:15 p.m., Resident 3 had long fingernails with some of them jagged and had brown debris underneath them. During a concurrent observation and interview on 5/21/25 at 4:52 p.m., CNA D confirmed Resident 3 ' s fingernails needed to be trimmed, cleaned, and smoothed with a nail file. During a concurrent observation and interview on 5/21/25 at 4:57 p.m., CNA D confirmed Resident 2 ' s fingernails were jagged and dirty, and some were long. CNA D stated nail care was hit and miss (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: 056259 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 056259 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Northvine Postacute Care 446 Arrowood Dr Santa Rosa, CA 95407 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)