Health inspection·February 5, 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 Based on observation, interview, and record review, the facility failed to provide activities of daily living (ADLS,Activities of daily living are those needed for self-care and mobility and include activities such as bathing, dressing, grooming, oral care, ambulation, toileting, eating, transferring, and communicating.) to one of three sampled residents (Resident 1), when Resident 1 did not receive schedules showers for nine weeks and fingernails were long with brown matter underneath the nail. Residents Affected - Few This failure placed Resident 1 feeling not cared for and neglected. Findings: During a review of Resident 1 ' s Face Sheet, dated October 2023, the Face sheet indicated Resident 1 was admitted to the facility in October 2023 with diagnoses to include left sided weakness. During a review of Resident 1 ' s Minimum Data Set (MDS, a resident assessment instrument used to identify resident care problems to be addressed in an individualized care plan.), dated 1/6/24, the MDS indicated, Resident 1 ' s Brief Interview for Mental (BIMS, is a scoring system used to determine the resident ' s cognitive status in regard to attention, orientation, and ability to register and recall information. A BIMS score of thirteen to fifteen is an indication of intact cognitive status.) was 15 out of 15. During a concurrent observation and interview on 1/17/24 at 9:26 a.m. in Resident 1 ' s room, Resident 1 was observed lying in bed. Resident 1 stated he liked showers but only had a shower two times since July 2023. Resident further stated he felt neglected. During a concurrent interview and record review on 1/17/24 at 10:30 a.m. with Certified Nursing Assistant (CNA), Resident 1 ' s January ' s electronic record for bathing was reviewed. CNA stated, Resident had shower on 1/14/24, then other days were all bed baths. CNA further stated, she was familiar with Resident 1 ' s care and had rejected care including showers before. CNA also stated, CNAs would notify charge nurse for refused care. During a concurrent interview and record review on 1/17/24 at 10:35 a.m. with CNA, facility ' s form titled Shower Day Skin Inspection filed in a purple binder at the nursing station was reviewed. The form had a section that includes Resident name, Room number and a skin assessment. Additionally, there were checklists provided to document shower if rendered or if refused. CNA stated residents shower schedule could be found on the first page of the binder. CNA showed the shower schedule and stated, Resident 1 ' s shower schedule were Mondays and Fridays, morning, and evening respectively. CNA also stated, she would use the form to document completion of shower or refusal. Page 1 of 2 056447 056447 02/05/2024 Hayward Hills Health Care Center 1768 B Street Hayward, CA 94541

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview on 1/17/24 at 10:45 a.m. with Registered Nurse (RN) 1, RN 1 stated that Resident 1 required one to two staff to assist with his ADLs. RN 1 stated Resident 1 had episodes of refusing ADL care that was documented on the progress notes. During a concurrent interview and record review on 1/17/24 at 10:50 a.m. with Medical Records (MR), Resident 1 hard copy chart was reviewed. MR stated he was responsible in filing the shower form that was filled out by the CNAs. MR stated that Resident 1 ' s shower form should be in the hard copy chart, however MR was unable to locate the form. During a concurrent interview and record review on 1/17/24 at 1:15 p.m. with Licensed Vocational Nurse (LVN), Resident 1 ' s Progress Notes for October 2023 till January 2024 was reviewed. LVN 1stated that she was not able to locate progress notes on shower refusals. During a follow up interview on 1/17/24 at 1:30 p.m. with MR, MR stated that he could not find Resident 1 ' s shower forms. During an interview on 2/5/24 at 11:17 a.m. with Registered Nurse (RN) 2, RN 2 stated that a shower was a part of Resident 1 ' s activities of daily living that would keep him clean. RN 2 further stated, Licensed Nurses should document resident refusal of care in the progress notes. During a review of the facility ' s Policy and Procedure (P&P) titled, Tub Bath and Shower, undated, the P&P indicated, The purposes of this procedure are to promote cleanliness, provide comfort to the resident and to observe the condition of the resident ' s skin. During a concurrent observation and interview on 1/17/24 at 10:00 a.m. with Resident 1, Resident 1 ' s right hand fingernails were about 1/8 inch long with brown matter underneath and around cuticles. Resident 1 stated he required assistance in trimming them because of his left side weakness. Resident 1 stated, he felt like he was not being cared for. During a concurrent observation and interview on 1/17/24 at 10:05 a.m. with CNA, CNA confirmed Resident 1 ' s right hand fingernails were long and had brown matter underneath. During an interview on 1/17/24 at 10:30 a.m. with CNA, CNA stated that Resident 1 ' s hands should be checked and cleaned daily, and nail trimming should be provided any day of the week if nails are long. During a review of the facility ' s Policy and Procedures (P&P) titled, Fingernail Care, undated, the P&P indicated, Care of fingernails promotes circulation to hands and help prevent small tears around the nails that could lead to infections. 056447 Page 2 of 2